As cases drop, Bengal gears up for possible third wave

The number of Covid-19 cases that peaked during the second wave of the disease on May 14 ( 20,846) in Bengal has been going down since with the state reporting 5,384 infections and under 100 deaths on Wednesday. Officials said they have now started preparations for a possible third wave even as though they are still uncertain whether and when it would hit.

An official said they are expecting the numbers to touch the baseline level by June-end or early July and that they do not know when exactly the third wave would come. “But going by the experiences of countries like the UK and Canada, we expect that it may hit sometime around October or November and have hence started our preparations accordingly. We want to utilise the gap we get between the two waves,” said the official, requesting anonymity.

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A second official said children accounted for around three per cent of the people infected during the second wave. “...on any given day, there were not more than 200 children in hospitals in the state. But going by the experience of other countries, where the third wave has hit, we apprehend children could get more affected if the third wave hits.”

Officials said the number of beds at Paediatric Intensive Care Units (PICU), Sick Neonatal Care Units (SNCU) and Neonatal Intensive Care Units (NICU) are being increased. “While 250-300 PICU beds would be kept aside for Covid-19 patients, which may be increased up to 500, around 500 HDU units would be kept for them which may be increased up to 1,000. ...we would keep aside around 800 beds initially, which may be increased up to 1,500 according to need,” said a third official.

In the 69 state-run SNCUs for infants less than a month old, there are around 2,583 beds. These would also be increased.

“The main objective is to set up at least one paediatric unit in each district. An HDU would be also located in nearby locations which would have facilities like BiPAP and high flow oxygen. At some, 2 to 3 beds in normal CCUs could be upgraded by keeping paediatric gadgets to treat children above five,” said the second official.

The health department is also in the process of purchasing paediatric pulse oximeters so that they could be distributed uniformly across health centres in advance. Officials said general duty medical officers may also be trained to handle paediatric cases.

To be sure, the country’s top experts have said there is no evidence that the third wave will hit children harder. “If we look at the data, and compare both the Covid-19 waves, children are usually protected as the numbers are fewer. Even if they get infection, the disease is usually mild...there is no indication that in the third Covid-19 wave, children will be more impacted,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences (New Delhi).

“There could also be another theory that says since kids aren’t exposed much yet, in the next wave there’s a possibility that proportionally they may get more affected by virtue of greater exposure.”

The Centre has also issued comprehensive guidelines for management of Covid-19 in children, including treatment of mucormycosis.