Reserve 10% Covid ICU beds for children during future Covid waves: Expert group

The group, comprising of senior paediatricians across India, has also said that there is a need to consider vaccination for kids urgently.
For representational purposes (File Photo | EPS)
For representational purposes (File Photo | EPS)

NEW DELHI: While stressing that there is no evidence so far that kids are at higher risk for the future Covid waves, an expert group of The Lancet COVID-19 Commission India Task Force has urged the government to earmark 10% of adult Covid ICU facilities for children in cases there are surges ahead.

The group, comprising of senior paediatricians from many cities in India, has also said that there is a need to consider vaccination for kids urgently.

“We urge the government to earmark at least 10% of the adult Covid ICU beds for children, 20 % in covid wards, with sufficient isolation rooms so that healthy parents can stay with their children as needed,” a 19-page report by the expert group has said.

It also recommended adding ICU and high dependency unit beds in the non-covid paediatric ward as it is anticipated that some cases of the multi-system inflammatory syndrome, a known post-Covid complication in some kids, maybe observed in future waves.

Among the confirmed cases of Covid-19 in India, less than 12% were children and young adults under the age of 20 years and only 3-4% were children under the age of 10 years.

In the absence of a national database on clinical presentation and outcomes of infected children during the two surges noted thus far, data of approximately 2600 hospitalized children below the age of 10 years, excluding neonates, from 10 hospitals in Tamil Nadu, Kerala, Maharashtra, and Delhi-NCR region was collected and analyzed.

It was observed that mortality rate amongst hospitalized Covid-19 positive children below the age of 10 years was 2.4%, about 4 % of children who died had comorbidities, 9 % of all hospitalized Covid positive children presented with severe illness, under 10 years of age and the findings were similar during the two surges of Covid-19 pandemic so far.

Based on data available, there appears to be no substantial evidence to suggest that children would be more affected or would have greater illness severity due to Covid-19 infection in the anticipated third wave, the experts noted adding that children have milder disease, better prognosis, and low mortality in comparison to adults.

“However, infants and children with underlying illness may be at higher risk and will require greater monitoring,” said the report adding that as there is insufficient information currently to estimate risk in children due to the new SARS Cov 2 variants and the consequences in children due to increased adult vaccination rates.

The experts said that they anticipated an increase in paediatric cases, corresponding to the expected increase in absolute numbers and the wave and the proportion of children of all confirmed cases may also be expected to increase because a substantial proportion of the adult population is expected to be completely vaccinated.

However, only a small minority of children are expected to require critical care, they insisted.

Yet, the experts have said that timely completion of the vaccine trials in children will substantially accelerate the efforts for ensuring protection, generate data, and guide immediate policy actions.

“We recommend a more 'at-risk' approach for consideration and adoption, prioritizing adolescent age groups including children with comorbidities (immunosuppression, neuro disabilities, asthma, gastrointestinal conditions, or diabetes), obesity, and young adults who become more susceptible to worsening the disease and need for critical care,” said their report. 

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