Although most children have been less affected than adults during the pandemic, children with medical complexity are at risk of severe COVID-19 complications.

HOW COVID-19 AFFECTS CHILDREN WHO ARE MEDICALLY COMPLEX

BY LAUREN AGORATUS, M.A.

A collaborative effort which included the AAP (American Academy of Pediatrics) addressed how COVID affects children who are medically complex (CMC). In the overview, it is noted that, unfortunately, there are disparities for race/ethnicity for children who are hospitalized.1 Although COVID-related hospitalizations for children are rare, and Intensive Care Unit is even rarer, children with complex medical needs made up a good portion of those children.2

What Supports Can Help CMC during COVID?

Home care supports are essential However, many families temporarily discontinued having aides or nurses in their homes, even for respite, due to COVID fears which increased stresses on families. There was also a shortage of personnel and medical supplies such as DME (durable medical equipment) including ventilator supplies, or PPE (personal protective equipment) such as masks and gloves routinely used by families of medically complex children, as these were needed in hospitals. Hospital discharges were even delayed due to lack of support personnel at home.3 Anyone coming into the home must observe infectious disease precautions.

There are other options to avoid contagion such as vaccination for children who must stay at home. Phlebotomists can also come into the home rather than go to a doctor's office or lab. There are even homebased options for dialysis and IV infusions.

Telehealth is another way to avoid exposure. The use of telehealth has increased exponentially during the pandemic. There are both benefits and challenges using telehealth.4 These include:

However, downsides include:

Children with Intellectual/Developmental Disabilities (I/DD) are more at risk

The New England Journal of Medicine noted the impacts on people with I/DD during the pandemic.5 Unfortunately it was found that "COVID-19 has had a devastating impact on individuals with intellectual disabilities. In this study, having an intellectual disability was the strongest independent risk factor for presenting with a COVID-19 diagnosis and the strongest independent risk factor other than age for COVID-19 mortality." The CDC (Centers for Disease Control and Prevention) developed a toolkit for people with disabilities to try to address this. The toolkit includes easy to read materials on: