Hidden pandemic trauma harming children

Matt Woodley

31/08/2020 5:03:55 PM

While children are unlikely to suffer physical harm as a direct result of COVID-19, its impact could still have health ramifications for years to come.

Boy in his room sad with  COVID mask on.
Children are probably among the most vulnerable groups during disasters, including pandemics.

GPs have been advised to remain aware of ‘the silent patient in the room’ when treating patients with young families.
Speaking at last week’s Federal Department of Health COVID-19 response update for general practitioners, Chair of the RACGP Specific Interests Disaster Medicine network, Dr Penny Burns, said children are ‘probably one of the most vulnerable groups’ in disaster events and as a result require special care.
‘Children’s brains are still developing and we know that the effects of trauma on this younger group can actually be quite significant,’ she said.
‘There can be neurological developmental changes that then affect their increased risk for mental health and physical health in adulthood … [while Australian research has] shown the deterioration in ability to learn and an effect on academic performance.
‘Probably 100% of Australian children have been affected by this big bug that’s arrived and that has absolutely changed the way we live … [so] it’s really important basically to remember the children when we’re going through all of this, because we have an opportunity to really change the outcomes.’
Aside from mental health concerns, Dr Burns’ warning preceded new research conducted by the Royal Children’s Hospital (RCH) in Melbourne, which found children are having their healthcare impacted due to parental concerns related to contracting the virus.
One in three unwell or injured children captured by the survey has had their treatment delayed due to COVID-19, while one in five children under the age of five has had a routine vaccination delayed during the pandemic.
The RCH Immunisation Service has also seen a decrease in presentations with almost two-thirds of families delaying or cancelling their appointment during the pandemic, prompting the hospital to launch a new drive-through immunisation clinic.
‘The main reason parents gave for delaying care was fear or concern about their child or themselves catching COVID-19 in a healthcare facility or service,’ Poll director and paediatrician, Dr Anthea Rhodes said.
‘Some families are of the misunderstanding that because their children are not exposed to other kids, perhaps they are not at risk of catching preventable diseases, so perhaps they are putting off having the children vaccinated.’
According to Dr Burns, one of the best ways to help children during the pandemic is to help the parents.
‘Whenever we see a parent come in who’s distressed, not coping, struggling with what’s going on, we need to remember that that parent has a strong effect on that child, any child they have,’ she said.
‘That child may not be presenting, but we can think of them as a silent patient in the room.
‘It’s very important that we realise that in helping the parents and helping them cope and develop agency – work out what to do, support their health, help them to get better, help them to adapt to the changes – we’re actually also helping the children.’
It’s also important, Dr Burns said, to ‘look at the world from a child’s eyes’.
‘Children are not little adults. They’re different,’ she said. ‘They’re very reliant on adults for their care, but they’re very much affected by their age and stage of development, by any pre-existing conditions or health, and by their cultural and family context, and also their experience of the event they’re going through.
‘What I’ve been trying to do is just stop with every child that comes in and … just take a moment to see how they’re coping and what they’re doing.
‘It’s really important basically to remember the children when we’re going through all of this, because we have an opportunity to really change the outcomes.’
Dr Burns suggested a number of resources to help GPs connect with younger patients and help them cope with the pandemic, including a book called My Hero is You: How kids can fight COVID-19, which she described as a ‘beautiful story of agency for children’ and has been translated into a number of different languages.
‘There’s another YouTube video which I really like called “The Great Revelation”, and it’s a father in the future talking about what happened back in the great revelation when COVID the virus came, and how it changed our lives for the better,’ she said.
‘There’s a lot of positive ways of looking at this, and you can give these to children and you can give them ideas on how they can contribute to this fight.’
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Dr Peter James Strickland   1/09/2020 11:36:48 AM

This article emphasises the psychological impact on children's wellbeing, and which goes into physical consequences. The fear produced by State governments closing borders, preventing the playing of sport, stopping socialisation in non-Covid areas etc has, and will have consequences. The medical advisers to these Premiers have now largely reached the stage of incompetence and inability to recognise the consequences of their advice along with the AMA. To hear of people dying due to suicide, non-admittance to their closest hospital for emergency treatment, not being allowed to feed farm animals in absolutely "clean" areas is an indictment on these authorities. Commonsense and democracy has been lost due to these so-called experts. 98+% recovery from Covid. Protect the elderly, and use distancing and sanitiser is all that is needed, and leave the young to live pragmatically with sensible advice. Eradication of virus will NOT occur, and a vaccine will NOT be 100%.

Dr Robert James Douglas   1/09/2020 11:56:12 AM

SO, what is worse - the possible mental health ramifications of lockdown, and prevention of a gross epidemic; or the mental health impacts of having your grandparents (or older parents) in hospital and dying/potentially dying?

Dr David Robert Talon Jones   1/09/2020 10:18:32 PM

I would assert those children put into iron lungs for weeks on end and/or developed permanent crippling neuro-muscular disability from Polio, or those blinded or deafened or sustained chronic pulmonary damage from measles etc. or who were family/friends of the same, or those who watched mothers, fathers, grandparents, siblings die from flu might have been significantly more traumatised by those events 100 years ago than the vast majority of the current cohort of children who, in most cases, just got more time to stay home and play online games.

I do not want to trivialise the significant impacts of COVID19 on some children who might have had important medical issues ignored by parents worried by accessing healthcare, but I worry we are simply mollycoddling. Because we have that luxury.