Editorial

Lloyd Fisher, MD

The COVID-19 pan D em IC has been a trage D y f O r our world, our country, and our communities. The lasting impact of the pandemic will go far beyond the direct effects of the virus itself. We are fortunate that the virus has not caused a significant amount of severe disease, hospitalizations, or death in children. However, children have been asked to make many sacrifices over the past two years, mostly to ensure the safety and well-being of the adults in their lives and in the broader community. It is quite clear that the lack of in-person education, extracurricular activities, ability to socialize in typical ways, and overall disruption in their routines has led to an unprecedented rise in mental health problems among children and adolescents. We keep hearing that “children are resilient,” “they will bounce back and be fine,” and “they will adapt.” While for some this may be true, the toll that it takes and the potential long-term negative effects it has on the way they view the world and their place in it will be seen for many years to come.

The nature of much of the discourse surrounding all COVID-19 related policies, especially as they impact schools,

has provided yet another source of stress, anxiety, and trauma to our children. It has made it nearly impossible for parents to truly understand how best to manage the various risks of the virus itself and the mitigation efforts which have been necessary to lessen its impact. The messaging that our patients and their families have received has been confusing, contradictory, and unfortunately influenced by politics more than medical facts. This has made many policy decisions unnecessarily controversial.

This generation will likely be defined by the events of the past several years. Now that we are in a different phase of our fight against COVID-19, we must do what we can to heal, and our priority must be on this generation which has had so much of their young lives disrupted.

In this issue we explore the various aspects of the impact of the pandemic on our youth. There are multiple articles looking into how our children’s and adolescents’ mental health has been negatively affected. In an article by Christina Arpin, a licensed social worker and school adjustment counselor, we hear of her experiences in working in the school environment and the numerous challenges that school personnel have endured as they navigate the daily changes and challenges. Dr. Sarah Palmer, a child and adolescent psychiatry fellow, shares her personal story of how her own health scare has impacted her training and the way she views her role in her patients’ lives. Dr. Michele Dalal, a primary care pediatrician, illustrates how the increase in mental health issues among children and adolescents grew significantly over the past two years. She explains the importance of using multiple resources and tactics to address each patient and their family’s unique needs and shares some concrete resources to address them.

A silver lining for many of us has been the ability to forge new professional relationships as a direct result of the pandemic. For me personally, participating in a multidisciplinary group consisting of school nurses, counselors, and administrators from the Worcester Public Schools (WPS) — who met on a regular basis with pediatricians in the area — was a rewarding experience. In her article, Dr. Beverly Nazarian explains how our coalition came together, what we accomplished, and how we hope to continue the collaboration in a post-pandemic world to address shared concerns and solutions that go far beyond COVID-19. A group of medical students from the UMass Chan Medical School tell their story of the unique collaboration and partnership they formed with the WPS as they set up a “Virtual Buddy” program to pair medical, nursing, and graduate students with WPS children who were struggling during the time of lockdowns and remote learning. These pairings were beneficial both to the mentee and the mentor, and some of the relationships have continued and adapted to an in-person connection.

Our Medical Society curator, Dr. Dale Magee, presents a fascinating piece of history from the archives of Worcester Medical News from the early days of the polio vaccination campaign. While we have made significant advances in vaccinology science, human nature has remained much the same. The challenges and controversies of mass vaccination efforts from them mirror what we are experiencing today. Chrystina Manero, a pediatric nurse practitioner and educator, discusses the challenges we all face with vaccine hesitance and misinformation surrounding the COVID-19 vaccination efforts and what efforts we can all take to build back public trust and confidence in vaccinations. The UMass Worcester Prevention Research Center and the Worcester Office of Health and Human Services detail the innovative program they developed, led by youths for youths, to encourage vaccination among their peers.

We have all struggled to provide the care our patients needed and continue to need during the pandemic. The rate of burnout is unprecedented which further worsens the difficulties we all face. As we move into a different phase of the ongoing efforts to control this ever changing and surprising virus, we need to consider the unique hardships that our youngest members of society have faced and the losses that they have endured. The decisions we make now and the actions we take will influence this generation for years to come. Physicians need to partner with other medical professionals as well as teachers, educational leaders, social workers, and parents to ensure we always have their needs first and foremost in our minds. +

Pediatrician and Assoc. Medical Director for Informatics, Reliant Medical Group Assistant Professor of Pediatrics, UMass Chan Medical School Immediate Past President, Mass. Chapter of the American Academy of Pediatrics