Intended for healthcare professionals

Rapid response to:


Risks to children and young people during covid-19 pandemic

BMJ 2020; 369 doi: (Published 28 April 2020) Cite this as: BMJ 2020;369:m1669

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Rapid Response:

Where is the voice of the child in weighing the cost of this pandemic?

Dear Editor,

As frontline paediatricians advocating for the rights and safeguarding of children, we applaud Dr Green’s editorial (1) and call upon the government to shift the focus to children and the collateral damage they have suffered as a result of the pandemic in terms of their health and well-being.

Information regarding the pandemic has not been communicated in a child and youth friendly manner. New Zealand and Norway have both held press conferences for children only, whereas our government has never done this since the pandemic broke (2,3).

As a collective we share concerns around the vulnerability of our children and young people. We worry for the children at home, hidden from society and some living with the perpetrator of their abuse. Their voices and cries cannot be heard.

Calls to Childline have dramatically increased (4) and domestic violence arrests are up by 25% (5) but by contrast, our child protection referrals are down. Teachers, social workers, health visitors, community midwives – all partners in safeguarding - have had their interaction with children and young people reduced.

As paediatricians on the frontline, we have seen an overall decline in attendances to the emergency department (ED) but witnessed families and young people coming to ED for issues that would have been absorbed by community and safeguarding teams: babies exhibiting poor weight gain who may have been picked up via our community services pre-Covid-19; distressed mothers bringing their constantly crying babies who may have avoided medical attention with the presence of extended family to support; parents presenting late with their septic babies, fearful to come to hospital due to the virus.

We worry for the mental health of young people who we are seeing attending ED in crisis with nowhere to turn. Their triggers are varied (6) but isolation has certainly played a part (7). Having previously been warned of the dangers of spending too much time in cyberspace, children and young people are now spending a vast amount of time online for education and socialisation and the risks are very real (8). Meanwhile their lives are on hold, impacting both emotional resilience and mental wellbeing.

Protecting children is everyone’s responsibility and never have those words been more meaningful. We must all act now to give children a voice: not just the professionals to whom this role would ordinarily be given, but their local communities. By empowering neighbours, delivery drivers, supermarket workers and those who now may be the only ones seeing our young, through education, they may speak up and report any concerns to the NSPCC or Children’s social care.

We call upon Government to direct resources to enable community workers from health, education and social care to visit homes and connect with children at risk. We also need a strategy to safely bring all children back to school.

We call upon Government to move quickly and decisively to try and repair the harm suffered by young, vulnerable people during this pandemic. Failure to do so will come at a price too high.

Where is the voice of the child in weighing the cost of this pandemic? These children need a voice.

1. Green P. Risks to children and young people during covid-19 pandemic BMJ 2020; 369 :m1669.
2. Young, E. 'It’s okay to be scared’: Norway PM holds children-only COVID-19 press conference’. SBS News. 2020 March 17..
3. Ainge Roy, E. Jacinda Ardern holds special coronavirus press conference for children, The Guardian. 2020 March 19.
4. Morgan, T. Coronavirus: Child abuse calls to NSPCC up 20% since lockdown. BBC News. 2020 April 30.
5. Kelly, J & Morgan, T. Coronavirus: Domestic abuse calls up 25% since lockdown, charity says. BBC News. 2020 April 6.
6. Gombert-Waldron, K. Children and stress, what’s worrying them most, Children’s Commissioner. 2020 May 20.
7. Young Minds. Coronavirus having major impact on young people with mental health needs – new survey. 2020 March 30.
8. Girlguiding. Girlguiding research briefing: Early findings on the impact of Covid-19 on girls and young women. 2020 May.

Competing interests: No competing interests

29 May 2020
Najette Ayadi O'Donnell
General Paediatric Registrar (ST7)
Pan London Trainee and Consultant Paediatric Safeguarding Group: Dr Sveta Alladi, Dr Anna Battersby, Dr Sarah Boutros, Dr Sonya Hiremath, Dr Hannah Jacob, Dr Rachel Jones, Dr Luximi Kabilan, Dr Alice Monfrinoli, Dr Kate O’Loughlin, Dr Emma Parish, Dr Philippa Singer
Great Ormond Street Hospital
Paediatric Intensive Care Unit, Great Ormond Street, London WC1N 3JH