Statistics and Research to Protect Children and Families:
A. More or less 80-83% of individuals with infections will present with symptoms of COVID-19. “Earlier estimates that 80% of infections are asymptomatic were too high and have since been revised down to between 17% and 20% of people with infections.” https://www.bmj.com/content/371/bmj.m4851
Many medical doctors agree that consistent temperature and symptom screens in ports, airports, schools and the general public are essential to effectively reduce risk and prevent harm for the general public.
B. “80% of the time COVID-19 is a mild disease that feels like a minor cold or cough”, Prof Peter Piot, Director for The London School of Hygiene and Tropical Medicine.
C. “4.5% of the global population is likely to require hospitalisation if infected with SARS-CoV-2 and 95.5% of the general population will likely not require hospitalisation”, The London School of Hygiene and Tropical Medicine.
D. A COVID-19 related infection mortality rate of more or less 0.14% has been reported, and a case mortality rate of 2.63% has been reported in the UK, 2.37% in France, 1.66% in the USA, 0.94% in Denmark, 0.88% in Norway and 0.05% in Singapore (January 2021).
E. “4% of those younger than 20 years could be at increased risk for severe COVID-19”, The London School of Hygiene and Tropical Medicine.
“About 1 in 5 individuals worldwide could be at increased risk of severe COVID-19, should they become infected, due to underlying health conditions, but this risk varies considerably by age, for instance, the risk is 4% for those younger than 20 years and >66% for those 70 years and older”. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30264-3/fulltext
It is important to consider these figures relating to risk of general hospital admissions (4.5%) for the global population and relating to children (4%) at risk for severe COVID-19 when considering figures relating to increased risk and harm to the general population and children (up to 400- 500% increase) due to indiscriminate mandatory initiatives.
Risks and benefits must be weighed in all bio-psycho-social contexts to comply with ethics and medico-legal guidelines.
F. The purpose of most vaccines is to reduce serious morbidity and mortality, not to reduce or avoid mild symptoms.
Available SARS-CoV-2 vaccines present with a likely efficacy rate of more or less 70-90% (after two vaccine doses given 21-28 days apart for vaccines available in the UK), which loses efficacy over time and will likely require annual boosters.
Doctors agree that immunity, after active infection, likely lasts more or less 4-5 months, and immunity from vaccines will likely last more or less 8 months.
Doctors are concerned that instead of providing vaccines as per manufacturer’s guidelines, 21-28 days apart, it has been decided to extend this interval to 3 months in the UK, the British Medical Association has raised concerns regarding consequences. We have been informed that some pharmaceutical companies now state that 3 month intervals are acceptable, however, doctors continue to be concerned and many agree that maximum protection, without the extra 2 months delay, for high risk individuals (for severe COVID-19) should be the clinical priority.
It is our understanding that the first vaccine dose provides a likely efficacy of more or less 50% and the second vaccine dose provides a likely efficacy of more or less 70-90%.
Many agree individuals should be vaccinated first who are (and many countries follow these guidelines):
• high risk for severe covid-19 due to age or illness (category 1)
• health professionals and category 2/3 individuals with the above concerns fall into category 1
• individuals offering public services such as healthcare, education, social care or Police (category 2)
• and individuals not able to socially distance (category 3)
• with the rest of the general public (category 4)
Most doctors are happy to take or to have taken the #Oxford (#AstraZeneca) #vaccine, due to the pharmaceutical company’s longstanding reputation regarding safety and also because the organisation offered to make no profit during the pandemic (despite news of research likely soon to be published, which many medical doctors are not very concerned about). Most doctors realise a vaccine is “one of the tools in the tool box to manage infections”.
G. More or less 30-40% of the world’s population presents with chronic disease. Some studies report that more or less 4.3% of the world’s population had no health problems in a 1 year period and that 30% of the world’s population experiences more than 5 ailments in a 1 year period. “Mortality, morbidity and disability attributed to the major chronic diseases currently account for almost 60% of all deaths and 43% of the global burden of disease. By 2020 their contribution is expected to rise to 73% of global burden of disease.” WHO.
Some individuals in this group are at high risk for severe COVID-19 (group A) and some individuals are not at high risk for severe COVID-19 (group B). Group B constitutes at least 50% of this group (chronic disease), but likely more, and can constitute up to 36% of the general population, which is significant (some doctors report this figure may be much higher). Some individuals in group B have made an appeal and have advocated for normalcy, liberty and autonomy (many have concerns regarding reduced life expectancy). Many of our medical colleagues in group A, due to age with associated underlying medical problems, agree with group B.
Many children or families living in poverty, in informal settlements or in detention camps, where face masks are clinically indicated (due to social distancing not being possible or due to medical symptoms or problems), do not have access to face masks. Individuals not living in poverty, not with symptoms or medical problems, where social distancing is possible, 1km from informal settlements, are however “threatened with fines and prison sentences if they do not wear masks”, without clinical indication or evidence to support this initiative.
H. “Even in the world’s richest countries 1 in 7 children still live in poverty. Today 1 in 4 children in the EU are at risk of falling into poverty.” UNICEF. 1 in 6 children lives in extreme poverty, World Bank-UNICEF analysis, Oct 2020, and more or less 50% of children “1 billion of the 2.2 billion children worldwide are multi-dimensionally poor – without access to education, health, housing, nutrition, sanitation or water”. More or less 40% of the world’s population will require adequate and affordable housing by 2030. UNICEF. These statistics were concerning before the pandemic and as many organisations report, the figures have increased significantly in the last year due to measures restricting liberty.
I. More or less 25% of the world’s urban population live in informal settlements. United Nations
J. Children make up less than one third of the global population, but were 50% of the world’s refugees in 2018. UNICEF
K. Children, 0-15 years, make up more or less 20% of the population in the UK. Most doctors refer to children under age 18, when referring to children.
Children have to be protected during the pandemic from a bio-psycho-social point of view.
Schools play a protective role for most children, however risk reducing measures within schools such as temperature screens and symptom questionnaires (before school attendance) are essential to safeguard the general public, and are not in place in many countries.
Important statistics to consider regarding children in schools are:
Please see relevance https://mentalhealthbus.wordpress.com/2020/11/16/children-neurodevelopment-learning-mental-health-and-schools/
L. More or less 2.5% of children present with learning difficulties, more or less 15% of school aged children have special educational needs.
M. More or less 3-4% of children present with ADHD and more than 50% of children with ADHD present with at least 2 co-morbidities.
N. More or less 20% of adolescents are at risk of experiencing mental health problems in any given year, more or less 12.5% of 5-19 year olds had at least one mental health disorder and 10% of children 5-16 years have a clinically diagnosable mental health problem, yet 70% of children with mental health problems have not had appropriate interventions (diagnoses and treatment) at a sufficiently early age, as reported by The Children’s Society. These figures were reported before the pandemic.
Mental health concerns have increased markedly over the past year, 55-80%, as reported by most mental health organisations. Many individuals report that their main concern does not relate to the biological risk of the virus, but relates to restrictive initiatives depriving liberty, not based on good clinical evidence, weighing risks and benefits, such as indiscriminate mandatory mask wearing, stay at home, curfews, quarantine and lockdown initiatives.
O. Prevalence of mental disorders in the WHO European region was more or less 15% before the pandemic and 50% if neurological disorders such as epilepsy, dementia and headaches are included, as reported by the WHO.
“Mental disorders are one of the most significant public health challenges in the WHO European Region, being the leading cause of disability and the third leading cause of overall disease burden, following cardiovascular disease and cancers.” WHO
“People with mental health disorders die 20 years younger than the general population. The great majority of these deaths are not cause specific (in particular suicide) but rather from other co-morbidities associated with their mental conditions, notably noncommunicable diseases that have not been appropriately identified and managed.” WHO
We always recommend that children referred to child and adolescent mental health teams be seen by a Child Psychiatrist, with CCT’s (specialist qualifications) in Child Psychiatry, within the first 2 weeks for this reason, to screen for medical problems, and for the concerns raised by The Children’s Society, that 70% of children with mental health problems have not had appropriate interventions (diagnoses and treatment) at a sufficiently early age. Please contact us for more details.
P. It was reported by the WHO that 18.6% of children in England alone (2.2 million) lived with domestic abuse, parental drug or alcohol dependency and/or severe parental mental illness before the pandemic. WHO.
Risk to children has increased 80-400% during lockdown in this context, as reported by England’s Children’s Commissioner, and 581%, as reported by Respect, a national domestic violence charity.
Q. More or less 50% of children aged 2-17 suffered violence and 75% of children aged 2-4 years regularly suffered physical or psychological violence before the pandemic. Globally it is estimated that nearly 50%, 1 billion children out of 2.2 billion children worldwide, aged 2-17 years, experienced child abuse in the past year (before the pandemic). WHO
The NSPCC has reported that risk to children has increased 30-65% in this context, further to lockdown and many organisations including UNICEF have raised concerns regarding stay at home, curfew and/or quarantine initiatives for children in this context. NCMEC has commented on a 90% increase in concerns relating to child sexual exploitation.
Please know that statistics relating to child abuse, mental health and neurodevelopmental problems are likely much higher than reported.
Indiscriminate Mandatory Stay at Home, Shelter in Place, Curfew, Quarantine, Mandatory Self-Isolation and Lockdown Initiatives:
Statistics indicating increased risks due to above indiscriminate mandatory initiatives (most research relates to the UK):
A. 30-65% increase in child abuse, NSPCC, with 60% increase in concerns regarding online sexual abuse, NSPCC, and 90% increase in concerns regarding child sexual exploitation, NCMEC.
B. 300% increase in violence. “In the UK 14 women and 2 children were murdered in the first 3 weeks of COVID-19 lockdown, the highest figures in 11 years.” WHO
C. 400% increase in alcohol abuse, Alcohol Change UK, 2020. The Royal College of Psychiatrists reported in September 2020 that “new analysis find nearly 8.5 million adults drinking at high risk (up from just 4.8 million in February 2020), while number of people addicted to opiates seeking help in April at highest level since 2015”. Many individuals report that they “drink to cope with masks”, lockdown, curfews, quarantine or stay at home initiatives. It is important to note than when alcohol sales are banned, individuals usually find other, often more harmful, ways to “cope”.
D. 80% increase in domestic violence, National Domestic Abuse Helpline, 2020. “In the UK, calls, emails and website visits to Respect, the national domestic violence charity, have increased 97%, 185% and 581% respectively.” WHO
These figures are likely much higher than reported. It is important to note that most children do not report abuse, and that most women and men do not report domestic violence, alcohol or drug abuse.
E. 75-80% increase in mental health morbidity in individuals with a relevant mental health history during lockdown and 55% increase in mental health morbidity in individuals without a relevant mental health history have been reported during lockdown. Concerns also increase in terms of self-harm and suicidal ideation or attempts. These concerns relate to children and adults of all ages and cultural, educational, professional and bio-psycho-social backgrounds. Please see MIND, Young Minds and Samaritans for more details.
Significant numbers of individuals with mental health and general health concerns have not been identified and many do not seek help for various reasons.
F. 93% increase in non-engagement in required hospital appointments, RCPCH. 50% of individuals with a worsening condition did not seek assistance, UK GOV. 40% of individuals with mental health problems did not seek assistance. Young Minds. Many report “protect the NHS” messages, mandatory mask wearing initiatives, quarantine, stay at home directives, lockdown and curfews prevented them from “seeking help”.
G. Cabinet Office polling, UK, indicates that only 17% of individuals with symptoms of COVID-19 informed health staff or requested tests in the UK. Many report “we live without freedom if we are healthy, why make it worse”, this increases risk.
H. The increase in statistics relating to poverty and extreme poverty has been extensively documented by many organisations. The Trussel Trust, UK, reported an 89% increase in need for emergency food parcels in the UK, April 2020. Oxfam identified that border closures, curfews and travel restrictions caused breaks in food supply that threatened to cause 12 000 deaths a day worldwide, exceeding the 10 000 deaths a day recorded from COVID-19 in April 2020.
WE RECOMMEND THAT YOU ALWAYS FOLLOW GOVERNMENTAL LAWS, RULES AND POLICIES.
“Lockdowns have just one consequence that you must never ever belittle, and that is making poor people an awful lot poorer.” Dr David Nabarro, Special Envoy on COVID-19, World Health Organisation
The UN reports “we are just beginning to fully understand the damage done to children because of their increased exposure to violence during pandemic lockdowns, said Henrietta Fore, UNICEF Executive Director.”
UNICEF, October 2020, reports “Lockdowns and shelter in place measures come with a heightened risk of children witnessing or suffering violence and abuse and can also expose children to new protection risks. When it comes to violence, a number of factors related to confinement measures are likely to result in increased risk for children including heightened tensions in the household, added stressors placed on caregivers, economic uncertainty, job loss or disruption to livelihoods, and social isolation. Children may also increasingly witness intimate partner violence.”
“Children have fewer health risks from COVID-19 and yet they have suffered disproportionally from the nation’s efforts to contain this virus.” Anne Longfield OBE Children’s Commissioner for England, Summer 2020
“This war, and I think it is reasonable to call it a war, against this virus, which is going to go on for the foreseeable future, is not going to be won by creating tougher and tougher rules that attempt to control people’s behaviour. The only way we will come out ahead of this virus is if we are able to do the right thing in the right place at the right time, because we choose to do it.” Dr David Nabarro, Special Envoy on COVID-19, World Health Organisation