The coronavirus pandemic and children

Dr. Özlem ÖNEN

A pandemic is the general term given to infectious diseases that spread across a very wide area, affecting multiple countries or continents around the world. According to the World Health Organisation, for an epidemic to be classified as a pandemic, the following conditions must be met: the emergence of a disease to which the community has not previously been exposed, the transmission of the disease-causing agent to humans, the agent causing a dangerous disease, and the agent spreading easily and continuously among humans.

The past few weeks, with meetings cancelled, travel restricted, schools and workplaces closed, and efforts to enforce quarantine and social distancing, have brought with them considerable anxiety.

Fear and anxiety about a disease can be overwhelming and cause intense emotions in adults and children alike. Our emotional responses to the pandemic vary depending on our personal characteristics and experiences, as well as the social and economic conditions of the community in which we live. Thoughts that make life difficult, such as focusing on the negative and only anticipating the worst-case scenario, can easily arise during such processes where uncertainty is at the forefront. It is impossible not to have these reactions and not to feel anxious, but it is also necessary to continue living without becoming overwhelmed by anxiety and by taking the most effective measures possible. Anxiety ensures that we take appropriate action when faced with danger. However, anxiety that makes life difficult remains constantly in our minds and consumes us.

During a pandemic, it is possible to experience a wide range of psychological difficulties. Individuals may worry about losing their own lives or those of their loved ones, experience poor sleep quality, feel less confident about the future, have nightmares, or find it difficult to concentrate on their work. Younger age groups and children may exhibit behaviour reminiscent of younger ages (regression).

Not only during this period, but also after it ends, many children and young people are at high risk of developing psychiatric disorders.

UNICEF recommends that families reorganise themselves according to the ‘new normal’, even if only temporarily, during such crises. To do this, it is recommended to first remain calm and proactive, and secondly to establish daily routines. Children are always less anxious and function better in well-structured and consistent environments.

In order to establish a regular routine for children, parents must first be able to organise their own daily routines. Within the framework of general “self-care” rules, parents should set regular bedtimes and wake-up times (avoiding shifting sleep patterns or daytime naps), engage in physical exercise at home as much as possible, strive for a balanced diet with regular meals, avoid excessive consumption of alcohol, tea, and coffee, and refrain from actions they may later regret (such as excessive online shopping).

To cope with anxiety and repetitive thoughts, it is recommended that they set aside a “worry time” at the same time each day for a limited period (e.g. 30 minutes a day) and thus limit their worrying. This is also intended to prevent wasting hours in front of news sources such as television or social media.

One way to use the time spent isolated at home during the pandemic wisely is to develop active problem-solving skills. In order to actively engage in problem-solving, it is important to identify and name a problem that already exists in our current lives. It is important to determine possible solutions for the identified problem and to make and implement a plan to apply the chosen solution. Evaluating the results will both alleviate anxiety and play an important role in our preparations for the post-pandemic period.

It is important to use the experiences gained during this period as an opportunity for growth and development in the post-pandemic period. As with other disasters, the novel coronavirus pandemic (COVID-19) can have a positive impact on children’s development, triggering learning and maturation, or it can continue to be a negative experience, causing fear and suspicion. Children who receive help in coping with difficulties from a sensitive and organised adult environment will benefit from this support.

Children and young people with a healthy support system may develop a strong curiosity about how to overcome the damage caused by the pandemic. However, children who learn to have a healthy level of confidence in the future may succeed in developing a strong desire to help others.

It is important to ensure that young children feel comfortable asking questions about the pandemic. Children should be given information about concepts such as bacteria and viruses in a way they can understand. It would be appropriate to be honest about when the pandemic will end, explaining that all doctors and scientists are working on this issue and doing their utmost to find a solution as soon as possible. Informing children that we should not be overly fearful but should be cautious, and that protecting ourselves is the most appropriate approach, will help to eliminate uncertainties in their minds.

Global crises that affect the whole world also have many negative consequences, such as economic losses and stigmatisation, which describes negative, disparaging, hostile, devaluing and discriminatory attitudes towards a particular person or group. Stigmatising approaches towards the elderly, refugees, those with low levels of education, the poor, and, more recently, healthcare workers can make this process even more hurtful.

We must remember that we are fortunate if we can safely navigate the social distancing process within the four walls of our homes. It is important to recognise that the pandemic is just one of our personal stories. While establishing our own daily routines during this epidemic, which will one day come to an end, it is also one of the most important issues that adults can model for their children: not forgetting our social responsibilities, helping those in risk groups, or at least being aware of their risks and respecting them.

Sources:

1. Briefing note on addressing mental health and psychosocial aspects of the COVID-19 outbreak, version 1.0; 26 February 2020 UN.pdf Centers for Disease Control and Prevention (CDC)

2. The psychological effects of quarantine and protective measures. Turkish Psychiatric Association Psychological Trauma and Disaster Working Group

3. Covid and Stigmatisation. Turkish Psychiatric Association Psychological Trauma and Disaster Working Group

4. Covid and Children. Turkish Psychiatric Association Mental Trauma and Disaster Working Group

5. Turkish Association of Child and Adolescent Psychiatry Covid-19 (Coronavirus) Pandemic: Psychosocial and Mental Health Support Guide for Families, Children, and Adolescents.