A Children’s Pandemic

A month of Pandemic measures and I already wince at a handshake or touched face on Netflix. Just yesterday, New York was bustling, packed and confident. Now it is cautious, dispersed and masked. If our relationship with the world around us has been instantly transformed, what about the impact upon children in their formative years?

It may be the single blessing of this ruthless pandemic that children are least vulnerable to the virus. But sadly not the potentially deadly ricochets and aftershocks it leaves in its wake. This week the UN Secretary General reported that health and food system impacts will increase other childhood diseases and malnutrition. The number of children living in extreme poverty is projected to increase from 386 to as much as 450 million as a direct result of a new Covid19-induced economic crisis. Extreme poverty is always a killer and likely to take more children than the virus itself. Perhaps reversing 2-3 years of global progress on preventable childhood deaths.

There is barely a child on the planet whose life has not been affected by the Pandemic in some way. 1.5 billion are at home and not school. At least tens of millions of children will be born into this crisis, mostly in conditions that would have been different if it weren’t for the pandemic. Children cannot see their friends and suffer major disruptions to learning, life and play. Sports tournaments, excursions and hackathons all shelved, teenage romance on hold. A recent study suggested that prolonged quarantine in general can make a person 4 times more likely to have poor mental health. The pandemic shocks touch all children .

Fortunately many children have the shock absorbers of a safe home, loving family and freedom from poverty, social exclusion or war. If just one from the set is missing, the impact of the pandemic is likely to be deeper and life-changing. There is now a new single thread of additional vulnerability tying together children in tightly packed slums in African cities with those in camps in Syria and Yemen. It extends to the low income children in rich countries like the UK and US and those at risk of severe acute malnutrition in the poorest countries. It also hits the approximately 5% of the world’s children with disability and the 15-20% in seriously dysfunctional, neglectful and violent homes. This pandemic has been merciless in piling more pressure on to those least able to absorb it.

The bottom billion have no means for social distancing or hand washing. Their health systems often have just a few ventilators and Intensive care beds. They are not thinking of flattening the curve, but rather a couple of dozen cases flattening their entire health system. Prevention of other childhood diseases is already disrupted, including vaccination programmes on hold in 23 countries. 30 million conflict affected children are dependent on humanitarian assistance which is likely to be battered as supply chains buckle and aid financing and fiscal space contract. 40% of the world’s children don’t even have hand washing facilities.

Remote learning is a great solution for most children, but even here in New York city it is estimated that 300,000 low income children don’t have the digital means to participate. School closures will widen the two main learning gaps. The first between countries with high performing education systems who have the agility and means to switch and those countries which cannot run their education system effectively at the best of times. The second gap is between the learning outcomes of wealthy and poor children within countries. 368.5 million of those poor children have also been cut off from essential school feeding programmes which are often the only source of nutrition. Children in need of special learning support at school or dependent on relationships with teachers and friends to mitigate the pain of violent and neglectful homes are suddenly adrift. All against a rising backdrop of increased reporting of intimate partner violence and child abuse from India to Greenland to Australia and all points in between.

If the Coronavirus was a pantomime villain waiting behind a curtain for an opportune moment to pounce, it did so with precision. Thus far, dwindling internationalism has made us too weak to address the Pandemic in the whole. But you cannot partially address a pandemic. Even during the Cold War, the USSR and the West realized this and joined forces to end smallpox. And thats what our polarised world needs to do now. If everyone is not safe, no-one is safe. The virus shows our interdependence and in the end, maybe thats its virtue.

This is not insurmountable. WHO, UNICEF, the Red Cross, scientists and artists have joined forces in the Solidarity Fund to mobilise resources for a vaccine and for prevention and response work in low and middle income countries. Scientists shared the genetic sequencing on the virus very early on and are collaborating across borders despite nationally-minded governments. There is also a global initiative to galvanise leaders into more collaborative and internationally-minded policy-making in response to the pandemic.

We have also seen national governments and societies prioritise children. 83 countries have adapted their social protection systems to help shield poor families and children from the crisis. Health, education and social work systems have often adapted to maintain basic services. Armies of school and health volunteers are helping minimise the impact of the pandemic upon children.

We should now see maintaining supply chains, aid flows and health systems in poor and humanitarian contexts as a first line response for us all, even though it seems far away. Look how far the virus has already travelled. We may also need to invest in social protection to help the bottom billion socially distance, particularly those in densely packed and poorly resourced urban slum and refugee/migrant camps.

In wealthy and poorer countries alike we should support adaptions for teachers and social workers to have exactly the same amount of contact with children as they had before the crisis and for school feeding programmes to be delivered to homes. When adapting education we need to prevent remote learning widening the gap between wealthy and poor.

Albert Camus may have appreciated the importance of teacher contact and continued learning. In 1957 he dedicated his Nobel Prize for literature to the teacher who was there for him in the midst of poverty and adversity. His masterpiece The Plague is once again a bestseller and remains a testimony to our interdependence and collective strength in the face of this crisis. In it, he wrote: “No longer were there individual destinies, only a collective destiny, made of the disease and emotions shared by all.” .

A Tale Of Two Pandemics

Will Covid19 Widen Inequality?

With Rugby & Football postponed and social gatherings replaced by social distancing-the only hope for an exhilarating weekend was a long bicycle ride. As Hudson suburbs gave way to inner city Bronx & Harlem before the more prosperous heartland of Manhattan- a simple bike ride shows how different income groups cope with Corona Virus. In prosperous neighbourhoods, cafe bars and barbers shop were half or three quarters empty. There was not a hipster to be seen. By contrast, poor migrant areas were bustling. It’s a bike ride-not a piece of scientific research. But do high rents, poor pay, insecure employment, no sick leave & “for profit” health systems prevent the poor from social distancing? Do they need to carry on as normal? Even when they are frightened of the virus?

We may all be frightened of getting sick. But the poor often fear the sickness itself less than the life consequences. One pay check away from homelessness, the potentially ruinous out of pocket hospitalisation costs or the direct relationship between todays work-shift & tonight’s family meal. Over time the secondary costs will hit the poor the most. If children are out of school, who will look after them? Online learning is a brilliant solution for social distancing, but those who already have the worse learning outcomes also have the worse connectivity: the poor. In the end, there will be job layoffs. Corona virus will break some businesses and the working poor will be the first to go.

27 million Americans don’t have health insurance. The world’s wealthiest country equals many middle and low income countries in having dramatically worse health outcomes for it’s poor. Brits shouldn’t be smug. Low income males in the UK die almost ten years earlier than the wealthy. Many of the non-communicable diseases and conditions that render Covid 19 lethal are much more prevalent for those in poverty. In the poorest countries on the planet, weak health systems may be overwhelmed by Corona Virus. This will divert resources from other child killers such as ebola, measles, cholera and pneumonia.

Child poverty is not the only driver of lifelong inequality. Adverse childhood experiences such as family violence and neglect also lead to serious inequality throughout adulthood . How do you think #StayAtHome sounds to a child who only feels safe when they are not at home? Whose only soothing & supportive relationship is with a teacher or a school deskmate. The pandemic will turn their already fragile world upside down and minimise their chances for recovery. When schools were closed during the Ebola crisis in West Africa increased rates of sexual abuse and exploitation of children were recorded.

Privileged cultures, wealth and education rightly equip children with skillsets to better navigate complex challenges in a way that often eludes the less well off. This is highly relevant in a pandemic. The ability to distill a stream of useful facts about the virus amidst an explosion of noisy fake news. The agility to regularly absorb and update ones knowledge and act up upon it. Adaptation to change and uncertainty and knowing where to seek help. When something goes wrong for a poor or high-adversity kid and they are knocked off course, it takes them much longer to get back on their feet.

In many countries including the US and UK, inequality seems to be expanding and social mobility declining. If you grow up without university educated parents, your future prospects seem to be in decline. It is rarely articulated, but deep in the sub-conscious of working class and poor people this trend has transformed voting trends. Growing inequality has created space for populist braggarts who shun science and international cooperation. The very people who now appear shrivelled and sheepish next to scientists with international networks of practice.

Covid 19 is not just a public health crisis. It will be an economic and social crisis, a jobs crisis, a housing crisis and it will certainly be a child crisis. It needs a social strategy as well as a public health strategy. Are we the Italian balcony Sopranos who celebrate our shared humanity by singing our hearts out together? Or the hysterical supermarket goers who elbow each other out the way to buy endless supplies of loo roll? I think time will show us to be more like the sopranos, but that social strategy needs to bring us together rather than build wedges to drive us even further apart.