First Do No Harm

First Do No Harm

“Lockdowns have just one consequence that you must never ever belittle, and that is making poor people an awful lot poorer.”  Dr David Nabarro, World Health Organisation 

“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 riles that attempt to control people’s behaviour. The only way that we will come out ahead of this virus is if we are all able to do the right thing in the right place at the right time, because we choose to do it.” Dr David Nabarro, 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.”

Statistics during lockdown:

Oxfam identified that border closures, curfews and travel restrictions had caused breaks in the 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. 

The Trussell Trust, Stop UK Hunger, reported an 89% increase in need for emergency food parcels in April 2020 compared to the same month last year.  At the end of April, 350 000 children were living in a household where someone had been forced to skip a meal in the last week and 249 000 were in families that accessed food-banks.  Only 47% of children who would usually be receiving Free School Meal scheme food were provided either meals or vouchers.

Young Minds, Survey, Summer 2020, reports “80% of respondents agreed that the corona virus pandemic had made their mental health worse; 41% said it had made their mental health ‘much worse’, up from 32% in the previous survey in March. This was often related to increased feelings of anxiety, isolation, a loss of coping mechanisms or a loss of motivation.  87% of respondents agreed that they had felt lonely or isolated during the lockdown period, even though 71% had been able to stay in touch with friends.  31% said they were no longer able to access support but still needed it.  Of those who had not been accessing support immediately before the crisis, 40% said that they had not looked for support but were struggling with their mental health.  11% of respondents said that their mental health had improved during the crisis, an increase from 6% in the previous survey. This was often because they felt it was beneficial to be away from the pressures of their normal life (e.g. bullying or academic pressure at school).” 

MIND, June 2020, reports “Two thirds (65%) of adults and three quarters (75%) of young people with experience of mental health problems said their mental health has gotten worse during lockdown.  Over half of adults (51%) and young people (55%) without experience of mental health problems also said their mental health has got worse during this period.  Young people are more than twice as likely as adults to have used self-harm as a coping strategy (28% of young people vs 11% of adults).  Nearly a third (30%) of under-18s self-harmed to cope, with this rising to over a third (36%) of 16 and 17 year olds.  One in three young people (33%) with experience of mental health problems self-harmed to cope during lockdown.”

Samaritans report “In a survey of over 70,000 adults in the UK just over 1 in 10 reported experiencing suicidal thoughts or thoughts of hurting themselves during the first week of lockdown.  2% reported to have self-harmed or attempted suicide during the first week of lockdown.”

The National Child Mortality Database (NCMD), England, July 2020, reports “In 2020, during the 82 days before lockdown, there were 26 likely child suicides and a further 25 in the first 56 days of lockdown, and the proportion of cases under 15 years of age appeared higher, but these differences did not reach statistical significance.  In 12 (48%) of the 25 post-lockdown deaths, factors related to COVID-19 or lockdown were thought to have contributed to the deaths.”  

MIND, June 2020, reports “A third (32%) of adults and over a quarter (28%) of young people did not seek mental health support during lockdown as they did not think that their issue was serious enough.  More than 1 in 6 (18%) of adults and a quarter (25%) of young people tried to seek help during lockdown, and 1 in 4 (24%) of adults and more than 1 in 4 (28%) of young people were then not able to access the mental health support that they sought.  6% of adults and 9% of young people did not seek mental health support as they were not sure how to do so. This rises slightly to 10% of 18–24 year olds, making them almost twice as likely as over-25s to not have accessed support because they did not know how to.”

Research and analysis, UK GOV, 15 October 2020:  “Of those reporting that they had a worsening health condition during the week leading up to 10 August, around 50% reported that they have not sought advice for their condition.  The most common reason for not doing so was to avoid putting pressure on the NHS.”

 Statistics illustrating significantly increased figures relating to at risk behaviour and child abuse (please know child abuse statistics are likely much higher than reported due to various factors):

Calls to the National Domestic Abuse Helpline increased by 80% in June 2020, while the number of people seeking help from Alcohol Change UK for problem drinking increased nearly 400% from 4089 between 23 March and 30 April last year to 20 067 in the same period this year. 

NSPCC:  Child abuse statistics pre-lockdown 30-day average, 6 Jan-22 March 2020 = 1 325, compared to lockdown 30-day average, 1-31 May 2020 = 1 730 (30% overall increase) 

Physical abuse = 420 vs 559  (33% increase) 

Emotional abuse = 303 vs 500  (65% increase)

Neglect = 30 vs 44  (46% increase)

Sexual abuse = 572 vs 627  (9.6% increase) 

The NSPCC helpline reports a 60% increase in contacts from people with concerns regarding children experiencing online sexual abuse.

Childline reports an 11% increase in the number of counselling sessions regarding online sexual abuse since the stay-at-home guidance was issued.

Between January and June 2020, the US National Center for Missing and Exploited Children (NCMEC) received 12.1 million reports of suspected child sexual exploitation, an increase of 90% from 6.3 million reports during the same time period a year earlier.  

The Internet Watch Foundation and its partners blocked at least 8.8 million attempts by UK internet users to access videos and images of child sexual abuse during lockdown.

Baseline statistics for child abuse before the pandemic (please know child abuse statistics are likely much higher than reported due to various factors): 

Globally, it is estimated that up to 1 billion children aged 2–17 years, have experienced physical, sexual, or emotional violence or neglect in the past year.  WHO

1 in 2 children aged 2-17 years suffered violence in the past year, 12% of children were physically abused in the past year.  WHO

Nearly 3 in 4 children or 300 million children aged 2–4 years regularly suffer physical punishment and/or psychological violence at the hands of parents and caregivers.  WHO

Every year, there are an estimated 40 150 homicide deaths in children under 18 years of age, some of which are likely due to child maltreatment.  WHO

Figures relating to the UK:

The WHO reports before the pandemic 2.2 million children in England alone lived with domestic abuse, parental drug or alcohol dependency and/or severe parental mental illness.  Just over 100 000 children in England lived in a household where all three issues were present.  Estimates by CCO show that 379 000 under-fives live with parents suffering from severe mental ill health, and 145 000 are living with parents suffering drug and alcohol problems.  It is estimated that 235 000 under-fives live in houses where domestic violence has taken place in the last year.  

As previously stated, and reported by England’s Children’s Commissioner, risk to children has increased 80-400% during lockdown in this context.  

In the last five years there was an average of 62 child deaths a year by assault or undetermined intent in the UK.  On average, at least one child is killed per week in the UK.  Children under the age of one are the most likely age group to be killed by another person, followed by 16- to 24-year-olds.  Child homicides are most commonly caused by the child’s parent or step-parent; whilst adolescent homicides are most commonly caused by a stranger, friend or acquaintance.  Official measures are likely to be underestimated. NSPCC 

New figures obtained reveal that police recorded more than 200 child sex offences, on average, every day last year.  There were 73,518 recorded offences including rape, online grooming and sexual assault against children in the UK in 2019/20, up 57% in the 5 years since 2014/15. Where gender and age were recorded girls were 4 times as likely to be victims, there were more than 8,000 offences committed against 14-year-olds, making it the most common age group to report offences, there were 12,374 sex crimes recorded against children under 10, and 449 offences were recorded against babies yet to reach their first birthday.  NSPCC, 10 August 2020, England.  

As previously stated, and reported by the NSPCC, child abuse figures in the UK have increased by 30-65% during lockdown in recent reports (90%, as reported by NCMEC).  

Child abuse statistics are likely much higher than reported due to various factors. 

These statistics were unacceptable before the pandemic and lockdown, especially in a world where emphasis is placed on safeguarding a future or a suitable environment or climate for the future.  Many would agree that children are our future, and considering child abuse statistics in every country, including the UK, this might be the most appropriate place to start to aim to ensure a future.

Let us work together to protect our most vulnerable in all age groups. 

#lockdown #covid19 #childabuse #FirstDoNoHarm #schoolmeals #mentalhealth #anxiety #suicide #depression #curfews #deaths #children #future #planet #world #safeguarding #priority #ChildProtection

The Immune System is a system designed to protect the body against risks such as infections including this virus; the immune system learns, adapts and develops, much like some viruses

The immune system is one of the most complex systems in the body and most doctors will agree that this system is not well understood by most, however, it is a system designed to protect the body against risks such as infections including this virus; the immune system learns, adapts and develops, much like some viruses.  

Immunity, considering a biological context, refers to resistance to pathogens and external agents, such as infections.  Tissue (eg spleen, liver, lungs, intestines, bone marrow, lymph nodes, blood and skin), cells (eg lymphocytes) and molecules (eg antibodies) mediate reactions and constitute an immune system.  The coordinated response of these cells and molecules to pathogens and other substances comprises the immune response.

The immune system or response significantly affects susceptibility or resistance to infections and subsequent prognosis in terms of morbidity (degree of illness, associated complications, recovery times and outcome) and mortality, as most medical doctors would agree.

We are concerned that this important system is not considered in the risk management plans or any of the ongoing debates during this health crisis.  We are not referring to herd immunity in any way or immunity in the context of vaccines; we are referring to the immune system in every human’s body that is designed for protection against external agents such as this virus.  

The protective role of the immune system extends to important functions such as relating to recovery, tissue generation, scarring and a defence against tumours, however, the main physiological function is to be a defence against, to prevent or eradicate, infections.  It is therefore essential that the immune system of every person is healthy, supported and protected, particularly in this context of the pandemic.  Initiatives that negatively impact on the immune system, by eg causing stress or chronic anxiety, will therefore likely cause significant immediate and long term harm, as per evidence-based research.  

The immune system is therefore directly related to clinical outcome for every member of the public in the context of the pandemic.  

Initiatives to support the immune system, for low and high risk individuals within the public, are usually simple, although it affects clinical outcome significantly, as most medical doctors would agree.  Many countries in Asia focused on these initiatives, particularly relating to normalcy, liberty and autonomy, as observed firsthand, with good clinical outcomes.  

 Our work with an immunologist on paediatric and neurology wards inspired us to remember the reciprocal interaction between the immune system, the brain and the body; it is one of the most effective tools we have to protect against biological risks and disease.  Most doctors will agree that the brain and body are given powerful messages by context, physical surroundings, social environment, behaviour, thoughts and feelings, and this affects general health and mental health significantly.

Simple protective initiatives often have a significant impact on clinical general health and mental health outcome for high and low risk children and communities.

#immunesystem #covid19 #resistance #prognosis #outcome #recovery #complications #mortality #protective #FirstDoNoHarm #anxiety #normalcy #liberty #autonomy #mentalhealth #health #medicaldoctor #anxiety #calm

Normalcy

Normalcy is a very significant protective factor for mental health and general health, and is often advised and emphasised by medical doctors as part of treatment programmes for children and adults with general medical and/or mental health problems.

We observed in countries in Asia that the public was advised to regularly leave their homes, engage safely within the community with general evidence-based initiatives to protect against respiratory infections (eg wash hands before a meal) and support the immune system (eg maintain a calm and positive mental state and environment, positive in person engagement with loved ones and peers, regular engagement in normative activities, relaxation in fresh air with nature and/or animals, regular exercise, sufficient sleep, adequate hydration and healthy food options such as fresh fruit and vegetables).  These recommendations were advised on large TV screens on a near constant basis within the public; one example was of a grandfather teaching his children how to fish and prepare meals with fresh vegetables, the way he was taught as a child.

Normative activities include engagement in positive face to face social interaction within the community with loved ones, supportive seniors and peers with similar interests, engagement in challenging, enjoyable, meaningful and relaxing activities and hobbies, along with learning and achieving goals, which improve or maintain confidence.  

These normative activities fall under protective factors and contribute significantly to a healthy immune system, general health and mental health for children and adults, along with social, language, emotional, cognitive and physical development, and general well-being in children and young people, preventing impairment and distress for the general public.  We consistently emphasise the importance of these protective factors in all clinical domains with good clinical outcomes.  Treatment resistant cases referred to as ‘hopeless’ are often referred to us, and we almost always attribute positive outcomes to an emphasis on protective factors including normative activities.  Many high risk children associate positive outcomes with “to be busy and to belong” (physical and mental health assessment of 93 unaccompanied minors in #Liverpool in 2005). 

 Normalcy requires a context of liberty and autonomy to maintain a protective function for most adults and young people.  Normalcy, liberty and autonomy were advocated throughout Asia during our travels, as observed firsthand; the public was educated well regarding risk and protective factors, and then asked to make responsible decisions to protect self and others. 

#childpsychiatrist #medicaldoctor #learning #mentalhealth #development #normalcy #normativeactivities #protection #health #interaction #confidence #liberty #autonomy #GlobalHealthPlan #Systemic #covid19 #coronavirus #Health #FirstDoNoHarm #immunesystem #childdevelopment #unaccompaniedminors

Children, neurodevelopment, learning, mental health and schools:

Children, neurodevelopment, learning, mental health and schools:

Schools and education play an important protective role for all children, including the most vulnerable, in terms of cognitive, language, social, emotional and physical development, mental health, physical health, social risk and well-being.  Please see statements relating to normative activities. Systemic risk and protective factors in the context of #covid19 must however be identified, considered, weighed and managed by professionals with experience in this context.  

Doctors with training and experience in neurodevelopment, especially in the context of respiratory infections, will likely have concerns regarding schools opening without additional and effective risk reducing initiatives.  Most adults who work with children present with frequently increased incidence of upper respiratory infections (colds or flu).  Children also visit grandparents and elderly relatives, and engage within the general community unsupervised or supervised.  This impacts on risk for communities.  

Normal neurodevelopmental stages of children indicate that children (without learning, neurodevelopmental and mental health problems) are often significantly more physically playful, fidgety, impulsive, inattentive and forgetful than adults.  Consider research where authority figures inform children that they cannot touch an object; that it would very likely result in imminent death.  Children proceed to touching and playing with the object within minutes.  This is normal behaviour for most children without mental health, neurodevelopmental or learning problems.  Research indicates that adults (mostly with fully developed frontal lobes and neurological systems) touch their faces more or less 16-23 times per hour, often without registering this behaviour.  In Europe and the UK, we observe most adults touching their faces underneath their masks with unwashed hands on a daily basis, masks hanging on ears or chins, or adults dropping masks on wet floors and wearing it again.  Children’s behaviour in this context will likely not be safer or more responsible, the contrary will be likely. 

Mental health problems, learning problems or neurodevelopmental disorders such as ASD or ADHD, often increase these features, relating to physical playfulness, fidgeting, impulsivity, inattentiveness and forgetfulness, markedly for children or adults.  

In the UK more or less 2.5% of children present with learning disabilities, as reported by MENCAP.  Learning problems are more prevalent, 14.9% of school aged children have special educational needs, as reported by GOV. UK.  Many children with learning problems have not been identified.  More or less 30% of children with developmental delay, present with associated mental health problems or concerns. 

Prevalence of neurodevelopmental disorders, such as ADHD, in children is more or less 3-4% in England and Wales.  It must be noted that children in this category are often most vulnerable for co-morbid mental health morbidity, often presenting with more than one co-morbid mental health diagnosis or concern, which are not always easy to identify; this is one of the reasons we recommend that children are assessed, diagnosed and treated or managed by Child Psychiatrists with training, CCTs, in Child Psychiatry, and that children with ADHD or ASD remain within generic CAMHS teams, rather than be referred to separate neurodevelopmental, ADHD or ASD teams.  Children also often wait months or years on ADHD waiting lists, whilst presenting with serious co-morbid concerns such as depression and suicidal ideation, which lead to markedly increased risk.  Co-morbidities of ADHD include depression (15%), anxiety disorders (25%), learning disabilities (15-40%), language impairment (15-75%), Oppositional Defiant Disorder (35-50%) and Conduct Disorder (25%).  More than 50% of children with ADHD meet criteria for 2 co-morbid conditions.  

The WHO reports that more or less 20% of adolescents may experience a mental health problem in any given year.  GOV.UK reports that more or less 12.5% of 5-19 year olds had at least one mental health disorder and that more or less 5% met criteria for 2 or more mental health disorders (survey 2017, published 2019).  The Children’s Society reports that more or less 10% of children and young people aged 5-16 years have a clinically diagnosable mental health problem, yet 70% of children and adolescents with mental health problems have not had appropriate interventions at a sufficiently early age.

It might be relevant to add in this context, considering recent research published by the Lancet, that longstanding research indicates that all or most physical health problems or disorders can increase mental health morbidity by up to 50%, neurological injury can increase prevalence by up to 500%, and neurological injury associated with epilepsy can increase prevalence by up to 1000%.

Biological risks in schools will affect risk in communities.  Risk reducing initiatives have been employed to reduce the risk in many countries for children attending schools.  Children now rotate through schools in some countries to keep the numbers down per classroom and at the school in general, for instance in corridors, to facilitate social distancing and reduce risk.  We have observed that social distancing is possible in almost all contexts in the public. Temperature screens and health questionnaires are also in place for every student and teacher to complete every morning at home before attending schools on interactive apps. Many countries still identify individuals with symptoms by paper questionnaires and old fashioned temperature screens, this is also effective.

Creative evidence-based options to reduce risk are always available in every domain and context, however, it is essential that risk factors and protective factors are identified, acknowledged, understood and managed appropriately, with regular review.  The importance of eduction for the general public is relevant in this and every context.  We offer pro bono training and presentations relating to this topic to staff supporting vulnerable children such as teachers, youth offending teams, Social Care or the Police, twice a year. Please contact us at admin@cinaps.co.uk for details of upcoming training events.

#childpsychiatrist #adhd #asd #neurodevelopment #learning #schools #mentalhealth #disabilities #development #mencap #who #lancet #probono #teaching #socialcare #police #communities #playful #fidget #hyperactive #impulsive #forgetful #inattentive #touchface #cct #depression #suicide #risk #comorbidities #mentalillness #epilepsy #neurological #socialdistancing

 

Calm leads to improved social risk, mental health and general health outcomes.

#Calm, lack of #stress or lack of chronic #anxiety supports and strengthens the #immune system, and contributes to improved general #health; #resistance to #infections, decreased #complications, improved #recovery times and #prognosis, which is supported by longstanding well established evidence-based research.  

#GlobalHealthPlan #Systemic #covid19 #coronavirus #Health #FirstDoNoHarm

Chronic anxiety or stress has serious consequences on social risk, mental health and general health.

Chronic anxiety or stress is a well established evidence-based and significant risk factor for social risk, mental health and general health; lowers the immune response, significantly increasing susceptibility to infections and worsening prognosis.  

Clarity, consistency and congruency between medical professionals and government contributed to calm within the public, as observed firsthand in much of Asia since the outbreak was reported in January 2020.

#GlobalHealthPlan #Systemic #covid19 #coronavirus #Health #FirstDoNoHarm

#clarity #consistency #congruency #calm #anxiety #stress #immunesystem #prognosis #susceptibility #Asia

First Do No Harm

First do no harm is a prevailing principle to protect.

In a medical emergency our role as doctors is first to do no harm or prevent harm, then to protect and to treat.

It is essential to ask questions regarding ethics, human rights, children’s rights during all recommendations and clinical initiatives; we have to first do no harm.

Initiatives put in place to protect the public must be weighed, taking a systemic approach, considering all of the relevant bio-psycho-social risk and protective factors and consequences with updated statistics recently published by organisations such as the WHO, UNICEF, NSPCC.

A systemic approach or management plan, with a focus on well established evidence-based risk and protective factors, including normalcy, liberty and autonomy, is essential, considering recent statistics.  Clinical outcome is often affected most by simple measures to prevent harm and to protect.  

All initiatives to protect the public in every context and medical discipline must be evidence-based to prevent harm and to protect, leading to improved statistics relating to general health and mental health morbidity and mortality.

First do no harm must be a prevailing principle that leads clinicians in complexity, chaos and clinical emergencies.

#coronavirus #Health #FirstDoNoHarm #covid19 #emergency #doctors #protect #systemic #risk #protectivefactors #normalcy #statistics

Global Health Plan

We observed various medical and governmental protocols with different public responses and statistical outcomes during our travels since January 2020.

We observed no delays in evidence-based risk management plans in many countries; many reported that they were prepared for such a crisis and days after the news reported the outbreak in January evidence-based initiatives were in place and a consistent, focused, targeted, yet systemic approach was observed eg symptoms questionnaires in paper format, temperature screens, track and trace with clear and predictable protocols for initial and secondary assessment with triage. We particularly want to thank Malaysia, Sri Lanka, India, Singapore and the Maldives for their coordinated response, diligence and commitment to the general public and travellers, especially immediately after the news broke.

We observed a consistent and systemic approach in many countries in Asia. Bio-psycho-social risks and protective factors were considered, weighed and balanced in a systemic manner to protect the public during this medical crisis.

Liaison and collaborative work with professionals and countries with clinical experience in managing similar clinical health crises are essential to achieve good clinical outcomes.

Many countries highlighted the importance of protective factors, promoting and sustaining a healthy immune system, which included initiatives to promote normalcy and liberty, with an emphasis on remaining calm and positive, with good clinical outcomes.

Protective factors markedly affect clinical outcomes in all domains of Medicine.  

It is essential that medical professionals and government communicate and work together. It is essential that nations communicate and work together. Harm to one nation will eventually affect all nations; consider the role of childhood immunisations.

A systemic global health plan is therefore essential; consistency and congruency between health professionals, government and health officials, and between nations, respecting the importance of education, transparency, normalcy, human rights and children’s rights, liberty and autonomy.  

This, in our opinion, will inspire calm, confidence and compliance within the public and result in immediate and long term improved clinical outcomes relating to morbidity and mortality. 

#GlobalHealthPlan #Systemic #covid19 #calm #positive #normalcy #outcomes

We have to consider the clinical outcomes of initiatives put in place to protect the public.

Please see recent statistics published by organisations such as the WHO, RCPCH, Public Health England, NCMEC, UNICEF, Oxfam, England’s Children’s Commissioner, the Trussel Trust and the NSPCC which refers to increased risk during lockdown; a 89% increase in need for emergency food parcels, a 93% decrease in hospital attendance, including accident and emergency, mostly by children, a 80% increase in helpline calls relating to domestic violence (June 2020), a 400% increase in helpline calls relating to alcohol problems and a significant increase in child abuse (33% increase in physical abuse, 65% increase in emotional abuse, 46% increase in neglect and 9.6% increase in sexual abuse, and 90% increase in concerns relating to child sexual exploitation).

Considering that the WHO reports an estimate of 1 billion children, age 2-17, abused in the last year, and 40 150 homicide deaths in children, some due to maltreatment, we cannot afford for these statistics to increase. Please know child abuse statistics are likely much higher than reported due to various factors.

Let us work together to protect our most vulnerable in all age groups.

#covid19 #FirstDoNoHarm #protect #children

We have to consider the clinical outcomes of initiatives put in place to protect the public.

Please see recent statistics.

“The RCPCH found decreases in hospital attendance in their survey of hospitals including up to a 93% decrease in A&E attendance, while Public Health England found that there was a drop in A&E visits by children specifically. Furthermore, there are indications that children were missing vaccinations.” Anne Longfield OBE Children’s Commissioner for England

“Unemployment is forecast to reach 12% at the end of the year as the recession unfolds. The Trussell Trust reported an 89% increase in need for emergency food parcels in April 2020 compared to the same month last year. At the end of April, 350 000 children were living in a household where someone had been forced to skip a meal in the last week and 249 000 were in families that accessed food-banks. Only 47% of children who would usually be receiving Free School Meal scheme food were provided either meals or vouchers.” Anne Longfield OBE Children’s Commissioner for England

Oxfam found that border closures, curfews and travel restrictions had caused breaks in the 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. 

“Ofcom estimate that between 1.14m children in total in the UK have no home access to a laptop, desktop or table. Furthermore, an estimated 60 000 11-18 year olds in the UK have no home internet access at all.” Anne Longfield OBE Children’s Commissioner for England

“Lockdowns have just one consequence that you must never ever belittle, and that is making poor people an awful lot poorer.” David Nabarro, World Health Organisation

“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

“Before the pandemic 2.2 million children in England alone lived with domestic abuse (800 000 children), parental drug or alcohol dependency (478 000) and/or severe parental mental illness (1.6 million children). Just over 100 000 children in England lived in a household where all three issues were present. These numbers are likely to have swelled, fuelled by families locked down in close quarters for weeks and months”. Anne Longfield OBE Children’s Commissioner for England

“Globally, it is estimated that up to 1 billion children aged 2–17 years, have experienced physical, sexual, or emotional violence or neglect in the past year.” WHO

“Estimates by CCO show that 379 000 under-fives live with parents suffering from severe mental ill health, and 145 000 are living with parents suffering drug and alcohol problems. We also estimate that 235 000 under-fives live in houses where domestic violence has taken place in the last year.” Anne Longfield OBE Children’s Commissioner for England

“Calls to the National Domestic Abuse Helpline went up 80% in June 2020, while the number of people seeking help from Alcohol Change UK for problem drinking soared nearly 400% from 4089 between 23 March and 30 April last year to 20 067 in the same period this year.” Anne Longfield OBE Children’s Commissioner for England

“Only a fifth of children where domestic abuse is perpetrated have a social worker. The number of children referred to a social worker has fell by almost a fifth between April and June 2020.” Anne Longfield OBE Children’s Commissioner for England

“The pandemic has also affected children who live away from their parents – the 75 000 children in care.” Anne Longfield OBE Children’s Commissioner for England

“At 31 March 2019, 49,570 children in England and 4,810 children in Wales were looked after by their local authority because of experience or risk of abuse or neglect.” Office of National Statistics

NSPCC:  Child abuse statistics pre-lockdown 30-day average, 6 Jan-22 March 2020 = 1 325, compared to 1-31 May 2020 = 1 730 (30% increase) 

Physical abuse = 420 vs 559 (33% increase) 

Emotional abuse = 303 vs 500 (65% increase)

Neglect = 30 vs 44 (46% increase)

Sexual abuse = 572 vs 627 (9.6% increase) 

“In the last five years there was an average of 62 child deaths a year by assault or undetermined intent in the UK. On average, at least one child is killed per week in the UK. Children under the age of one are the most likely age group to be killed by another person, followed by 16- to 24-year-olds. Child homicides are most commonly caused by the child’s parent or step-parent; whilst adolescent homicides are most commonly caused by a stranger, friend or acquaintance. Official measures are likely to be underestimated.” NSPCC

“1 in 2 children aged 2-17 years suffered violence in the past year, 12% of children were physically abused in the past year.” WHO

“Nearly 3 in 4 children – or 300 million children – aged 2–4 years regularly suffer physical punishment and/or psychological violence at the hands of parents and caregivers. Every year, there are an estimated 40 150 homicide deaths in children under 18 years of age, some of which are likely due to child maltreatment.” WHO

NSPCC 10 August 2020 England “New figures obtained by us reveal that police recorded more than 200 child sex offences, on average, every day last year.  There were 73,518 recorded offences including rape, online grooming and sexual assault against children in the UK in 2019/20 – up 57% in the 5 years since 2014/15. Where gender and age were recorded girls were 4 times as likely to be victims, there were more than 8,000 offences committed against 14-year-olds, making it the most common age group to report offences, there were 12,374 sex crimes recorded against children under 10, and 449 offences were recorded against babies yet to reach their first birthday.”  

“Between January and June 2020, the US National Center for Missing and Exploited Children (NCMEC) received 12.1 million reports of suspected child sexual exploitation, an increase of 90% from 6.3 million reports during the same time period a year earlier. The Internet Watch Foundation and its partners blocked at least 8.8 million attempts by UK internet users to access videos and images of child sexual abuse during lockdown.” Anne Longfield OBE Children’s Commissioner for England