COVID-19 Pandemic: The Effect on Well-Being of Children

January 18, 2021 by
Sanjivan V. Patel, MD, FAAP

Sanjivan V. Patel, MD, FAAP

 

Sanjivan Patel, MD, FAAP
Chairman, Department of Pediatrics
Wyckoff Heights Medical Center

 

Kyle Russell, DO, PGY3
Chief Pediatric Resident

 

The COVID-19 pandemic has been especially difficult for children despite mortality being lower than that of adults.  Specifically for children, they have had to deal with loss of loved ones, the stress of quarantine, and ever changing school landscape.  An overwhelming sense of fear and unknowing is present in these children, as none of them have had to deal with a pandemic of this nature and were unprepared for the difficulties of a global pandemic.  While the medical ramifications of Sars-CoV2 are rightfully the focus of the country, we have failed to acknowledge the significant psychiatric effects of this virus.

At the time of this publishing, there are over 23 million cases and more than 385,000 deaths attributed to COVID across the country.  Out of those 23 million, there are also hundreds of thousands, if not millions, of people who now have long term or lifelong morbidity due to this disease.  The worldwide death toll just hit over 2 million lives lost.  Children, if not affected themselves, are forced to come to terms with family members, many young or healthy, that have succumbed to this disease.  Often times, these are parents, grandparents, or other loved ones. In some cases, children have had entire households of their family die from COVID.  At a time that we are unable to see these family members before they pass or to attend funerals, it is even more difficult for children to cope with loss of loved ones.

Being isolated with family is extremely difficult for children and adults alike, even in ideal circumstances.  As many of us have found out, being isolated with family members for extended periods of time can be stressful for relationships.  The small living spaces in New York only exacerbate the high stress, as well as the potential infectivity for families.  However, there are many more cases where children are in less than ideal situations such as living with abuse, in subpar living conditions, or other unsafe conditions.  In these cases, being home is stressful and dangerous as is.  Due to shelter in place laws and quarantine, these children are being forced to spend additional time in these conditions is even more harmful for them.

In years past, school has been a constant in children’s lives.  However, this year, school has been nonexistent or vastly different than in the past.  As many of families know, it is exceedingly difficult to juggle online schooling.  New York’s cramped living spaces, parents working from home, having small children unable to work computers, and families without access to computers or internet all combine to make an extremely stressful and sometimes near impossible school experience.  Some children have difficulties learning online and also suffer from not being in the classroom.  Children also miss out on developing social skills with other children.  Classes such as gym and music also suffer when taught online.  When children were in school, resources such as in class teachers or helpers were decreased and children were unable to take advantage of the full resources as typical classes used to be.  Despite all the precautions taken, the spread of cases between children and to teachers was still a looming threat.  Children with special needs suffered the most from online or part time school.  Routines the additional resources offered to them were cut off, making it more difficult for them to learn and even more difficult for parents to take care of them at home, often while trying to work remotely themselves.

The number of children experiencing psychiatric symptoms has increased during the pandemic.  Young children have shown signs of psychiatric problems, such as inattentiveness, poor appetites, disturbed sleep, nightmares, more clinginess to caregivers, and significant separation problems1.  Children across the globe had increased rates of depression, anxiety, and posttraumatic stress symptoms from the pandemic than before2,3,4.  Similar to the long-term and possibly lifelong physical effects of COVID-19, we may see significant psychiatric effects on children and adults alike for long-term periods.

However, there are some resources for parents and children alike to aid them during these difficult times.  PBS provides parents with online resources to help teach children how to cope with these times6.  Likewise, Child Trends recommends the following to support and protect children’s emotional well-being during the pandemic5.

  • Understand that reactions to the pandemic may vary
  • Ensure the presence of a sensitive and responsive caregiver
  • Social distancing should not mean social isolation
  • Provide age-appropriate information
  • Create a safe physical and emotional environment by practicing the 3 R’s: Reassurance, Routines, and Regulation
  • Keep children busy
  • Increase children’s self-efficacy
  • Create opportunities for caregivers to take care of themselves
  • Seek professional help if children show signs of trauma that do not resolve relatively quickly
  • Emphasize strengths, hope, and positivity
  • Age appropriate yoga, mindfulness, or other forms of meditation

While COVID-19 has obviously ravaged this country with deaths and other medical morbidities, we have failed at acknowledging the psychiatric effects on the pediatric populations. Through age-appropriate teaching and facts, we can help to educate and prepare children for what is going on around them.  However, we need to be quick to refer these children to proper psychiatric help when deemed necessary.

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