Reopening of schools has begun in different states across India, bringing much relief to both children as well as their parents after almost two years of schools remaining shut due to the pandemic.
States, including Punjab, Haryana, Uttarakhand, Jharkhand, Bihar and Uttar Pradesh, have reopened schools in a phased manner, but a few other states, such as Kerala and Himachal Pradesh, have extended closure of schools for longer duration. Meanwhile, some other states like Maharashtra have taken to reopening of schools in select districts.
On Thursday, Mumbai Mayor Kishori Pednekar said the decision of reopening schools in Mumbai and surrounding areas will be taken by Diwali, that is in November.
This would mean that in the next two months, most state governments are planning to open up so that the current academic year can progress as per schedule through offline classes held within the school premises. Recently, the Indian Academy of Pediatrics (IAP) had framed, published, and disseminated its guidelines on ‘School Reopening, Remote Learning, and Curriculum during and after COVID- 19 Pandemic’ to address schooling issues during the pandemic.
In Maharashtra, this week, a task force presented standard operating procedures for the reopening of schools across the state, recommending full vaccination for both, teaching and non-teaching staff. According to Dr. Surbhi Rathi, a practicing paediatrician at Mumbai-based Nair hospital, which had been a frontrunner in providing COVID-19 treatment in the city, "53 per cent children in the city showed presence of antibodies due to acute or chronic infection or due to the infection in the first wave." Dr. Rathi was part of the team that carried out the survey across all the wards of the city during the peak of the second wave. "As of now I can say that the number of children reporting COVID-19 infections in the city has not increased, but we know for sure that a very high number of them have already been infected with the novel coronavirus," said Dr. Rathi in an interview to THE WEEK.
However, even as this bit of news regarding the opening up of schools may bring a sense of relief to parents, it comes at a time when the third wave stares at us and reports show a high number of children falling prey to the coronavirus infection in several states across the country. Even more concerning is the fact that children are contracting the disease when reports suggest that the number of active cases are falling below peak levels and experts are suggesting that the second wave is gradually on the decline, and the nation may be edging towards pre-second wave levels. In the city of Mumbai alone, as per the fifth serosurvey carried out by the BMC, 87 per cent of citizens were found to have developed antibodies against coronavirus. Yet, disturbingly, around the same time, in just one children's home in the city, the Chembur Children's Home in Mankhurd, 18 children aged between 10-18 years were found to be COVID-19 positive. Since the past few months, experts have been saying the "expected" third wave will impact children "more."
In the latest serosurvey conducted among children by the Chandigarh based Postgraduate Institute of Medical Education and Research (PGIMER) among 2,700 children, 71 per cent showed the presence of antibodies. The survey was conducted in the areas of Chandigarh covering rural, urban and slums. "We are at the beginning of the third wave of Covid-19 pandemic," PGIMER Director Dr Jagat Ram reportedly said. He also added that the survey from Maharashtra and Delhi showed that about 50-75 per cent of children had developed antibodies. Around the same time, The Empower Group-1 or the EG-1, set up by the government to formulate India's COVID-19 emergency strategy shared data which showed that the number of COVID-19 cases among children increased two-fold since March this year and the rise has been steeper among children under ten years of age. This may not be a cause for alarm just yet, but a strict vigil is being maintained to make sure that the numbers do not increase significantly in the coming days, the authorities said. At a time when there is no vaccine available for kids just yet, the chances of them contracting infection is high.
All states are ramping up their infrastructure to deal with the imminent crisis of a third wave. Karnataka Health Minister K. Sudhakar, on Thursday, said as part of its preparation to fight the possible third wave of COVID-19, the state government reserved 20 per cent of beds in district and taluk hospitals and community health centres for children.
"The present situation is such that in the last three to four weeks we have definitely seen a big jump in the upper as well as lower respiratory infections and pneumonia among children. But the number of covid cases is unexpectedly low this time. In fact, we are getting children suffering from other viruses, including influenza and RSV (Respiratory Syncytial virus) rather than just COVID-19. In the last one month, we saw five COVID positive cases only among children and this is nothing compared to the numbers in the second wave in April-May, which were anywhere close to eight-nine patients every day. So, a lot of children are presently coming to us with respiratory infections and when tested for COVID they come negative," said Dr Yogesh Kumar Gupta, a consultant paediatrician practicing at Fortis hospital, Bannerghatta road in Bengaluru. The RSV virus, says Dr Gupta, is particularly concerning, "especially because this is the same virus being noticed in the US and UK too. It belongs to the common influenza viruses and is very common in children under the age of two. High grade fever, cold, cough are the symptoms which take time to recover but the outcomes are good, say doctors.
As per epidemiologist Dr. Chandrakant Lahariya, who has worked with the World Health Organidation earlier, the second wave is over across India but there is ongoing sustained transmission of the infection across the country's more than 70 districts, reflecting local COVID-19 waves. But for a major third wave to hit India, a new variant which is highly transmissible and immune to vaccines has to be present, which does not seem to be a likelihood so far. Scientific evidence has been suggesting throughout the past several months that children are not at additional risk of COVID-19 in any subsequent wave and that the delta variant does not do any more harm to children than the previous variants. Epidemiological data from many countries has pointed out that fully vaccinated adults are more at risk to COVID-19 infections than even unvaccinated children.
Why is that so? Scientists believe that it is because the ACE-2 receptor which is a requirement for COVID-19 to be able to enter into lungs and multiply, is under-developed in children. Children also have a higher level of active neutrophils, that are white blood cells which kill infection by ingesting microorganisms and releasing enzymes which kill the microorganisms. Also, children have a very high expression of a particular gene encoding receptor which recognises viruses and immediately triggers production of interferons, which are proteins that form a part of the body's natural defenses. These are the reasons why children are better protected, as per scientists.
Interestingly, at a time when the Indian government mulls over the reopening of schools in India, the news of the first “school-centred” COVID-19 surge in China has strengthened the case for keeping schools shut for now, at least in some states. Officially, about 120 COVID-19 cases were reported by the Chinese authorities, but nobody got severely infected. Meanwhile plans are being readied with Zydus Cadila’s DNA vaccine ZyCoV-D, which has received emergency use authorisation for children, and this programme is likely to be kickstart in October.
