– Aahana Sapkota

Introduction on COVID-19

Corona virus disease 2019 (COVID-19) also known as the corona virus or COVID, is a contagious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease has since spread worldwide, leading to an ongoing pandemic.

 During the initial outbreak in Wuhan, China, the virus and disease were commonly referred to as “corona virus”, “Wuhan corona virus”, and “Wuhan pneumonia”. The official names COVID-19 and SARS-CoV-2 were issued by the WHO on 11 February 2020, explained as CO for corona, VI for virus, D for disease and 19 for when the outbreak was first identified (13 December 2019).

Impact of COVID-19 on Children and Youth

Medical literature shows that children are not the face of this pandemic, but they risk being among its biggest victims. Although the children are minimally susceptible to 2019-Coronavirus disease, the crisis is having a profound effect on their wellbeing. All children in all countries, are being affected by the socio-economic impacts, psychological impacts, and in some cases by mitigating measures that may have inadvertently do more harm than good. This is a universal crisis and for some children the impact will be lifelong.

There are different channels through which children and youth are affected by this crisis: infection with the virus itself; the immediate socio-economic impact; the potential long term effect of delayed implementation of the Sustainable Development Goals; and the psychological impact.

The first channel is through infection with the virus

Thankfully, children have been largely spared from the direct health effect of COVID-19 – at least to date. Much more common has been for children to tragically lose a parent, family member, or caregiver to COVID-19. Children are hit the hardest by psychological impact like being quarantined in homes and institutions, school closure, lack of outdoor activity and abnormal dietary and sleeping habits.

The second channel is through the socio-economic effects of virus

As large number of people is infected with COVID-19, health services become overwhelmed in caring for them due to which children and pregnant women are less able to access standard care. Children of frontline worker and living are overcrowded and marginalized areas are struggling extensively to access health services. Physical distancing and lockdown measures, restriction to movement and border closures are affecting children.

Different child based services like schooling, nutrition program, maternal and newborn care, immunization services, sexual and reproductive services have been partially suspended. The impact of the pandemic extends far beyond the circle of physical health. The pandemic is having profound effect on children’s and youth’s metal well being, their safety and privacy, their social and psychological development, their economic security. Although children are not the face of this pandemic, it has vulnerable impact of children.

The third channel is the risk that the virus poses to the longer-term efforts to achieve the Sustainable Development Goals

The longer and worse the current crisis is getting, the more dramatic and worse the impact on children and youth may occur. As economies struggle and government spending is restricted, it increases the push and pull factor for child recruitment, sexual exploitation and abduction. Incidence of domestic violence, child abuse, adulterated online contents are on the rise. Falling in poverty, exacerbating the learning crisis, threats to child survival and health, risk for child safety, are multiple effects of this pandemic in children and youth.

Psychological impact on Children and Youth

In children and youth the pandemic and lockdown have a greater impact on mental and emotional health. Children are likely to have symptoms of clinginess, the fear of family members being infected and experience inattention and increased irritability. Children are likely to felt uncertain, fearful and isolated during current situation and experience disturbed sleep, nightmares, poor appetite, and anxiety.

The home confinement of children and youth is attributed to disruption in their education, physical and social activities. Absence of structured setting of school for long period of time results in boredom, lack of innovative ideas, lack of engagement in extracurricular activities, make them become more clingy, attention seeking and dependent on their parents which can have a long term negative effect on their overall psychological wellbeing.

Due to extended confinement at home children with special needs may face difficulties in following instructions, understanding complexity of the pandemic, behavioral and emotional difficulties.  Lack of resource material, peer group interaction, and opportunities of learning and developing social behavior and skills may trigger outburst of tantrums, and conflict between parents and children as the parents lack professional expertise and therapists to help them out to handle the children.

The pandemic and lockdown has turn-down the global economic which has directly worsen the existing social inequality. The imposed lockdown forced the underprivileged children and youth face acute deprivation of nutrition and overall protection. Poor and street children have no source of income; make them a high risk population to face abuse, exploitation, violence and mental health issues. With the restriction of movement due to lockdown, there is increase in rate of children being victim of violence and abuse in their own homes. Children from marginalized communities are particularly susceptible to the infection and may suffer from extended ill-consequences like child labor, child trafficking, child marriage, sexual exploitation and death.

During lockdown an increasing number of poor families have no source of daily wages which lead to frustration and feeling of helplessness. The frustration and family conflict may manifest itself in the form of violence towards children which can make children more vulnerable to depression, anxiety and suicide. Worst of all, during lockdown when schools, legal and preventive services are no functioning, children are rare in a position to report violence, abuse and harm.

Roles to minimize impact of COVId-19 on Children and Youth

As the nation continues to battle COVID-19 in the months and years to come, identifying, responding and intervening to mental health needs is more important to mitigate harmful outcome for individuals, families, and communities. The following are the recommended principles to improve outcomes for children and youth:-

• Immediate expansion of social assistance to families.
• Urgent securing of food supply chains and local food markets.
• Adaption of standard physical distancing and lockdown strategies.
• Prioritizing the continuity of child centered services with focus on equity on access.
• Ensuring children and youth have access to COVID-19 testing, treatment and vaccine.
• Build supportive environment for youth.
• Make evidence-based mental health care accessible to youth.
• Take care of most vulnerable communities.
• Ensure public information about COVID-19 is accurate and accessible.

Read more articles

• LET’S TALK ABOUT-RAPE!– Aahana Sapkota
• Depression and Suicide: The Hidden Crisis– Aahana Sapkota

Recommended readings

• POCKET BOOK FOR INFECTION PREVENTION AND CONTROL MEASURES FOR COVID-19 IN THE HEALTHCARE SETTING
• LIST OF LABORATORIES FOR COVID-19 TESTING IN NEPAL
• LIST OF LABORATORIES FOR SARS COV-2 RAPID ANTIGEN TEST
• LIST OF LABORATORIES FOR COVID19 TESTING IN NEPAL
• HEALTH SECTOR EMERGENCY RESPONSE PLAN, MOHP NEPAL
• COVID-19 CONTINUES TO DISRUPT ESSENTIAL HEALTH SERVICES IN 90% OF COUNTRIES
• ENHANCED SURVEILLANCE ON SERO-PREVALENCE OF SARS-COV-2 IN GENERAL POPULATION
• COVID-19 VACCINE FAQS (NEPALI)
• COVAX ADVANCE MARKET COMMITMENT (AMC)-ELIGIBLE ECONOMIES
• GUIDELINE FOR COVID19 FACILITATION GROUP MOBILIZATION
• GUIDELINE FOR ISOLATION KIT DISTRIBUTION
• GUIDELINE FOR OPERATION OF COVID-19 TEMPORARY HOSPITALS 2077
• INFECTIOUS DISEASE ACT NEPAL, 2020(1964)
• COVID-19 CASES ISOLATION MANAGEMENT GUIDELINES
• INTERIM GUIDANCE FOR RMNCH SERVICES IN COVID 19 PANDEMIC