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| EDITORIAL |
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| Year : 2021 | Volume
: 14
| Issue : 4 | Page : 367-368 |
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Child health in the times of COVID-19
Amitav Banerjee
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| Date of Submission | 14-May-2021 |
| Date of Decision | 15-May-2021 |
| Date of Acceptance | 16-May-2021 |
| Date of Web Publication | 17-Jun-2021 |
Correspondence Address:
Amitav Banerjee
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/mjdrdypu.mjdrdypu_355_21
How to cite this article:
Banerjee A. Child health in the times of COVID-19. Med J DY Patil Vidyapeeth 2021;14:367-8 |
The ongoing COVID-19 pandemic has aggravated and exposed the inequities in healthcare. Power dynamics dictate priorities in medicine and public health.[1] From the beginning of the pandemic, all interventions to control the pandemic have disadvantaged the poor and vulnerable, particularly children. Lockdowns and restrictive measures took livelihoods which will increase all-cause mortality among the vulnerable. These interventions cause deaths in the developing world to prolong lives in the developed world.[2]
The ethics and economics of public health demand that with limited resources, maximum benefit to maximum number is achieved. A child born in India today has 3.2% chance of dying before it reaches its first birthday.[3] The under-five child mortality in India is also high. Every day, >2000 under-five die in India from preventable causes.[4] Hazards of survival for children in India are much higher from non-COVID causes.
The ongoing pandemic of COVID-19, now in its vicious second wave in India, threatens to adversely impact the community child health programs. Mortality from the novel coronavirus appears to be low in children and women of child-bearing age.[5],[6] However, because of the pandemic which now has spread to the rural areas, there is likely to be disruption of health services which will impact the most vulnerable, i.e. the infants and children below 5 years. A study from Uttar Pradesh confirms this.[7] The authors of this study reported declining trend in utilization of child health services during the pandemic. There was almost 25% drop in routine immunization services. The cycle of malnutrition and infections (including with the novel coronavirus) has the potential to take deeper roots.
More importantly, we have a host of neglected endemic diseases such as malaria, typhoid (which has an effective vaccine), dengue, and diarrheal and respiratory infections (some of which are vaccine preventable), which contribute to high infant and child mortality in India. In most of these infections, malnutrition is an important effect modifier.
The developed countries enjoy the luxury of having overcome most of these infections and can afford to invest heavily to control the novel coronavirus in children. They also have a very low proportion of children as compared to developing countries like India, which has a very broad base of children and young people. Other prevalent infections in India take a toll of young lives many times more than the novel coronavirus.
Public health practice keeps encountering difficult choices. It challenges us to be fair and also accountable when making such rational decisions.[8] We need reliable data about our endemic diseases to make such choices. The current model of real-time monitoring of cases and deaths of the novel coronavirus can be extended to our endemic diseases, which take a much heavier toll of our children. Comparative data, available real-time in the public domain, like we have for COVID-19, will facilitate rational allocation of scarce resources to control child morbidity and mortality in the country. Most child deaths occur against the background of child malnutrition which is likely to increase manyfold due to the bleak economic future.
| References | |  |
| 1. | Banerjee A. The British Raj and rise and fall of tropical medicine. Med J DY Patil Univ 2013;6:121-2.  [Full text] |
| 2. | Broadbent A, Walker D, Chalkidou K, Sullivan R, Glassman A. Lockdown is not egalitarian: The costs fall on the global poor. Lancet 2020;396:21-2. |
| 3. | Registrar General. Sample Registration System. Vol. 53. New Delhi, India: SRS Bulletin, Office of the Registrar General; 2018. |
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| 5. | Livingstone E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. JAMA 2020;323:1335-7. |
| 6. | Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020;109:1088-95. |
| 7. | Singh AK, Jain PK, Singh NP, Kumar S, Bajpai K, Singh S, et al. Impact of COVID-19 pandemic on maternal and child services in Uttar Pradesh, India. J Family Med Prim Care 2021;10:509-13. [Full text] |
| 8. | Griffiths SM, Martin R, Sinclair D. Priorities and ethics in health care. In: Guest C, Ricciardi W, Kawachi I, Lang I, editors. Oxford Handbook of Public Health Practice. 3 rd ed. Oxford: Oxford University Press; 2013. p. 12-27. |
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