The Children Are Not All Right

"Kids are not doing well. This is really taking its toll."

"They spend 24/7 in their bedrooms. They are not getting out of bed. Even when schools open up, they have no motivation."

"They are so far behind, they can't even bring themselves to go to school." 

"These kids are on a downhill trajectory."

Dr.Jane Liddle, pediatrician, Ottawa Community Pediatricians Network

"[Closing schools might have been the right response to the pandemic], but it is having some pretty big implications on the pediatric situation on a daily basis."

"All of us are seeing an increased referral volume from family physicians [for eating disorders] that is out of proportion to what we typically would see."

Dr.Kelley Zwicker, founder, Ottawa Community Pediatricians Network

"We are the doorkeepers. We are the ones who keep children from coming to CHEO [Children's Hospital of Eastern Ontario]."

"What CHEO is seeing is the tip of the iceberg in terms of what we see in our practices."

"In a situation where everything is taken away, including the routine of school, this makes very much sense that these children who see a complete loss of control concentrate on the one thing they can do [refuse food or eat too much food]."

Dr.Andrzej Rochowski, chief of pediatrics, Queensway Carleton Hospital

Discipline, purpose, opportunities for physical exertion, playtimes, school routines, exposure to other children in their peer group, casual decision-making, have all been extracted from the daily lives of children living under the new life-rules of COVID-inspired restrictions. Parents are pressed to expose their children to opportunities for learning, at a time when the home has become the learning centre, with the closure of public and private schools as part of an effort to maintain distancing to tamp down rising numbers of COVID cases and more infectious transmission with the presence of new variant strains.

Children are now increasingly exhibiting symptoms of mental disturbance in the most troubling of ways, going from puzzlement to reaction and graduating to severe mental health crises. Some children have been left feeling suicidal, suffering from major depression and extreme anxiety. Their world has been overturned and nothing is the same as it always has been. An exponential rise in young patients presenting with clear signs of increasing mental disturbance has alarmed area pediatricians, and what they are experiencing is obviously occurring everywhere that COVID has locked down entire communities.

Medical professionals belonging to the recently-inaugurated Ottawa Community Pediatricians Network are raising the alarm over frightening levels of mental and physical illness being seen among children and teens in reaction to a pandemic stretching into its second year of disrupting daily life. Their concerns are not only for the current situation which appears to be growing in the numbers of children presenting for care, but for the prospect of what lies ahead as the situation continues to grow.

 

Children in a playground outside Hastings Elementary School in Vancouver. Anxiety, depression, behavioural issues and post-traumatic stress could become far more common in children both during the pandemic and in its aftermath, the research review found. (Ben Nelms/CBC)

 

When the schools are opened, children find support in the presence of others like themselves. When they close, during lockdowns occasioned by the upward swings of coronavirus cases, physicians start seeing growing numbers of patients, as mental health disorders begin to surge. Some of these doctors specialize in caring for patients under the age of six. Doctors are witnessing alarming signs of poor mental health, including anxiety and clinical depression in five-year-olds.

In some of these children body mass index has rapidly increased, partially as a result of the children spending so much more time at home and parked in front of computer screens. Many of these children have completely lost any interest in schools, and have no wish to return when they do re-open for in-person classes. The concern over their academics, over eating disorders which have rapidly increased during the pandemic is shared by family, family physicians and the specialists these ailing children are referred to.

 

A volunteer takes a call at the Crisis Centre B.C office in Vancouver. (Ben Nelms/CBC)

 

The Children's Hospital of Eastern Ontario reports a fifty percent increase in emergency assessments for eating disorders, pandemic-induced, even while community pediatricians see many more cases, not yet admitted to hospital. Some of these children presenting with eating disorders represent a much younger cohort than seen in the past, becoming sicker more quickly than in the past. Food is something youth and children feel they can control, explains Dr.Rochowski, reflecting the dangerous spike in severe eating disorders seen now nation-wide.

 

The group of pediatricians have in mind the need to dispel a prevailing attitude that children have not and will not be severely affected by the fallout of the pandemic. "There has been a false sense of security that kids were going to be fine out of this. Kids are not fine", stressed Dr.Liddle. All of the doctors concerned agree that the detrimental effects of the pandemic will be seen for months and years into the future, for the children so badly affected.

Often, children will present signs of mental illness in ways that are not quite the same as adults. You may observe changes in behaviour, mood, sleep patterns, appetite and/or interactions with others that are having a negative effect on your child’s day to day activities. It is important to seek help.

Is your child experiencing any of these?

• Extreme outbursts or excessive mood swings
• Worrying so much that they are getting stomach aches or headaches
• Persistent nightmares and a lack of sleep that are affecting your child’s day
• Avoiding formerly enjoyable activities, including spending time with friends
• Unusually quiet, sad or reserved, preoccupied
• Change in appetite – eating considerably less, or more.

CMHO Family Health Centre