This editorial in The Lancet published November 5 looks at this vexing issue. 

The editorial suggests that the UK Government’s consideration of young people in its COVID-19 response has been inadequate and some eight months into the pandemic it argues that it is causing lasting harm to a whole generation. 

Although children and adolescents are generally less clinically vulnerable to COVID-19 than adults, the wider effects of COVID-19 policies are having disproportionately and negatively lasting issues on the young. 

It argues that data emerging from multiple sources show that during the first phase of the pandemic in March to June, closure of schools, nurseries and outdoor play spaces, and reduced clinical and community services have endangered child health and widened pre-existing disparities. 

Early findings of a survey of 500 patients showed that young children, those aged from 0 to 3, from a disadvantaged background were less likely to engage in enriching activities and have less access to outdoor space and books then their wealthier peers. 

In some areas of England, more than half of health visitors who support new parents and infants have been redeployed to COVID-19 services, and this raises the concern about missing needs in young children’s growth, development and safeguarding. 

A quarter of pupils, that is roughly 2.5 million children, in the United Kingdom had no schooling or tutoring during lockdown; while 74% of those at private schools had full days of teaching, compared with only 38% for state school pupils.  

Cancelled exams and the heavily criticised grading system have left many students missing out on university places and facing an uncertain future. 

Young people are also more likely to work in sectors affected by COVID-19; in the social mobility survey, 11% of those aged 16 to 25 reported losing their jobs between February and September, compared with 5% of older adults and nearly 60% of young people reported a fall in their earnings.  

These diminished educational and economic prospects compounded the burden of the pandemic on young people’s mental health and wellbeing.  

In July 2020, a mental health in young people survey included 3570 participants aged 5 to 22 years old and found that 16% had a probable mental disorder, this was a sizable increase from 11% in 2017.  

One in 10 young people aged 11 to 22 years said that they often or always felt lonely and nearly 30% reported sleep problems in the past seven days prior to questioning.  

A report by the Resolution Foundation showed that over 40% of young adults aged 18 to 29 years old, reported higher than normal levels of mental health problems in April 2020, an increase of 80% from the 2017 to 2019 levels and a much higher proportion than other older adult age groups. 

The editorial argues that inadequate preparations in the summer – notably, the failure to implement an effective test trace isolate strategy and scarce support for early reopening in schools – once again left people in a chaotic situation in September. 

After encouraging students to go back to university campuses, many were left self-isolated in their halls of residence with limited support.  

As the UK faces this second wave (personally, I do not believe this is the second wave, I believe this to be a continuation of the first wave on those persons not yet affected), these mistakes must not be repeated.  

The needs of children and adolescents must no longer be sidelined in policymaking. 

Child health and social services should remain accessible and adequately staffed, especially as the winter typically sees peak demand for paediatric acute and emergency care.  Schools should remain open for as long as possible; in cases of closures, additional support, such as free school meals and access to laptops and internet connections must be given to vulnerable children to avoid widening disparities further.  

Catch up tutoring and careful planning for exams in 2021 should be in place to give pupils a fair chance at this crucial life stage. 

The editorial goes on to say that the handling by the UK Government of the pandemic has exacerbated an already precarious state of national child health resulting from the cuts and funding for children’s services.  

The editorial comments that before the pandemic the 2020 State of Child Health report already highlighted the increase in child poverty in working families, worsening mental health and widening inequalities.  

With this whole generation caught in limbo in 2020 the editors argue the Government must immediately step up long term investment in prevention and early intervention services to help children and adolescents to recover from the effects of COVID-19.  

Early childhood interventions are needed to help the youngest children to regain months of missed school, social and educational development in the crucial first
1000 days of their lives. 

Mental health support in schools, catch up vaccinations, social care for vulnerable families and funding to alleviate child poverty must be prioritised the editors argue.  

The pandemic will eventually pass, but we must not let its shadows continue to find and affect a whole generation of young people. 

The London General Practice is aware of the disastrous effects that this pandemic has had on the population’s physical and mental wellbeing.  

It remains fully open and asks all those who have suffered to seek help in whatever way is available to them.  

The London General Practice does not agree with disparity in health or society and urges all those in any managerial role to help with the rebuilding of all aspects of society including health and in particular, mental and physical wellbeing.

Dr Paul Ettlinger
London General Practice

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