Seeking Normalcy as the Curve Flattens: Ethical Considerations for Pediatricians Managing Collateral Damage of Coronavirus Disease-2019

Abstract

F earful. Uncertain. Overwhelmed. Committed. Hopeful. Pediatricians around the world have cycled through these emotions when considering the health and safety of patients and families during this coronavirus disease 2019 (COVID-19) pandemic. We worry about the direct medical effects of COVID-19. We also worry about the ancillary effects of the lockdowns, stay-at-home orders, closed clinics, schools, and daycare centers, and newly unemployed parents on the well-being of children. We focus on those concerns. We believe that responding to these ancillary effects of COVID-19 will be a bigger challenge for pediatricians than the clinical care of children with COVID-19. These challenges will be with us for the foreseeable future.

Integrating Public Health Ethics into Shared Decision Making for Children During the Novel Coronavirus Disease-19 Pandemic

“…4 We also know that the measures helping to control COVID-19 infection rates have negatively impacted the health of children through delays in routine vaccination and well child care, mental health consequences of school closures, and heightened concerns about the risk of child abuse in socially-isolated children. 5 , 6 , 7 These unintended consequences are presumed to be acceptable harms to protect public health.…”

The psychological burden of restricted parental visiting in paediatric intensive care

“…There have been some recent publications observing the collateral damage this pandemic has caused on children's education, social care, and health services. 2,3 This commentary refers to collateral damage in terms of visiting restrictions on children in paediatric intensive care units (PICUs). A pertinent consideration is the psychological burden of separation on children, young people, and their families during this time.…”

Experiences of siblings of children with congenital heart disease during Coronavirus disease 2019; A qualitative interview study

“…Recent literature highlights collateral damage affecting children during the COVID-19 pandemic ( Crawley et al, 2020 ; Feltman et al, 2020 ). Children are thought to have been hit hardest psychosocially ( Ghosh et al, 2020 ).…”