Until recently it was thought that the novel coronavirus, COVID-19, was less severe in children. Now as more cases can be studied, that prognosis is less likely to be true. The number of cases overall in Africa is still lower than the rest of the world, with 36,857 cases reported by the Africa CDC as of 29 April 2020, compared to over 3 million globally. One assumes out of this that the number of child cases would also be lower, but there is worry about other indirect effects of the pandemic on children.

Initial beliefs that the young would be less impacted by COVID-19 may have led to complacency. For example, the Atlantic reports that, “Africa will enjoy the advantage of youth. COVID-19 kills mostly the old, and Africans are relatively young, with a median age of 18.9. (The median age in the United States and China is 38.) That means, in effect, that about half of Africans who get COVID-19 will have a low risk of death.” The reality is turning out much different.

First from the medical standpoint, VOA reports that, “Doctors in Britain, Italy, Portugal and Spain are exploring a possible link between a severe inflammatory disease in children and the coronavirus. A growing number of children of various ages in several European countries have been admitted to hospitals with high fever and heart issues. Some also have suffered from gastrointestinal problems, such as vomiting and diarrhea.” There is not enough information disaggregated by age to tell us how coronavirus is affecting children in Africa.

Secondly, UNICEF tells us that, “in any crisis, the young and the most vulnerable suffer disproportionately,” as children suffer from “collateral damage.” Lockdowns reduce access to essential services such as routine immunization, nutritional supplementation and malaria treatment and prevention programs and thus increase morbidity and mortality among children.

Nature published on 7th April that measles has currently, “killed more than 6,500 children in the Democratic Republic of the Congo (DRC) and is still spreading through the country.” Unfortunately “23 countries have suspended measles vaccination campaigns as they cope with SARS-CoV-2.”

There are groups of children that are especially vulnerable. In Kenya. “Street children are having a rough time during the curfew. Food and water are a real problem as hotels and eating places where they would normally get food have closed down. Movement is restricted,” according to the Guardian. The article goes further to share the concern that, “the virus could drive homeless children back to families where they are at risk of abuse.” Abuse of children during stressful times goes affects many confined to homes with out-of-work parents, not just street children.

We cannot afford to lose more children to direct and collateral mortality from the COVID-19 pandemic as it spreads in Africa. We need to begin with better data to tell us about infection and effects on children. Nigeria has done some reporting on age.  We need to ensure that all countries collect data on children and COVID-19 and also maintain routine child survival services.