How Fear of Covid-19 is Affecting Children's Health

Delays in vaccinations, delays in care: How fear of Covid-19 is affecting children's health

Editor's: Dr. Edith Bracho-Sanchez is a primary care pediatrician and assistant professor of pediatrics at Columbia University Irving Medical Center.

The virus that causes Covid-19 has been relentlessly preying on adults around the world for months, while largely sparing children. Although children are not directly impacted by the illness, their health is undoubtedly being affected by our collective new reality.

Before Covid-19, my clinic in New York City used to be filled with children coming in for checkups, vaccines and minor illnesses. Parents in my community always erred on the side of bringing their kids in right away when sick rather than waiting at home, to make sure whatever they had "was not serious." They knew I'd squeeze them into my schedule, treat them, reassure where appropriate and send them on their way.

The new coronavirus changed everything. Parents are now afraid to take care of some of their children's basic health needs.

Although children have, as a group, been largely spared by the illness, families are now making a new calculation: to some, the risk of exposure to Covid-19 seems greater than the benefit of vaccinating on time or that of promptly seeking medical attention for minor illnesses and injuries.

For these families, our efforts to explain the measures we have taken to keep their children safe while in the office don't seem to offer much reassurance.

We are seeing sick children in a completely different floor; we are screening every child and every family for symptoms of Covid-19 and rescheduling if positive. We hand out masks as soon as everyone comes in the building and disinfect every room thoroughly, we say. But still, resistance.

"I hear you, but I'd rather not leave my house with my baby right now," they reply.

It's hard to blame them. One look outside a New York City window and all you see are desolate streets and a constant stream of ambulances. As children quarantine with their parents, the threat of this virus feels much more real than that of any other infectious disease. Seeking care in an emergency room for minor illnesses and injuries has become unthinkable for some.

Our offices, the emergency room, previously places where parents found solace and reassurance, are now seen as dangerous.

The results have been evident for weeks now. On any given day, about half of scheduled infants come into our office for vaccines. And illnesses and injuries for which parents would have previously sought medical care promptly are now advancing and worsening at home.

The problem is not unique to New York City or even to the United States. In a recent report, UNICEF warned that more than 117 million children around the world may miss out on receiving measles vaccines as vaccination campaigns are delayed over the Covid-19 pandemic.

The full impact of delays in vaccinations and delays in seeking care are difficult to wrap our minds around now. We may face outbreaks of vaccine-preventable illnesses, some much more serious to children than Covid-19, locally and around the world. We may see parents hesitant to seek care for illnesses and injuries even after the pandemic is over. The effects would come on top of many other challenges families are facing -- the effects of lost wages, disruption of routines and education and the loss of family members.

Our work is cut out for us -- the parent/pediatrician team -- in what remains of this crisis and what comes after it. We must begin to restore the trust and decrease the fear now.