Fragile and Vulnerable
Dear Readers,
Welcome to the 10th Anniversary issue of Double Helical, your trusted national health magazine, dedicated to spotlighting groundbreaking developments, extraordinary individuals, transformative products, and exemplary services that are shaping the future of healthcare in India. By focusing on affordable, high-quality, and inclusive healthcare solutions, we aim to foster awareness and contribute to the collective effort of improving health outcomes across the nation.
In this issue, we bring to you a poignant and significant story titled “The Plight of Orphaned Children”. Experts categorise children who lose their parents due to death, abandonment, or other circumstances as Orphaned and Abandoned Children (OAC). These vulnerable children, particularly those raised in institutional care, face an array of challenges that encompass social, psychological, and economic difficulties. The absence of a nurturing familial environment often leaves them grappling with fragile health, emotional instability, hampered cognitive development, and personality alterations. These adversities serve as a clarion call for society to establish robust care systems to secure their health, happiness, and overall wellbeing.
The destiny of OACs often diverges into various possibilities: some are fortunate to find love and care in adoptive families, while others might be taken in by extended relatives. Sadly, many are left to survive on the streets or find themselves in institutional settings. Today, these institutions are more commonly referred to as juvenile homes rather than orphanages, reflecting a shift in societal attitudes. Despite this change, research has revealed the myriad challenges faced by institutionalised children. The psychological and emotional repercussions of early parental separation are profound, with studies indicating that children who experience neglect or trauma during their formative years are more likely to develop aggressive behaviours and maladaptive tendencies as they grow older.
On another front, our cover story, “Overlooked Yet Real,” shines a spotlight on the rising threat of Human Metapneumovirus (HMPV), particularly its implications for malnourished children. Malnutrition exacerbates vulnerability to viral infections like HMPV, which are otherwise mild and self-limiting in well-nourished children. This underscores a grim reality in India, where respiratory infections contribute significantly to child mortality. Despite its gravity, this issue has long been overlooked by both policymakers and the media.
The Covid-19 pandemic has left a lingering psychological impact on populations worldwide, and reports of emerging viruses like HMPV have reignited fear and uncertainty. However, it is critical to understand that HMPV is not a novel virus. Identified in The Netherlands in 2001, it has been part of the global virological ecosystem for decades. In fact, sero-surveys conducted on stored serum samples reveal that HMPV has been circulating globally for over 50 years. It is a respiratory virus that predominantly infects children, causing mild symptoms. Alarmingly, undue media sensationalism around what is essentially a common respiratory virus has unnecessarily heightened public anxiety.
HMPV outbreaks, such as those recently observed in China, are not isolated events. Post-pandemic surges in respiratory viruses and other pathogens have been reported in countries like France, New Zealand, Australia, Italy, and the United Kingdom. The phenomenon can be attributed to what epidemiologists describe as an “immunity debt” or “immunity gap”.
Under normal circumstances, infants and children are regularly exposed to a variety of microorganisms, which helps to prime and develop their immune systems. However, during the Covid-19 pandemic, stringent lockdowns and non-pharmaceutical interventions (NPIs) such as social distancing, isolation, and excessive sanitisation disrupted this natural process. As a result, a significant portion of the population—especially children—became immune-naïve, lacking exposure to common pathogens of childhood.
HMPV typically begins infecting children around six months of age. Under normal conditions, nearly all children (90-100 per cent) encounter the virus by the age of five, allowing their immune systems to build appropriate defences. However, in countries like China, where pandemic restrictions remained in place for nearly five years, this natural progression was severely interrupted. As a result, large cohorts of children, previously shielded from the virus, are now encountering it for the first time simultaneously, leading to widespread infections.
It is vital to note that HMPV is a mild virus with low virulence, posing minimal mortality risk to healthy children. However, its impact on malnourished and vulnerable populations should not be underestimated. Policymakers must strike a balance between safeguarding public health during pandemics and preserving the natural processes that foster long-term immunity. Reactionary measures, driven by media-induced panic, should give way to well-researched, evidence-based strategies that prioritise resilience over temporary containment.
This issue of Double Helical is packed with numerous fascinating, thought-provoking, and insightful stories. We hope it inspires you to reflect on the pressing healthcare challenges of our times and the solutions that lie within our grasp.
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Happy reading!
Thanks and regards
Amresh K Tiwary,
Editor-in-Chief