COVID‐19 in children: I. Epidemiology, prevention and indirect impacts

Abstract

Children globally have been profoundly impacted by the coronavirus disease 2019 (COVID‐19) pandemic. This review explores the direct and indirect public health impacts of COVID‐19 on children. We discuss in detail the transmission dynamics, vaccination strategies and, importantly, the ‘shadow pandemic’, encompassing underappreciated indirect impacts of the pandemic on children. The indirect effects of COVID‐19 will have a long‐term impact beyond the immediate pandemic period. These include the mental health and wellbeing risks, disruption to family income and attendant stressors including increased family violence, delayed medical attention and the critical issue of prolonged loss of face‐to‐face learning in a normal school environment. Amplification of existing inequities and creation of new disadvantage are likely additional sequelae, with children from vulnerable families disproportionately affected. We emphasise the responsibility of paediatricians to advocate on behalf of this vulnerable group to ensure the longer‐term effects of COVID‐19 public health responses on the health and wellbeing of children are fully considered.

The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment

“…In households with cases of infections, the mean risk of SARS-CoV-2 infection among all other members was 52% (range: 11%-100%). The study showed that children had similar incidence rates of SARS-CoV-2 infection compared with adults, but a larger proportion of infections among children were asymptomatic [ 58 , 59 , 61 ].…”

COVID-19 Vaccines in Children and Adolescents

“…Infection rates in children and adults were comparable whether schools were open or closed. According to secondary attack rates, children were less affected than adolescents and adults (9,16). However, there is little or no information available on the effects of the recent Omicron (B.1.1.529) variant on children and adolescents (17).…”

“…Severe illness from acute COVID-19 is uncommon in healthy children; however, it can occur, especially in those with pre-existing conditions. Children and adolescents play an important role in SARS-CoV-2 transmission (3,4,5,10,13,16). With widespread adult immunization, younger people account for a greater proportion of COVID-19 infections.…”

“…As a result, the direct benefits of vaccination to the individual is lower compared to that in other age groups: However, immunization of children and adolescents with an effective and safe vaccine is likely to promote disease prevention directly and stop the spread of the infection, thereby reducing the disease burden. Vaccinating children and adolescents will facilitate their reintegration into schools and the society (4,5,8,10,16,22).…”

Implications of COVID-19 Mitigation Policies for National Well-Being: A Systems Perspective

“…Multiple and potentially lagged interdependencies between well-being components are challenging to oversee and comprehend. A few studies have already revealed some dimensions of well-being that have been critically affected by the COVID-19 crisis not only directly but also indirectly [10,11]. Therefore, systematic tracing of the multi-dimensional effects of policies aimed at curbing the spread of the pandemic on the national well-being is critically important-both to minimize the adverse effects [12] and to be better informed and, hence, prepared for future crises of a similar nature.…”