BANGALORE - As India's second wave of Covid-19 continues its devastation, doctors and health experts have noted a rise in infections among children, fuelling concerns that children are more vulnerable to catching the disease.
Claims that the B1617 variant first detected in India disproportionately affects children, the only segment of the population ineligible for vaccination, have further fed the fears.
"There is no scientific evidence and epidemiological data to say that a third wave of Covid-19 in India will affect mainly the children. All susceptible age groups are likely to be equally affected," said Dr Chandrakant Lahariya, an epidemiologist formerly with the World Health Organisation.
But public concern is pushing many states and the Indian government to set up task forces and exclusive Covid-19 care centres for children, and to issue advisories on preventing transmission from children.
Vaccine maker Bharat Biotech has also launched a clinical trial for a children's vaccine.
More children have indeed been infected in India's second wave of Covid-19.
The country does not keep national-level data on the ages of those who are infected. But some states do.
In Karnataka state, the number of children aged up to nine testing positive in the past two months has been 1.4 times the total number of infections from January to March 18. It was 1.6 times for the 10-19 age group.
The increase in deaths is less pronounced.
While 28 children have died of the virus as at March 18, 15 have died in the two months since. Among adolescents, 46 had died as at March 18, and there have been 16 more since.
In Maharashtra, the worst-hit state in India, 75,387 children were infected in the past month - an almost 51 per cent increase.
But they form a small percentage of overall infections: Those aged under 10 made up only 3 per cent of infections, while those aged between 10 and 19 made up 6.8 per cent.
To dispel fears, the Indian authorities clarified on Tuesday (May 18) that a majority of children are asymptomatic and only a small proportion needed hospitalisation.
In a meeting on Thursday, Prime Minister Narendra Modi asked district magistrates of 10 states to collect and analyse data on the transmission of Covid-19 among youth and children to protect them.
Many states are testing more children, especially if they have been exposed to a family member with Covid-19. The Delhi government will form a special task force to prepare medical infrastructure for children.
Mrs Shantamma G, a rural health worker in Chamarajanagar in Karnataka, said: "We are now educating parents in villages to get their children to wash hands more and not touch their face."
Doctors warn that children can catch and spread the virus more easily.
Mr Nagaraj, a systems engineer in Bangalore who goes by one name, said his eight-year-old son became infected in late April because he "kept touching his mask and putting his fingers all over his face".
A test showed the child to be negative for Covid-19, but a chest scan revealed infection in the lungs. Mr Nagaraj admitted his son in Aster RV Hospital's paediatric Covid-19 ward.
"He was really upset and kept pulling the cannula and oxygen mask off, so I stayed with him in the critical care unit to calm him down," said Mr Nagaraj, who also tested positive and recovered at the same time as his son.
Dr Supraja Chandrasekar, a paediatric intensivist at Columbia Asia Hospital in Yeshwantpur, Bangalore, said that unless a child was completely on a ventilator, she preferred having one parent or caregiver staying with a child in hospital to aid the recovery.
But other adults in the family have to isolate themselves to break the chain of transmission.
Dr Chandrasekar called children "Covid butterflies", flitting from person to person playfully, inadvertently transmitting the virus.
Most children with Covid-19 get only mild diarrhoea or a cold, so adults tend to let their guard down when it comes to the young ones, she said.
Since it is challenging to isolate young children, Dr Chandrasekar recommended "reverse isolation", where vulnerable adults such as grandparents lock themselves away.
How kids in other nations are faring
More children have been infected in the second and subsequent waves of the coronavirus in some countries. However, most countries do not keep national data about children infected with Covid-19. Instead, these figures are usually kept by individual states and provinces.
Collating state data, the American Academy of Paediatrics said that as at May 13, more than 3.9 million child Covid-19 cases were reported. This is 14 per cent of all cases.
Between 0.1 per cent and 1.9 per cent of all child cases resulted in hospitalisation.
Children accounted for less than 0.21 per cent of all Covid-19 deaths. About 140 children under four have died.
The United States last week vaccinated 600,000 teens between 12 and 15 years old with the Pfizer-BioNTech vaccine.
Since January, about 12 to 15 children aged eight to 14 have been hospitalised every week for post-Covid-19 complications called paediatric inflammatory multisystem syndrome (Pims), official statistics say.
These complications show up as cough, rashes, fever, low blood pressure and abdominal pain.
Studies show that 47 per cent of those with Pims - a rare but extreme immune response - were of Afro-Caribbean origin and 28 per cent were of Asian origin.
The Health Ministry said 832 children under five years old have died of Covid-19. Other reports suggest that 2,060 children under nine have died, including 1,302 babies.
Of the total number of Covid-19 cases as at March 24, 4.19 per cent were children below 10 years old, and 6.76 per cent were aged between 10 and 19.
But deaths among children are extremely rare, the government has said.
The coronavirus variant first found in Britain is prevalent among Italy's infected children, some experts have warned. They said schools must be reopened with caution.
More than 50,000 children and teens tested positive in January, more than during the first and second waves of Covid-19 infection, largely because of the more contagious variant first detected in Britain.
The vaccination drive is now expanded to 12- to 15-year-olds.