While India‘s 2nd wave of COVID-19 is plateauing, there is a possibility of a 3rd wave, but it is difficult to predict its timing and severity!
On this note, let’s try to answer some of the key questions circumscribing the buzz around the inevitable 3rd wave of the COVID-19 pandemic.
Q: Will there be a 3rd wave of COVID-19?
Ans: As per the experts, the 3rd wave of COVID-19 is more or less inevitable. However, its severity and exact timeframe cannot be predicted. Pandemics like COVID-19 tend to exhibit a rising and declining pattern just like sea waves. The journey with COVID-19 gave us a glimpse of these life-threatening waves, each more dangerous than the other. Eventually, with time the majority of the population may get immune to the COVID-19 infection by acquiring herd immunity*. This will help reduce the transmission of a 3rd wave and soon the disease may die out or become less prominent with low transmissibility .
*A form of indirect protection from infectious disease when a large part of the population of an area becomes immune to an infection due to vaccination or preventive measures. This helps to reduce the likelihood of getting contaminated by infection for individuals who lack immunity.
Q: How would one identify a 3rd wave, if it comes?
Ans: COVID-19 has altered many lives with each of its waves. The most recent 2nd wave has caused havoc by infecting large masses within a short time. Experience with the effect of previous waves can give us an idea about the possibility of a 3rd wave soon. Even though there is not enough data to suggest the exact impact and severity of any such new wave, it would be best to prepare ourselves and follow safety guidelines as advised by the government. A possible surge in the number of COVID-19 cases may occur in the anticipated 3rd wave if we do not follow the COVID-19 appropriate behavior and ignore vaccination. If a fresh surge of cases continues for a few weeks or months, it would get classified as the 3rd wave of the COVID-19 pandemic .
Q: How different will COVID’s 3rd wave be from the first two?
Ans: The anticipated 3rd wave of COVID-19 is more or less inevitable due to the high levels of circulating virus. As new variants of a virus are natural, the existing variants will make way for new variants which may or may not be more destructive. However, in any case, the best approach to remain on the safe end is to follow the obvious COVID-19 appropriate behavior and vaccination. COVID 1st wave had a generalist approach, similar to a key that can be fitted into many locks, affecting people with low immunity. In the 2nd wave, the virus changed its structure (mutations) to fit better inside the human body. Cases of re-infection were also observed during this ferocious wave.
The new variants of viruses that are of concern represent a much more dangerous picture as they can adapt effortlessly inside the human body. To add to the cause, non-compliance of COVID-19 appropriate behavior creates opportunities for the virus to invade our lives. So, whatever measures we can adopt to lower its transmissibility must be followed religiously. In the anticipated 3rd wave, previously recovered cases of COVID-19 infection and vaccinations may cause adaptive pressure on the virus, affecting its ability to mutate and cause infection as most of the population will become immune to the virus .
Q: Are children at greater risk in the 3rd wave of COVID-19?
Ans: Although children remain prone to infection, it is highly unlikely that the 3rd wave will predominantly or exclusively affect children . On similar lines, the WHO-AIIMS serosurvey also suggests that it is not certain that any future 3rd wave will have any special effect on children of the age group 2-17 years . However, the virus may target the non-immune population, including children.
Q: Are there any serious complications of COVID-19 in children?
Ans: Multisystem Inflammatory syndrome (MIS-C) is a serious condition that is found to be associated with COVID-19. Its occurrence is majorly observed in some children. It is a group of symptoms that can cause inflammation in different body parts, including the heart, lungs, skin, and eyes. However, cases of MIS-C are not very common, and most children who have contracted it eventually get better with medical care. The exact cause of such occurrence is not clear. It is treatable with effective results if diagnosed early. Moreover, most children who get affected cannot transmit the infection to others .
Q: What precautions should be followed if the 3rd wave comes and affects children?
Ans: The preventive behaviors are the same for children as for adults. Parents should act as ideal role models and teach their children the basics of following mask etiquette, hand hygiene, and social distancing. Children above the age of 2 to 5 years can be trained to use a mask. Indian Academy of Pediatrics (IAP) has also set guidelines for the safe reopening of schools for the safety of the children .
Q: When can children get the COVID vaccine?
Ans: Vaccine safety and efficacy for children (<18 years) are being assessed in clinical trials. Recently, the Drugs Controller General of India (DCGI) has approved Phase II/III clinical trials of COVAXIN in the age group of 2 to 18 Years on 13th May 2021. Under this trial, the vaccine will be given intramuscularly in two doses. If proven immunogenic and safe, it could be fast-tracked for mass vaccination in children [1,4].
Q: What measures can be taken to prevent the spread of the anticipated 3rd wave of COVID-19?
Ans: Each wave of COVID-19 came with a different set of challenges. Among other precautionary measures, vaccines can be considered the most potent tool against COVID-19 infections. Therefore, vaccinating the vulnerable population becomes crucial. Though we do not have concrete data on the protection offered by the various vaccines against the mutant strains, most experts agree that some degree of protection against severe infections exists with these vaccines. Therefore, vaccines can be considered as the most rational way to manage this proposedly upcoming 3rd wave. Also, other measures such as compliance to COVID-19 appropriate behavior, continuous surveillance, and allocation of essential resources along with reliable data altogether can help India tackle the hit of COVID-19 3rd wave if it comes .
We can win!
These wreath-taking waves are not coming to us, but rather are originating from us as we become reluctant towards accepting the fact that COVID-19 is still among us. Non-compliance of safety measures and casual approach has contributed to the rise in the cases as seen in the previous waves. The best way to control disease transmission is to get vaccinated and follow COVID-appropriate behavior, including mask donning, following hand hygiene, and ensuring safe distancing.
We can avert this inevitable 3rd wave if we collectively act responsibly and do our part religiously.
With inputs from Dr. Rajiv Chhabra, Chief of Pediatrics, Artemis Hospital, Gurgaon.
1. Indian Academy of Pediatrics (IAP). VIEWPOINT ON THE THIRD WAVE OF COVID-19 IN INDIA. IAP. pp. 1-4. https://iapindia.org/pdf/hA5Gnpt_lQv63Bk_IAP%20view%20point%20for%203rd%20wave%20Covid%2022%20May%202021.pdf
2. Misra P, Kant S, Guleria R et al. Serological prevalence of SARS-CoV-2 antibody among children and young age(between age 2-17 years) group in India: An interim result from a large multi-centric population-based seroepidemiological study. https://www.medrxiv.org/content/10.1101/2021.06.15.21258880v1.full.pdf
3. Indian council of Medical Research (ICMR). WORLDWIDE COVID-19 CANDIDATE VACCINES. COVID-19 Vaccines. ICMR. https://vaccine.icmr.org.in/covid-19-vaccine
4. Daily Motion. Video: Third wave of Covid-19 inevitable, says Centre. https://www.dailymotion.com/video/x813h6f