As Covid-19 cases surge in Chandigarh since the beginning of the month– with more than 600 cases reported in the last few days– doctors have consistently observed that the young, below 50 years are increasingly reporting to hospitals with moderate and severe symptoms, and are being hospitalised.
As per data, from January 1 to April 20 this year, there have been 432 patients in the age group of 0-10 years, making up 2.83 per cent of the total cases. The number of Covid-19 patients in the age group of 11 to 20 years during the same period is 1,137, which is 7.45 per cent. The highest number of infection is among those between 21 and 30 years– 3,372 cases, which is 22.09 per cent of the total count, followed closely by the 31 to 40 age group, with 3,252 cases, composing 21.31 per cent of the cases. The number for those in the age group of 41 to 50 years is 2,668, which is 17.48 per cent of cases.
The notion of the so-called ‘fearlessness’, and a false sense of belief that they cannot be affected, is a big cause of the high rate of infection among the youth, believe doctors. This, coupled with the fact that those in the age group of 20 to 50 years step outside their homes more often, for work, family responsibilities and leisure.
As opposed to the first wave, when the elderly were more susceptible, this time, confirms Professor GD Puri, Head of Department of Anaesthesia and Intensive Care, who has also spear-headed the Covid-19 initiative at PGI, a high number of younger patients are deteriorating fast in less than a week. The common complaints are diarrhoea, breathlessness, Covid pneumonia, late cough, and persistent high fever. Many, in the age group of 20 to 30 years need intensive care treatment for moderate and severe symptoms. “Despite no co-morbidity, they are very sick and have to be admitted to the ICU, with some on ventilators. Our advice is to get tested and treated and if the saturation drops while walking, see a doctor and don’t delay treatment,” says Professor Puri. Meanwhile, Dr Pankaj Malhotra, Department of Internal Medicine, PGI, says that young people are the super-spreaders, and while seniors and those with co-morbidities have to pay the price for their lack of responsibility, the youth too are suffering.
Talking about the on-going second wave that the country is witnessing, Professor Jagat Ram, Director, PGI says that in this wave, all age groups and a higher population is affected. “A sense of fearlessness has aggravated the situation, as we see more admissions of people below 45 years. Their oxygen saturation dips faster, below 95, there is lung involvement and they need oxygen support. The only way to break this chain of transmission is to follow Covid appropriate behaviour and get vaccinated,” says Professor Ram.
‘Carelessness has been the major contributor to this second surge’
Dr Jayashree, Chairperson of PGI’s APC Covid Committee, answers some important questions regarding those in the age group of 0 to 12 years getting infected:
In this wave, a number of young people, including children are getting severely infected. Why is it so, what are your observations on how is this wave different?
There is a perception that more kids are getting affected this time. Many paediatricians all over the country feel so. In terms of actual data we will need to do a detailed analysis to see if this is actually true. Since the overall adult numbers are very high in the second wave, proportionately the affected children numbers have also automatically gone up. The recent ICMR data shared on 19-4-21 is as follows, as I quote: From zero to 19 years – the difference was 5.8 per cent versus 4.2 per cent, and in 20-40 years, the difference was 25 per cent versus 23 per cent. There is a marginal difference in this.
Also we must remember that most children are affected as part of family clusters. Since more adults are getting affected, they spread it to the kids at home. The virus is highly infectious and spreads fast among close contacts. Expecting children to adopt Covid appropriate behaviour in the form of masks, social distancing is very difficult. So, the responsibility rests on the adults.
As you are part of the Covid Committee, are there any reflections about the mutants, besides the callous behaviour, being a cause of this mayhem?
Not following Covid appropriate protocols, letting our guard down and carelessness have been the major contributors to this second surge.
What have we learnt in this one year in terms of treatment, management of Covid 19?
For children the treatment modalities remain the same as in the first wave. The disease, fortunately, is still mild in a majority of the kids and can be managed with home isolation, adequate hydration, diet and paracetamol for fever. A small proportion especially those with underlying co-morbidities are at risk and require hospitalization. Children, however, need to be monitored for post-Covid Multisystem Inflammatory Syndrome ( MIS-C), an entity described in a small proportion of children and can present 2-4 weeks after acute Covid. Recurrence of fever along with loose stools, abdominal pain and rashes should alert parents to seek medical help.
Any word of caution for the public, especially the youth?
Most important is the adoption of Covid appropriate behaviour — social distancing, masks, and hand hygiene. There is no other magic bullet. Second, believe in science. Take the available vaccine when your turn comes.