Google “COVID kids book” right now and you will see a surprisingly large selection of new children’s books to choose from, all aiming to explain to our little ones what is happening in the world around them. And it makes sense to try to fill this market: as a mother, I have found myself often wondering about my toddler’s social development now that her world has shrunken to a handful of adults. I find solace in the fact that her current developmental stage primarily involves “parallel play,” but I know that she will very quickly grow out of this stage and crave interaction with other kids. I worry, Is my kid going to be socially awkward? Is she going to be spoiled? Will she be able to make friends? Even though she is at an age where she perhaps does not realize much of what is happening around her, I still wonder: does she miss her grandparents? How about her friends? Is she lonely?
I know that I am not alone in my troubled thoughts. Some reassuring data for parents: we may be lucky in the sense that so far, SARS-CoV-2 (the virus causing the disease termed COVID-19) generally does not seem to have the same disastrous outcomes in children as it does in adults. An early report in April from the Center for Disease Control (CDC) analyzing data from the 149,082 U.S. cases of COVID-19 showed that only 2,572 (1.7%) were cases in patients who were less than 18 years old, even though this group accounts for 22% of the U.S. population. Furthermore, infants less than one year of age accounted for only 15% of these pediatric cases. In adults, the primary cause of severe disease and/or death from COVID-19 is widespread dysregulation of the immune response leading to multi-organ failure, whereas this is not as common in pediatric cases of COVID-19. And even though there have been several reports of multisystem inflammatory syndrome (MIS) thought to be associated with SARS-CoV-2 infection in children, it is still, thankfully, rare. Most children who contract SARS-CoV-2 remain asymptomatic or have mild disease that is managed at home without the need to see a doctor. (All that being said, I want to make this explicit: the best and safest way to care for your child is to avoid contracting the virus altogether with social distancing, hand hygiene, and mask-wearing.)
But setting the physiological consequences of COVID-19 aside, we still have much to worry about when it comes to the psychosocial impact that this pandemic will have on our society and, particularly, our younger generations. To me, this is the long game: An economic recession that will disrupt and destabilize millions of homes, disproportionately affecting families who were already marginalized and at risk (recall that Black, non-white Hispanic, and other non-white races who become ill with COVID-19 have persistently poorer clinical outcomes than white persons, and there may be emerging data that pediatric patients do not escape this disparity, either.) School closures and distance-learning protocols that will not only highlight the stark wealth gap in our country but will further widen the education gap that will only diverge even further as our kids get older. Education for kids who do not have reliable access to internet, much less all the technological gear required to dial-in to a Zoom classroom, will suffer. They will fall behind compared to their more affluent or privileged classmates, which have much consequences on future opportunities available to them long after this pandemic is over. We know how this story goes — deprive someone the chance to reach their full potential at an early age and the obstacles just get more plentiful and harder to overcome as they age.
Other aspects of child development I rarely thought before the COVID-19 era? Children who have unsafe living situations or suffer from domestic abuse are suddenly finding themselves spending most of their day in the very environments from which school had previously offered them relief. Those with special needs or other learning disabilities are substantially more negatively affected by distance-learning and lack of access to counseling, physical/occupational/speech therapists, or psychiatric care. Anxious, quarreling grown-ups will likely have a negative impact on a child’s emotional and mental well-being.
I offer no real answers — as a mom, I’m learning as I go, just as you are. But I do believe in treating our children with autonomy, respect, and information. As an infectious disease physician, much of my day involves answering questions and correcting misconceptions about COVID-19. And it got me thinking, what kind of information are our kids getting? How would I explain this to my daughter, how do I teach her the importance of social distancing, of masks, or about the more nuanced but important facts of life including racial inequalities and health disparities that have only become much more apparent during this pandemic?
During such uncertain times, clear and honest communication with your kids now more important than ever. Educate yourself so you can keep your family safe and educate your kids to keep themselves safe. It’s not easy, but you aren’t alone and there are many great resources out there. The CDC offers guidance on how to talk to kids about COVID-19. Talk to your doctor and your pediatrician. Check out the American Academy of Pediatrician’s FAQs on COVID-19. Encourage your kids to keep a regular sleep schedule and maintain physical activity. Need more professional help? Luckily, so many therapists are readily available via telehealth now, and schools are also becoming increasingly aware of the need for mental health support for their students.
As I said, I’m also learning. How are you coping with your kids during COVID-19?
