COVID-19 pandemic has been 'devastating' to pediatric care, Saskatoon doctor says

The COVID-19 pandemic has been “devastating” to pediatric care, Saskatoon pediatrician Dr. Mahli Brindamour says.

“It's been really hard because we care about our patients so much and we want them to be well, and there have been limited opportunities for us to support them through the pandemic because the usual resources that we count on and are able to link or work with are just not available.”

She’s worried about kids not getting their immunizations, either because public health departments are overwhelmed or because people are restricting their visits to doctors' offices out of fear their child might contract COVID-19.

"Routine vaccines are probably the best public health interventions that we can ever do in someone's life. And so if, on top of COVID, we find ourselves with vaccine-preventable medical illness outbreaks, like, God forbid, measles, or rubella, or tetanus, then of course this is going to have devastating effects on children's health.

"We don't have time at the moment to deal with other pandemics because we need to deal with COVID. And so I don't even want to think about the effects of starting to find measles outbreaks, for example, in a daycare – that would be a catastrophe."

Brindamour also said public health departments are overwhelmed, leading to kids not getting properly screened and measured.

In fact, Saskatchewan public health nurses now begin their care of infants at the age of two months rather than two weeks due to the pandemic, according to Saskatchewan Union of Nurses President Tracy Zambory.

That puts nurses "behind the eight ball" when it comes to measuring a baby's growth; as a result, not all infants are being weighed and measured like they should be, she said.

In addition, appointments are now 15 or 20 minutes rather than 30 minutes to account for COVID-19 safety protocols. The Saskatchewan Health Authority has deemed measuring kids a "nice to have" rather than a "need to have" like immunizations and mental health check-ups, she said.

"Now it's just rushed and pushed, and it's just feeling like we're not giving the best that we could – doing the best with what we've got, but knowing that it's nothing like it was pre-pandemic."

Those early measurements can detect a medical issue slowing growth, Brindamour said. Kids might also miss developmental screens for issues such as a speech delay – and even if they are screened, access to specialists has been limited during the pandemic because of both COVID-19 cases and restrictions, she said.

"So for example, a child who doesn't hear properly, if we don't identify the hearing loss early enough, then the neurons that this child had in his brain develop his hearing and his speech will be lost. And so every day counts when we think in terms of therapies for children, and if we wait a year, that means that we have a year loss of that window to provide adequate care to these kids. And that might mean that they will have lifelong disabilities that could have been prevented had they had access to appropriate therapies early on."

She said there has also been an "explosion" of mental health disorders in kids during the pandemic – and one of the big factors is missing time in school.

"Schools are extremely important to the well-being of children for a variety of reasons. Not only do they need to learn and socialize, but it's also a safe space for children to be. And when kids don't access school, what has been demonstrated is that their mental health suffers.

"In our offices, and I speak in terms of pediatricians and pediatric care because that's what I do, we've been seeing so much more anxiety, so much more depression, we've seen an explosion of eating disorders during the pandemic times. And so of course, this is something that we need to think about in terms of the pandemic effects on kids’ health."

She said she tells parents that these are extraordinary circumstances and that grief, anxiety and depression are normal reactions. Parents should strive to normalize kids’ lives as much as they can while keeping them safe, and to contact their health care providers if they're struggling.

They can also advocate for public health measures to return so that the pandemic can end and people can go back to their normal lives, she said.

"Children have sacrificed so much to protect us. They stopped going back to school. They stopped doing activities, they stopped being in organized sports for our society to be safe. And now it's our turn to make sure that they are well, because adults, they can be vaccinated. They can wear masks to protect the most vulnerable members of our society, which now include unvaccinated children."

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