Intended for healthcare professionals


Is the UK's covid inquiry at risk of forgetting about children and young people?

BMJ 2022; 376 doi: (Published 24 March 2022) Cite this as: BMJ 2022;376:o785

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Covid-19: Public inquiry must include effects on children, say experts

  1. Robert C Hughes, clinical research fellow1,
  2. Michael Absoud, honorary reader2,
  3. Sunil S Bhopal, clinical lecturer in pediatrics3
  1. 1Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  2. 2Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
  3. 3Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

Almost the only thing that people seem to agree on about the SARS-CoV-2 pandemic and its management is that we need to learn lessons for future crises. As such, in the UK, there are high expectations of the upcoming public inquiry, chaired by Heather Hallett. But did those drawing up the draft terms of reference, published recently, forget about children? Hallett has a golden opportunity to examine who in government was responsible for childrens’ rights and needs, and to consider how children and adolescents have been affected by our pandemic response.

The (albeit short) Terms of Reference do not include the words child, childhood, babies, toddlers, school, childcare, college, or for that matter, play, interaction, or socialisation.1 During periods of lockdown and restrictions over the past two years, children have had their opportunities to interact, socialise, and play with other children or people outside their household severely limited. The covid inquiry now needs to consider whether these responses were proportionate to the risk faced by children from SARS-CoV-2 or to a broader goal of protecting society.

There is a mention in aim 1 of the terms of reference to the need to examine restrictions on education, which is clearly vital, and ought to be central to a wider examination of the impact of lockdown policies. Aim 2 specifically examines disparities relating to protected characteristics under the Equality Acts. It is important that the inquiry considers the role that schools play in providing a place where children access nutrition, exercise, safeguarding services, social care, healthcare therapies, and emotional wellbeing support. This is especially relevant for those living in poverty, and importantly for children with special educational needs and disabilities.

But we think that rather than considering age as just one among many protected characteristics, there needs to be specific mention of babies, children, and young people in this critical document guiding the inquiry.

Unless children are, by design, given prominence they are far too often absent from decision making, and their needs, opinions, and voices are diminished. We agree with the Children’s Commissioner Anne Longfield who said in September 2020, that “in many decisions taken over the last 6 months, children haven’t been at the forefront.”2

There is a growing body of evidence of the scale of harms that the covid pandemic, and our attempts to manage it, have done to children.3 From obesity to mental health, autism, protection from abuse, hearing or speech services, to universal health visits—the harms to children are different to those experienced by adults, and need to be considered separately. Many of these harms will have lifelong implications, affecting the health and happiness of families, communities, and the nation for many decades to come.

We would like to suggest the following changes to the terms of reference:

The terms of reference ought to specifically highlight the need to engage with children, young people, and parents, and consider their needs in the research phase. It must consider the differentiated impacts on children and young people, as distinct from adults, when learning lessons.

Children and young people ought to be actively involved in the inquiry, for example through inclusion on advisory boards or reference groups. For too long, their voices have not been heard by the government.

Initiatives like the Covid Inquiry inevitably attract lobbying from a variety of groups. But, for us, one early lesson from the pandemic is that children do not have enough lobbyists. Those adults working with children and young people need to bear this in mind, and help to ensure that their voices are sufficiently prominent in this inquiry.


  • Competing interests: none declared.

  • Provenance and peer review: not commissioned, not peer reviewed.