Wong, C. A., Ming, D., Maslow, G., & Gifford, E. J. (2020). Mitigating the impacts of the COVID-19 pandemic response on at-risk children. Pediatrics, 145(4), e20200973.
Although children are not at the highest risk for coronavirus disease 2019(COVID-19)1severe illness, necessary pandemic public health measureswill have unintended consequences for the health and well-being of thenation’s at-risk children. School closures, social distancing, reduction inhealth care services (eg, canceling nonurgent health care visits), andubiquitous public health messaging are just some of the measuresintended to slow the COVID-19 spread. Here, we (1) highlight thehealth risks of the pandemic response measures to vulnerable pediatricsubpopulations and (2) propose risk mitigation strategies that can beenacted by policy makers, health care providers and systems, andcommunities (Table 1). The selected risks and proposed mitigationstrategies are based on existing evidence and opinions of expertstakeholders, including clinicians, academicians, frontline serviceproviders (eg, social workers), and public health leaders.
We focus on risks and mitigation strategies for 3 at-risk subpopulations ofchildren: (1) children with behavioral health needs, (2) children in fostercare or at risk for maltreatment, and (3) children with medical complexity(CMC). Mitigation strategies delineated for these at-risk populations arealso likely beneficial for any child and family. Importantly, children notalready in these groups are at risk for facing new medical, behavioral, orsocial challenges that develop during the pandemic. In particular, childrenin households of low socioeconomic status are likely at the highest risk fornew or worsening issues, underscoring the critical leadership role ofMedicaid programs in these risk mitigation strategies.
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