Children and COVID-19 Research Library

Singapore was one of the first Asian countries to be affected by the Covid-19 outbreak. The article shares the experience of a consultation liaison psychiatry service within the largest women and children’s hospital in Singapore. The adoption of telepsychiatry has enabled continuous provision of care whilst reducing unnecessary exposure to COVID-19. This clinical case demonstrates the clinical utility of the telemedicine service for youth mental healthcare during the pandemic. 

COVID-19 has significantly changed the way we work, play, and lead our everyday lives. It has caused serious public health, economic and social challenges, impacting individuals’ health and well-being. Our Occupational Therapy (OT) services at Child Development Unit (CDU), which is a hospital-based outpatient paediatric clinic, had to adapt to pandemic-related national policies to provide ongoing support and care for our patients and families. Healthcare services were required to leverage on teleconsultations and suspend physical consultations during the national ‘Circuit Breaker’ period. This disruption made us review our clinic workflows and service delivery options to comply with pandemic-related national measures. Our service continuity was maintained through teleconsultations, online parent workshops and developing online resources for community outreach. Though challenging, online platforms have continued to create new opportunities in providing care to our families, and supporting

The COVID-19 pandemic has shown a markedly low proportion of cases among children. Age disparities in observed cases could be explained by children having lower susceptibility to infection, lower propensity to show clinical symptoms or both. We evaluate these possibilities by fitting an age-structured mathematical model to epidemic data from China, Italy, Japan, Singapore, Canada and South Korea. We estimate that susceptibility to infection in individuals under 20 years of age is approximately half that of adults aged over 20 years, and that clinical symptoms manifest in 21% (95% credible interval: 12–31%) of infections in 10- to 19-year-olds, rising to 69% (57–82%) of infections in people aged over 70 years. Accordingly, we find that interventions aimed at children might have a relatively small impact on reducing SARS-CoV-2 transmission, particularly if the transmissibility of subclinical infections is low. Our age-specific clinical fraction and susceptibility estimates have implications for the expected global burden of COVID-19, as a result of demographic differences across settings. In countries with younger population structures—such as many low-income countries—the expected per capita incidence of clinical cases would be lower than in countries with older population structures, although it is likely that comorbidities in low-income countries will also influence disease severity. Without effective control measures, regions with relatively older populations could see disproportionally more cases of COVID-19, particularly in the later stages of an unmitigated epidemic.