Covid-19 will hit children hard. Here’s why

Children might not be among those – such as the elderly – who are flagged as high risk in the Covid-19 coronavirus pandemic, but they will still bear a considerable burden of trauma and economic fallout during and in the aftermath of the pandemic.

In responding to the virus and giving emphasis to protective measures, medical health experts and health authorities have primarily focused on high-risk groups, including the elderly, people who are living with HIV and/or tuberculosis, and those with underlying medical conditions, such as diabetes and asthma.

Global statistics have shown most Covid-19-positive children eventually recover. But, writes the University of Vermont’s Alice Fothergill: “Disasters last a long time in the lives of children.”

Fothergill co-authored the book, Children of Katrina.

‘Bouncing back’ from trauma

Rather than “bouncing back”, as many adults seem to expect, children incorporate trauma into their growth and future lives. Unfortunately, adults do not usually consider this in their policymaking, especially when it comes to dealing with a crisis.

“People are talking about vulnerability, but they are not talking about children at all,” writes Fothergill. The effects of the pandemic will be talked about for generations to come. They will be traumatic, but the trauma will hit the youngest among us the hardest.

Disasters last a long time in the lives of children.
University of Vermont’s Alice Fothergill

Children can experience anxiety and panic as acutely as adults do; only they might be better at hiding it.

That fact might contribute to a general sense among adults that children are somehow naturally “resilient” and can bounce back easily. That very attitude from adults can hamper the proactive attempts to help children process what is happening and stifle therapeutic efforts that will be necessary in the aftermath of the pandemic.

Bottled emotions don’t go away: They either blow up in emotional fears, or blow up into anger or acting-out behaviour. In older children these fears can lead to anxiety, depression or self-destructive behaviour, such as drug abuse, alcohol abuse or even suicide. The effects of Covid-19 will ease with time but, if untreated, direct or indirect psychological damage might persist for years.

On some level, the effects of the pandemic on individual children will depend on family and community circumstances and also government safeguards for children’s mental and physical wellbeing.

There are going to be many children who are going to be fine after this tumultuous period and there are going to be some children who might have a more acute response. They might have symptoms initially, maybe trouble sleeping or increased worry or increased behavioural outbursts and there will be children who will have more long-term effects. Parents, caregivers, community structures and the government all have a role to play.

Calm and collected parents or caregivers can help children to remain calm and collected. Practically, schedules and routine can offer some semblance of stability. This can include regular bedtimes and mealtimes. This might be a significant ask especially for parents already struggling to work from home and keeping themselves safe. But, it is important to note that children’s resilience is at least in part a product of adult behaviour.

Interrupting extended sources of care

To curb the spread and effects of the virus, many countries closed their borders. South Africa embarked on a nationwide lockdown and instituted travel restrictions to “flatten the curve” and prevent devastation on a similar scale as in Italy and Spain.

For children who spend their time in multiple households, and who also rely on people outside their household for guidance or mentoring, or those who are used to a stream of relatives coming in and out of their homes, such prolonged social-distancing measures will mean profound separation from some of these external and extended sources of care.

Due to the new type of Covid-19, children are the
Due to the new type of Covid-19, children are the most affected ones by restrictions and curfews that are applied in a large part of the world. Picture: Abdulhamid Hosbas/Anadolu Agency via Getty Images

All the FaceTime, Skype, WhatsApp video calls in the world cannot make up for “fill-in help” from aunts, uncles, grandmothers and grandfathers. For some children, these extended sources of support are often a crucial buffer in toxic or even more (physically) dangerous home environments.

What is more, parents now have to both home-school their children and keep up with their jobs. The effects of the school closures, however, go beyond just the loss in “learning time”. Schools are often the primary source of structure and socialisation for children who have rich social lives, often experienced almost exclusively in school and through extracurricular activities. In many cases schools are the primary providers of essential resources.

A new dimension of hardship

In a society where inequality is vast and millions of people live in poverty, the government’s role in providing safeguards cannot be overstated. Key safeguards, such as school-feeding programmes, are often critical in ensuring children get the nutrition they need. The government’s constitutional obligations towards children should not be suspended because of restrictions, such as school closures imposed during the lockdown.

Still, the government took a decision to stop running school-feeding schemes during the lockdown. When the Western Cape government, contrary to this decision, decided to still feed schoolchildren in the province, the parliamentary portfolio committee on basic education’s chairperson lashed out and urged Basic Education Minister Angie Motshekga to intervene.

Disruption of the School Nutrition Programme is devastating to many children depending on this meal. This is not a time for political mud fights. Children need to eat. A coordinated and safe roll-out of food packages directly to distribution points in food-stressed neighbourhoods must be implemented with the greatest of urgency – not just by provincial education departments, but through a concerted inter-departmental effort spearheaded by the department of social development and its social relief of distress efforts.

In many cases schools are also the only places where some children receive care, such as immunisations, mental-health care through social workers, and rigorous physical activity needed for healthy development. In some rural communities accessing water means travelling long distances with buckets to collect this precious resource from dams or boreholes. But, when schools are open, access to clean water and taps are often easier and so too are a measure of psycho-social and medical support.

In its efforts to “think outside of the box” in its response to Covid-19, the government should consider that children are the most vulnerable of all to the unintended or unanticipated consequences of its mitigation efforts.

Augmenting the child support grant

Many have made a case for augmenting the child support grant. Research has shown that social grants are an effective mechanism for protecting children and families against the effects of poverty.

According to figures from the Children’s Institute at the University of Cape Town, nearly two-thirds of children in South Africa – that is more than 12 million children – depend on the child support grant.

This grant supplements the income of more than 5 million households and effectively supports entire households in their efforts to mitigate the impact of poverty.

In a briefing document, the Children’s Institute made a case for an increase in the child support grant that could help offset the economic backlash of the pandemic on poor households.

Thulas Nxesi, the minister of employment and labour, earlier announced support measures to help workers during this time but this was limited to those who were employed. Many people are unemployed. Many of them have dependants who are children and, increasing, the monthly child grant could be heaven-sent to these households.

The law provides for the minister of social development to increase this amount without a drawn-out legislative process.

In terms of the Social Assistance Act, Lindiwe Zulu, the minister, can determine grant amounts in concurrence with the minister of finance and these new amounts “would merely require a notice in the Government Gazette to enable implementation and could, technically, be enacted at the touch of a button”, the Institute said.

The pandemic came at a time when the country already was in a technical recession. Now, with the pandemic, food security, physical health and general wellbeing for children will be severely undermined as many parents, guardians and caregivers face economic instability.

The economic insecurity and poverty-related stresses and anxiety caused by the pandemic contribute to increases in violence against women and children. In addition to reducing hunger, economic strengthening – such as an increase in social grants – will be protective of women and children.

A coordinated and safe roll-out of food packages directly to distribution points in food-stressed neighbourhoods must be implemented with the greatest of urgency.

On April 6, The Teddy Bear Clinic in Johannesburg recorded more than 25 cases of child abuse in the Covid-19 lockdown period. The clinic provides services for abused children, including forensic medical examinations, forensic assessments, counselling and psychological testing.

The clinic said some of these children had witnessed their mothers being assaulted; others had been raped and sexually assaulted. The clinic’s director of clinical services, Shaheda Omar, said this needed to be addressed urgently.

It is government’s obligation, specifically the department of social development as well as the department of justice and correctional services, to ensure justice for women and children in this state of disaster and national lockdown.

Programmes and campaigns against gender-based violence must continue. There should be public awareness campaigns on how victims of abuse can access services, reporting processes to the law officials and places of shelter. These services should be made available to all victims of domestic violence, including those living under quarantine and self-isolation.

. Mphahlele is a legal assistant at Section 27

. This article was first published in Spotlight – health journalism in the public interest. Like what you reading? Sign up for our newsletter and stay informed

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On Sunday, President Cyril Ramaphosa announced that the country would immediately re-enforce a ban on the sale and distribution of alcohol, to reduce the volume of trauma patients, so hospitals have more beds for Covid-19 coronavirus patients
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