Dr Sadaf Asim
ACCORDING to United Nation, COVID-19 pandemic presents the greatest test the world has faced since the Second World War. People around the world are anxiously tracking the numbers of new cases and deaths due to COVID-19. But in doing so, we are distracted from the catastrophic effects of the pandemic on children. While children are not the face of SARS CoV 2 (severe acute respiratory syndrome corona virus 2)/ COVID 19 (Coronavirus infection discovered 2019), its broader impact is on children’s physical and mental health being catastrophic and lasting for societies as a whole. The effect of the pandemic is not limited to health but extends to many dimensions of children’s life: their education, safety and poverty are a few to name. This effect is largely attributable not to the virus but to the mitigation measures governments have taken. Effect on health and disease: Before this crisis, we lived in a world that failed to care adequately for children; where a child under age 15 dies every five seconds; where one in every five children is malnourished (stunted); over half (53%) of 10-year old children in low and middle-income countries (as high as four in five children in poor countries) can’t read and understand simple stories; and one child in four under the age of 5 does not have their birth registered.
Loss of vaccination: The health effects of the pandemic extend far beyond the virus itself. Immunization campaigns globally are on hold. It also includes the suspension of all polio vaccination campaigns worldwide, setting back the decades-long effort to eliminate the wild virus from its last two vestiges, Afghanistan and Pakistan and to tackle recent outbreaks of the vaccine-derived virus in Africa, East Asia and the Pacific. Pakistanis soaring with 51 new polio cases in 2020. In addition, measles immunization campaigns have been suspended in at least 23 countries that had cumulatively targeted more than 78 million children up to the age of 9 years. Non-Covid illnesses: Delay in the diagnosis and management of non COVID illnesses, delay in the follow of children with known chronic illnesses lead to the development of complication triggering to increased mortality. Infant mortality rate: According to UNICEF the global economic downturn could result in hundreds of thousands of additional child deaths in 2020, reversing the last 2 to 3 years of progress in reducing infant mortality within a single year. This is due to the reduced access to essential reproductive, maternal, newborn and child health interventions, such as antenatal care, skilled attendance at birth and treatment for under five killers like pneumonia, diarrhea and malnutrition.
Effect on sleep, physical activity and eating habits: Children’s physical activity is interrupted and they cannot go to parks, gyms, sports arenas and lack of intake of imbalanced diet. It is leading to problems of sleep, headache and vision due to excess screen time and disturbance of sleep wake cycle leading to the hormonal imbalances and their consequences. We expect to have the increasing number of children with diabetes, hypertension and chronic kidney disease in the coming years. Covid positive parents: Children are away from the parents if one of them get infected with COVID. Stresses of living in isolation and quarantine, affect their cognitive, emotional and social development. Falling into poverty and malnutrition: The impact of COVID-19 on children’s poverty, survival and health, learning and safety are far-reaching. According to a report from BBC the poorest will be hardest hit by all of these effects, lockdowns are expected to widen the existing inequalities across the globe, with repercussions for years to come. It’s disadvantaged children who pay the greatest price here, as they will fall the furthest behind, and have the fewest resources available to ‘catch up’ once the pandemic threat has passed the children in under resourced regions of the world will face the consequences of poor economic status of the family Where parents losing jobs and country aggravating malnutrition, schooling, Communicable and non-communicable diseases and death.
According to UNICEF, an estimated 42-66 million children could fall into extreme poverty as a result of the crisis this year, adding to the estimated 386 million children already in extreme poverty in 2019.For poor households around the world, a reduction in income means reductions in essential expenditures on health and food, whose effects are especially grave for children the breadwinners lose their jobs or be forced to sell productive assets in order to survive, with long-running consequences for children living in poverty. We anticipate hundreds of thousands of additional child deaths this year. Progress towards the Sustainable Development Goals (SDG) for children were already off track and will further worsen. Academic excellence: According to UNESCO, the education of nearly 1.6 billion pupils in 190 countries has so far been affected – that’s 90% of the world’s school-age children. With School closures children no longer have that sense of structure and stimulation that is provided by that environment, and now they have less opportunity to be with their teachers and peers and get that social support that is essential for good mental well-being. School closures have been imposed pre-emptively: in 27 countries closures were introduced before cases of the virus were recorded. With schools in many countries planning for extended lockdowns, at least 58 countries and territories have postponed or rescheduled exams, while 11 countries have cancelled exams altogether. According to UNESCO, while more than two-thirds of countries have introduced a national distance learning platform, only 30 percent of low-income countries have done so.On line schooling is not considered a better option by children because although parents are helping but they are not focused at home and face lot of distraction effecting their academics. Parents themselves are working in many scenarios and cannot support children for on- line learning hours. Children’s reliance on online platforms for distance learning has also increased their risk of exposure to inappropriate content and online predators increasing the issues of children security.
—The writer is MBBS, DCH, MCPS, FCPS (Paediatrics), FCPS (Paediatric Nephrology). HoD, Paediatrics Nephrology. Consultant Paediatrics and Paediatric Nephrology, Jinnah Sind Medical University-National Institute of Child Health. Tabba Kidney Institute.
