Almost 1.2 million children could die as a result of the coronavirus lockdown, new modelling shows.
While evidence suggests children are less likely to be severely affected by the coronavirus, the indirect effects of the outbreak could be deadly, experts say.
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A new paper published in the medical journal, The Lancet, this week warns that if mothers and children living in low and middle-income countries are unable to access routine health care or get enough food, the increase in child and maternal deaths will be "devastating".
Lockdown measures and disruptions to health services could mean mothers have reduced access to essential medications, antibiotics and clean birth environments, while children may become malnourished and waste away.
The researchers from Johns Hopkins Bloomberg School of Public Health and Unicef modelled three different hypothetical scenarios, where the outbreak's impact on health services and wasting (acute undernutrition) would be small, moderate and severe.
The modelling showed that even under the best-case scenario – if essential health care services are reduced by around 15 per cent and child wasting increases by just 10 per cent – an additional 253,500 children under the age of 5 and 12,200 mothers will die over just six months.
Under the worst case scenario – if health services drop by 52 per cent and wasting increases by 50 per cent – an additional 1,157,000 children and 56,700 mothers will die over the same time.
More than 6000 children would die every day.
"These projected child deaths would be in addition to the 2.5 million children who already die before their fifth birthday every six months, threatening to reverse nearly a decade of progress on ending preventable child deaths," the United Nations children's charity, Unicef, said.
Sacha Deshmukh, the executive director of Unicef UK, said the pandemic was "undoubtedly the biggest and most urgent global crisis children have faced since World War II".
"Children's lives are being up-ended across the globe – their support systems ripped away, their borders closed, their educations lost, their food supply cut off."
THE INDIRECT EFFECTS OF EBOLA WERE 'WORSE'
According to the researchers, travel bans, the redistribution of medical supplies and health workers to help deal with the influx of virus patients, as well as major disruptions to the global medical supply chain could all have an impact on mothers and children.
Burnout among health workers, a reduction in public transport, missed vaccinations, lost income and increased prices could also hit vulnerable families hard.
"Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and as communities remain fearful of infection," Unicef said.
An analysis of the 2014 outbreak of Ebola virus in west Africa showed that the indirect effects of the outbreak were actually more severe than the outbreak itself, the paper said.
Not only did access to antenatal care decrease, but there were also declines in access to family planning, facility delivery and post-natal care.
"Qualitative studies suggest that these reductions were due to fear of contracting Ebola virus at health facilities, distrust of the health system, and rumours about the source of the disease," the paper noted.
GOVERNMENTS MUST WEIGH THEIR OPTIONS
As the pandemic drags on and countries face potentially several more months, if not years of living with social distancing and strict public health measures, experts have warned governments must consider each move carefully.
"In weighing their options, policy makers must consider not only the immediate health effects of the pandemic but also the indirect effects of the pandemic and the response to it," the researchers said.
"The choices that governments make in responding to the pandemic will have consequences for the health and livelihoods of populations."
The 10 countries that could see the greatest number of additional child deaths, according to the paper, are Bangladesh, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and United Republic of Tanzania.
The World Health Organisation (WHO) has previously warned that outbreaks "often" lead to the neglect of basic and regular essential health services.
Unicef UK has now launched its biggest ever appeal – Save Generation Covid – to help tackle the impact of coronavirus.
It says the money raised will go towards "supplying vital medical equipment, working with communities, supporting health, education and social services for children, tackling misinformation and carrying out prevention campaigns".