The impact of the COVID-19 pandemic on child health

Abstract Most Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in children are mild or asymptomatic. Severe Coronavirus Disease 2019 (COVID-19) in children is infrequent. An estimated 0.3–1.3% of children with SARS-CoV-2 infection were admitted to hospital, and of these 13–23% needed critical care. SARS-CoV-2 related deaths were very rare in children, estimated at 2 per million. The vast majority of admitted children had one of shortness of breath, fever, and cough, but atypical symptoms are more common in children. Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) have been linked to SARS-CoV-2 infection. Cardinal symptoms include prolonged fever, clinical signs of inflammation, gastro-intestinal symptoms, and cardiac dysfunction. Twenty two to 80% of patients with MIS-C needed critical care; mortality of MIS-C is around 2%. Six to 24% of children with MIS-C had coronary artery dilatation or cardiac aneurysms. Equipoise still exists between first-line treatment with immunoglobulins and steroids. Outcomes for children with MIS-C are generally very good in those recognised early and started on appropriate treatment. Vaccination schemes for children are rapidly expanding, with the benefits of preventing severe COVID-19 disease and MIS-C and reducing community transmission outweighing the risks of adverse events of, amongst others, myocarditis temporally related to COVID-19 vaccination in children and young adults. The imposed social distancing measures reduced the overall number of children with acute illness or injury presenting to urgent and emergency care facilities worldwide. No clear signal was seen that large numbers of children had a delayed presentation to emergency care departments with a serious illness. The social distancing measures negatively impacted the mental health of children.

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What is the Impact of Public Care on Children's Welfare? A Review of Research Findings from England and Wales and their Policy Implications

Journal of Social Policy ◽

10.1017/s0047279409003110 ◽

2009 ◽

Vol 38 (3) ◽

pp. 439-456 ◽

Cited By ~ 34

Author(s):

DONALD FORRESTER ◽

KEITH GOODMAN ◽

CHRISTINE COCKER ◽

CHARLOTTE BINNIE ◽

GRAHAM JENSCH

Keyword(s):

Child Welfare ◽

Policy Implications ◽

Public Care ◽

England And Wales ◽

Number Of Children ◽

Outcomes For Children ◽

Children In Care ◽

The Impact ◽

Over Time ◽

Specific Impact

AbstractThe outcomes for children in public care are generally considered to be poor. This has contributed to a focus on reducing the number of children in care: a goal that is made explicit in the provisions of the current Children and Young Persons Bill. Yet while children in care do less well than most children on a range of measures, such comparisons do not disentangle the extent to which these difficulties pre-dated care and the specific impact of care on child welfare. This article explores the specific impact of care through a review of British research since 1991 that provides data on changes in child welfare over time for children in care. Only 12 studies were identified, indicating a lack of research in this important area. The studies consistently found that children entering care tended to have serious problems but that in general their welfare improved over time. This finding is consistent with the international literature. It has important policy implications. Most significantly it suggests that attempts to reduce the use of public care are misguided, and may place more children at risk of serious harm. Instead, it is argued that England and Wales should move toward a Scandinavian system of public care, in which care is seen as a form of family support and is provided for more rather than fewer children and families.

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Predictions of COVID-19 dynamics in the UK: Short-term forecasting and analysis of potential exit strategies

PLoS Computational Biology ◽

10.1371/journal.pcbi.1008619 ◽

2021 ◽

Vol 17 (1) ◽

pp. e1008619

Author(s):

Matt J. Keeling ◽

Edward M. Hill ◽

Erin E. Gorsich ◽

Bridget Penman ◽

Glen Guyver-Fletcher ◽

...

Keyword(s):

Critical Care ◽

Health Service ◽

Age Groups ◽

Transmission Model ◽

Bed Occupancy ◽

Time Data ◽

Social Distancing ◽

Number Of Patients ◽

The Uk ◽

The Impact

Efforts to suppress transmission of SARS-CoV-2 in the UK have seen non-pharmaceutical interventions being invoked. The most severe measures to date include all restaurants, pubs and cafes being ordered to close on 20th March, followed by a “stay at home” order on the 23rd March and the closure of all non-essential retail outlets for an indefinite period. Government agencies are presently analysing how best to develop an exit strategy from these measures and to determine how the epidemic may progress once measures are lifted. Mathematical models are currently providing short and long term forecasts regarding the future course of the COVID-19 outbreak in the UK to support evidence-based policymaking. We present a deterministic, age-structured transmission model that uses real-time data on confirmed cases requiring hospital care and mortality to provide up-to-date predictions on epidemic spread in ten regions of the UK. The model captures a range of age-dependent heterogeneities, reduced transmission from asymptomatic infections and produces a good fit to the key epidemic features over time. We simulated a suite of scenarios to assess the impact of differing approaches to relaxing social distancing measures from 7th May 2020 on the estimated number of patients requiring inpatient and critical care treatment, and deaths. With regard to future epidemic outcomes, we investigated the impact of reducing compliance, ongoing shielding of elder age groups, reapplying stringent social distancing measures using region based triggers and the role of asymptomatic transmission. We find that significant relaxation of social distancing measures from 7th May onwards can lead to a rapid resurgence of COVID-19 disease and the health system being quickly overwhelmed by a sizeable, second epidemic wave. In all considered age-shielding based strategies, we projected serious demand on critical care resources during the course of the pandemic. The reintroduction and release of strict measures on a regional basis, based on ICU bed occupancy, results in a long epidemic tail, until the second half of 2021, but ensures that the health service is protected by reintroducing social distancing measures for all individuals in a region when required. Our work confirms the effectiveness of stringent non-pharmaceutical measures in March 2020 to suppress the epidemic. It also provides strong evidence to support the need for a cautious, measured approach to relaxation of lockdown measures, to protect the most vulnerable members of society and support the health service through subduing demand on hospital beds, in particular bed occupancy in intensive care units.

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Predictions of COVID-19 dynamics in the UK: short-term forecasting and analysis of potential exit strategies

10.1101/2020.05.10.20083683 ◽

2020 ◽

Cited By ~ 12

Author(s):

Matt J. Keeling ◽

Edward M. Hill ◽

Erin E. Gorsich ◽

Bridget Penman ◽

Glen Guyver-Fletcher ◽

...

Keyword(s):

Critical Care ◽

Health Service ◽

Age Groups ◽

Transmission Model ◽

Bed Occupancy ◽

Time Data ◽

Social Distancing ◽

Number Of Patients ◽

The Uk ◽

The Impact

AbstractBackgroundEfforts to suppress transmission of SARS-CoV-2 in the UK have seen non-pharmaceutical interventions being invoked. The most severe measures to date include all restaurants, pubs and cafes being ordered to close on 20th March, followed by a “stay at home” order on the 23rd March and the closure of all non-essential retail outlets for an indefinite period. Government agencies are presently analysing how best to develop an exit strategy from these measures and to determine how the epidemic may progress once measures are lifted. Mathematical models are currently providing short and long term forecasts regarding the future course of the COVID-19 outbreak in the UK to support evidence-based policymaking.MethodsWe present a deterministic, age-structured transmission model that uses real-time data on confirmed cases requiring hospital care and mortality to provide up-to-date predictions on epidemic spread in ten regions of the UK. The model captures a range of age-dependent heterogeneities, reduced transmission from asymptomatic infections and produces a good fit to the key epidemic features over time. We simulated a suite of scenarios to assess the impact of differing approaches to relaxing social distancing measures from 7th May 2020 on the estimated number of patients requiring inpatient and critical care treatment, and deaths. With regard to future epidemic outcomes, we investigated the impact of reducing compliance, ongoing shielding of elder age groups, reapplying stringent social distancing measures using region based triggers and the role of asymptomatic transmission.FindingsWe find that significant relaxation of social distancing measures from 7th May onwards can lead to a rapid resurgence of COVID-19 disease and the health system being quickly overwhelmed by a sizeable, second epidemic wave. In all considered age-shielding based strategies, we projected serious demand on critical care resources during the course of the pandemic. The reintroduction and release of strict measures on a regional basis, based on ICU bed occupancy, results in a long epidemic tail, until the second half of 2021, but ensures that the health service is protected by reintroducing social distancing measures for all individuals in a region when required.DiscussionOur work confirms the effectiveness of stringent non-pharmaceutical measures in March 2020 to suppress the epidemic. It also provides strong evidence to support the need for a cautious, measured approach to relaxation of lockdown measures, to protect the most vulnerable members of society and support the health service through subduing demand on hospital beds, in particular bed occupancy in intensive care units.

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Belgium: Creeping Vulnerability of Children

10.1093/oso/9780198797968.003.0003 ◽

2017 ◽

Author(s):

Julie Vinck ◽

Wim Van Lancker

Keyword(s):

Social Protection ◽

Child Poverty ◽

Growing Up ◽

Important Lesson ◽

The Great Recession ◽

Number Of Children ◽

Poverty Risk ◽

Poor Households ◽

Families With Children ◽

The Impact

Belgium has been plagued by comparatively high levels of child poverty, and by a creeping, yet significant, increase that started in the good years before the crisis. This is related to the relatively high share of jobless households, the extremely high and increasing poverty risk of children growing up in these households, and benefits that are inadequate to shield jobless families with children from poverty. Although the impact of the Great Recession was limited in Belgium, the crisis seems to have had an impact on child poverty, by increasing the number of children living in work-poor households. Although the Belgian welfare state had an important cushioning impact, its poverty-reducing capacity was less strong than it used to be. The most important lesson from the crisis is that in order to make further headway in reducing child poverty, not only activation but also social protection should be improved.

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Beyond the Pandemic: COVID-19 Pandemic Changed the Face of Life

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115645 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5645

Author(s):

Shaden A. M. Khalifa ◽

Mahmoud M. Swilam ◽

Aida A. Abd El-Wahed ◽

Ming Du ◽

Haged H. R. El-Seedi ◽

...

Keyword(s):

Human Activities ◽

Social Life ◽

Positive Impact ◽

Mental Wellbeing ◽

Negative Effects ◽

Population Movements ◽

Social Distancing ◽

The Face ◽

The Impact ◽

Positive Impacts

The COVID-19 pandemic is a serious challenge for societies around the globe as entire populations have fallen victim to the infectious spread and have taken up social distancing. In many countries, people have had to self-isolate and to be confined to their homes for several weeks to months to prevent the spread of the virus. Social distancing measures have had both negative and positive impacts on various aspects of economies, lifestyles, education, transportation, food supply, health, social life, and mental wellbeing. On other hands, due to reduced population movements and the decline in human activities, gas emissions decreased and the ozone layer improved; this had a positive impact on Earth’s weather and environment. Overall, the COVID-19 pandemic has negative effects on human activities and positive impacts on nature. This study discusses the impact of the COVID-19 pandemic on different life aspects including the economy, social life, health, education, and the environment.

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Risk of Low Birth Weight According to Household Composition in Brussels and Montreal: Do Income Support Policies Variations Explain the Differences Observed between Both Regions?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157936 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7936

Author(s):

Mouctar Sow ◽

Myriam De Spiegelaere ◽

Marie-France Raynault

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Household Composition ◽

Income Support ◽

Welfare Benefits ◽

Number Of Children ◽

Households With Children ◽

Vulnerable Households ◽

Welfare Families ◽

The Impact

Variations in social policy between countries provide opportunities to assess the impact of these policies on health inequities. This study compares the risk of low birth weight in Brussels and Montreal, according to household composition, and discusses the impact of income support policies. For each context, we estimated the impact of income support policies on the extent of poverty of welfare recipients, using the model family method. Based on the differences found, we tested hypotheses on the association between low birth weight and household composition, using administrative data from the birth register and social security in each region. The extent of poverty of welfare families differs according to household composition. In Quebec, the combination of low welfare benefits and larger family allowances widens the gap between households with children and those without children. The risk of LBW also differs between these two contexts according to the number of children. Compared to children born into large welfare families, first-born children are more at risk in Montreal than in Brussels. In addition to the usual comparative studies on the topic, our study highlights the importance of an evaluative perspective that considers the combination of different types of income support measures to better identify the most vulnerable households.

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Evaluation of Clinical Outcomes after Introduction of a Dedicated Infectious Diseases- Critical Care Medicine Service in Critical Care Units

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab182 ◽

2021 ◽

Author(s):

Polina Trachuk ◽

Vagish Hemmige ◽

Ruth Eisenberg ◽

Kelsie Cowman ◽

Victor Chen ◽

...

Keyword(s):

Critical Care ◽

Infectious Diseases ◽

Clinical Outcomes ◽

Broad Spectrum ◽

Critical Care Medicine ◽

Care Hospital ◽

Intervention Period ◽

Broad Spectrum Antibiotics ◽

Antibiotic Utilization ◽

The Impact

Abstract Objective Infection is a leading cause of admission to intensive care units (ICU), with critically ill patients often receiving empiric broad-spectrum antibiotics. Nevertheless, a dedicated infectious diseases (ID) consultation and stewardship team is not routinely established. An ID-Critical Care Medicine (ID-CCM) pilot program was designed at a 400-bed tertiary care hospital in which an ID attending was assigned to participate in daily rounds with the ICU team, as well as provide ID consultation on select patients. We sought to evaluate the impact of this dedicated ID program on antibiotic utilization and clinical outcomes in patients admitted to the ICU. Method In this single site retrospective study, we analyzed antibiotic utilization and clinical outcomes in patients admitted to an ICU during post-intervention period from January 1, 2017 to December 31, 2017 and compared it to antibiotic utilization in the same ICUs during the pre-intervention period from January 1, 2015 to December 31, 2015. Results Our data showed a statistically significant reduction in usage of most frequently prescribed antibiotics including vancomycin, piperacillin-tazobactam and cefepime during the intervention period. When compared to pre-intervention period there was no difference in-hospital mortality, hospital length of stay and re-admission. Conclusion With this multidisciplinary intervention, we saw a decrease in the use of the most frequently prescribed broad-spectrum antibiotics without a negative impact on clinical outcomes. Our study shows that the implementation of an ID-CCM service is a feasible way to promote antibiotic stewardship in the ICU and can be used as a strategy to reduce unnecessary patient exposure to broad-spectrum agents.

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The impact of quarantine on Covid-19 infections

Epidemiologic Methods ◽

10.1515/em-2020-0038 ◽

2021 ◽

Vol 10 (s1) ◽

Author(s):

Pablo Marshall

Keyword(s):

Health System ◽

Infection Rate ◽

District Level ◽

Infection Model ◽

Social Distancing ◽

Proposed Model ◽

Lower Infection ◽

The Impact ◽

Lower Infection Rate ◽

Over Time

Abstract Objectives: Coronavirushas had profound effects on people’s lives and the economy of many countries, generating controversy between the need to establish quarantines and other social distancing measures to protect people’s health and the need to reactivate the economy. This study proposes and applies a modification of the SIR infection model to describe the evolution of coronavirus infections and to measure the effect of quarantine on the number of people infected. Methods: Two hypotheses, not necessarily mutually exclusive, are proposed for the impact of quarantines. According to the first hypothesis, quarantine reduces the infection rate, delaying new infections over time without modifying the total number of people infected at the end of the wave. The second hypothesis establishes that quarantine reduces the population infected in the wave. The two hypotheses are tested with data for a sample of 10 districts in Santiago, Chile. Results: The results of applying the methodology show that the proposed model describes well the evolution of infections at the district level. The data shows evidence in favor of the first hypothesis, quarantine reduces the infection rate; and not in favor of the second hypothesis, that quarantine reduces the population infected. Districts of higher socio-economic levels have a lower infection rate, and quarantine is more effective. Conclusions: Quarantine, in most districts, does not reduce the total number of people infected in the wave; it only reduces the rate at which they are infected. The reduction in the infection rate avoids peaks that may collapse the health system.

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The Effects of Social Distancing Policies on non-SARS-CoV-2 Respiratory Pathogens

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab133 ◽

2021 ◽

Author(s):

Jeff Nawrocki ◽

Katherine Olin ◽

Martin C Holdrege ◽

Joel Hartsell ◽

Lindsay Meyers ◽

...

Keyword(s):

Public Health ◽

Influenza A ◽

Detection Rate ◽

Respiratory Illness ◽

Respiratory Pathogens ◽

Public Health Response ◽

Mixed Effect ◽

Detection Rates ◽

Social Distancing ◽

The Impact

Abstract Background The initial focus of the US public health response to COVID-19 was the implementation of numerous social distancing policies. While COVID-19 was the impetus for imposing these policies, it is not the only respiratory disease affected by their implementation. This study aimed to assess the impact of social distancing policies on non-SARS-CoV-2 respiratory pathogens typically circulating across multiple US states. Methods Linear mixed-effect models were implemented to explore the effects of five social distancing policies on non-SARS-CoV-2 respiratory pathogens across nine states from January 1 through May 1, 2020. The observed 2020 pathogen detection rates were compared week-by-week to historical rates to determine when the detection rates were different. Results Model results indicate that several social distancing policies were associated with a reduction in total detection rate, by nearly 15%. Policies were associated with decreases in pathogen circulation of human rhinovirus/enterovirus and human metapneumovirus, as well as influenza A, which typically decrease after winter. Parainfluenza viruses failed to circulate at historical levels during the spring. Total detection rate in April 2020 was 35% less than historical average. Many of the pathogens driving this difference fell below historical detection rate ranges within two weeks of initial policy implementation. Conclusion This analysis investigated the effect of multiple social distancing policies implemented to reduce transmission of SARS-CoV-2 on non-SARS-CoV-2 respiratory pathogens. These findings suggest that social distancing policies may be used as an impactful public health tool to reduce communicable respiratory illness.

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Mining Google and Apple mobility data: temporal anatomy for COVID-19 social distancing

Scientific Reports ◽

10.1038/s41598-021-83441-4 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 2

Author(s):

Corentin Cot ◽

Giacomo Cacciapaglia ◽

Francesco Sannino

Keyword(s):

Infection Rate ◽

The United States ◽

Strong Decrease ◽

Social Distancing ◽

Mobility Data ◽

Actual Measure ◽

The Us ◽

The Impact ◽

Political Decisions ◽

Mobility Reduction

AbstractWe employ the Google and Apple mobility data to identify, quantify and classify different degrees of social distancing and characterise their imprint on the first wave of the COVID-19 pandemic in Europe and in the United States. We identify the period of enacted social distancing via Google and Apple data, independently from the political decisions. Our analysis allows us to classify different shades of social distancing measures for the first wave of the pandemic. We observe a strong decrease in the infection rate occurring two to five weeks after the onset of mobility reduction. A universal time scale emerges, after which social distancing shows its impact. We further provide an actual measure of the impact of social distancing for each region, showing that the effect amounts to a reduction by 20–40% in the infection rate in Europe and 30–70% in the US.

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