Covid-19’s impact on Asian children should give countries hoarding vaccines pause

Vaccinations are gathering speed in many parts of Asia for adults who can get their hands on doses. Jabs are under way for teenagers in some countries. But this pandemic is having a silent and devastating impact on children. Millions of young people have seen family members die. Children from India to Indonesia and Vietnam have been orphaned. Countless others lived in fear that this would happen to them. And it still might. Before the huge waves of Delta variant infections washed onto Asia in May, a study in The Lancet found that globally, more than 1.5 million children had already experienced the death of a primary carer or grandparent who lived in their home. Imagine what that’s like for a child, living with the trauma of losing a parent to this disease. This virus does not discriminate. Yet the pandemic is having an unequal impact on people who can’t access vaccines because richer countries have taken the lion’s share. It’s affecting children whose parents can’t afford to stay at home so the virus is brought in through the front door. In Asia, both infections and deaths are higher than most could have imagined possible when the disease first broke out. Around 54 million people have been infected. Many have been hospitalised with serious and long-lasting health effects. Total lives lost from Covid-19 across Asian countries are creeping towards 1 million. Yet these official figures paint only part of the picture. Estimates place the likely global death toll at up to four times higher, the bulk of it in countries in Asia, Africa and the Middle East where deaths are under-reported, according to a recent study from researchers at Hebrew University and University of Tübingen. This year in Asia, the Delta variant has caused severe illness and a rising death toll among children and young people. Many have died even though early last year many thought that children, at least, were safe. Initially, it was critical to focus on protecting older people, but as Covid-19 threatens further waves of misery across Asia, we must look after both young and old in the race to contain this pandemic of a century. Amid low vaccination rates, this year’s tragic Covid-19 surge across Asia left children exposed in crowded homes, while enduring lengthy lockdowns and online schooling. In Bangladesh, schools have only recently reopened after 18 months. Online school is deepening disadvantages and the digital divide for children living in poverty. This affects overall health. Most schools in the Philippines, Malaysia and several other Asian countries are still closed. Children are remarkably resilient and can bounce back after disasters. Yet the immense strain on the mental health of young people caused by the pandemic must not be underestimated. The longer-term mental health effects are not yet clear. But it is of great concern that studies across multiple countries already show increased mental health disorders for children during this pandemic, according to a recent British Medical Journal paper. The evidence also suggests that children who had prior mental health disorders were at increased risk of pandemic-related mental health trauma. Young adults have also been hit hard by this crisis. We also need to focus more on supporting teenagers and young people through this pandemic. Give Asian youth a voice to decide their post-pandemic future Young people may not be leading the death toll but a recent study from the Organisation for Economic Cooperation and Development showed that about 50 per cent of young people have experienced a job-related disruption either themselves or via a household member. The study also showed that close to two-thirds of young people are worried about their financial security and well-being. The longer-term physical health effects of Covid-19 – known as “long Covid” – are a growing concern as infections in young people have skyrocketed across Asian countries that are easing restrictions. An analysis of 15 studies and nearly 48,000 adult Covid-19 patients who contracted the disease last year found that 80 per cent experienced longer term symptoms including fatigue, headache and attention disorder. Children are not immune. Nearly 10 per cent of 2-to-11-year-olds and 13 per cent of 12-to-16-year-olds infected with Covid-19 in the United Kingdom reported continuing symptoms five weeks later, according to a British Office for National Statistics study released in April. Vaccinations appear to offer millions of people in Asia a bright light at the end of this long, dark Covid-19 tunnel. But some countries are still languishing because they just can’t get enough doses, and this is placing more children in peril. Indonesia and Vietnam still have less than 25 per cent of the population fully vaccinated whereas Bangladesh has just 11 per cent and Myanmar 8 per cent, according to Oxford University’s Our World in Data. Richer countries have bought enough doses to vaccinate their populations, and many are now administering booster jabs, while people in Asia are still at risk of dying from a lack of vaccine access. Children are suffering in this pandemic and we are only just starting to realise how much. Dr Abhishek Rimal is Asia Pacific emergency health coordinator with the International Federation of Red Cross and Red Crescent Societies