Fortunately, children are less vulnerable than older adults to the physical effects of COVID-19; however, this does not mean that they are immune to all the effects of the virus. School, family structure, cultural practices have all been disrupted. Ensuring children stay connected with family members during isolation is important to their health and wellbeing. With school and in-person socialization such as youth programs and ceremonial ties to culture and language suspended, children have had to move to ways to participate virtually. Some Tribal cultural programs are turning to videos for teaching, too. But, access to reliable internet, a tablet or computer or even a quiet place to study can be difficult in homes in rural areas or with multiple generations living under one roof.
Often in our Native communities, support systems include extended friends and family who live in separate households. Before the pandemic, relatives were helping to provide childcare. With social/physical distancing now the norm, these systems are impacted, and parents are finding fewer supports are available. Children affected by their guardians’ stress may be acting out. Young children may not know how to express their anxiety or frustrations with the changes to their lives because of the pandemic. Parents should have patience with themselves too.
Another important aspect of children’s health are vaccines. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend that children two years and younger should receive vaccines on schedule. However, to decrease exposure to Coronavirus and preserve personal protective equipment (PPE) for healthcare workers, many pediatric providers have postponed well-child visits during the Coronavirus pandemic.
Though these types of precautions are needed, it could cause an increase in vaccine-preventable diseases in children. This is especially important in American Indian and Alaska Native (AI/AN) children, as they are at an increased risk for vaccine-preventable diseases with higher rates of morbidity and mortality than the general population due to geographic isolation and socioeconomic factors. Vaccines have drastically reduced the rates of diseases in the AI/AN population. For example, just 35 years ago American Indian children suffered at a rate 10 times higher than the general population from diseases like Hepatitis A, Hepatitis B, Haemophilus influenzae type b, and Streptococcus pneumoniae.
Despite the uncertainty of the foreseeable future due to COVID-19, health clinics should prioritize in-person newborn care, newborn well-visits and immunizations for children up to 24 months of age. The CDC offers guidance to decrease exposure to patients and healthcare providers while still following the CDC vaccine schedule during this crisis. Many clinics are looking to alternatives such as drive-through vaccines or designated hours or screening rooms for healthy children to receive their vaccines. Clinics are also encouraged to conduct well-child visits not requiring vaccinations via telemedicine and continue screening for developmental delays.
Here are ways that parents, guardians or loved ones can support children during COVID-19:
- Keep children on a routine at home, including a consistent wake up time and bedtime.
- Set up daily “call an elder” time where children choose a family member/friend to call to help maintain relationships.
- Talk to children about the virus using simple language and a calming tone.
- Teach children how to reduce the spread of germs with good hand washing and covering coughs and sneezes with their elbow or tissue.