The COVID-19 pandemic has impacted all countries, diverse populations and all strata of society. But what has been the impact on one of the most important groups, namely children, who make up 20-30 per cent of any given population?
Firstly, what has COVID-19 contributed in terms of direct sickness in children in Malta?
Although there have been several COVID-related hospital admissions, complications have been unusual or very rare and mortality zero among children.
Essentially, COVID is a (serious) disease of the elderly and most COVID-positive children are generally asymptomatic or only mildly affected. There have been fewer than six children in Malta with significant COVID-related illness. All have made a full recovery.
Similarly, there have been very few adverse events in those aged 12-16 who have received an anti-COVID vaccine. Again, all have recovered.
The pandemic has indirectly reduced illness in children, mostly the effect of social distancing measures and face masks that have significantly reduced the transmission of most other common respiratory viruses.
Hence, the past two winters have been relatively quiet in terms of paediatric workload both in and out of hospital. Asthmatic children, in whom wheezing is generally triggered by viral illnesses, have had a ‘medical holiday’.
Indeed, a resurgence in all these illnesses is now being observed ‘un-seasonally’ since the relaxation of social measures, reopening of nurseries, summer school, etc.
This trend is likely to continue with the return to on-site schooling but this is the norm and does not override the benefits of traditional schooling.
What about the educational impact of the pandemic? From personal experience, online schooling has been ‘better’ or, at least, ‘very good’ for no more than 15 per cent of children, including the very bright, computer-savvy or retiring types with such attributes. For the vast majority, strictly online education has been inferior to the classroom experience and everything else that makes up school life.
For most children with learning difficulties or some form of physical, intellectual or educational disability, online has been an unmitigated disaster. For many, an entire 18 months of progress has been written off.
For the vast majority, strictly online education has been inferior- Simon Attard Montalto
This (personal) observation is certainly not due to substandard teaching. Educational institutions have, in the main, made superlative efforts to provide quality online teaching. The suspension of friendships and cancellation of diverse school activities, combined with a reliance and transfer of teaching duties to parents (mostly mothers) who may not be suitably trained and have had to cope with two or more curricula often while working from home, ensured that this was a negative experience for most (parents included).
Not surprisingly, research from the US has reported decreased cognitive, verbal and written abilities in children compared with matched, pre-pandemic cohorts.
The net result has been an inexorable resort to ever more screen time. Already a serious problem pre-pandemic, this has now reached epidemic proportions where, in the mid-school and teenage age groups, screen time may exceed 10-15 hours a day, consisting mostly of games and trawling social media with little educational value.
This, in turn, has ensured that the already-poor rates of involvement in sports and exercise have plummeted and will undoubtedly ensure that the obesity rates in children in this country will continue to top the world order.
Equally of concern, during the pandemic many have reported increased rates of mental illness and dysfunctional disorders in children.
Certainly, we have repeatedly observed young infants manifesting altered behaviour including fear of close family members such as grandparents, due to the unfamiliarity imposed by lockdowns. In older children, headaches and stress-related symptomatology are currently the key reasons for referral to general paediatrics.
However, children are resilient and I suspect that most will adjust to the new social ‘norms’.
Some of the long-term effects of the pandemic can be anticipated, like obesity-associated complications. But what about others, yet unknown?
Recovery from any adverse effects will probably depend on the duration of the pandemic which is, in turn, closely linked to the effectiveness of population-based immunisation.
Indeed, even if COVID vaccination is not necessarily medically crucial for children, as it is for the elderly, without immunising children, herd immunity cannot be achieved and effective control of the pandemic will remain impossible.
Yet, only then will children be allowed to be children and enjoy what is generally considered to be the best time of their life.