The Kids Aren’t All Right
COVID-19 doesn’t appear to be a major concern for children’s health, but the youngest among us will still bear the larger burdens of trauma and economic fallout.
One of the lonely silver linings of the COVID-19 pandemic is that the disease doesn’t appear to be that bad for kids. Although children are certainly not immune, and a study of the outbreak in Wuhan indicates that infants are susceptible to severe complications, most healthy kids don’t seem to face a significant risk of death.
So far, at least in America, much of the conversation around social distancing and lockdowns has centered on protecting elderly folks and those with underlying medical conditions from a virus that is uniquely dangerous for them. Even adults with kids—present company included—tend to consider their kids in terms of how they interact with older people. Yet the long-term health and well-being of our suddenly housebound cherubim haven’t really entered the picture. They’ll be all right, right?
Perhaps not. If the world has learned anything in the past week, it’s that mortality is only one risk of this crisis. The global economic system is in full panic mode. State lockdowns and travel restrictions are proliferating with the expectation that coronavirus cases will soon skyrocket, bringing Italy-like situations to many places in America. This is likely a once-in-a-generation disaster, and it will affect every domain of human life. It will be traumatic. And trauma always falls hardest on the youngest among us.
The country has learned this lesson the hard way before. In 2005, when Hurricane Katrina and the crucial failures of federal levees devastated the Gulf Coast and the city of New Orleans, a generation of young people bore the brunt of the long-term damage. The storm and the flood were only the first in a chain reaction that uprooted children from homes and communities, and evacuated many of them to brand-new places across the country. They lost family members and friends, endured bullying in new places, suffered high rates of homelessness and violence, and faced major disruptions in learning and support traditionally provided by school.
The body of research conducted in the years since Katrina indicates that those effects have endured over time, especially for poor children and children of color. In the book Children of Katrina, the University of Vermont’s Alice Fothergill and the University of Colorado at Boulder’s Lori Peek spent seven years studying the effects of Katrina on young people. Their findings were stark. Children exposed to Katrina and its aftermath were much more likely to suffer emotional disturbances than other kids, even years later. They found that the likelihood of uneven recovery among kids was directly linked to existing social disadvantages—namely poverty and race.
“Disasters last a really long time in the lives of children,” Fothergill told me by phone. Rather than “bouncing back,” as many adults seem to expect, children incorporate trauma into their growth and future lives. Unfortunately, adults don’t usually consider that in their policy creations, especially when it comes to dealing with crises. “People are talking about vulnerability, but they are not talking about children at all,” Fothergill said.
Even now, almost 15 years after Katrina, there’s a frank acknowledgment of the way the flood still lives with people who were children then. Billboards around town featured a slogan of sorts from Denese Shervington, the president and CEO of the Institute of Women and Ethnic Studies. Untreated trauma is the underbelly of violence the slogan reads, and Shervington told me it’s a guiding principle for her work promoting healing and resiliency in youth. “Katrina left PTSD rates in children similar to veterans,” she said.
To be sure, Hurricane Katrina is not a perfect parallel to the coronavirus pandemic. Kids were not spared from the floodwaters, or from any phase of the disaster after. The hurricane and flood in 2005 were sudden, brief events, whereas according to the much-discussed Imperial College of London report on social distancing, it’s possible to expect 18 months of waves of lockdowns to stop the coronavirus, including periodic school closures.
Yet Fothergill said the actual dynamics of how kids absorb this pandemic will follow patterns observed during and after Katrina. According to a 2017 study by Fothergill, kids experience the general atmosphere of anxiety and panic as acutely as adults do, only they might be better at hiding it. That fact might contribute to a general sense among adults that children are somehow naturally “resilient,” and can bounce back easily. And that attitude from adults can hamper both proactive attempts to help children process what’s happening, and necessary therapeutic efforts after the disaster.
Hunkering down at home may seem different from the mass evacuation after Katrina, but in practice it can have similar effects, especially for kids who are already vulnerable. For children who spend time in multiple households, rely on outside figures for guidance or mentoring, or are used to a stream of relatives in and out of home, prolonged social-distancing measures will mean profound separation from some people who provide care. All the FaceTime in the world can’t make up for fill-in help from aunts, uncles, grandmothers, and gym coaches. And for some kids, those supports are the main things interceding in a toxic—or even dangerous—home environment.
While most adults still have work and other routines to carry on, school is the primary source of structure and socialization for kids. Children have rich social lives, often experienced almost exclusively in school and extracurricular activities. And schools are the primary providers for lots of essential services. As New York City debated recently, schools are the only thing standing between some children and food insecurity. Beyond that, schools might be the only places some kids receive even cursory dental, physical, or mental-health care; rigorous physical activity; or clean water. A 2019 overview of formally established school-based health centers found they provided primary-care services for more than 6 million students across almost 11,000 schools. Low-income households are already struggling to grapple with the rising price of municipal water—and now a major source of free water for low-income kids will be gone in some places for a month or more.
The staggering economic fallout from the coronavirus pandemic will add a new dimension of suffering to the experience of young people. The numbers struggle to capture the reality of the situation. In the middle of mass freezes of whole sectors of industry, perhaps a fifth of all workers have lost their jobs or had significant cuts to hours in a span of days. If the pandemic does indeed spark a recession, then data from previous downturns indicate that food security, physical health, and general well-being for children will diminish, and quickly.
Rand Conger, a professor emeritus at UC Davis and a longtime researcher of the intergenerational consequences of poverty, told me the data from previous recessions are clear, and that we’re only beginning to see the effects. Conger studied the agricultural downturn in the 1980s, and followed patterns of disintegration of spousal and parental relationships, as well as spikes in child abuse. “It was so devastating for so many families,” Conger said, “and severe punishment tends to increase.” Child neglect and abuse tend to track with greater traumatic events, economic instability, and stress. Sadly, they might be tracking already. Reportedly, a single hospital in Fort Worth, Texas, has treated six children with severe physical-abuse-related injuries. Doctors believe the cases are related to parents’ stress over the pandemic.
All the evidence suggests that children—and poor children especially—will bear an incredible burden during the coronavirus pandemic and the attendant economic shocks. But that evidence has trouble breaking into a national conversation dominated by mortality rates and work-from-home strategies. Bruce Lesley, the president of First Focus on Children, told me this failure could be costly for kids. “It’s all the stuff that people just aren’t thinking about in terms of this crisis and how it feeds into existing problems and exacerbating them,” he said. “In enormous ways, I just think that people are missing all those sorts of things.”
It’s a morbid, anxiety-inducing exercise—trying to forecast all the ways things could go wrong—but it’s one Lesley thinks is necessary for working proactively to save children. In addition to supporting direct payments to families in this crisis, Lesley is advocating for an expansion of the Supplemental Nutrition Assistance Program (SNAP), funding increases to federal support for homeless and foster children, and a national moratorium on evictions. The one piece of good news is that there are plenty of lessons to learn from events like the Great Depression, the HIV crisis, and Hurricane Katrina that can help the country prepare to protect the youngest generation.
The coronavirus is a strange beast. By severing intergenerational relationships, it disrupts all the ancient ways families have always coped with disasters. It is singularly difficult to combat in the modern age of interconnected economies. And, through whatever quirk of biology, the virus appears to mostly spare children. All of those things might tempt Americans to think of it as something new, to be relieved by its selective mercies. But the most likely outcome is that this pandemic, like most others in history, will again uncover our most basic inequities. For children and their parents, that might mean that mortality rates are only the beginning of the story.