The COVID-19 pandemic will continue to have serious effects worldwide long after the crisis has passed.

Pediatricians and public health experts have been calling attention to an increasingly serious problem: the effects of the COVID-19 pandemic on the physical and mental health of children and adolescents.

Although COVID-19 is mostly benign in children, causing mild flu-like symptoms, it can also have effects beyond the disease itself. They can develop what is called multisystem inflammatory syndrome in children (MIS-C), a rare but serious condition.

MIS-C is characterized by inflammation of multiple areas in the body and, although its cause has not been yet determined, many children with this condition have had the virus that causes COVID-19, or have been exposed to someone with the infection. According to the Centers for Disease Control and Prevention, as of Oct. 4, some 5,217 cases of MIS-C had been reported in the United States, including 46 deaths.

In addition to the risk of children contracting MIS-C, their mental health has been negatively impacted by COVID-19. From a young age, socialization is critical for a child’s development. The isolation measures imposed by the pandemic have severely curtailed these activities resulting in a wide array of mental, emotional and behavioral health issues.

Particularly for older children, isolation measures to contain the pandemic have decreased opportunities to build crucial social-emotional peer relationships. Globally, 188 countries have imposed countrywide closures, affecting more than 1.5 billion children and young people.

These mental health issues have also been aggravated by the pandemic in the form of school closures, which means school-based mental health services are unavailable to children. UNICEF estimates that, globally, schoolchildren have missed 1.8 trillion hours of in-person learning since the beginning of the COVID-19 pandemic and subsequent lockdowns.

The children’s agency urges governments, local authorities and school administrations to reopen schools as soon as possible, taking all possible precautions to mitigate transmission of the virus in schools.

Anxiety and depression make up about 40% of the mental health problems children suffer, which are aggravated by the pandemic. Studies show that symptoms of anxiety and depression have approximately doubled compared to pre-pandemic levels among children and adolescents. Such young people living in institutions and migrant children are particularly vulnerable.

The pandemic has also increased economic strains on families. Poor families struggling to pay for rent and food face considerable difficulties in providing for their children’s most basic needs. At the same time, loss of income often provokes stress within such families, which may manifest as domestic violence between parents or against children.

As the death toll from COVID-19 continues to climb, with over 700,000 such fatalities in the U.S. alone, many children and adolescents have to confront the traumatic experience of losing a parent or a sibling. According to one estimate, 40,000 children have lost a parent to the coronavirus in the U.S. This leaves them at elevated risks for depression, anxiety and poor educational outcomes.

Stressful events, called Adverse Childhood Experiences (ACEs), have short- and long-term consequences, including impaired cognitive and emotional development. According to UNICEF, exposure to at least four ACEs is strongly associated with sexual risk-taking, mental health conditions and alcohol abuse later in life.

Mental health is not a top priority among many governments. At a global level, expenditure on mental health is only around 2.1% of the median government expenditure on health.

The chronic lack of investment in mental health care means that medical personnel are not properly trained. In addition, prevailing stigmas about mental health issues deters the parents of children and young people from seeking treatment, thus limiting their opportunities for emotional healing and social development.

The U.N. states, “What started as a public health emergency has snowballed into a formidable test for global development and for the prospects of today’s young generation.” The COVID-19 pandemic has created an opportunity for governments to properly address mental health issues for children and adolescents. And they must. The future of our youth depends on it.

Cesar Chelala is an international public health consultant and the author of “Adolescents’ health in the Americas,” a publication of the Pan American Health Organization.

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