Profiles

The initial impression that paediatric SARS-CoV-2 infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children and adolescents across low-, middle-, and high-income countries, with recognition of a widening disease spectrum. Critical knowledge gaps, especially in low- and middle-income countries, remain that have significant public policy and programme implications. Insufficient data disaggregated by age, geography and race/ethnicity continue to hinder efforts to fully assess prevalence of infection and disease manifestations in children and adolescents and their role in transmission. Potential biologic differences in susceptibility to infection and transmissibility between children, adolescents and adults need to be assessed. Determination of mother-to-child SARS-CoV-2 transmission during pregnancy, the peripartum period, or through breastfeeding requires appropriate samples obtained with proper timing, lacking in most studies. Finally, predictors of disease progression, morbidity and mortality in children need to be determined and whether these predictors vary by geographic location and in settings where poor nutritional and health conditions and other vulnerabilities are more frequent. Countries, UN agencies, public health communities, donors and academia need to coordinate the efforts and work collectively to close the data and knowledge gaps in all countries (high-, middle- and low-income) for better evidence to guide policy and programme decision-making for children and COVID-19 disease.

(19 November 2020) From health to education, every child in the world has been affected by the COVID-19 pandemic, with many impacted in multiple ways. As the crisis rages on, further entrenching pre-existing inequalities, there is an urgent need for scalable and cost-effective solutions for children. Such solutions require more evidence on COVID-19, which is not yet available. A new report by the UNICEF Office of Research—Innocenti, Beyond Masks: Societal impacts of COVID-19 and accelerated solutions for children and adolescents, examines past health crises (such as HIV/AIDS, SARS, and Ebola) to provide insights into COVID-19, and proposes proven and promising solutions.

It is commonly accepted, at least for now, that children and adolescents (0-19 years) have been largely spared the direct epidemiological effects of the COVID-19 crisis on their own health and survival. This narrative is based predominantly on early data from the first affected countries of the virus, notably from China (Wuhan Province) and Italy in early 2020, and also other high-income countries including the United States and some European nations.

It is commonly accepted, at least for now, that children and adolescents (0-19 years) have been largely spared the direct epidemiological effects of the COVID-19 crisis on their own health and survival. This narrative is based predominantly on early data from the first affected countries of the virus, notably from China (Wuhan Province) and Italy in early 2020, and also other high-income countries including the United States and some European nations.

While some countries are now moving to reopen schools, nearly 1.3 billion children are still out of school and dependent on remote learning, due to nationwide shutdowns. As national educational systems strive to meet this challenge, Multiple Indicator Cluster Survey (MICS) data offer some important insights into how we can ensure every child has an equal opportunity to learn remotely.

A total of 835,401 children and adolescents were out of school in Nepal in 2017, equivalent to 11.3 per cent of the primary and secondary school aged population (UNESCO – UIS, 2020). This rate varies across the country and population, as barriers related to poverty, social exclusion linked to caste and ethnicity, disability, social norms and gender biases, migration, child labor, mother tongue, and geographical location disproportionately keep children out of school (Nepal Ministry of Education School Sector Development Plan, 2016).

In some way, mental ill health has touched everyone. The statistics are alarming, and by some accounts constitute a public health emergency. Today, around 10-20 per cent of all children and adolescents suffer from some type of mental health disorder and mental health conditions account for around 16 per cent of