By Poornima Prabhakaran, Head, Environmental Health and Deputy Director, Centre for Environmental Health, Public Health Foundation of India
We must address the intertwined nature of threat multipliers like climate change and pandemics to the physical and mental health of our children
Amidst the Covid-19 pandemic, it is often heard that the infection spares children. While statistics reflect this in the age distribution of confirmed cases, preliminary findings from an early study in China suggested that this may not be entirely true.
A little over 2,000 children assessed retrospectively based on clinical manifestations and exposure history showed that children of all ages are indeed susceptible, with infants being particularly vulnerable. However, in comparison to adults, children have milder symptoms and a lower case fatality.
The cases recorded in Karnataka, Kerala and more recently in Delhi further prove that children are less susceptible. While this augurs well for a healthcare system already under pressure, there is another side to the story regarding the health and vulnerabilities of our children in the wake of the Covid-19 epidemic.
With all good intentions, in India, directives to close were sent out to all educational institutions, including schools, colleges and universities. While applauding the educational system for bailing out to save their academic year by shifting classes online, it also implies other repercussions for children.
Grounded children
School years encompass a lot more than streamlined in-class lessons — the joy of riding to school with friends, interacting with teachers and buddies, extracurricular activities like music and sports — were all curtailed in one sweeping measure. A whole generation of youngsters has been grounded and forced to be cooped up for an average of 6-8 hours in front of their computers.
The earlier frustrated parents who lamented their gadget-savvy millennials and Gen-Z have now accepted this as possibly the only way to maintain some sanity in their households. The impacts of this forced grounding on the physical and mental health of children has received less than adequate attention.
Recent concerns on growing levels of childhood obesity may possibly see some increase with outdoor activity reduced further and recourse to fast foods and sugary beverages during the enhanced screen time.
While this speaks to the urban component of our child cohorts, children from rural India face a different set of challenges. Most of them will not have access to online resources and could clearly suffer the consequences of a disrupted academic year. The loss of momentum could further affect educational outcomes and enhance inequities in access to future academic opportunities.
For a group largely dependent on school midday meals and nutrition packages distributed through day-care centres, the chaos in these established distribution channels could translate into worsening of our child health indicators in coming months. Pregnant mothers failing to receive their share of the supplemental nutrition packages, antenatal care and infants missing out on immunisation could prove detrimental to future health and well-being.
The hundreds of thousands of migrant labourers leaving from Indian cities, many with accompanying children, have no certainty regarding the family’s next meal. Regardless of being infected by the virus itself, the indirect ramifications of absent or poor nourishment coupled with poor access to safe water, sanitation and hygiene for preventive measures could sound a death knell of sorts for these vulnerable sections of our society. See: Locked in migrant workers of South Asia cannot see a way out
Fallout of confinement
Another concern, often ignored, is the mental health of our children. We could anticipate greater instances of the whole spectrum of anxiety disorders (headaches, palpitations, muscle pains, body aches, sleep disturbances and panic attacks being some manifestations), depression, aggressive behaviour and post-traumatic stress disorders, all from the sheer pressures of confinement, restrained social interaction, reduced outdoor activities and the helplessness of constant parental control over a large part of their waking hours.
The loss of privacy and freedom has been especially stressful for the ‘quaranteens’ and can manifest as behavioural changes that are not anticipated under normal circumstances. The excessive, though now necessary focus on frequent hand-washing warranted by the pandemic may exacerbate obsessive compulsive disorders in those already suffering from it. Some could be on the edge of requiring professional therapy or counselling for failing mental health.
Recent directives of the government to cancel end-of-year academic exams came as a relief to many parents and students alike, but certain cohorts are impacted in more ways than one as they ramp up preparations to appear in competitive exams, often ones that decide their careers and lives going forward. The stress of uncertain futures can take its toll in the months to come. Parents and caregivers must watch out for telling signs of breakdown among their wards and reach out early for assistance with coping strategies.
Age of eco-anxiety
Only last year, children the world over had begun a clamouring for climate action from world leaders. They sought intervention on a wide range of sectoral issues for curbing and limiting greenhouse gas emissions. A new phrase called eco-anxiety had surfaced.
In 2017, the American Psychological Association described it as a “chronic fear of environmental doom”. Anxiety was expressed around environmental issues ranging from risks like extreme weather events, losses of livelihood or housing, feelings of helplessness and fears for future generations.
The current Covid-19 pandemic is a zoonotic disease and is a glaring example of infectious diseases that emerge as fallout of deforestation, land-use changes, captive animal breeding and human-induced activities leading to climate change.
Scientists writing in the medical journal The Lancet had articulated in their reports in the last quarter of 2019 that “the health of a child born today will be impacted by climate change at every stage of their lives”. The eco-anxiety and feelings of helplessness stemming from the current macro- and micro-environment for our children — whether from the pandemic or the climate crisis — needs serious attention.
With various forms of lockdown mandated across several locations, the consequent improvement in our air and water quality is obvious. One cannot help but appreciate the pictures of a clean Yamuna river in Delhi. But can these short-term outcomes serve as a predictor of what really is possible in the form of an adequate, appropriate and responsible climate response from every region of the world?
The race for growth and political one-upmanship may just succeed in further ravaging our remaining natural resources and feeding into a vicious cycle of disease as well as social and economic fall-outs that could soon become unmanageable.
As responsible adults, healthcare providers and policymakers, what can we promise our children? Can our post-Covid-19 resurgence strategy chart in a (re-)growth curve that ensures sustainable growth of all sectors decoupled from greenhouse gas intensive operations across our energy, transport, agriculture and even our healthcare systems?
Can we finally play a role of responsible adults who can recognise and address the intertwined nature of these global threat multipliers of climate change and the pandemic to the physical and mental health of our children?