LAUSR

Agent, host and environment decide the course of an outbreak of infectious diseases. Both pandemic flu and SARS-CoV-2 spread by respiratory droplet, but it is thought that the mortality is higher in SARS-CoV-2 infected cases. While pandemic flu caused significant mortality in children, SARS-CoV-2 mainly kills people over 60 and with comorbidities. From the data published so far, it appears that children account for 1-5% of all cases and would generally have a milder disease compared to adults [3]. The less severe presentation may be attributed to less exposure or sensitivity to COVID-19, different immune response mechanisms, or higher levels of antibodies to viruses than in adults due to broader exposures to respiratory infections in winter. There is some interest in the possible role of measles [4] and BCG vaccine in providing protection against SARS CoV2; if true, India stands to gain from its recent Measles-Rubella vaccine campaign. However, we cannot be complacent and we need to be on the lookout for severe disease in ‘high risk’ children (immunocompromised, lung or airway disease, long term steroids, thalassemia, nephrotic syndrome etc.), in addition to continuing their ongoing management [5]. Seasonality of influenza is largely dictated by temperature and it remains to be seen how these factors affect SARS-CoV-2 transmission. Social determinants of health, including health equity and agerelated illness, may play an important role in both pandemic flu and COVID-19 pandemic.