Journal Articles

The COVID-19 pandemic has exposed the urgent need to tackle the crisis of mental health among children and young people. We call for a multi-stakeholder Global Mental Health Alliance for Children, which would achieve the following objectives: to strengthen evidence and understanding of mental health and well-being, causes and risks for children and young people; to scale up investment in mental health programming for children and young people, and particularly expanding the global cadre of health workers, social workers and community workers, with a focus on prevention and promotion of mental health; to support youth-led, evidence- and rights-based initiatives; to expand advocacy and knowledge of mental health for children and young people among the wider public, and reduce stigma, marginalization and discrimination against those experiencing mental ill-health; and to enhance funding from both the public and private sectors for promotion of mental health, prevention of ill-health and treatment of mental health disorders.

• The initial impression that paediatric infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children across countries and by income group, with recognition of a widening disease spectrum.
• Critical knowledge gaps remain that have significant public policy and programme implications.
• Insufficient age and race/ethnicity disaggregated data are hindering efforts to assess fully the prevalence of SARS-CoV-2 infection and COVID-19 in children and the role of children in transmission.
• Potential biologic differences in susceptibility to infection and transmissibility between children and adults need to be explored.
• Determination of mother-to-child SARS-CoV-2 transmission requires appropriate samples obtained with proper timing, lacking in most studies.
• Predictors of disease progression and morbidity and mortality in children need to be determined, particularly as the pandemic moves to low-income and middle-income countries.
• The full spectrum of SARS-CoV-2 infection in children remains to be defined, and surveillance for and investigation of the pathogenesis of postinfectious sequelae, such as multisystem inflammatory syndrome, are vital.

The COVID-19 pandemic could increase violence against children at home. However, collecting empirical data on violence is challenging due to ethical, safety, and data quality concerns. This study estimated the anticipated effect of COVID-19 on violent discipline at home using multivariable predictive regression models. Under a “high restrictions” scenario there would be a 35% to 46% increase in violent discipline scores in Nigeria, Mongolia and Suriname, and under a “lower restrictions” scenario there would be between a 4% to 6% increase in violent discipline scores in these countries. Policy makers need to plan for increases in violent discipline during successive waves of lockdowns.

In the early stages of the coronavirus disease 2019 (COVID-19) response, children were described as invisible carriers who posed a risk of infection to others. Here we outline how responses to COVID-19 may increase children’s exposure to violence and neglect. We also highlight ongoing efforts to address violence against children and argue for continued action and research on violence prevention within the COVID-19 response.