Children's Mental Health and the COVID-19 Pandemic

Many of us reminisce back to our lives before the COVID-19 pandemic and hope for things to get back to the way that they were, while we simultaneously try to adapt to this new normal. The pandemic has affected our lives in numerous ways but it is imperative that we focus on our mental health. Many people have reported about the fear and uncertainty about their own health, the health of their loved ones, their financial situation and job outcomes as well as tackling social isolation through following public health protocols. 

Mental health is inclusive to all age groups and should leave no one behind in terms of spreading awareness. With this being said, 

Have you ever considered the effect that COVID-19 has had on children? 

We could say that children are unable to fully grasp the concept of their mental health and well-being, but the pandemic has taken away aspects of their life just like any other member of the community.

Read this blog post till end for some insight on the mental health of the children within our communities and how you as a parent guardian or any type of caretaker can help to ease their experience.

Although there are many factors to address, children are particularly vulnerable due to their limited understanding of the current pandemic. Because of this many of them are also unable to physically and mentally escape the harms of the situation as they have little to no coping strategies and it is hard for them to communicate their feelings easily unlike adults. 

Although their understanding is minimal, children can pick up on unverified information through social media or word of mouth as adults communicate which can aggravate mental distress and feelings of uncertainty as misinterpretation is bound to happen. 

Children are also in a continuous and critical period of development as they require special care in order to preserve and promote their mental health which has been primarily affected by a drastic change in routine. The suppression of all class activities and learning as well as a shift to an online schooling has led to the creation of an isolated learning environment. 

Essentially, schools are responsible for providing structure to a child's daily activities. Many articles have postulated the importance of physical activity during the quarantine as it is associated with a decline in symptoms of anxiety and depression. 

Research has also argued that schools play a primary role in providing a consistent daily calorie intake to ensure that children are getting their nutritional needs. These basic requirements have been drastically reduced because of pandemic.

A nationwide study in Canada conducted by the International Journal of Behavioral Nutrition and Physical Activity, found that children and youth were actually less active, played outside less, were more sedentary engaged in more recreational screen time and slept more in comparison to before the covid19 restrictions. But special needs are extremely vulnerable to the psychological impacts that come along, for example shifting to an online learning environment has disrupted their daily routines and therapy sessions. 

Children with autism or neurocognitive disabilities are more likely to show problematic behaviors such as irritability aggression and social withdrawal. 

Online learning has also led to a decrease in assistance to these children as parents cannot replace special education teachers. There is also a lack of technology to assist with this transition. In addition to that, social distancing and its effects are extremely new and difficult to understand especially for children that are experiencing developmental and intellectual delays. For these reasons spreading awareness of the mental health of children with disabilities needs to be done on a global scale.

It is also no surprise that the pandemic causes parents and caregivers to become fearful of their own concerns. Research shows that fear can be contagious as children are sensitive to the emotional state of the adults that surround them. 

To make matters worse, parents are also unable to alleviate the stress through familiar mechanisms that were established prior to the pandemic, such as visiting family and friends or going on excursions can actually decrease in frequency as there are limited ways for children to flee from perpetrators, as schools usually act as an avenue for children to report issues. 

Regardless, the frequency of children experiencing abuse at home may increase due to continuous contact with perpetrators in quarantine. Additionally, browsing on online social media platforms and lack of supervision over the internet access has also increased vulnerability to online offenders, attempted fraud and sexually inappropriate content. 

Due to these circumstances, issues such as deteriorating performance, aggression and regression may escalate. These are all examples of environmental impacts that impair a child's mental health and physical perception of the world around them. Despite any of the negative impacts the internet has been a critical tool for children and youth in learning, entertainment and even social interactions since the start of the COVID-19 pandemic. 

In particular research has shown that video games offer a temporary escape from real life, but they also provide a fair amount of social engagement. One of the greatest digital game distributors known as STEAM, reports that since the pandemic started the number of users has increased significantly. This report indicates that weekly users has increased from 19 million to 23.5 million. 

So what can you do to help your child during this pandemic.? 

Well, there are several avenues of support that can be offered for children to ensure that their mental health is being addressed. 

One of the main technique that is The CARD system provided by the hospital for sick kids for parents and caregivers. this system provides strategies that parents can play to help their children cope with stressful situations. 

CARD is an acronym that stands for Comfort, Ask, Relax and Distract.

The COMFORT aspect involves: 

• Talking to your child about what they can do to cope with their anxiety. 
• Try to empower your child to overcome their negative thoughts by saying things like "you are stronger than you feel". 
• Also be sure to validate your child's concern by saying things like "it's okay to be upset".
• Avoid focusing on the worry. 
• Limiting exposure to the media and news 
• Be mindful of the conversations that you have around family members
• Creating daily routines that give your child predictability and control. 

Next by ASKING questions your child is given an opportunity to open up. Some questions you can ask your child include: 

• What questions do you have? 
• How are you feeling? 
• What are your friends saying about this? 
• What fun things can you do today? 

Thirdly by RELAX this means: 

• To do things that you and your child enjoy to help them feel more secure and connected.
• Listening to a mindfulness or relaxation activity together. 
• Practicing positive self-talk.
• Engaging in an enjoyable physical activity. 

Lastly a great thing to do is DISTRACT: 

• Try to talk about things that are important to your child such as sports or exercising or art.
• Reading books. 
• Watching movies. 
• Playing board games. 
• Working on puzzles. 
• Helping your child with their homework. 

Using CARD you can make a personalized system for your child to make their routines during the pandemic a little less difficult and hopefully this benefits your mental health in return. Because mental health is inclusive to all.

Origin of Covid-19| Animal-Human Leap or Wuhan Lab Hypothesis?

A seafood market, a virology lab, and a mountain mine, the events that occurred in these locations in China may be significant in understanding how a small cluster of coronavirus infections spread throughout the world. Because, over a year and a half after the global health crisis began, policymakers and scientists are still arguing what caused it. If you're going to investigate the cause of a pandemic, you should do it as soon as possible. That appears to be a tall order right now. This is due to the extremely restricted access to Wuhan.

The most common theory is that the virus came from bats. Jumped from one animal to another, then back to us. And it's possible that the transition to humans took place in Huanan Seafood Market.

According to some scientists, the virus may have accidentally leaked from a lab 10 miles away. And both of these Wuhan locations are becoming increasingly linked to a location over 1000 miles away in Yunnan province's mountains.

As a result, experts travelled to these critical locations to dissect what is known about the coronavirus in order to better understand how the worldwide pandemic began.

Stop number one, the Huanan Seafood Market, December 31st, 2019. This is the day the WHO learned about a cluster of pneumonia cases in Wuhan. And increasingly, the focus was on the market. The complex spans an area that's the size of nine football fields and has over 600 stalls. About 10 of those were selling wild animals like bamboo rats, hedgehogs and hog badgers. These wildlife are raised on farms, sometimes in crowded conditions where it's easy for animals to spread viruses back and forth between each other and the viruses start to mix and match and can change. 

Some wildlife that are receptive to coronavirus infections are consumed in China, either for food or used in traditional medicine. These animals are shipped to urban markets where they are sold sometimes live and butchered onsite. And all this contact with live possibly infected animals or the infected fresh meat has become a major concern in recent years. And in Wuhan, many of the first cases were either vendors who worked at the market, or people who had shopped there. By January 1st, Chinese authorities shut the place down.

Well, originally Chinese authorities did feel that it possibly came from the Huanan Market and from wild meat of some sort. About three weeks later, scientists in Wuhan and Beijing published a pivotal paper in the medical journal, The Lancet.

In this paper scientists showed some data of the early cases were people who hadn't been at the market. More than a year later, there was new data to piece together a clearer picture, that's because China allowed a group of international scientists to come to Wuhan for several weeks to visit the market and hospitals.

A team from the WHO that visited China also learned going through the data that by mid to late December, the viruses that were infecting people were genetically different enough that they knew it wasn't all coming from the same place. The WHO said the presence of early cases not linked to the market could suggest that it was not the original source of the outbreak. 

And increasingly, one place a team visited is at the center of another hypothesis, the Wuhan Institute of Virology. This is a world-class Institute with high security laboratories and does a lot of work with scientists outside of China, very vibrant collaboration before the pandemic. They would travel to caves where bats are known to roost and take samples, and then study them in their lab. These bat coronaviruses and pathogens are cataloged in databases. The researchers used this library of information to compare it to blood samples and oral swabs from patients in Wuhan. And about a month after the market was closed, these researchers discovered that COVID-19 had a 96.2% genetic match with the bat coronavirus that the institute had found back in 2013.

Scientists around the world consider this a breakthrough in the search for COVID-19 source, because it strongly indicated that it could have originated in bats. This laboratory studies bat coronaviruses in Wuhan, was an obvious question, could it have escaped? And even the Institute's own researchers asked that question and went and did their own research.

As questions swirled around a possible accident at the institute, it's top bat coronavirus expert said the virus didn't leak from her labs, and none of its staff have tested positive for COVID-19. These are not the first times that we've had a world exposed to virus as a result of failures in a Chinese lab.

Last year, what started out as a basic scientific question got politicized with a lot of finger pointing at China yet there was no evidence presented. And there was also limited access to data during the WHO-led team's trip to Wuhan. One of the stops was the virology institute. They asked questions and they had a tour, but they didn't get any firsthand look at databases, medical records, any sort of raw data which would have shed light on whether the virus could have escaped or not. 

Almost a week later, scientists summed up their findings at a press conference. They said the spillover from an intermediate host to humans was likely to very likely, and as for questions surrounding the lab. The findings suggest that the laboratory incident hypothesis is extremely unlikely. But later, the WHO chief said the team didn't sufficiently examine the lab hypothesis, and called for a fuller probe. Three months later after that press conference, a group of leading virologists and epidemiologists wrote a letter saying there were no findings in clear support of either a natural spillover or a lab accident. This group of people is not saying that they believe it came from a lab. What they're saying is that there's not enough evidence to rule it out.

Scientists investigate hypotheses and they rule them out one by one. And they just said that process hasn't been able to happen and it needs to happen. China says it's cooperated fully with the effort to search for COVID-19's source and has urged the WHO to investigate early cases in other countries. 

And one place that could provide some new evidence for both hypotheses, Yunnan. It's China's Southwestern most province and home to many coronavirus-carrying bats. And could set the stage for where the investigation into the origin of the virus could go next. It's clearly an area where coronaviruses are circulating, including coronaviruses that are very closely related to SARS, the epidemic in 2003.

Researchers from the Wuhan Institute of Virology went to Yunnan to study large bat populations inside caves. In these crowded spaces, viral strains can mix together, and become the building blocks of coronavirus that then jump to humans. And at the same time, there are wildlife farms there that supply animals to Wuhan. 

Scientists say, this could explain how a virus from a bat cave leapt to an intermediate host then made its way to the market. There was also a mine in Yunnan where scientists from the institute spent some time from 2012 onwards. It's where six miners who'd been clearing bat droppings had gotten sick, and developed an unexplained pneumonia. Three of them died. So in 2013, scientists from the Institute went to the cave to collect samples from bats. 

A virus from one of these samples turned out to be that 96.2% genetic match that was discovered by the institute, inhaled as a big break during the early days of the pandemic. It took months for the institute to reveal that the bat coronavirus samples were from the mine, and that there were sick miners.

The failure to describe it more became kind of a touchpoint for people who wanted more information from the laboratory about the viruses they do have, and what work they've been doing with them. Then, there was another allegation about the institute that surfaced more than a year later. What US intelligence officials learned is that there were three researchers who became ill enough to seek hospital care. They had symptoms that were like COVID, but the symptoms like COVID are also like flu symptoms. And flu was definitely circulating in Wuhan at that time.

Four days after the intelligence report about the sick lab workers, the Biden administration ordered a US intelligence inquiry into the two scenarios. China said the report was untrue. Some people don't believe China and say this has to be a coverup. Others say we just need to verify, though that's what we do in science. It really does boil down to a question of transparency.

So for any progress to be made in the origins of the virus, it'll ultimately require more data, and fuller access to where it was first detected in China.

Vaccine Side Effects are Actually a Good Sign...!

Developing a vaccine is not an easy task as it involves a number of steps. Image below is showing the common steps involved in the process of developing a vaccine: from development in the lab, testing, approval, manufacturing and all the way to getting it to millions of people.

But arguably the most important part is here: is the human trials. Where the vaccine is tested on real people, in three main phases, starting with just a small group of people, and ultimately testing a group of thousands. This is where scientists confirm the effectiveness and safety of the vaccine on a large scale. Before that, scientists scrutinize its effectiveness. But before any of that, a vaccine has to pass this crucial first phase, where scientists study the side effects.

Dr. Kirsten Lyke (University of Maryland, School of Medicine) led a Phase I trial for the Covid-19 vaccine made by Pfizer and BioNTech. She says: ''Side effects are a possibility with any vaccine. In general, it's nothing to fear. It's our own immune systems kicking in and doing what it's supposed to do''.

The most common flu vaccine this year, for example, comes with a chance for many normal side effects: pain, fatigue, headaches. But many of the new Covid-19 vaccines are more likely to cause these kinds of side effects than you might be used to. Particularly after the second dose. Most people will feel a little pain in their arm. Many will be tired and get headaches.

Obviously, having no side effects is desirable. But with the spike protein of the coronavirus, it really does elicit some side effects. But that’s totally normal. And once you understand why vaccine side effects happen, you might actually be happy to get them. 

First, we have to talk about this: your immune system, which is a huge network of different cells and proteins in your body. You’ve got things like:

• white blood cells that fight the invading virus or bacteria, 
• communication cells that organize the response, and 
• antibodies that search for and identify the enemy.

When, a virus attacks your body, your immune system attacks back. Your body increases blood flow to get more of these battle cells in circulation. Your temperature might go up, too, as one of the tactics your body has to help kill the invaders. And after your white blood cells destroy the virus, they produce antibodies that will identify the virus should it reappear in the future, and remember how to fight it. This is how you gain immunity. 

This response is actually what gives you a lot of the symptoms you feel when you catch, for example, the common cold. But the cold virus doesn’t give you a fever, or a runny nose, or body aches — your immune system does, while fighting the virus. And triggering this system, without actually getting you sick, is how vaccines work.

Most vaccines are made up of a weakened or dead pathogen, or a portion of one. Or, in some of the new Covid-19 vaccines, the genetic code of a portion of one, either in the form of DNA, or what’s called messenger RNA, along with minor ingredients to keep it stable. It’s harmless, but when your immune system detects it, it responds just like it’s a real danger. It attacks the intruder, and creates those memory antibodies to be able to fight it again in the future. 

Vaccines are designed to give you the same immunity as if you had fought off the real virus. And some of the new Covid-19 ones do this particularly well. The messenger RNA vaccines are quite good at stimulating your immune system. That's why you have ninety-five percent efficacy. That’s right — a 95% chance of being protected against Covid-19. That makes them some of the most effective vaccines. But that also means they’re really good at activating your immune system. Which means your body will increase blood flow to where that vaccine is, which is why pain at the injection site is so common. Your body might even think, better turn up the heat, and then you get a fever, or the chills. So experts emphasize that we should look at most side effects as a good thing: it means the vaccine is working. 

When we talk about these common reactions to vaccines, like fever and fatigue, we’re mostly talking about the mild-to-moderate ones. These are the lowest of the side effect categories that health regulators use, the kind you get over in a day or two. 

Then there’s severe side effects — the type that might make you call in sick to work or call a doctor. These were rare in the clinical trials for the first two studied vaccines to become available, with the exception of some severe fatigue and muscle pain on the second dose. And that’s because if these vaccines were dangerous, they’d never reach the public in the first place. We really don't accept any sort of permanent, serious harm from a vaccine, nor should we. 

News stories that imply otherwise can be scary, but they get more attention than they probably deserve. Like one about a serious allergic reaction. It may have occur in someone with a history of serious allergic reactions. Or about someone dying after getting a second dose of the vaccine. When, it turned out, other factors had caused his death. 

In fact, no deaths have been reported from the millions of doses that have been given out. And the controlled studies with thousands of people found the same thing: no deaths from the vaccine. These vaccines aren’t just safe — they’re life savers. 

You should be skeptical of anything you put in your body, including vaccines. But once you've seen the data, and you see that there wasn't a serious side effect before approval, and hasn't been a serious side effect post-approval, then I think you should be convinced. Basically, you want to reduce where the virus can go. And if you immunize as many people as possible, that pool of people that it can transmit to becomes less and less and less and less..!

Vaccines are the way out of the Covid-19 pandemic. And, like with all vaccines, many of us who get it will also feel a little merely for a day or two. But the scientists who have studied these vaccines — who have seen the side effects — are some of the most eager to get it... I hope now you must have got some motivation for getting yourself jabbed. So, get up and get your shot as soon as possible...!!

High dose Vitamin-D and Covid-19

We turn to anything that increase our chances of survival, including supplements to boost our immunity. The demands for supplements has grown as people put their faith into it to elude COVID19. Vitamin D is the most common supplement consumed by people in this pandemic. But all of us have some questions regarding vitamin D, like; 

Can it really protect us from COVID19? 

What is the evidence and what is the danger if you are taking too much of it?

Why Vitamin D? 

Vitamin D is very special, it has been associated with numerous health benefits. It is like one vitamin cures all. It has been established that vitamin D is important for bone and muscle along with calcium. It helps prevent osteoporosis. There is also growing evidence that vitamin D has a role in boosting the body's immune system. 

A systematic review was published in 2017, they analyzed 25 randomized control trials concluded vitamin D helped prevent acute respiratory tract infections and because of that vitamin D is perhaps the most talked about vitamin during this pandemic.

Can vitamin D really protect us from COVID19??

Several research have been done to prove the protective effects of this vitamin against COVID 19. Some studies have shown that people who are hospitalized with severe COVID19 also have vitamin D deficiency. Studies have found that the relative risk of getting COVID19 was 1.77 times greater for patients who were vitamin D deficient compared with those with sufficient levels. 

Furthermore the risk factors for developing severe COVID 19 are the same as tools for developing vitamin D deficiency. So it is difficult to tell if vitamin D deficiency itself is the cause of severe COVID19.

Is there strong evidence to support taking vitamin D during the pandemic?

A Cochrane review published a few months ago, it's probably the highest evidence so far to answer this question. It assessed the use of vitamin D as treatment for adults with confirmed COVID19 compared with a placebo. Three studies with 356 participants were analyzed in this review it concludes that there is not enough evidence to recommend taking vitamin D to fight off COVID19. 

A review of research by NICE (national institute of health and care excellence) in the UK suggests there is no evidence to support taking vitamin D supplements to prevent or treat corona virus. However, it is reasonable to get enough of it for other health benefits. It is important to keep people as nutritionally fit as possible during this pandemic.

What is the recommended dietary intake for vitamin D? 

The endocrine society regards vitamin D levels of between 30 to 100 nanograms per milliliter as sufficient. It recommends vitamin D intake of 1005 to 2000 international unit per day for adults. 

Michael Holik (an expert in vitamin D research) in his paper, recommends us to maintain serum vitamin d at least 30 nanograms per milliliter and preferably between 40 to 60 nanogram per milliliter. It is to minimize the risk of COVID19 infection and its severity. 

This recommendation sounds very sensible with more people staying indoors during the pandemic and get less sun exposure. Some may have been more deprived of vitamin D. People with dark skin may not be getting enough even if they spend time outdoors. This group of people may want to speak to their doctors and check their baseline vitamin D levels. 

High dose vitamin D is it safe? 

Some experts recommend high dose vitamin D of 10,000 international unit per day or even more to reach serum vitamin D levels of more than 100 nanograms per milliliter during this pandemic. 

If you look at your vitamin D blood test report, it is always mentioned that possible toxicity can occur above a level of 100 nanograms per milliliter. so it is prudent to adhere to this parameter to avoid vitamin D poisoning. Those people taking high dose of vitamin D must be careful because vitamin D is fat soluble unlike vitamin C, which is water soluble. There is a risk of getting too much that can lead to toxicity which can be harmful. 

A lot of people believe taking supplements is safe, supplements do not come with a prescription or warning about the possible side effects. Actually they also contain active ingredients that can have strong biological effects and can cause toxicity that can be dangerous and even life threatening. Vitamin D is by far the most common cause of poisoning, especially if your serum vitamin D level is above 100 nanograms per milliliter. So do not underestimate vitamin D toxicity. 

What are the signs of vitamin d toxicity vitamin D toxicity is related to hypercalcemia?

Vitamin D and calcium work together in our body to protect our bones. Vitamin D is responsible for absorption of calcium from the blood and help its deposition in bones. High level of vitamin D in blood may cause hypercalcemia. 

In cases with vitamin D toxicity, most patients experience nausea, vomiting, constipation. Some complain of muscle weakness and even depression, decreased appetite and dehydration. You feel thirsty and consequently drink a lot of water, these are signs of vitamin D poisoning. Very non-specific if you are unwell, you will have at least one of these symptoms therefore, many people never think these symptoms occur because of vitamin D toxicity. 

Vitamin D overdose in the long run can cause complications such as kidney stones even kidney failure and calcium deposits in the coronary arteries, heart fats, arrhythmia or irregular heartbeat, pancreatitis and even death so do not underestimate vitamin D toxicity. 

POINTS TO REMEMBER:

• Although vitamin D is important for bone and muscle it can boost the body's immune system but there is no evidence to support taking vitamin D supplements to prevent or treat corona virus. 
• We need to consume vitamin D according to the Endocrine Society recommendation and maintain a serum vitamin D levels of between 30 to 100 nanograms per milliliter but it is safe to aim between 40 to 60 nanograms per milliliter.  
• High tooth vitamin D can cause vitamin D toxicity, it can happen when a serum vitamin D level rises above 100 nanograms per milliliter its consequences can be serious. A proper treatment is required to avoid complications of hypercalcemia.