Children may be less at risk for COVID-19 infection, but indirect health impacts abound | #covid19 | #kids | #childern

EXETER, England – The COVID-19 pandemic continues to have a widespread and devastating impact on the world. Older adults and individuals with preexisting health conditions are bearing the brunt of the direct health effects. Even though children seem to be less likely to contract the virus or develop severe cases, there’s still plenty of reason for concern. A new study by researchers at the University of Exeter warns that the pandemic can indirectly impact the physical and mental health among children.

In the paper, published in the Canadian Medical Association Journal, researchers outline several key ways in which children are negatively impacted by the pandemic.

COVID-19 keeping parents from children’s doctor visits

One concerning change brought on by the pandemic is that fewer families and children appear to be using health care services. Data from the United Kingdom, Ireland, and Italy reveal a 75% reduction in pediatric emergency department visits during the quarantine compared to previous years. Moreover, caregivers seem to be waiting longer to seek out health care for children.

The researchers suggest that these trends are likely due to fear of COVID-19 infection from medical facilities or public transit and lack of child care for other children. Other reasons include closures of primary care facilities, and strict limitations on hospital visitations which would require parents to leave their children alone in the hospital.

As a result of omitting and delaying health care, children are missing scheduled childhood vaccinations. According to a recent survey of 1,000 children across the U.S., vaccinations for measles, mumps, and rubella decreased by 50% the week of April 5, 2020 compared to two months prior.

At-risk children now at even greater risk

Children are also missing developmental checks. This is particularly concerning given that approximately 15% of children have a delay in at least one area of development. Early identification of delays improves cognitive development and medical outcomes.

In addition to physical health and development, COVID-19 also puts children’s social and mental health at risk. The pandemic may be causing widespread social isolation, overcrowded housing conditions, financial strain, and food insecurity. Adverse childhood experiences such as these are associated with negative mental health outcomes, obesity, and cardiovascular disease later in life.

Delayed and cancelled visits by child welfare services and reduced supervised visits among birth parents for children in foster care are also a significant concern. Economic recessions tend to increase family violence, and a lack of child welfare check ups among at-risk families places children’s health at risk. Moreover, mothers who breastfeed during supervised visits with biological children are no longer able to do so.

School closures resulting from the pandemic are also a serious concern for many families and children. Many children depend on school meals for food and schools serve as a safe place for children in violent homes.

“We need to better understand what goes into the decisions families make regarding the complex needs of their children during this pandemic and how we can better support them,” says co-author Francine Buchanan, a Research Patient & Family Engagement Coordinator at SickKids, in a media release. “Both practical and personal considerations need to be taken into account.”

Healthcare providers to the rescue?

To combat the negative effects of the pandemic on child health, the researchers propose several strategies.

First, family doctors and pediatricians must clearly communicate with parents and other child care providers to inform them that health care services are available if a child needs them. Second, hospitals should work with children and families to develop alternative methods of providing care, such as in different locations or online.

Finally, more data needs to be collected to understand issues related to children during pandemics. For example, more data is needed to better understand how children and young people contract and spread COVID-19. Similarly, it’s unclear of the benefits and risks of reopening schools, and the long-term implications of delayed child health care visits.

“We owe it to our children and young people to proactively measure the COVID-19 pandemic’s indirect effects on their health and to take steps to mitigate the collateral damage,” urge the authors.

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