Children are bearing the brunt of COVID-19

By Alex Munter

Last year, the Ontario government challenged the health-care sector to re-organize and make care less complicated to access.

The government introduced the concept of “Ontario Health Teams” (OHT) — to build a connected health-care system centred on patients, families and caregivers. These teams are to support both the patients and health-care providers, delivering a coordinated continuum of care in designated regions. The goal of this new and innovative system is to provide faster access to better quality care while making it easier for families to move from one provider to the next.

Children and youth are not tiny adults. They have unique needs and their lives are very different than their parents, teachers, and child-care workers. Understanding this, child and youth health organizations and physicians in the Champlain region of Eastern Ontario came together to organize services around their reality. Called an “innovative model” by the Ministry, eastern Ontario’s Kids Come First Health Team has tailored the OHT concept for kids. Health Minister Christine Elliott said, “As we reviewed the many excellent applications to become an Ontario Health Team, it became clear to us that there are some proposals like Kids Come First that provide invaluable services for specific patient populations that should not be contained within a single team.”

Partnered with family and youth, the Kids Come First Health Team includes over 60 organizations, supported by 1,100 pediatric physicians. Since the beginning of the COVID-19 outbreak, we have been able to mobilize our services to serve children and youth infected by the virus and, just as important, support families affected by it.

When COVID-19 arrived in Canada, the Kids Come First Health Team saw the possibility of children bearing the brunt of Canada’s response. Amidst a pandemic like this, are kids supposed to suddenly stop being kids? To just stop growing and developing? In the life of a child, every day counts. The difficult choices we had to make around provision of health care disproportionally affect kids’ developing brains, growing bodies, and wellness. We cannot afford for young people in Ontario to be collateral damage, especially since COVID-19 will be with us for some time.

The early years are crucial to a child’s development, and not something we can put on pause. How do you tell a family that their occupational therapy visits to teach toilet training or behaviour therapy sessions to teach social skills are not essential? Investing in pediatric health not only provides personal benefit when kids are kids but, also, long-term economic benefit to the province when our children grow into healthy, thriving adults.

During the COVID-19 pandemic, health-care providers have been forced to reduce services and focus on ‘essential and urgent’ care. As many services were temporarily suspended, seemingly overnight, the Kids Come First Health Team mobilized to support children and their families. With the member organizations’ strong foundation of services already established, the Kids Come First Health Team was able to adapt to the changing needs of our patients.

The Kids Come First Health Team acted quickly and effectively to address some key gaps. We set up immunization clinics for scheduled vaccinations of babies and toddlers under the age of 2. These clinics were centered around families who were not able to obtain their immunizations through family physicians or community pediatricians. Our goal was to prevent a legacy of post-COVID-19 outbreaks of preventable disease.

We established an isolation centre for vulnerable youth at risk of homelessness, aged 16 – 21, to provide a safe space to self-isolate, recover or await COVID-19 test results. In addition, we set up a unique child and youth protection clinic for high-risk children who did not have primary-care providers within their foster homes.

We provided in-home nursing assessments and in-home respite services for families of children and youth with medically complex or palliative needs. This included emergency respite to family caregivers, giving them a temporary break because caring for a child with special needs or complex care needs is unimaginably tough at the best of times and even harder when community support options are forced to temporarily close.

We delivered expertise and support for congregate living and care facilities — we could not afford to have these specialized, limited group homes shut down as part of the COVID-19 response, potentially leaving youth with disabilities no place to live. This response was akin to how hospitals stepped up to help seniors in long-term care homes.

As Ottawa Public Health has stated, the prolonged school shutdown has also had big impacts on the lives of many children — their development, emotional well-being, physical and mental health. For some, these impacts have even included losing access to nutrition and losing their safe refuge from difficult or dangerous home situations. Kids Come First stands ready to work with families, teachers, school boards, and others to help support a safe return to school.

COVID-19 is not going anywhere fast, so the Kids Come First Health Team is here for families when, where, and how they need us most. We exist to connect child and youth health services for better quality, faster access and easier transitions. And, we are here to support other Ontario Health Teams by bringing pediatric expertise to the table to ensure our new system works for kids.

We’ve got this. Young people — and their parents and caregivers — are counting on us.

 Alex Munter, President and CEO of CHEO, a pediatric health and research centre in Ottawa, one of the 61 organizational partners in the Kids Come First Health Team.