Preface| Volume 68, ISSUE 5, Pxix-xx, October 2021

How Do We Take Care of Children During this COVID-19 Pandemic?

      On March 10, 2021, a colleague of mine posted the following on Facebook, “A year ago today we were living the last normal week of our lives, and we had no idea.” He was, of course, correct that we have shared a very life-altering and very difficult year due to COVID-19. In the United States alone, over half a million have died of COVID-19; many jobs have been lost, and our way of life has been grossly altered due to loss, social distancing, and pandemic precautions.
      The pandemic has affected children and adolescents in different ways than it has affected adults, and in different ways than we anticipated. Our asthmatics had a break from the emergency room and hospital because of decreased exposure to all viruses while staying home. School was transformed into a screen. Obesity secondary to lack of exercise and food insecurity plagued many children and adolescents. Children did not suffer the morbidity and mortality that their elders realized, but a newly described severe inflammatory syndrome associated with COVID-19 multisystem inflammatory syndrome in children (MIS-C) began to affect children. Treatments for COVID-19 in children and treatments for MIS-C lagged behind treatments for adults, as did vaccine opportunities for children and adolescents. Pediatricians and pediatric subspecialists mobilized through telehealth visits to reach chronically ill children and adolescents who were unable to access health care during the pandemic, and mental health issues worsened secondary to isolation and anxiety. And, of course, not all children and adolescents were equally affected, and children of color, children with disabilities, and children of lower socioeconomic classes, as usual, lost the most.
      We have tried to cover the major aspects of what we learned this year. We have covered safety precautions, treatment, vaccines, educational adaptations, special populations (eg, substance abuse disorder, diabetes, and immunocompromised children), and mental health issues. There is, as in every review, much we do not yet know.