Close to Home: For kids, a long road back from COVID

The growth chart for my patient, a 12-year-old boy, showed a 40-pound weight gain in one year. Down the hall, a 16-year-old had been surprisingly frank, sharing her paralyzing anxiety and academic struggles. Earlier that week, a colleague described a 9-year-old sitting in the hallway of the emergency department — on suicide watch.

We must reckon with the tremendous impact that two years of adult-centered policies have had on our children, including rising rates of pediatric obesity, an explosion of mental health issues, learning loss and socio-emotional effects.

This is March 2022, two years since the pandemic was declared. COVID is not gone — it may never be — and we are just beginning to process the altered reality we have been living. Many parents and physicians, myself included, are feeling relief: schools remain open, soccer and basketball seasons are underway, birthday parties resumed, theater groups rehearsing. Many children are vaccinated. Despite the recent omicron surge, life for our children feels so much better than it did one year ago. And yet the family doctor in me knows that we have a long road to get our children back on track.

My patient’s 40-pound weight gain corresponds to eight times the normal weight gain for a child his age. Childhood obesity was already an epidemic before the pandemic, with 20% of American children qualifying as obese. According to multiple studies, it is now measurably worse.

It is not a leap to say the situation is a result of policies that disrupted in-person schooling, physical activities, social opportunities with friends and mentors, access to health care and social services. Unsurprisingly, every negative outcome impacts those children who were vulnerable to begin with: poor children, children of color and children with disabilities.

My patient’s anxiety is not an exceptional case. Prior to COVID, 1 in 5 children in the U.S. had a mental, social, emotional or behavioral disorder. Studies during the pandemic demonstrate increases in pediatric emergency mental health visits, mental health referrals from primary care providers, eating disorders and teen suicides. These issues are not easily or immediately resolved by restarting school and extracurricular activities. Many children, particularly in poor families, lack access to mental health services.

Learning loss is real. The average U.S. student in grades three through eight returned to school this fall 9-11 percentile points behind in math and 3-7 percentile points behind in reading. While students are starting to make up for learning loss, the gap for children of color is disturbing. Whereas historically children in majority Black schools have had a nine-month gap compared to majority white schools, that gap is now 12 months. English language learners are also disproportionately affected.

To be sure, COVID is a terrible tragedy; almost a million Americans have died, and public health measures, including masking, vaccination and behavior modification have been critical interventions at different times. Early school and programmatic closures were important as a novel virus was being assessed. But by summer 2020, we knew enough to make different choices for children. And we knew that by keeping millions of vulnerable children at home, off playgrounds, in front of screens, away from peers and safe adults, we were causing harm.

The most distressing part of the pandemic for me, as a parent of three children and a physician caring for COVID patients, is how repeatedly children have been disregarded in policy and decision-making. And when parents have spoken out about our children’s suffering, many have been deluded into believing that COVID was risky enough that it was worth the sacrifice.

COVID didn’t create these problems; it magnified everything. As we plan for the inevitable next pandemic, let us reflect critically upon how policy decisions and priorities set to protect adults have negatively impacted children.

And, as we prepare for life with COVID, let us consider multidisciplinary well-funded interventions to assess and repair the harm our children have experienced. This should not be left to individual families, health care workers, educators or counselors to solve — we need a village.

Veronica Jordan is family physician in Santa Rosa and the mother of three children.

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