As the global leader in child-focused humanitarian response, Save the Children knows that kids are particularly vulnerable during infectious disease outbreaks. For a variety of reasons, including the immediate impacts on their health to social disruptions caused by outbreaks, children can be greatly affected.

The current coronavirus or COVID-19 outbreak has now spread across more than 145 countries/regions worldwide.  While the Centers for Disease Control and Prevention (CDC) has noted that most confirmed cases of COVID-19 have occurred in adults[i], it’s important to note that infections in children have been reported as well.

Save the Children’s guidance on how to protect children from coronavirus follows that of the World Health Organization -- practicing good hygiene is the best way to prevent illness. However, there are additional ways in which children can be affected by coronavirus, even if they don’t get sick. For example, we know infectious diseases can disrupt the environments in which children grow and develop. Also, some preventative measures taken by health and medical professionals to control the spread of the disease can present risks to children, including in the area of child protection.

“We know from our work fighting Ebola that children can be at great risk in a health crisis,” said Amy Richmond, Save the Children’s Director of Child Protection in Emergencies. “It is essential to put into place the plans that will ensure children’s health, safety and psychological well-being are the forefront of government and community responses.

Here are 6 things to consider, based on Save the Children’s history of responding to global pandemic threats, about the ways in which children around the world can be affected by coronavirus, even if they don’t get sick.

1. Children’s dependency on adults put them at risk

Children, especially younger ones, are dependent upon their caregivers for meeting their basic needs like food and shelter. If an adult caregiver in a child’s life falls ill, the child’s basic needs could be impacted.

From the start of the Coronavirus outbreak, the World Health Organization emphasized that the best way to avoid spread of the Coronavirus is to keep routine hand washing and good cough etiquette. However, we know that children are less likely to adhere to some basic hygienic practices without adult supervision.

2. Reduced parental supervision can leave children more vulnerable to violence

During infectious disease outbreaks, caregivers may be unable to provide attentive care to their children due to illness, psychological distress, or other reasons. Reduced parental supervision can leave children more vulnerable to violence, exploitation and abuse.

In Yemen during the cholera outbreak in 2017, children who accompanied their sick caregivers to cholera treatment centers were at times left alone to sleep outside on the veranda while their caregivers were admitted for treatment. This unsupervised arrangement exposed children, especially girls, to risks of harassment, sexual violence and abuse.[ii]

3. Disruptions to family income can have immediate and longer-term consequences

Infectious disease outbreaks can have a devastating effect on families by limiting sources of income of family members due to illness, due to the need to care for sick family members, or by increasing household health-related expenses.

During an outbreak of Chikungunya in Orissa, India in 2006, for example, a

study showed that families’ increased health-related expenses threatened their ability to pay for other necessities.[iii]

4. A lapse in education can cause children to feel anxious

Children can perceive time differently to adults, and a few weeks or months out of school may seem like a much longer period of time to them. This means children tend to feel particularly anxious about any period of time they are out of school and the learning and socialization they are missing. They fear they will not be able to catch up and start to worry that the longer schools are closed, the more likely they are to forget what the previously learned.

In Sierra Leone, during the Ebola crisis, children said they felt they were becoming “backward.”

5. Interruptions in social interactions can impact children’s emotional well-being

Beyond the family, children’s relationships with their friends can also be disrupted due to an infectious disease. Children may not be able to play or interact with their friends regularly or at all for long periods of time. Social interactions children have with peers play an important role in children’s social development.

During the Ebola outbreak in Sierra Leone, children reported feeling sad, lonely and lost without the camaraderie of their peers.[iv]

6. At the community level, infectious diseases can disrupt the cultural way of life

Children generally grow and develop within family and friendship circles that are nested within communities. Disruptions to families, friendships and the wider community can have detrimental consequences for children’s well-being, development and their protection.

The SARS outbreak in Singapore in 2003 had a psychological impact on healthy community members, fostered by anxiety and fear of infection.[v] In Tanzania, the impacts of a Rift Valley fever (RVF) outbreak in 2007 included the stigmatization of affected communities for having lost “respect and dignity.”[vi] All of these community-level impacts affect children.

As Save the Children works around the clock to help ensure the health, safety and emotional well-being of children, our teams are providing training and equipment to help reduce the risk of the disease spreading. As with all disease outbreaks, children and families who have limited access to health care or clean water are the most vulnerable.