Mitigate the effects of home confinement on children during the COVID-19 outbreak.
TL;DR: It is the responsibility and keen interests of all stakeholders, from governments to parents, to ensure that the physical and mental impacts of the COVID-19 epidemic on children and adolescents are kept minimal.
About: This article is published in The Lancet.The article was published on 2020-03-21 and is currently open access. It has received 1363 citations till now.
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TL;DR: The coronavirus disease 2019 (COVID‐19) pandemic has affected hundreds of thousands of people and data on symptoms and prognosis in children are rare.
Abstract: Aim: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare.Methods: A systematic literature review was c ...
1,756 citations
TL;DR: Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends, and this may increase as enforced isolation continues.
Abstract: Objective Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method For this rapid review, we searched MEDLINE, PsycInfo, and Web of Science for articles published between January 1, 1946, and March 29, 2020. Of the articles, 20% were double screened using predefined criteria, and 20% of data was double extracted for quality assurance. Results A total of 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n = 51,576; mean age 15.3 years). In all, 61 studies were observational, 18 were longitudinal, and 43 were cross-sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias, although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion Children and adolescents are probably more likely to experience high rates of depression and most likely anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventive support and early intervention where possible and be prepared for an increase in mental health problems.
1,385 citations
Cites background from "Mitigate the effects of home confin..."
...Eighteen studies followed participants over time (Table 3).(61,62,64,65,67-72,74-77,79,80) Several of these were conducted in childhood (N 1⁄4 6), or adolescence (N 1⁄4 8), although three were in university students....
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...In all, 12 of the 15 studies found that loneliness is associated with depression and explained a significant amount of the variance in severity of depression symptoms several months to several years later.(61,62,64,65,67-72,74-77,79,80) Two studies found that loneliness in childhood at age 5 years was not associated with depression several years later,(73,74) although other studies that assessed loneliness during childhood found evidence that it is associated with subsequent depression....
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TL;DR: A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China, and may inform public health policy in other countries and regions.
Abstract: Importance Coronavirus disease 2019 (COVID-19) has become a pandemic, and it is unknown whether a combination of public health interventions can improve control of the outbreak. Objective To evaluate the association of public health interventions with the epidemiological features of the COVID-19 outbreak in Wuhan by 5 periods according to key events and interventions. Design, Setting, and Participants In this cohort study, individual-level data on 32 583 laboratory-confirmed COVID-19 cases reported between December 8, 2019, and March 8, 2020, were extracted from the municipal Notifiable Disease Report System, including patients’ age, sex, residential location, occupation, and severity classification. Exposures Nonpharmaceutical public health interventions includingcordons sanitaire, traffic restriction, social distancing, home confinement, centralized quarantine, and universal symptom survey. Main Outcomes and Measures Rates of laboratory-confirmed COVID-19 infections (defined as the number of cases per day per million people), across age, sex, and geographic locations were calculated across 5 periods: December 8 to January 9 (no intervention), January 10 to 22 (massive human movement due to the Chinese New Year holiday), January 23 to February 1 (cordons sanitaire, traffic restriction and home quarantine), February 2 to 16 (centralized quarantine and treatment), and February 17 to March 8 (universal symptom survey). The effective reproduction number of SARS-CoV-2 (an indicator of secondary transmission) was also calculated over the periods. Results Among 32 583 laboratory-confirmed COVID-19 cases, the median patient age was 56.7 years (range, 0-103; interquartile range, 43.4-66.8) and 16 817 (51.6%) were women. The daily confirmed case rate peaked in the third period and declined afterward across geographic regions and sex and age groups, except for children and adolescents, whose rate of confirmed cases continued to increase. The daily confirmed case rate over the whole period in local health care workers (130.5 per million people [95% CI, 123.9-137.2]) was higher than that in the general population (41.5 per million people [95% CI, 41.0-41.9]). The proportion of severe and critical cases decreased from 53.1% to 10.3% over the 5 periods. The severity risk increased with age: compared with those aged 20 to 39 years (proportion of severe and critical cases, 12.1%), elderly people (≥80 years) had a higher risk of having severe or critical disease (proportion, 41.3%; risk ratio, 3.61 [95% CI, 3.31-3.95]) while younger people ( Conclusions and Relevance A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China. These findings may inform public health policy in other countries and regions.
1,307 citations
TL;DR: The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention.
Abstract: Background Along with its high infectivity and fatality rates, the 2019 Corona Virus Disease (COVID-19) has caused universal psychosocial impact by causing mass hysteria, economic burden and financial losses. Mass fear of COVID-19, termed as “coronaphobia”, has generated a plethora of psychiatric manifestations across the different strata of the society. So, this review has been undertaken to define psychosocial impact of COVID-19. Methods Pubmed and GoogleScholar are searched with the following key terms- “COVID-19”, “SARS-CoV2”, “Pandemic”, “Psychology”, “Psychosocial”, “Psychitry”, “marginalized”, “telemedicine”, “mental health”, “quarantine”, “infodemic”, “social media” and” “internet”. Few news paper reports related to COVID-19 and psychosocial impacts have also been added as per context. Results Disease itself multiplied by forced quarantine to combat COVID-19 applied by nationwide lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run. These have been fueled by an “infodemic” spread via different platforms of social media. Outbursts of racism, stigmatization, and xenophobia against particular communities are also being widely reported. Nevertheless, frontline healthcare workers are at higher-risk of contracting the disease as well as experiencing adverse psychological outcomes in form of burnout, anxiety, fear of transmitting infection, feeling of incompatibility, depression, increased substance-dependence, and PTSD. Community-based mitigation programs to combat COVID-19 will disrupt children’s usual lifestyle and may cause florid mental distress. The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention. Conclusion For better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. Psychosocial preparedness by setting up mental organizations specific for future pandemics is certainly necessary.
1,146 citations
Cites background from "Mitigate the effects of home confin..."
...In the same way, children at this time of COVID-19 may develop phobia, PTSD etc after learning risk information and other worrisome details through audio-visual media, including social media [66,71]....
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...Today’s self-centered, busier-than-ever human race could potentially appreciate home-confinement during COVID-19 as a mere opportunity to promote healthier parent-child relationships by correct parental strategies and strengthen family bonding by spending more quality times together with older parents/dependent members residing in the same household [66]....
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...Stressors, such as monotony, disappointment, lack of faceto-face contact with classmates, friends and teachers, lack of enough personal space at home, and family financial losses during lockdowns, all can potentially trigger troublesome and even prolonged adverse mental consequences in children [66]....
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...Specific psychological needs, healthy life-styles, properhygieneadvices, andgoodparentingguides can be addressed through the same online platform [66]....
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...The interaction between their daily-routine changes, home confinement, and fear of infection could further intensify these undesirable mental reactions resulting in a vicious cycle [66,69]....
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TL;DR: Findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.
Abstract: Healthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth. A national sample of Canadian parents (n = 1472) of children (5–11 years) or youth (12–17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported. Only 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources. This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.
644 citations
Cites background from "Mitigate the effects of home confin..."
...Although parents and their children are undoubtedly experiencing higher stress during the COVID-19 outbreak [28], promoting physical activity and outdoor play by targeting co-participation, while respecting public health restrictions, may be one strategy to enhance health behaviours of children and youth [28, 29]....
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References
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TL;DR: A review of the psychological impact of quarantine using three electronic databases is presented in this article, where the authors report negative psychological effects including post-traumatic stress symptoms, confusion, and anger.
10,370 citations
1,356 citations
TL;DR: It is indicated that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic.
Abstract: ObjectivesThis study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences.MethodsA mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C).ResultsDisease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports).ConclusionsThese findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures. (Disaster Med Public Health Preparedness. 2013;7:105-110)
776 citations
UNICEF1, Johns Hopkins University2, University of Auckland3, University of London4, World Bank5, South African Medical Research Council6, American University of Beirut7, University of the Western Cape8, Peking University9, Centre for Science and Environment10, University of Ibadan11, Aga Khan University12, SITA13, University of Queensland14, Stellenbosch University15, University College London16
TL;DR: The case for placing children, aged 0–18 years, at the centre of the SDGs is presented: at the heart of the concept of sustainability and the authors' shared human endeavour.
471 citations
TL;DR: In this article, the Structured Days Hypothesis (SDH) was used to compare weekend day versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children.
Abstract: Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential. There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the ‘Structured Days Hypothesis’ (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children’s obesogenic behaviors are more unfavorable during weekend days compared to weekdays. In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development.
441 citations