Children and COVID-19 Research Library

When a mother's own milk is not available, WHO recommends pasteurised donor human milk as the first alternative.  Human milk banks screen and recruit donors, and have wide-ranging precautions to ensure the safety of donor milk. Screened donor milk principally feeds babies of very low birthweight, protecting them from a range of complications, as well as babies with congenital anomalies or neurological conditions. The benefits of a human milk diet highlight the importance of providing these infants with donor milk for short periods—with appropriate use in the context of optimal support for lactation, such provision can support mothers to establish their milk supply without the need for supplementation with infant formula milk. The coronavirus disease 2019 (COVID-19) pandemic is presenting many challenges to human milk banks worldwide and highlights a range of vulnerabilities in service provision and emergency preparedness. 

The COVID-19 pandemic has resulted in governments implementing disease containment measures such as school closures, social distancing and home quarantine. Children and adolescents are experiencing a prolonged state of physical isolation from their peers, teachers, extended family and community networks. Quarantine in adults generally has negative psychological effects including confusion, anger, and post-traumatic distress. Duration of quarantine, infection fears, boredom, frustration, lack of necessary supplies, lack of information, financial loss, and stigma appear to increase the risk of negative psychological outcomes. Social distancing and school closures may, therefore, increase mental health problems in children and adolescents, already at higher risk of developing mental health problems compared to adults  at a time when they are also experiencing anxiety over a health threat and threats to family employment/income.

As the coronavirus pandemic extends to low and middle income countries (LMICs), there are growing concerns about the risk of coronavirus disease (COVID-19) in populations with high prevalence of comorbidities, the impact on health and economies more broadly and the capacity of existing health systems to manage the additional burden of COVID-19. The direct effects of COVID are less of a concern in children, who seem to be largely asymptomatic or to develop mild illness as occurs in high income countries; however children in LMICs constitute a high proportion of the population and may have a high prevalence of risk factors for severe lower respiratory infection such as HIV or malnutrition. Further diversion of resources from child health to address the pandemic among adults may further impact on care for children. Poor living conditions in LMICs including lack of sanitation, running water and overcrowding may facilitate transmission of SARS-CoV-2. The indirect effects of the pandemic on child health are of considerable concern, including increasing poverty levels, disrupted schooling, lack of access to school feeding schemes, reduced access to health facilities and interruptions in vaccination and other child health programs. Further challenges in LMICs include the inability to implement effective public health measures such as social distancing, hand hygiene, timely identification of infected people with self-isolation and universal use of masks. Lack of adequate personal protective equipment, especially N95 masks is a key concern for health care worker protection. While continued schooling is crucial for children in LMICs, provision of safe environments is especially challenging in overcrowded resource constrained schools. The current crisis is a harsh reminder of the global inequity in health in LMICs. The pandemic highlights key challenges to the provision of health in LMICs, but also provides opportunities to strengthen child health broadly in such settings.

Since December 2019, health systems around the globe have struggled with an increasing number of cases of a viral respiratory syndrome that emerged in China. The cause is a new strain in the coronavirus family, provisionally named 2019 novel coronavirus (2019-nCoV)1, SARS-CoV-2 or COVID-19. The European Paediatric Association–Union of National European Paediatric Societies and Associations (EPA-UNEPSA) has established a collaborative working group with key Chinese academic institutions and medical centers with the purpose of facilitating the reciprocal exchange of information and sharing scientific knowledge. The aim of this commentary by the China-EPA-UNEPSA working group is to raise awareness regarding children's psychological needs during epidemics and report early data collected in the COVID-19–affected areas in China during the current outbreak, emphasizing the role of families and caregivers in the timely recognition and management of negative emotions.

To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.

 

This rapid review collates and synthesizes evidence on the child protection impacts of COVID-19 and previous pandemics, epidemics and infectious disease outbreaks. It provides lessons for global and national responses to COVID19 and recommendations for future research priorities.

The evidence on the impacts of pandemics and epidemics on child protection outcomes is limited and skewed towards studies on the effects of HIV/AIDS on stigma. There is also some evidence on the effects of Ebola on outcomes such as orphanhood, sexual violence and exploitation, and  school enrolment, attendance and dropout. The evidence on other pandemics or epidemics, including COVID-19, is extremely limited.

There are various pathways through which infectious disease outbreaks can exacerbate vulnerabilities, generate new risks and result in negative outcomes for children. Outcomes are typically multi-layered, with immediate outcomes for children, families and communities - such as being orphaned, stigmatization and discrimination and reductions in household income - leading to further negative risks and outcomes for children in the intermediate term. These risks include child labour and domestic work, harmful practices (including early marriage), and early and adolescent pregnancy.

Lessons from previous pandemics and epidemics suggest that the following could mitigate the child protection risks:

• Responding to children in vulnerable circumstances, including orphans (e.g. throughpsychosocial interventions focused on improving mental health and community-based interventions that provide families with resources and access to services)
• Responding to stigmatization and discrimination (e.g. throughinformation and communication campaigns and support from public health systems, communities and schools)
• Investing in social protectionenable livelihoods during outbreaks and to counteract shocks
• Promoting access to health, protective and justice services, which may be restricted or suspending during infectious disease outbreaks
• Ensuring continued access to education, particularly for girls, who may be adversely affected

There is a high burden of proof for data collection during the current COVID-19 outbreak than there would be in normal circumstances. Evidence generation strategies during and after the COVID-19 crisis should consider rigorous retrospective reviews and building upon monitoring, evidence and learning functions of pre-existing programmes – particularly where there is ongoing longitudinal data collection. There should also be efforts to synthesize evidence from existing research on the effectiveness of interventions that respond to the key risk pathways identified in this review.

 

 

• The research brief can be found here.
• Access the Evidence Gap Map on child protection and violence outcomes here.
• Access the study protocol here.

 

Community-based health care is an essential part of primary care at all times; in the context of the COVID-19 pandemic, the distinct capacity of trusted community members for social engagement and delivering care where it is needed is ever more critical. This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.

In December 2019, a pneumonia caused by a previously unknown coronavirus emerged in Wuhan, Hubei Province, China. During the subsequent weeks and months, the disease, later named COVID-19, spread rapidly nationwide and globally, and was declared a global pandemic by the World Health Organization. Existing studies have confirmed that all people are susceptible to this novel coronavirus (SARS-CoV-2). Cases of COVID-19 among pregnant and lactating women have also been confirmed. Chinese guidelines recommend suspending breastfeeding if the mother is suspected or confirmed with COVID-19. The Centers for Disease Control and Prevention of the USA have published recommendations for mothers with COVID-19 and their family members and healthcare providers on whether and how to start or continue breastfeeding. However, none of the above recommendations provide relevant supporting evidence. As existing recommendations on whether mothers with COVID-19 should continue breastfeeding are still conflicting. We aimed to conduct a rapid review of the mother-to-child transmission of COVID-19 during breastfeeding.

In December 2019, an unexplained pneumonia emerged in Wuhan, China, and has since then spread rapidly throughout the country and the world. On February 11, the International Committee on Taxonomy of Viruses (ICTV) named the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On the same day, the World Health Organization (WHO) named the disease caused by the virus as COVID-19. According to the latest data, by March 31, 2020, a total of 1,174,866 cases had been confirmed worldwide, with 36,405 deaths. The number of confirmed cases in children continues to increase, with the youngest infected person being diagnosed only several minutes after birth. The outbreak of COVID-19 is the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century, after the severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) epidemics. The aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients

A novel coronavirus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected on December 8, 2019, when several cases of pneumonia of unknown etiology were reported in China (1-3). As of April 12, a total of 1,696,588 confirmed cases had been reported in more than 200 countries, and the number of cases was still rapidly increasing, creating global alarm and concerns about the impact on health care and economy of the affected areas. As the COVID-19 outbreak presents a new, life-threatening disease. Our aim was to assess the potential effectiveness and safety of antiviral agents for COVID-19 in children.

There is no doubt that coronavirus disease 2019 (COVID-19) has huge economic implications as highlighted by the media, but there are also a myriad of considerable direct and indirect health, social, and educational consequences for children and families experiencing homelessness, while living in temporary or insecure accommodation (eg, staying with friends or family, sofa surfing, shelters, bed and breakfast lodging). In particular, young children (aged ≤5 years) living in temporary accommodation have an invisible plight that might not seem obvious to many people because they are not on the streets as homeless (eg, rough sleepers), but are perhaps the most susceptible to viral infection because of pre-existing conditions (eg, diabetes, asthma, epilepsy, anxiety, depression).1 Additionally, these children rarely have the ability to self-isolate and adhere to social distancing, with previous extreme inequalities and inequities in accessing health care becoming exacerbated.

The Asia Pacific region has seen significant progress in gender equality in recent years in a number of areas, such as education and political participation. From 2000-2016, the number of out-of-school girls in primary and secondary school dropped by 67 million. 1 The number of females in tertiary school rose by 41 million. From 1990 to 2018 the proportion of women in national parliaments has risen from 8 percent to18 percent. Unfortunately, in other areas, Asia and the Pacific have seen a decline in equality. According to UNESCAP, women’s economic empowerment has remained nearly stagnant and those who are young and in the informal labour market are expected to be hit the hardest. The East Asia Pacific Region is one of the only regions in the world where rates of teenage pregnancy are increasing in low-and-middle-income countries.Any emergency risks increasing existing discriminations and incidents of violence. It also risks losing progress so recently made for girls and young women. The COVID-19 Pandemic is an emergency on a scale not seen for nearly 100 years. 

The COVID-19 pandemic is putting millions of children at heightened risk, and jeopardising their immediate and long-term health and well-being. As countries around the world battle to prevent, contain and respond to COVID-19, it is critical that their efforts reach those most vulnerable and ensure primary health care  is continued and accessible to all. All stakeholders must take proactive measures to mitigate the impacts of COVID-19 on children’s health and nutrition, and response efforts should consider vulnerable children’s needs and rights. Based on extensive experience working with children, families and communities in emergencies, including epidemics, World Vision outlines a number of recommendations for Governments, UN Agencies, Donors, NGOS, Private Sector, and Faith Leaders. 

The COVID-19 pandemic is wreaking unprecedented havoc on the lives of millions, creating devastating impacts on children, families and communities around the world. This brief focuses on the pandemic’s impact on children’s education, which cannot be overstated. COVID-19 related school and university closures have disrupted the education of more than 1.5 billion learners—over 90% of the world’s student population.

Around the world reports are emerging of numerous residential institutions for children being closed as a result of the novel coronavirus disease 2019 (COVID-19) pandemic. Children appear to be being sent back to their communities without proper consideration of where they will reside, how their transition will be supported, and whether their safety will be monitored. Our view as international experts on institutional care reform is that although overall a shift from institutional to family-based care is a priority, these transitions need to be carefully planned and managed, with effective and sustained family preparation, strengthening, monitoring, and other support provided to ensure the best interests of the child are maintained.