Putting children at the centre of COVID recovery efforts

By Emily Gruenwoldt

If children are not at the centre of our country’s recovery efforts from the COVID-19 pandemic, we will have collectively failed as a nation. A costly mistake for which we will pay the price for many years to come.

Since day one of this global pandemic, children have been invisible victims of COVID-19. While Canada’s kids have, thus far, largely been spared from serious illness associated with the novel coronavirus, evidence is mounting that children and youth have been – and will continue to be – the most affected by this country’s response to the pandemic.

Beyond a disruption to the routine and structure in which children thrive, COVID-19 has resulted in social isolation from extended family, other adults, and peers; lengthy delays or cancellations of health assessments, diagnoses, and elective procedures; disruptions in routine vaccinations and primary care. For vulnerable children and youth, a lack of access to safe and healthy foods and the security that comes with access to trusted adults outside the home.  Compounding these already serious concerns will be any further disruptions or delays in a full (in-class) return to school this Fall. This ‘perfect’ storm is poised to result in potentially significant and long-lasting physical, mental, and developmental impacts for many children and to widen the gaps between them.

As jurisdictions across the country (federal, provincial, territorial, local and Indigenous) grapple to define and implement a COVID recovery strategy, one thing is clear: Canada’s children are being overlooked. In order for our country to successfully rebound from the multitude of economic, social, and health impacts associated with the pandemic, children’s healthcare leaders from across the country believe all levels of government must act now to prioritize the long-term health and wellbeing of children and youth.

Putting children at the centre of our recovery efforts means prioritizing policies and investments that address children’s health and wellbeing today and into the future. Children’s Healthcare Canada and the Pediatric Chairs believe the federal government has an important leadership role to play in three areas: establishing an independent federal Commissioner for Children and Youth, investing to sustain the child health research enterprise, and advancing access to critical health services for children and youth.

While many believe Canada to be one of the best places to raise healthy vibrant children and youth, the numbers tell us differently. In 2017, UNICEF’s child wellbeing report card revealed that Canada ranks 25thof 41 OECD countries on measures of children’s health and wellbeing. While many countries are implementing measures which improve their standing, Canada’s ranking continues to decline from a position of 12th place in 2007.

One tactic the government could employ to reverse this trend is to establish an independent federal Commissioner for Children and Youth. Such an office would fulfill a central recommendation made repeatedly to Canada by the United Nations Committee on the Rights of the Child. A Commissioner for Children and Youth would support parliamentary committees and the budget process to ensure that legislation, policies, and investments that pertain to children and youth consider their rights and well-being in order to maximize impact and avoid unintended consequences and costs. It would also work to amplify the voices of young people themselves, to ensure their opinions and experiences are better incorporated into the decisions Parliament makes on their behalf.

Putting children at the centre of our recovery efforts also means investing in discovery and innovation through support for Canada’s child health research enterprise – a sector that has suffered significant setbacks associated with the pandemic and economic downturn. Basic and translational research programs and hundreds of clinical trials to uncover life-saving or otherwise essential therapies are imminently at risk.  In spite of this pandemic, children continue to be born prematurely, have rare diseases, and remain at risk for life threatening or chronic diseases. The erosion of material security during the pandemic may lead to worse birth outcomes. A child-first recovery strategy would prioritize the viability of the child health research community to ensure life changing work is not lost, for the children of today, and generations of children to come.

Last but not least, it is well established that the COVID-19 pandemic has exposed and exacerbated many existing gaps in the delivery of health services to Canadians, including vulnerable children and youth. For almost fifteen weeks, most non-urgent and elective procedures came to a halt in health delivery centres serving children and youth. Routine care, including some well-baby visits and childhood vaccinations were deferred. For children with special needs, most essential services delivered in the community or in the home shut down or their accessibility was significantly reduced as the result of COVID-19. The disruptions were, for the most part,  an inconvenience in the short term, however many families now fear their children are experiencing an irremediable loss of functioning, and/or are observing significant physical and behavioural regressions, particularly in children with neurodevelopmental disorders.

The capacity of our health systems to thoughtfully and safely ramp up services in the days and weeks to come will be critical to reducing morbidity and ensuring health equity and positive health outcomes for Canada’s children and youth for months and years to come. To support this transition, provincial and federal governments will be required to prioritize investments to secure personal protective equipment for healthcare and education workers and families, enhance testing and contact tracing, ramp up delivery of virtual services where appropriate, and facilitate tackling an ever-growing backlog of essential physical and mental health services.  Yet they – and therefore Canada’s children – will be in competition with others for resources and priority.

With news from public health officials that it could be 12-24 months before broad public health measures are relaxed in a significant way, the time to consider the impact of this pandemic on children and their families is overdue. The next several weeks and months will be defining times for all Canadians, including our children and youth. Children are by nature resilient, but the time has come to implement solutions to ensure their health and wellbeing.

Canada’s federal government, working in close partnership with provincial and municipal counterparts, plays an essential leadership role in the COVID recovery, and more broadly in the delivery of compassionate, safe and effective health care for all Canadians. Let’s not lose sight of the burden this pandemic has had on our children and youth, the sacrifices they have made to flatten the curve, and our overdue responsibility to put them first.

Emily Gruenwoldt is the President & CEO of Children’s Healthcare Canada and the Executive Director of the Pediatric Chairs of Canada.