Many believe that one of the only silver linings of the Covid-19 pandemic that has been relentlessly preying on adults around the world for months is that the disease largely appears to spare children.
Does it really though? Perhaps we need to think again.
The reality of the coronavirus is undeniably real and as it spreads its tentacles across the globe, it is taking a toll on the lives and livelihoods of people. What started as a public health emergency has evolved into an avalanche of dire implications for global development and future prospects for the younger generation.
The direct impact of Covid-19 on children seems to be less severe than on adults in terms of severe symptomatic reactions, but its indirect and hidden consequences risk leaving a detrimental longstanding effect.
According to Unicef's estimates, approximately 99% of the world’s children are living with some form of pandemic-related movement restrictions whereas 60% live in countries with full or partial lockdowns.
So far, at least in Pakistan, much of the conversation and public debate around social distancing and lockdowns has centred on protecting the elderly and those with underlying medical conditions from a virus that is uniquely dangerous for them.
Yet the long-term health and well-being of our housebound younglings hasn’t really made it to the forefront. If we have learnt anything in the past few months, it is that mortality is only one of the risks of this virus.
Covid-19 has already caused a disruption in the utilisation of routine immunisation services, threatening outbreaks of diseases, such as polio and measles, for which vaccines already exist. Not only that, reduced access to essential reproductive, antenatal and newborn and child health services means that a lot more newborns, young children and pregnant women can be lost to non-coronavirus related causes.
Water, sanitation and hygiene (WASH) services are likewise in danger of disruption by lockdown measures, posing further threats to children’s health through water-borne diseases. Over 700 children under the age of five die every day from diarrhoea-related illness directly associated with deficient WASH services, and this number could rise sharply if existing services breakdown.
School closures have been a global response to the Covid-19 pandemic, with children in many countries spending all of their time at home with parents or guardians. Many parents are squeezing in jobs or work-related tasks with the additional responsibility for home schooling their children. This increased stress and burden on parents, added to the social isolation of children from their friends and teachers, can affect the socio-emotional skills of children.
Another likely outcome of the Covid-19 pandemic is that psychological issues in children will get amplified if the home environment is stressful. An exacerbation of pre-existing psychological and behavioural issues can very likely become a formidable problem in children from low educated and less affluent households, a majority of which unfortunately overwhelm Pakistan’s domestic landscape.
Self-isolation also continues to drive an ever increasing number of youngsters to move online during the Covid-19 pandemic, leading to a phenomenal rise in screen time, raising safety risks for millions of young people.
The global lockdown of education institutions has caused a major (and presumably unequal) interruption in students’ learning; disruptions in and cancellation of internal assessments and public assessments for qualifications or their replacement by an inferior alternative.
Teaching is shifting online, at an untested and unrivalled scale. However, we cannot overlook the fact that not every household in Pakistan has access to a computer, let alone Wi-Fi. And families are more likely to pull children out of schools entirely. These interruptions will not just be a short-term issue, but can also have long-term ramifications for the affected cohorts and in all likelihood, will increase disparities already prevalent within our population.
Perhaps the most vexing of all is the threat that Covid-19 poses to unravelling the progress made towards sustainable development goals, the work of not just a few months but years. As poor families face economic hardship during these trying times, they are more likely to cut back on expenditure towards essential food and health needs.
Unfortunately, this may not be the end of our tribulation. With global recession gaining pace and drawing on from the verifiable connection between GDP and infant mortality in developing countries, we also face the peril of many more child deaths in 2020 compared to the pre-pandemic scenario. This can be a cataclysmic consequence for a country like Pakistan that is distinguished as having the worst infant mortality rate by the Unicef.
While we remain focussed on the current lockdown and talk about vulnerability for the elderly, we are not talking about children at all.
All evidence from previous catastrophes, such as Ebola and the polio outbreaks, suggest that children — especially from poor families caught at the apex of this plight — will bear an incredible and lasting brunt of the Covid-19 pandemic.
Contrary to popular belief that children are naturally resilient and can 'bounce back', they incorporate trauma into their growth and future lives. Regrettably, we do not consider this when making policies to deal with crises.
In these extraordinary circumstances, when feelings of uncertainty and anxiety are at an all-time high, we must not forget that crises also present an opportunity to conceive new options.
Now is the time to plan for the future that we envision and try to take steps to mitigate the impact of Covid-19 on millions of children who can otherwise become forgotten victims of this pandemic.
Although the government has taken an initiative to provide social assistance to the poorest in the country, more robust efforts such as rolling out child grants, need to be made to protect children from falling into poverty.
To stand in unity: develop and implement policies for children after consensus with pediatricians and child psychologists.
Prioritise the continuum and restoration of child health services, such as immunisation, and antenatal and postnatal care as the lockdown measures are eased.
Upgrade safeguarding policies for children to reflect the new and increased internet usage and equipping children with the appropriate knowledge and information for navigating their lives online.
Support parents and guardians on matters such as talking to their children about the pandemic, managing their own mental health and that of their children.
Train health, education and social service workers on the impact that Covid-19 may have on children's well-being, including increased online risks; raising awareness and starting educational initiatives on child online safety.
Secure food supply chains and replenishing local food markets so that children don't have to face a food security crisis.
Need to ensure that the current lockdown, travel restrictions and delayed production does not limit our capacity to procure essential supplies to support our health, education and WASH programmes and our philanthropic response.
Lastly, despite the sui generis nature of the current times, it is our vigilance and actions that will determine what the future of our children will look like.
Javairia Khalid is a Research Specialist in Maternal Newborn and Child Health at Aga Khan University.
The author is an Associate Professor, head of the immunisation subcommittee at the Aga Khan University and a WHO stage member.
The views expressed by this writer and commenters below do not necessarily reflect the views and policies of the Dawn Media Group.