As the world navigates the challenge of COVID-19, we are learning but kids are losing.  We have learned that social distancing works to slow the spread of the disease, and this practice is successfully postponing infection and possible death in millions of people.  Medically vulnerable and elderly adults have minimal opportunities of exposure when we all stay home.  Unfortunately, if they do become ill, with vaccine hope still far away and no medical cure, they will face the same outcome. In fact, a vaccine may never be fully protective (think of the flu vaccine, which has been studied and revised for decades), and there may never be a cure (as with hundreds of other viruses that we face every day).

Meanwhile, as children pass through crucial stages of development, we are restricting every aspect of learning.  Through social interactions kids learn to regulate their emotions, develop new interests, confront challenges, solve problems, and they learn to acquire and balance the skills of exploring, leading, following and adapting.

Through social interactions, kids develop a sense of self, a feeling of connectedness and affirmation, and they learn the natural, interpersonal processes of cause-effect; action-reaction.  Through these processes kids develop security, compassion and empathy.

Even more affected are the children that need extra help to accomplish the tasks of development.  Millions of children with special needs are currently isolated from the professionals that can help them and their families.  Children with autism spectrum disorders, learning difficulties, speech delays, and physical challenges are all on hold, separated from opportunities to progress.

On the academic forefront, self-motivated, knowledge-hungry, organized and capable students are able to independently navigate online learning (if they have reliable internet access).  However, the vast majority of children are dependent upon the assistance of and relationships with talented teachers in order to make progress.  Parents have variable ability and availability to help.  Except for the elite, top students, academic progress for children has stalled.  Special needs students, now isolated from the mandated services that allow them the opportunity to strive along side their peers, are falling further behind.

Parents, too, are paying a high price.  Parenting is the most important role and the most difficult challenge that we encounter in our lifetime.  Parent isolation is an established risk factor for child abuse.  In fact, multiple pandemic realities are established risk factors for child abuse, all of which are on the rise:  emotional health problems, substance abuse, intimate partner violence, poverty and food scarcity, lack of support for caretakers, and lack of structure.  Children ages 0-3 are at highest risk of injury and death from child abuse, and childcare centers which normally provide reprieve for parents, and structure and loving relationships for children, are largely closed.

Should we be asking ages 0-20 to sacrifice safety, social-emotional development, education and mental health in order to prolong life for 70+?  It is not an easy question to answer, but COVID-19 is here, and it is asking.  We have to answer.

It is our moral obligation to prioritize our children and their future.  Their sacrifices must stop while we go forward protecting the COVID-vulnerable population to the best of our ability.  It will require systemic change and a paradigm shift.  As a society, it is time to shift our focus to ages 0-20 and to prioritize them above all other ages.  It is time to prioritize health broadly defined because social and emotional wellbeing are fundamental to physical survival.  We must think creatively, relentlessly hold children in high esteem, and hold ourselves accountable to prioritizing their needs.

Lynette Froula, MD is an assistant professor of pediatrics and pediatric emergency medicine at URMC. She is dedicated to advocating for children’s health and the prevention of child abuse. She is a member of the ROC the Future School Readiness Outcomes Team.