Yes, we’ve seen schools close. But the evidence still shows kids are unlikely to catch or spread coronavirus


Allen Cheng, Monash University

Brunswick East Primary School and Keilor Views Primary School in Melbourne have temporarily shut down after children from both schools tested positive to COVID-19, while a confirmed case in a year 2 student led to the closure of Sydney’s Lane Cove West Public School. A childcare centre in the Melbourne suburb of Essendon has also closed for cleaning after a child tested positive.

These cases, and others in young children, follow a handful of positive cases in teenage students in Sydney and Melbourne and may be prompting some to wonder whether it’s time to rethink reopening schools after lockdown.

The short answer is: no. The research still suggests that while children can be infected with COVID-19, it is uncommon. They also don’t seem to pass the disease on as efficiently as adults do, and cases of child-to-child infection are uncommon. And when children do get infected, they don’t seem to get very sick.

The temporary closure of schools (and at least one childcare centre) is evidence the system is working as it should — cases are being identified, contact tracing and deep cleans are underway and every effort is made to limit the spread.




Read more:
Worried about your child getting coronavirus? Here’s what you need to know


What we know about children and coronavirus

We still don’t know exactly why COVID-19 is much more common in adults than children. The COVID-19 virus (SARS-CoV-2) infects people by attaching itself to a receptor called the ACE2 enzyme, and differences in this receptor in children may be one reason why children are less susceptible.

A lot of the thinking around schools and COVID-19 in Australia is based on follow up of school cases by the National Centre for Immunisation Research and Surveillance (NCIRS). It was released in April but still reflects what is currently known about the virus and how it interacts with children and school settings.

The report found:

In NSW, from March to mid-April 2020, 18 individuals (9 students and 9 staff) from 15 schools were confirmed as COVID-19 cases; all of these individuals had an opportunity to transmit the COVID-19 virus (SARS-CoV-2) to others in their schools.

  • 735 students and 128 staff were close contacts of these initial 18 cases
  • no teacher or staff member contracted COVID-19 from any of the initial school cases
  • one child from a primary school and one child from a high school may have contracted COVID-19 from the initial cases at their schools.

Data from the Netherlands also found “children play a minor role in the spread of the novel coronavirus”.

In younger children, a rare but severe complication called PIMS-TS has been described. However, these cases have occurred in areas where there is extremely high transmission of COVID-19 in the community.

A bigger concern around schools is how adults congregate. Schools now have some version of physical distancing in the staff room and on school grounds to limit the risk of transmission between adults. Parents are asked not to enter school grounds or congregate in close quarters at the school gate, although the fact that this is outdoors and not a long period of contact also helps reduce the risk.

What about COVID-19 and high school students?

There have been several reports of cases in high schools both in Australia and abroad.

Older children in high school start to have similar risk to adults, although the risk of complications is still substantially lower than in the elderly. Importantly, kids in this age group are more able to physically distance and adhere to personal hygiene measures than primary school-aged kids.

At least one instance of a high school outbreak in Auckland was related to an event outside the classroom at which many adults were present. So it was less about transmission in the classroom and more related to a particular event.




Read more:
Coronavirus or just a common cold? What to do when your child gets sick this winter


The system is working

It’s important that schools remain open. But precautions are still required: teaching children to maintain personal hygiene, enhanced cleaning, and making sure adults (teachers and parents) are appropriately distanced from each other.

The latest school cases are not unexpected, and don’t mean that school closures across the board are required. They show the system is working as it should — we are spotting cases early and intervening quickly to limit the spread.

When we do find COVID-19 cases in children, we don’t usually find cases of child-to-child transmission. But of course, we still need to go through the process of managing each case as it arises.

If there are ongoing cases in the community, it is likely that cases will continue to occur in students or teachers, and schools will need to have contingency plans for this.




Read more:
Coronavirus or just a common cold? What to do when your child gets sick this winter


Parents need to make sure their children are well before sending them to school, and be prepared to get them tested and to keep them at home if they show any sign of illness. And of course, hammer home the message about hand washing.

Hand washing and physical distancing remain the very best things we can do to reduce the risk of COVID-19 spreading.The Conversation

Allen Cheng, Professor in Infectious Diseases Epidemiology, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus or just a common cold? What to do when your child gets sick this winter



Shutterstock

Nicholas Wood, University of Sydney and Philip Britton, University of Sydney

It’s Sunday night, around 8pm, when your ten-year-old tells you she has a sore throat. She doesn’t have any other symptoms, and feels OK. You tell her “let’s see how you feel in the morning” and she happily goes off to sleep.

But you’re left wondering what you’ll do if her throat is still sore the next day — or if she’s developed other symptoms by then. Should you get her swabbed for COVID-19?

Like most Australians, you haven’t recently travelled overseas or been in contact with anyone with COVID-19. And like most kids, your children often get coughs and colds during winter.




Read more:
Worried about your child getting coronavirus? Here’s what you need to know


COVID-19 symptoms in kids resemble other respiratory infections

Generally, in their first 12 years, children can experience up to four to eight respiratory tract infections, or “colds”, per year. This number is highest among the youngest children.

One-quarter of all GP visits in children under five in Australia are for respiratory tract infections.

A recent review showed COVID-19 symptoms in children were typical of most acute respiratory infections and included fever, cough, sore throat, sneezing, muscle aches and fatigue.

In general, COVID-19 in children is less severe than in adults.

In children, the symptoms of COVID-19 might appear like the symptoms of any cold or flu.
Shutterstock

So how do I know if I should get my child tested?

If your child is unwell you can check their symptoms using healthdirect’s coronavirus symptom checker.

It will ask you questions based on what we know to be common symptoms of COVID-19, including whether you or the person you’re caring for have:

  • a fever of 37.5℃ or more; or

  • symptoms suggesting fever (such as night sweats or chills); or

  • an acute respiratory infection (for example, cough, shortness of breath, sore throat); or

  • loss of smell or taste.




Read more:
Coronavirus and Kawasaki disease in children: it’s an intriguing but unproven link


It’s possible these could also be symptoms of a different respiratory infection. But if your child is displaying any of these symptoms, the current federal government guidelines recommend they stay at home and get tested.

You can also ask your GP if you’re not sure whether your child needs a test.

How likely is it my child will test positive to COVID-19?

Although Victoria is currently experiencing a spike, Australia has largely “flattened the curve”. In the past month there have been less than 40 new cases nationally each day.

Around the country, since the pandemic began, we’ve performed more than two million tests and identified 7,521 cases.

This means fewer than 0.5% of tests have been positive. And only a small proportion of confirmed cases have been in children.

So in our current situation it’s much more likely your child’s fever or runny nose is caused by one of the common respiratory viruses, such as rhinovirus, that we see each winter.

How sustainable is all this testing?

We’re now performing more tests each day than we were at the height of the pandemic in late March.

Australia’s high level of testing has undoubtedly played a significant role in our successful response to the COVID-19 pandemic.

But we now must ask ourselves whether, with potentially diminishing returns, it’s sustainable to keep testing every child with a cold for the foreseeable future.

Let’s remember there are 4.7 million children in Australia under 15 and each of them, particularly the younger ones, are likely to get multiple respiratory infections each year.




Read more:
‘Stupid coronavirus!’ In uncertain times, we can help children through mindfulness and play


One of the risks of a continued emphasis on COVID-19 testing is that when a child returns a negative result, the parent thinks “all good, my child doesn’t have coronavirus, they can go back to school”.

This risks spreading non-COVID-19 viruses to others, who then develop respiratory symptoms and need to be tested. Many of these viruses spread easily among children, especially where they’re in close contact, such as in childcare centres.

This may lead to an upward spiral of respiratory infections, particularly during winter when colds and the flu are traditional foes.

Viral infections can spread easily among children.
Shutterstock

Keep sick kids at home

While testing is important, physical distancing and hygiene measures have been instrumental in flattening the curve.

And as a bonus, these measures may have led to decreased incidence of other viral infections in the community.

In our hospital in Sydney, we’ve seen fewer hospitalisations for respiratory syncytial virus this year, a common cause of infant hospitalisations.

Nationally, in the first five months of 2020 there were 20,569 influenza notifications, compared to more than 74,000 at the same point last year.




Read more:
Kids are more vulnerable to the flu – here’s what to look out for this winter


Although restrictions are easing, Australians should continue to focus on physical distancing and hygiene throughout winter.

We need to see this pandemic as an opportunity to shift to a new normal: that is, staying at home when you’re sick, and keeping your child at home if they’re unwell (until their symptoms resolve).

We know it’s not always practical, but hopefully this “new normal” will see more flexibility from employers in these circumstances.

Finally, yes, follow public health advice around getting tested for COVID-19. But let’s not view this as the only thing that matters.The Conversation

Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of Sydney and Philip Britton, Senior lecturer, Child and Adolescent Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Number of Australia’s vulnerable children is set to double as COVID-19 takes its toll



Shutterstock

Kate Noble, Victoria University; Peter Hurley, Victoria University, and Sergio Macklin, Victoria University

Three quarters of a million Australian children are likely to be experiencing employment stress in the family as a result of COVID-19. This is on top of around 615,000 children whose families were already dealing with employment stress, whose situation may have worsened.

Latest figures from the Australian Bureau of Statistics show 2.7 million people left their job or had their hours reduced between March and April. This means the jobs crisis is affecting 1.4 million Australian children, according to new modelling from the Mitchell Institute.

The stress and anxiety facing parents who have lost their jobs, coupled with social isolation and educational disruption, are likely to put many children at a significantly higher risk of poorer education and health outcomes.

Financial stress affects healthy development

A family’s socio-economic status is the biggest factor influencing children’s educational opportunities in Australia. Research by the Mitchell Institute has found children from struggling families are 10-20% more likely to be missing key educational milestones compared with their peers.



Children in families experiencing job loss are more like to start school developmentally vulnerable, to repeat a grade, to leave school early and may be less likely to attend university.

As stress in the home increases, children and young people’s health and well-being often suffers too. Extreme employment stress, for example in jobless households, can compromise the quality of parenting and home environments. Providing basic necessities can be challenging, and lead to poorer child nutrition.

Health and well-being issues caused by the crisis may undermine young people’s learning and efforts to reengage with school. Young people who don’t receive a good education are more likely to have poor longterm health outcomes.

Preschools and schools can help children recover

With schools and preschools now resuming something close to normal operations, it’s time to shift our collective focus from how we deliver education remotely, to how we support a huge newly vulnerable population of students.




Read more:
1 in 5 kids start school with health or emotional difficulties that challenge their learning


Many students will benefit by simply resuming learning and socialising at their preschool or school. Others will find life returns to normal as their parents return to work or find a new job, and their families regain financial security.

But previous recessions tell us recovery may be slow. For some parents, unemployment and underemployment will be prolonged, leaving many children, including some who were never previously considered vulnerable, at risk.

Teachers have shown agility, resilience and skill in the face of COVID-19. But preschools and schools aren’t equipped to deal with the huge upsurge in student vulnerability, on top of the upheaval of COVID-19.

Here’s what needs to happen

The Australian government has made childcare free for parents as part of a temporary relief package, but that policy is under review.

Governments must ensure children and families aren’t locked out of early education because they can’t afford it. Ensuring access is critical for children’s learning and development, as well as economic recovery through parental workforce participation.

Along with an emphasis on academic learning and re-engaging students with school routines, school children would benefit from an increased focus on health and well-being in schools. Supporting students to reconnect socially and build their own resilience will improve academic learning and should be central to schools’ efforts.




Read more:
Childcare is critical for COVID-19 recovery. We can’t just snap back to ‘normal’ funding arrangements


Links between schools and external social and health services also need to be strengthened to support children of all ages. Many of the issues that need to be addressed to reduce student vulnerability occur at home and in the community, requiring targeted and expert care from a range of non-school service providers.

Dedicated well-being staff could be employed in schools to facilitate these connections, and drive schools’ focus on health and well-being.

Senior secondary students face a high risk of disengagement from education as a result of disruption and parental unemployment. Prior to COVID-19, the cost of leaving school early was calculated at around $A900 million per year, per cohort. Helping students remain in education is critical to improving health and employment outcomes later in life.

Current funding arrangements will not enable preschools and schools to adequately respond to this unprecedented situation. Investing in prevention and outreach now is vastly more effective than dealing with the fallout later.The Conversation

Kate Noble, Education Policy Fellow, Mitchell Institute, Victoria University; Peter Hurley, Policy Fellow, Mitchell Institute, Victoria University, and Sergio Macklin, Deputy Lead of Education Policy, Mitchell Institute, Victoria University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

7 tips to help kids feeling anxious about going back to school


Veja/Shutterstock

Mandie Shean, Edith Cowan University

As COVID-19 lockdown measures are lifted, some children may experience social anxiety about the prospect of returning to school.

People with social anxiety may fear embarrassment or the expectation to perform in social situations, or worry exceedingly about people judging you poorly.

In certain situations, people with anxiety may find their heart beats quicker as adrenalin is released into their blood stream, more oxygen flows to the blood and brain, and even digestion may slow down.




Read more:
Don’t want to send the kids back to school? Why not try unschooling at home?


These are helpful responses if you need to run away or fight danger. But social situations are generally not life threatening, and these physical symptoms can interfere with socialising.

People with social anxiety may fear looking silly, being judged, laughed at or being the focus of attention. For anyone, such experiences might be unwelcome but for those with social anxiety they pose an unacceptable threat.

Social anxiety in Australian children

One Australian report found that about 6.9% of children and adolescents surveyed have a diagnosed anxiety disorder, 4.3% experience separation anxiety and 2.3% a social phobia.

Social phobia (social anxiety) is more common in adolescents, whereas separation anxiety (intense anxiety over leaving caregivers, such as parents) is more prevalent in children.

These figures only account for those who have a diagnosis of anxiety. They do not include undiagnosed young people who experience high stress in social situations.

Not all children will be happy to be back in school.
Tom Wang/Shutterstock

Any recent prolonged absence from school may have increased social anxiety, as avoiding what you fear can make your fear become greater.

This is because you do not get to learn that the thing you fear is actually safe. Your beliefs about the threat go unchallenged.

Anxiety can also increase through what pyschologists call reduced tolerance. The more children withdraw from the situations that cause them fear, the less tolerance they have for those situations.

Anxiety can affect education

The educational cost for students with anxiety is considerable.

The research shows students with poor mental health can be between seven to 11 months behind in Year 3, and 1.5 – 2.8 years behind by Year 9.




Read more:
5 reasons it’s safe for kids to go back to school


That’s because these students experience more absences from school, poorer connection to school, lower levels of belonging and less engagement with schoolwork.

7 strategies to help overcome social anxiety

So what can children do to overcome anxiety as they return to school? Here are some useful tips.

  1. deal with some of the physical symptoms. It is hard to think if your body is stressed. Use calming strategies like mindfulness or breathing exercises. Slowing your breathing can reduce symptoms of anxiety, depression, anger and confusion. Useful apps to help you control your breathing include Smiling Mind (iOS and Android) or Breathing Bubbles (Android only).

  2. anxiety increases while using avoidance techniques such as avoiding eye contact, not raising your hand to answer a question, or not attending school. So the most effective way to deal with social anxiety might be to face it. Allow your child to have small experiences of social success – give their opinion to one person, start a conversation with someone they know – so they can learn to feel safe in these social situations.

  3. fear and anxiety are normal and benefit us by helping us to respond efficiently to danger. Rather than read your body as under threat, think about the changes as helpful. Your body is preparing you for action.

  4. while avoiding your fears is not the answer, being fully exposed to them is not the answer either. Providing overwhelming social experiences may lead to overwhelming fear and failure, and may make anxiety sufferers less likely to try again – or at all. Start small and build their courage.

  5. supportive listening and counselling are less effective than facing your fears because these approaches can accommodate the fears. While you want to support your child by providing them with comfort and encouragement – ensure you also encourage them to face the fears that cause the anxiety.

  6. you cannot promise negative things won’t happen. It is possible you will be embarrassed or be judged. Rather than try to avoid these events, try reframing them. Remember that that we all experience negative social feedback, and this does not make you silly or of less value. It makes you normal. Or, rather than see it as embarrassing, maybe it can be funny.

  7. remember it is the “perception” that something is a threat – not the reality. Reasoning with your child to help them see your perspective may not change theirs. This reality only changes with positive real experiences.

Breathing Bubbles in action.

What we think is truth is often revealed as untrue when we face our fears. There is joy in social situations. Keep turning up to them.




Read more:
How not to fall for coronavirus BS: avoid the 7 deadly sins of thought


The Conversation


Mandie Shean, Lecturer, School of Education, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

‘I’m scared’: parents of children with disability struggle to get the basics during coronavirus



http://www.shutterstock.com

Helen Dickinson, UNSW and Sophie Yates, UNSW

COVID-19 has had a significant impact on all Australians, but there are very good reasons why the impact might be more keenly felt by people with disability and their carers.

Our new research on behalf of Children and Young People with Disability Australia (CYDA) provides insight into these issues, capturing the impacts at the height of the pandemic.

These findings throw the daily inequities people with disability face into sharp relief. Without urgent action, future emergencies will have similar impacts.

How have families found life in the pandemic?

As coronavirus reached crisis point in Australia, CYDA was concerned that we lacked a coherent national response to assist younger Australians with disabilities. So it launched a survey about families’ pandemic experiences.




Read more:
People with a disability are more likely to die from coronavirus – but we can reduce this risk


This was designed to explore the specific impact of COVID-19, but also to help plan for future emergencies, including other pandemics, bushfires and floods.

The survey was launched in mid-March and stayed open for almost six weeks. Nearly 700 responses were received, mostly from family members of children and young people with disability.

Scared and uncertain

Our report, More than Isolated, shows families were confused about how to handle the crisis.

More than 80% of respondents said they lacked information about coronavirus and how it related to children with disability. This exacerbated their distress and uncertainty.

Households reported feeling scared and uncertain about the best ways to act to protect themselves and loved ones, and this was having an impact on the mental health of all family members.

Respondents also reported a great deal of uncertainty about schooling and school closures. As one parent said

Should we be waiting for school to close or should we keep him at home? Should we keep our other kids home from school to protect him? How serious is this?

Missing out on supplies, medication

More than 60% of respondents were unable to buy essential supplies (such as groceries, special dietary products and hygiene products). Almost 20% said they were unable to buy essential medication.

Panic buying was particularly hard on families of children with disability.
James Gourley/AAP

While this was an issue for many Australians, often these products were especially necessary for the children and young people with disability.




Read more:
We’ve had a taste of disrupted food supplies – here are 5 ways we can avoid a repeat


As one parent reported:

Families with ASD [Autism Spectrum Disorder] children don’t meet criteria for special shopping times and so we have run out of essential items. In my spare time I’m running around all day looking for toilet paper and food that my child will eat. I’m exhausted.

The shortages also meant some children and young people went without food or continence supplies. Other families found themselves spending up to three times the usual budget on essential items, sometimes at the expense of paying their rent.

Less support, declining mental health

One in three respondents had to deal with the cancellation of support workers.

This was either because the family had to cancel because of concerns about people coming into the home, or the services themselves cancelled. This meant family members had increased support requirements, with some reporting they had to give up their own paid work to care for their kids.

Half of survey respondents reported a decline in mental health, either for themselves or for the child or young person with disability. This increased over the period of the survey.

As another parent reported:

I’m scared as a parent, I’m scared of failing my child, and I’m scared about
the mental health impacts on me as a parent with absolutely no support.

Often the impacts were interconnected. For example, service cancellation led to parents’ reduced ability to work, which put stress on obtaining essential supplies.

Some people were unable to access pre-existing support networks, and unsure of what would happen in the days and weeks ahead. Many respondents expressed heartbreaking distress and worry.

I am struggling significantly to meet my children’s needs … I am completely isolated from any therapies, support workers and family support.

Families are struggling: what needs to change

Many of those who care for children and young people with disability are constantly beset by difficult decisions – balancing work, play, care and education to provide the best possible lives for their kids.

Many people can only manage these things when the world is operating as it normally does. But this pandemic (which was preceded by a summer of horrific bushfires) has thrown these carefully balanced routines off to such a degree that families are struggling to cope.

Families’ carefully balanced routines have been thrown off by recent disasters.
Sean Davey/AAP

There are lessons that we can learn from this pandemic that can inform future emergency responses.

Our survey findings point to the importance of information that is tailored to children and young people with disability.

The fragmentation of national and state/territory responsibilities (especially around education) made for confusing messaging for these families, and this continues.

It is crucial the voices of children and young people with disability and their families are heard and responded to in emergency planning.




Read more:
How coronavirus could forever change home health care, leaving vulnerable older adults without care and overburdening caregivers


But improving messaging and ensuring a more coherent response will not solve many of the issues.

It is well established that people with disability face significant inequities in many facets of their lives (from health to work, education and social interaction). The only way we will prevent an impact like this again is to address the various inequities faced on a daily basis by children and young people with disability and their caregivers.

This is not a new observation, but it is also at the heart of the Convention on the Rights of Persons with Disabilities that Australia is a signatory to.

There is a richness in diversity and human experience and this needs to be valued and planned for.

During this period of the COVID-19 pandemic there was not enough recognition that some groups might require more support and intervention so that they can be viewed as equally valued members of society.

CYDA is a not-for-profit community-based organisation and receives its core funding from the Department of Social ServicesThe Conversation

Helen Dickinson, Professor, Public Service Research, UNSW and Sophie Yates, Postdoctoral Fellow, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus and Kawasaki disease in children: it’s an intriguing but unproven link



Shutterstock

David Burgner, Murdoch Children’s Research Institute; Davinder Singh-Grewal, University of Sydney; Linny Kimly Phuong, Murdoch Children’s Research Institute, and Ryan Lucas, University of Sydney

Doctors in the United Kingdom and other European countries have recently reported small but increasing numbers of critically ill children with features of both Kawasaki disease and toxic shock syndrome. These are uncommon conditions affecting the blood vessels.

England’s National Health Service (NHS) issued an alert to doctors as a result.

These children presented with fever, severe abdominal pain and/or a skin rash. Some also had inflammation of the coronary arteries which supply blood to the heart, and inflammation of the heart muscle itself.




Read more:
Worried about your child getting coronavirus? Here’s what you need to know


Some, but not all, tested positive for SARS-CoV-2, the virus causing COVID-19.

But what is Kawasaki disease, and how might these cases be related to COVID-19?

Kawasaki disease

Kawasaki disease is an uncommon disease of childhood, typically occurring between six months and five years. It occurs less frequently in older children and rarely in adults.

Initially described in Japan in 1967, it is most common in North East Asia but is seen worldwide. In Australia, on average, one child is diagnosed with Kawasaki disease every day.

Kawasaki disease is a vasculitis or inflammation of blood vessels, resulting from excessive immune activation. We don’t know what causes it and there’s no diagnostic test. Diagnosis is based on the clinical features, which include:

  • prolonged fever
  • rash
  • red eyes
  • swollen or red hands and feet
  • sore, red or swollen lips or tongue
  • a swollen lymph node in the neck.
There’s about one diagnosis of Kawasaki disease in Australia every day.
Shutterstock

The most serious complication of Kawasaki disease is damage to the coronary arteries, which in rare cases may be life-threatening. Timely treatment with a blood product containing purified immune proteins, called intravenous immunoglobulin (IVIG), reduces the risk of this complication from 25% to 5%.

Rarely, children with Kawasaki disease can present critically unwell with shock (low blood pressure) due to impaired heart muscle function – a serious condition called Kawasaki shock syndrome.

Kawasaki shock syndrome can resemble severe infection or toxic shock syndrome, a massive inflammatory response to toxins produced by certain bacteria. Toxic shock syndrome is also treated with IVIG, along with antibiotics.

While Kawasaki disease is generally an acute inflammatory disease and rarely recurs, patients who sustain more serious coronary artery damage may carry this with them through their lives. This may mean they have to take medications and are at higher risk of events like heart attacks.




Read more:
Toxic shock syndrome is rare. Be vigilant but not alarmed


So what does Kawasaki disease have to do with COVID-19?

Recently reported clusters of children with an illness resembling Kawasaki shock syndrome have emerged from the UK and other European countries.

Some of these children diagnosed with Kawasaki disease are testing positive for SARS-CoV-2, leading clinicians to consider a link between coronavirus and Kawasaki disease or Kawasaki shock syndrome.

Paediatricians have been looking for the cause of Kawasaki disease for more than 50 years. Many features of Kawasaki disease point to one or more infectious triggers; suggested causes have included common bacteria, viruses, fungi, and even carpet shampoo.

And this isn’t the first time Kawasaki disease has been linked to a coronavirus. In 2005, researchers from Yale University isolated a novel coronavirus (New Haven coronavirus, HCoV-NH) from eight out of 11 children with Kawasaki disease. But these findings couldn’t be replicated in other groups of children with Kawasaki disease.




Read more:
8 tips on what to tell your kids about coronavirus


However tempting it might be to conclude COVID-19 may trigger Kawasaki disease, we should be cautious. There are as yet few details on the cases and not all children had positive tests for SARS-CoV-2 – nor all the features of Kawasaki shock syndrome. Many children are also older than is typical of Kawasaki disease.

Further, both Kawasaki disease and COVID-19 cause illness via excessive inflammation – particularly of blood vessels. And both diseases can progress to a state of overwhelming whole-body inflammation sometimes called a cytokine storm. So it might be difficult to differentiate one disease from the other in their most severe forms.

Another possible explanation could be COVID-19 infection led to bacterial infection which then caused features similar to those of Kawasaki disease or toxic shock syndrome. (Bacterial infections may occur if a viral infection impairs the body’s defences against other infections.)

For the most part, children have escaped the more serious health consequences of coronavirus.
Shutterstock

Should we be worried?

SARS-CoV-2 clearly hasn’t followed the textbook on how a respiratory virus “should” behave. Unlike other respiratory viruses (such as influenza) young children generally appear to have mild or no symptoms. Severe COVID-19 in children does happen, but is extremely rare.

Similarly, Kawasaki disease is uncommon – and toxic shock syndrome and Kawasaki shock syndrome even rarer still.

We may see cases of Kawasaki disease or Kawasaki shock syndrome linked to COVID-19 in Australia, but probably only a few.




Read more:
How are the most serious COVID-19 cases treated, and does the coronavirus cause lasting damage?


Parents should be reassured COVID-19 is generally very mild in children. But it’s important if your child has features of serious illness you should come to hospital immediately – pandemic or no pandemic.

Clinicians should be vigilant for cases of this possible new association. As more information emerges, we’ll develop a clearer picture of whether and how SARS-CoV-2 might relate to Kawasaki disease. At present it remains an intriguing but unproven association.The Conversation

David Burgner, Clinician and Scientist, Murdoch Children’s Research Institute; Davinder Singh-Grewal, Clinical Associate Professor, Paediatric Rheumatology, University of Sydney; Linny Kimly Phuong, Honorary Research Fellow, General Paediatrics & Infectious Diseases Advanced Trainee Doctor, Murdoch Children’s Research Institute, and Ryan Lucas, Paediatric Registrar and PhD Student, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How to help young children regulate their emotions and behaviours during the pandemic



Shutterstock

Cathrine Neilsen-Hewett, University of Wollongong and Steven Howard, University of Wollongong

With governments around the world asking their citizens to avoid places, activities and gatherings to save lives, this just might be the largest ever international effort to self-regulate our actions against competing desires and impulses.

To achieve this, we must overcome our desire to enjoy the sun and sand, go shopping or to the pub, and even embrace family and friends.

Of course, it’s not so easy for young children, who must forego activities they previously enjoyed and may be confused by contradictions – like being able to see friends at, but not after, school.

But there are ways parents can help children learn to regulate their emotions and behaviours, and to practise these skills.




Read more:
8 tips on what to tell your kids about coronavirus


Why do kids need to learn to self-regulate?

Self-regulation has always played an important role in our lives. It’s what underpins our ability to control our behaviours, emotions and interactions, while at the same time avoiding distractions and enticing alternatives.

With lower levels of self-regulation, our decisions and behaviours would more frequently be poorly conceived, unnecessarily risky or inappropriate to the situation – often with undesirable results.

Even in the early years of life, the ability to self-regulate is important. Pre-school-aged children who have better self-regulation are often better prepared for school and life.

They then tend to:

  • have higher levels of academic success
  • make fewer risky decisions as adolescents
  • and have better health, wealth and productivity as adults.
So many things have changed for children recently.
Shutterstock

So, what can we do to support children’s self-regulation, especially during this pandemic, when their capacity for self-control already appears to be under strain?

Self-regulation requires at least three things: selecting a goal, problem-solving and working on motivation, and overcoming distraction and impulses.

1. Selecting a goal

Self-regulatory behaviour is goal-directed. That means children must first decide to behave in a particular way.

If a child is unaware of (or forgets) a family convention to wait for everyone to be seated before starting to eat, a child starting to eat before others may appear like a consequence of poor self-regulation. Yet the child never decided to pursue that goal in the first place.




Read more:
A parent’s guide to why teens make bad decisions


We need to support children’s thinking and decision-making around goals, while acknowledging that plans can change and often need to be adjusted.

Adults can support children to be more goal-oriented by giving them opportunities to lead and make decisions, as well as encouraging them to devise simple plans, strategies and procedures to achieve goals.

This may be as simple as asking children to decide what they would like to play (building a cubby house), and plan where they would play it (bedroom), with whom (mum, dad, sibling), and what resources they will need (cardboard box, cushions).

2. Problem-solving and motivation

Even when a goal has been decided, the path to its achievement is often not immediate. Children will encounter numerous distractions and competing opportunities along the way. So they need effective problem-solving and motivation strategies.

To be an effective problem-solver, children must understand there is more than one way to achieve something. This requires creative and critical-thinking, flexibility and persistence.

As adults we can encourage these by:

  • engaging children in brainstorming activities, like finding an alternate ending to a familiar story, such as Peter Pan losing his shadow

  • using open-ended questioning and posing small problems – as in “How might we capture our shadow? What will we need?”

  • encouraging reflective thinking, such as “I wonder, why don’t we see shadows on the ground at night?”

Supporting young children to persist in the face of challenge means taking cues from your child, validating their efforts, reinforcing their solutions and encouraging creative alternatives.

3. Overcome distractions and impulses

Children need to be able to overcome distractions and impulses that are contrary to their goals.

As with most things, this self-regulatory capacity can benefit from practice. This can be achieved in simple, playful ways.

One game, played all around the world, is musical statues. Children dance while the music plays and freeze when the music stops.

Musical statues allows children to practise controlling their impulse to keep dancing.
Shutterstock

What often happens in this game, though, is children who can’t or don’t freeze are either left to continue dancing or they are “out”. Those who perhaps could benefit most from the practise get the least opportunity to practise.

Instead, if a child doesn’t freeze in time, have them try the next round sitting on their bottom, removing their legs from the equation. As they succeed, they can return to standing.

Where children can already do this well, why not reverse things so you dance when the music is off and remain still while the music plays?

This gives children practice controlling impulses – in this case, to keep dancing when the rule requires them to stop – at an achievable level of challenge.

For parents, it gives them unique insight into children’s capacities to control their behaviours, and where they may require additional support.




Read more:
‘Stupid coronavirus!’ In uncertain times, we can help children through mindfulness and play


What else do you need to take into account?

Things like stress, tiredness, hunger, fear, sadness and loneliness can deplete children’s limited self-regulation resources. Parents should seek to minimise these factors before trying to extend children’s self-regulation further.

In the current climate, we can ensure children are operating at their self-regulatory best when we reduce unnecessary demands, ensure routines are not overloaded, are patient and realistic when setting responsibilities.

Lastly, whether we are aware of it or not, children often model themselves on the ways we act and respond. As adults, it’s important to reflect on our own behaviours too: do we give up when challenged, yell when frustrated, fight for resources, or preference others in need over our own wants?

How we respond to this “new normal” will set an example for our youngest generation – and they will undoubtedly learn from our responses.




Read more:
Coronavirus: 5 tips for navigating children’s screen time during social distancing


The Conversation


Cathrine Neilsen-Hewett, Associate Professor in Early Childhood Education, Early Start and School of Education, University of Wollongong and Steven Howard, Associate Professor, Child Development, University of Wollongong

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Students less focused, empathetic and active than before – technology may be to blame



Shutterstock

Pasi Sahlberg, UNSW and Adrian Piccoli, UNSW

Teachers say most students have lost the ability to focus, are less empathetic and spend less time on physical activity.

These are some of the results from our Growing Up Digital Australia study, in which we surveyed almost 2,000 teachers and school leaders across Australia.

We asked them how students from primary school to year 12 have changed in the last five years, and what might explain these changes.

Nearly four out of five teachers said they saw a decrease in students’ ability to focus on learning tasks, 80% saw a decline in students’ empathy and 60% observed students spending less time on physical activity.




Read more:
Do you ‘zombie check’ your phone? How new tools can help you control technology over-use


These downward trends could be caused by many factors. But a good starting point is to look at the undeniably biggest change in children’s lives in the last decade – screen technology.

Growing up digital

Educational technologies have opened new opportunities for teaching and learning.

Teachers use technology to make complicated content more understandable, students learn how to communicate their knowledge across digital platforms like podcasts, and schools use technology to report students’ performance.

But a 24/7 connection to the internet comes with possible downsides too. Researchers and health experts around the world have expressed concerns about the possible consequences of heavy screen use on children.

The steady increase in depression, anxiety disorders and other mental health issues among young people has been well reported. And researchers have debated whether screens may be a possible reason for young people’s declining mental health.




Read more:
Is social media damaging to children and teens? We asked five experts


It is hard to prove a direct causal link between worsening health outcomes and extended time spent on digital devices. But we can learn much about these complex relationships by exploring views and experiences of teachers, parents and young people themselves.

So, what do we know?

According to a recent poll by the Royal Children’s Hospital, 95% of high-school students, two-thirds of primary school children and one-third of preschoolers own a screen-based digital device.

In an earlier study we found 92% of Australian parents think smartphones and social media have reduced time children have for physical activity and outdoor play.

Most children in Australia own a digital device.
Shutterstock

Four out of five parents said social media was a distraction in their child’s life, that impacted negatively on their well-being and family relations.

Another survey showed young people spend one-third of their time awake staring at screens.

In the Growing Up Digital in Australia study, 84% of teachers said digital technologies were a growing distraction in the learning environment.

One teacher told us:

The numbers of students with cognitive, social and behavioural difficulties has increased noticeably. Students appear to have more difficulty concentrating, making connections, learning with enthusiasm and increasing boredom in school.

Similar results were found in a study in Alberta, Canada in 2015.

Our data tells us more than 90% of teachers think the number of children with these kinds of challenges has increased over the last five years. Anxiety among students was also a common concern.

What parents can do

As most Australian children are studying from home this term, and perhaps next, parents will most likely make similar observations of their children – both positive and negative – as the teachers in our study.

Parents might see how fluently children use technologies to learn new concepts. They may also notice how hard or easy it is for their children to concentrate and stay away from the distracting parts of their digital devices.

If a child can’t get through all the tasks their teacher assigns them, it’s important for parents to know this doesn’t mean they are a poor learner or failing student.

Parents can try to understand how children feel about learning – what makes it interesting, what makes it boring and what makes it challenging. A student could be finding it difficult to get a task done due to distractions. The best help in that case is to support the child to stay away from the causes of distraction, which may be their smartphones.

Teachers should also, as much as possible, design learning activities with elements that don’t require any technology. For example, projects that include building, drawing or communicating with others at home can be easily done without devices.




Read more:
Forget old screen ‘time’ rules during coronavirus. Here’s what you should focus on instead


Parents and teachers can work together to find smart ways to teach children safe and responsible use of media and digital technologies. Learning to regulate our own screen behaviours as adults and modelling this behaviour to our children can be a much more effective strategy than simply banning devices.

Studying from home can also be a good opportunity to help children learn to cook, play music or engage in other home-based activities we may wish we had time for but tend to void in our busy daily schedules.

Spending more time with children – with technology and without it – is now more important than ever.

Perhaps the best way to improve the quality of Australian education is to change how we do things. We should understand children are not who they used to be and better learning requires changing the ways both adults and children live with digital devices.The Conversation

Pasi Sahlberg, Professor of Education Policy, UNSW and Adrian Piccoli, Professor of Practice, School of Education, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

5 reasons it’s safe for kids to go back to school



Shutterstock

Asha Bowen, Telethon Kids Institute; Christopher Blyth, University of Western Australia, and Kirsty Short, The University of Queensland

In mid March, cases of COVID-19 – the disease caused by SARS-CoV-2 – dramatically increased in Australia and the government responded with an effective public health strategy. People who could, shifted to working from home, social distancing measures were applied and Australians experienced life in isolation.

Somewhere in the mix, kids stopped attending school. While the federal government has consistently maintained it is safe for schools to remain open, other states like Victoria and NSW told parents to keep their children at home if they could.

Sign up to The Conversation

We are now in a different phase of the pandemic in Australia. With cases dropping, NSW Premier Gladys Berejiklian has announced students would be making a staggered approach back to classrooms from the third week of the second term – initially for one day a week, then for more time on campus as the term progresses. Schools in Western Australia reopen on Wednesday April, 29.

On Friday, Prime Minister Scott Morrison said the same social distancing rules as in the community did not apply in the classroom. He said:

The 1.5m in classrooms and the four square metre rule is not a requirement of the expert medical advice for students in classrooms.

Closure of schools has meant kids not seeing their friends and a disruption to their usual education routine.

For some children fears of violence, hunger and lack of safety, that are usually modified through school attendance, have become more real. Inequality and mental health needs have likely become more apparent for some children.




Read more:
Schools provide food for many hungry children. This needs to continue when classes go online


The federal and state governments who say it is safe for children to return to school are working off the latest evidence. Here are five reasons we know it’s safe.

1. Kids get infected with coronavirus at much lower rates than adults

This is the case in Australia and throughout the world. There are no clear explanations for this yet, but it is a consistent finding across the pandemic.

Although SARS-CoV-2 can cause COVID-19 in school-aged children, it rarely does and children with the disease have mild symptoms.

Fewer than 150 children below 15 years have been infected with SARS-COV-2 in Australia since the pandemic began. This is compared to the 6,695 confirmed cases of COVID-19 in Australia at 25 April, 2020.

2. Children rarely get severely ill from COVID-19

Data from around the world and Australia have confirmed children very rarely require hospitalisation, and generally only experience mild symptoms, when infected with SARS-CoV-2.

Deaths in children due to COVID-19 are incredibly rare. Very few children globally have been confirmed to have died from the virus (around 20 by our calculations), in comparison to more than 200,000 overall deaths.

Many parents have worried their kids’ friends could be infected with the virus without showing symptoms. But this doesn’t seem to be the case. A study in Iceland showed children without symptoms were not detected to have COVID-19. No child below ten years of age without symptoms was found to be infected with SARS-CoV-2 in this study.

3. Children don’t spread COVID-19 disease like adults

During the yearly flu season, children spread the flu to friends and grandparents alike. But COVID-19 behaves differently. In household clusters in China, Singapore, South Korea, Japan and Iran, fewer than 10% of children were the primary spreader – meaning the virus goes from adult to adult much more effectively than from children to other children, or even children to adults. The same has been found in new studies in The Netherlands.

We still don’t know why this is. It takes us all by surprise as kids with snotty noses are always blamed (and probably responsible) for driving the annual round of winter coughs and colds.

4. School children in Australia with COVID-19 haven’t spread it to others

Schools where cases have been diagnosed in Australia have not seen any evidence of secondary spread.

This means even with kids sitting right next to each other in the classroom, they are very unlikely to infect their friends.

5. There is no evidence closing schools will control transmission

Modelling shows only a small incremental public health benefit to closing schools in the case of usual respiratory viruses such as influenza. But COVID-19 is quite different to flu, so any of the benefits seen for influenza are likely to be even less in the case of COVID-19.

During the 2003 SARS outbreak, school transmission was not found to be a significant contributor to the outbreak and school closures did not influence the control of transmission.

Back to school doesn’t mean back to normal

Schools reopening does not mean a return to education as it was before. Other measures may also be put in place, like staggering lunch breaks, limiting face to face contact between staff and parents and regular hand-washing breaks.

Kids with a cold or other symptoms must stay home from school. And older teachers or those with underlying health conditions that put them at greater risk of complications if infected with SARS-CoV-2 will have altered responsibilities.

It is important parents and the public differentiate between schools reopening from all the other important strategies used to reduce transmission still in place. These include social distancing, travel restrictions, case isolation and quarantine, and banning of large gatherings.




Read more:
Other countries are shutting schools – why does the Australian government say it’s safe to keep them open?


But returning to schools is safe. Our leaders are advised on this issue by some of the best infectious diseases, public health and microbiology physicians in Australia, who have repeatedly said that schools can safely remain open.

The Australian Health Protection Principal Committee (AHPPC) has provided sensible advice for schools to reopen. It makes sense to get our kids back to doing what they do best.


Correction: the article originally stated children in NSW would start returning to schools in term one.The Conversation

Asha Bowen, Head, Skin Health, Telethon Kids Institute; Christopher Blyth, Paediatrician, Infectious Diseases Physician and Clinical Microbiologist, University of Western Australia, and Kirsty Short, Senior Lecturer, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

1 in 10 children affected by bushfires is Indigenous. We’ve been ignoring them for too long


Bhiamie Williamson, Australian National University; Francis Markham, Australian National University, and Jessica Weir, Western Sydney University

The catastrophic bushfire season is officially over, but governments, agencies and communities have failed to recognise the specific and disproportionate impact the fires have had on Aboriginal peoples.

Addressing this in bushfire response and recovery is part of Unfinished Business: the work needed for Indigenous and non-Indigenous people to meet on more just terms.

In our recent study, we found more than one quarter of the Indigenous population in New South Wales and Victoria live in a fire-affected area. That’s more than 84,000 people. What’s more, one in ten infants and children affected by the fires is Indigenous.




Read more:
Strength from perpetual grief: how Aboriginal people experience the bushfire crisis


But in past bushfire inquires and royal commissions, Aboriginal people have been mentioned only sparingly. When referenced now, it’s only in relation to cultural burning or cultural heritage. This must change.

Bushfire residents

Indigenous people comprise only 2.3% of the total population of NSW and Victoria. But they make up nearly 5.4% of the 1.55 million people living in fire-affected areas of these states.

And of the total Indigenous population in fire-affected areas, 36% are less than 15 years old. This is a major concern for delivering health services and education after bushfires have struck.

Importantly, where Indigenous people live has a marked spatial pattern.

There are 22 discrete Aboriginal communities in rural fire-affected areas. Of these, 20 are in NSW, often former mission lands where people were forcibly moved or camps established by Aboriginal peoples.

Ten per cent of Indigenous people in fire-affected areas in NSW and Victoria live in these communities.

And those living in larger towns and urban areas aren’t evenly distributed. For example, Indigenous people comprise 10.6% of residents in fire-affected Nowra–Bomaderry, compared with 1.9% of residents in fire-affected Bowral–Mittagong.

These statistics are steeped in histories and geographies that need to directly inform where and how services are delivered.

Indigenous rights and interests

Aboriginal people hold significant legal rights and interests over lands and waters in the fire-affected areas. These are recognised by state, federal or common law. This includes native title, land acquired through the NSW Aboriginal Land Rights Act or lands covered by Registered Aboriginal Parties in Victoria.

Even where there’s no formal recognition, all fire-affected lands have Aboriginal ownership held and passed down through songlines, languages and kinship networks.

Areas in NSW and Victoria burnt and affected by fires of 250 ha or more, July 1, 2019 to January 23, 2020, and Aboriginal legal interests in land.
Author provided

The nature of these legal rights and interests means the bushfires have different consequences for Aboriginal rights-holders than for non-Indigenous landowners.

Many non-Indigenous land-owners in the fire-affected areas face the difficult decision of whether to stay and rebuild, or sell and move on. Traditional owners, on the other hand, are in a far more complex and unending situation.

Traditional owners carry inter-generational responsibilities, practices and more that have been formed with the places the know as their Country.

They can leave and live on someone else’s Country, but their Country and any formally recognised communal land and water rights remain in the fire-affected area.

Relegated to the past

Clearly, Aboriginal people have unique experiences with bushfire disasters, but Aboriginal voices have seldom been heard in the recovery processes that follow.




Read more:
Our land is burning, and western science does not have all the answers


The McLeod Inquiry, which followed the 2003 Canberra bushfires and the 2009 Black Saturday Royal Commission – were critical processes of reflection and recovery for the nation. Even in these landmark reports, references to Aboriginal people are almost completely absent.

There were only four brief mentions across three volumes of the Black Saturday Royal Commission. Two were cultural heritage protections discussions in relation to pre-bushfire season preparation, and two were historical references to past burning practices.

In other words, Aboriginal people – their cultural practices, ways of life and land management techniques – are relegated to the past.

This approach must change to acknowledge that Aboriginal people are present in contemporary society, and have distinct experiences with bushfire disasters.

More than cultural burning

This year, we’ve seen strong interest in Aboriginal people’s fire management, including in the early months of the federal royal commission, and in NSW and Victoria state inquiries.

Aboriginal voices only in regards to cultural burning is deeply problematic.
Shutterstock

But including Aboriginal voices only in regards to cultural burning is deeply problematic. Yet, it’s an emerging trend – not only in these official responses, but in the media.

This narrowly defined scope precludes the suite of concerns Aboriginal people bring to bushfire risk matters. Their concerns go across the natural hazard sector’s spectrum of preparation, planning, response and recovery.

Aboriginal people need to be part of the broad conversation that bushfire decision-makers, researchers, and the public sector are having.

Amplifying Aboriginal voices

To date, Victoria offers the most substantial effort to include Aboriginal voices by establishing an Aboriginal reference group to work alongside the bushfire recovery agency. But Aboriginal people require a much stronger presence in every facet of these state and national inquiries.

We identify three foundational steps:

  1. acknowledge that Aboriginal people have been erased, made absent and marginalised in previous bushfire recovery efforts, and identify and address why this continues to happen

  2. establish non-negotiable instructions for including Aboriginal people in the terms of reference and membership of post-bushfire inquiries

  3. establish Aboriginal representation on relevant government committees involved in decision-making, planning and implementation of disaster risk management.




Read more:
Friday essay: this grandmother tree connects me to Country. I cried when I saw her burned


The continued marginalisation of Aboriginal people diminishes all of us – in terms of our values in living within a just society.

It was never acceptable to silence Aboriginal people in responses to major disasters. It’s incumbent upon us all to ensure these colonial practices of erasure and marginalisation are relegated to the past.The Conversation

Bhiamie Williamson, Research Associate & PhD Candidate, Australian National University; Francis Markham, Research Fellow, College of Arts and Social Sciences, Australian National University, and Jessica Weir, Senior Research Fellow, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.