The COVID-19 pandemic is the greatest public health challenge of our time. Children, although largely spared from the direct health effects of SARS-CoV-2, have been profoundly affected. Four key areas of risk for children globally have been identified: poverty, education, threats to survival and health, and risks to safety (United Nations (UN), 2020).
Governments worldwide are responding to this evolving situation with ever-changing legislation and policy. Northern Ireland is uniquely influenced both by its political position as a devolved nation of the UK and its geographical location on the island of Ireland. As a result, its coalition government, the Northern Ireland Executive, has faced unenviable political challenges as the pandemic unfolded.
Northern Ireland implemented two regionally imposed school closures in 2020 and again is in lockdown in 2021 due to the emergence of a new SARS-CoV-2 variant. The risks of accrued loss of learning are tangible and school closures face heavy criticism; however, in contrast to previous closures, childcare facilities and schools for children with special educational needs have remained open. England has pledged to open all schools for all pupils in March 2021; however, Northern Ireland is planning a more cautious approach (Department of Education (DE), 2021a). Online learning has been implemented regionally during lockdown, but high poverty rates and many rural communities make delivery of equitable online learning challenging.
Threats to survival and child health in the pandemic are considerable. It is acknowledged that there is a direct link between economic status and infant mortality (UN, 2020). Even pre-pandemic, 21% of children in Northern Ireland were living in absolute poverty (Department for Communities, 2020).
During the first wave, many child health services in Northern Ireland were downsized, staff redeployed, and elective paediatric surgery suspended. Moving forward, the Executive has committed to maintaining child health services, including immunisation programmes and mental health services.
This pandemic poses substantial risks to both the physical and emotional safety of children and young people. Families face undeniable levels of stress and lockdown heightens the risk of domestic violence or abuse (Gibson, 2020). There are concerns that online abuse is rising. In response, changes to legislation and guidance have been implemented to prioritise the welfare of vulnerable children (DH, 2020a).
The UN's four risk areas are inextricably linked by perhaps the most insidious risk of all, that of children and young people's mental wellbeing. The pandemic's potential to expose children to additional adverse childhood experiences has been acknowledged and an action plan developed (DH, 2020b).
As we look towards emerging from lockdown, Siobhan O'Neill, Mental Health Champion for Northern Ireland, has warned that, ‘unless we act now and we act strategically, then we will have failed a generation of young people’ (Bain, 2021). The Executive has attempted to align the disparate influences associated with its unique position and its response would, at this time, appear to be proportional to the magnitude of the risks outlined by the UN. There remains much to do and the launch of the Children and Young People's Emotional Health and Wellbeing in Education Framework (DE, 2021b), with an annual investment of £6.5 million, confirms the commitment to the welfare of the next generation. The fear is, however, that we may not be able to fully evaluate the success of these interventions until it is too late to get them right.