Irwin Redlener, a pediatrician, directs the National Center for Disaster Preparedness at the Earth Institute and is a professor at Columbia University’s Mailman School of Public Health and president emeritus of Children’s Health Fund. Karen B. Redlener is a co-founder of Children’s Health Fund and serves as the organization’s executive vice president.
While we are understandably consumed with the daily, seemingly unstoppable firehose of news about the most dangerous pandemic in a century, little attention has been paid to the long-term impact of this crisis on the world's most vulnerable children.
It’s impossible to overstate what this crisis will mean for the pandemic generation. This prolonged, unpredictable and highly contagious disease is upending their education, family lives, social relationships, resiliency and opportunities to pull themselves out of multigenerational cycles of poverty. The result might be a chasmic gap between relatively affluent children and those in poverty deeper than at any other time in modern history.
There is no doubt that persistent lockdowns and school closings have affected children everywhere. UNICEF reports that more than 91 percent of the world’s children are impacted by school shutdowns, and at least 117 million children are at risk of missing vital health care, including critical vaccines. Extensive surveys conducted by Save the Children also found that nearly half of all children said they were “worried” and a third reported feeling “scared.”
These challenges only add to the serious adversities many children already face — from poverty and homelessness to food insecurity and suboptimal schools. A new report from Columbia University’s Center on Poverty & Social Policy projects that if unemployment reaches 30 percent, child poverty could rise from 13.6 percent as of February 2020 to nearly 21 percent by the end of the year, representing an enormous setback in the painfully slow progress that has been made over the past four decades.
The sudden closing of schools and elimination of educational summer activities in many communities might have lifelong consequences for children who already live with severe social and economic adversities, impairing even further their ability to read at grade level, graduate from high school on time and have equitable access to post-education opportunities generally. A recent study from the University of Southern California finds that 37 percent of students whose families make less than $25,000 per year do not have Internet access, appropriate technology or both to allow remote learning. Nearly 23 percent of New York City high school students living with low-income families have not availed themselves of Internet-based classes. This does not include another 19 percent of the student body who are in schools that have not yet reported attendance.
If we assume that full reopening of schools will not be feasible until an effective vaccine is available, it is altogether possible many children will lose at least a good part of the 2020-2021 school year in addition to what they lost in the current academic year. It is nearly impossible to imagine, much less calculate, what this will cost in opportunities lost for our most vulnerable children.
Many of us have taken some comfort in early data suggesting that covid-19 had largely spared children from the most dire medical consequences of the disease. While it is true that the prevalence of the diseases’s most serious complications will likely remain predominantly among adults, there are reasons to be concerned about a new pediatric illness that experts believe is related to covid-19, known as pediatric multisystem inflammatory syndrome, consisting of rash, high fever and, while rare, cardiovascular shock and death. While data are not yet published, we spoke with pediatricians in Detroit, San Francisco and New York and have concluded that hundreds of children have been admitted to hospitals with this condition across the United States, and at least five of these patients have died.
As tragic as these medical issues are, the greater worry is that a generation of children will experience long-term and possibly lifelong consequences caused by a global infectious wildfire that we should have predicted, prepared for and been able to control far better than we have over the past five months.
Yes, we should acknowledge that some children have exhibited unexpectedly high levels of resiliency and independence while dealing with the restrictions and disruptions imposed by the pandemic. That said, for millions of children, the outlook is grim.
In the United States, the pain will be unbearable for many of our children whose futures — and ours — are now on the line for the foreseeable future. Is all of this inevitable? Not necessarily. An all-out bipartisan “Marshall plan” for this generation might be our only chance to salvage the United States’ strength and influence in the 21st century.
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