Pham Minh Triet
During the previous wave of infection, her neighborhood was placed under lockdown after a resident tested positive for Covid-19.
Fortunately, everyone in her family tested negative and so did not have to go to a government quarantine. But health workers had informed her that should anyone in her family test positive, her child would have to be quarantined too.
The child, unable to move or speak without assistance, has needed 24-hour care since birth.
“If forced to go into quarantine my child will probably die,” the woman said, asking me if I had any solution.
I have looked up regulations on medical quarantine for children.
A document from the Ministry of Health merely says children under five can be isolated at home while those aged five to 15 would have to quarantine at government-run facilities. There are no separate provisions for disabled children.
The Ministry of Labor, Invalids and Social Affairs has policies to support children staying at quarantine centers and those that test positive for Covid. They include fully covering treatment costs, provision of essential supplies and psychological support.
But from a professional perspective, I would like to add some equally important notes.
Children might be in the low-risk group for Covid, but its impact on their mental health is far from insignificant. A study in China found that children might experience psychological issues such as insecurity, having nightmares, anxiety, decreased appetite, sleep disturbance, fear of losing relatives, decreased attention span, and irritability.
It said 13-37 percent of children were affected.
In another study in the U.S., 40 percent of parents found that their children showed signs of stress and anxiety caused by being quarantined.
One of my patients, a middle school student studying in Europe, was severely affected mentally during the previous Covid wave. She went to the airport by herself with the intention of returning to Vietnam, but all flights were canceled. Alone, with no relatives by her side, she had a panic attack and had to be hospitalized for a while. Though her condition has improved, the psychological trauma is still affecting her daily life and ability to study.
And that is just the impact on normal children.
For disabled children, the impact is often more severe due to poor adaptability and a lack of supportive medical services amid the pandemic. The majority of children with autism often have violent reactions when placed in a new environment without a long period of preparation beforehand.
In the case of children with cerebral palsy, medical quarantine will clearly affect their and their families’ daily lives, and put even more burden on the healthcare system, which is already overloaded due to the pandemic.
Many studies also found a number of other factors likely to trigger psychological and psychiatric disorders in children. Most notably, children without relatives by their side and children with parents suffering from stress and anxiety are more likely to be affected than children with “normal” parents.
Children wait to be picked up by their parents after finishing 21 days of quarantine at their kindergarten school in Bac Giang Province, northern Vietnam, May 30, 2021. Photo by Le Loi Kindergarten.
Vietnam has so far quarantined over 4,000 children without relatives by their side. While there are no statistics on their mental health, I am afraid the number of children who must be psychologically affected is not small.
One of the important conditions to help children achieve mental stability is creating a quarantine and treatment environment similar to the environment they live in every day.
If possible, quarantining should be done in schools similar to ones the children go to. This is especially important for children of kindergarten age who would struggle in a military camp environment.
That is why I believe it is very important for teachers to participate in the fight against the pandemic. In addition to taking care of children onsite, teachers could also help them through online means. I know many passionate teachers that would be ready to organize online storytelling sessions for children during the pandemic.
Being able to meet and talk to parents or relatives on a regular basis could also help improve children’s morale. Face-to-face visits that comply with anti-pandemic regulations or online meetings could be a solution, but the relatives need to remain calm during the visits so as not to spark anxiety in the children.
With my experience working at the Department of Psychology, Children’s Hospital No.1, I believe that social workers could assist quarantined children together with health workers. They could play with the children, help them study, organize group activities for them, calm them down, and identify children with psychological issues so that they can receive help from experts.
Finally, arming the children with basic information about Covid could help protect them.
Like for the national program on HIV/AIDS prevention and control for children, documents compiled in the form of comics that include questions such as what Covid-19 is, how it spreads and why quarantine is necessary will be useful.
The U.S. Centers for Disease Control and Prevention has already compiled such documents, and these are provided for free on its website.
To return to the woman I mentioned earlier, I told her I had yet to find an answer in the case of her child and disabled children in general.
“What is the solution according to you?” I asked in return.
Her instant reply: “I just hope that if something happens, my child will be allowed to be quarantined at home so that we can take care.”
*Pham Minh Triet is a doctor and former head of the Psychology Department at the Children’s Hospital No.1 in Ho Chi Minh City. The opinions expressed are his own.