At the beginning of this pandemic, there were many unknowns about the virus. No one knew how contagious the virus was, whether it affected children and adults equally, or how long the pandemic would last. My daughter was born during the first lockdown of the COVID-19 pandemic. The transition of bringing a new life into this world alongside the constant worry of how to best take care of a newborn during a pandemic was definitely overwhelming in those first few months. What we didn’t know at the time, but do now, is that SARS‑CoV‑2 will be with us for a long time. The worry of how the pandemic will impact babies and children in the long term, especially in terms of development and mental health, is very real and probably resonates with many other parents.

Due to a lack of social interactions, and with public health measures such as social distancing and masking in place, children are missing out on crucial ways to hone social skills and develop language. A retrospective study from China looking at the SARS pandemic of 2003 suggested that experiencing SARS in childhood was associated with delayed milestones, including walking, saying a sentence, and dressing independently.[1] That is worrisome, as this pandemic is even more extensive and on a much larger global scale.

The first few years are a crucial time in a child’s development. As we try to carry on with the pandemic being our new normal, I now find it challenging to weigh the risks and benefits of trying to establish social interactions while also staying safe. I want my daughter to experience as much of a normal childhood as possible, while doing it within our family’s comfort zone.

The COVID-19 pandemic is undoubtedly also contributing to significant mental health concerns. A study in China investigating symptoms of depression and anxiety among close to 2000 students in Hubei Province, the epicentre of the outbreak, showed 22.6% reported depressive symptoms while 18.9% reported anxiety symptoms in the last year.[2] In the US, there has been a significant increase in emergency department visits related to mental health for children younger than 18 years. Compared with 2019, there was an increase of 24% in children aged 5 to 11 and an increase of 31% in those aged 12 to 17.[3] This is concerning given the potential long-term impacts of this pandemic on youth for years to come. There will likely be many downstream effects, which I think all health care providers will come to deal with. Caring for a young, evolving mind can be a challenge on its own, but the pandemic adds an even more complex layer.

As the pandemic continues to evolve, such as with the introduction of the Delta variant and challenges with vaccinations, we are all learning to carry on with our lives. For some children; unfortunately, the pandemic is all they have known. My daughter thinks it is normal for people to wear masks and that we rarely have play dates indoors. Being a parent is hard enough, and the pandemic has not made it easier. If this is our new normal, then we need to find new ways to live our lives and teach our children the same. How we as adults perceive and deal with the pandemic can have an enormous impact on children’s psychology and well-being. Constantly comparing things to the past might be a reason for disappointment, and constantly thinking about the past might be a reason for anxiety. Although this pandemic has taken a toll on everyone’s lives, I hope that in the end it builds resilience in our future generations and we are able to one day look back and learn from it.
—Yvonne Sin, MD

References

1.    Fan Y, Wang H, Wu Q, et al. SARS pandemic exposure impaired early childhood development in China. Sci Rep 2021. doi: https://doi.org/10.1038/s41598-021-87875-8 [10].

2.    Xie X, Xue Q, Zhou Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr 2020;174:898-900.

3.    Leeb RT, Bitsko RH, Radhakrishnan L, et al. Mental health–related emergency department visits among children aged < 18 years during the COVID-19 pandemic—United States, January 1–October 17, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1675-1680.