RE: Addressing the indirect effects of COVID-19 on the health of children
References
1. Guthold R, Stevens RA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc Health 2020; 4: 23–35
2. Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected. Prog Cardiovasc Dis 2020; 63 (4): 531 - 532
3. Xie X, Xue Q, Zhou Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr 2020;174(9): 898-900
4. National 4-H.Council. 4-H youth mental health survey. Accessed June20, 2020. https://4-h.org/about/research/#!healthy-living
5. Chanchlani N, Buchanan F, Gill PJ. Addressing the indirect effects of COVID-19 on the health of children and young people. CMAJ 2020;192:E921-E927.
In 2018, the World Health Organization (WHO) launched a global action plan targeting a 15% reduction in insufficient physical activity among adolescents by 2030, because 80% of youth were not meeting recommendations.1 Accordingly, the WHO called for an urgent “scaling up” of programmes aimed to increase physical activity and reduce screen time.1 Unfortunately, the COVID-19 pandemic has thwarted these efforts. Surveys of 2426 children from China showed a reduction of 7 hours per week in physical activity and a corresponding increase in 30 hours per week of screen time, when comparing activities before and after implementation of pandemic restrictions.2 The implications are dire, since prolonged screen time has been linked to depression and anxiety among youth.3 In fact, 64% of teenagers surveyed indicated that COVID-19 will have a lasting effect on their generation’s mental health.4 Public health measures must therefore balance the effects of pandemic restrictions against the risks of viral transmission among children.5
The authors highlight the need for data collection among youth groups.5 To this end, Swim Alberta performed a retrospective analysis of data collected from 5873 registered swimmers who participated in swimming cohorts from July to November 2020. Aggregate data from 5447 of 5873 registered swimmers (93%) representing 223324 swimming hours were included. The majority (86%) of cohort participants were aged 18 years or younger, with a female preponderance (59%). Among 332 swimming cohorts, there were 14 incident cases of COVID-19. There were no reported cases of viral transmission between swimmers, from coach to swimmer, or swimmer to coach. The retrospective nature of this analysis and self-reporting mechanism of COVID-19 status were obvious limitations. It is also unclear whether the low rates of infection reflect the efficacy of the cohort model or the protective effects of a chlorinated environment; these issues warrant further study.
The indirect effects of COVID-19 threaten the physical, social, and mental health of youth.5 Physical fitness has benefits for children that carry forward into adulthood. Efforts to mitigate the “collateral damage”5 caused by pandemic control measures should focus on the safe return to sports and recreational activities. Data-informed policies must be aligned with the WHO global action plan, nurture foundational physical literacy, and protect the right to play.1