By F. Pdianghunlin Nongbri
In March 2020, the World Health Organisation reported more than 118,000 cases of coronavirus disease 2019 (COVID-19) worldwide and declared the situation a pandemic. After health campaigns recommending preventive measures and social distancing, lockdowns etc., were established in numerous countries to limit the spread of the infection Over 3.4 billion people were confined worldwide on March 31. In this unprecedented situation, schools were closed, the possibilities of going out were limited, direct contact with friends and other family members was stopped, and rehabilitation and medical follow-up were interrupted.
This exceptional situation abruptly changed the daily lives of children with disabilities and their families.
The impact of the COVID-19 pandemic extends beyond the children with increased susceptibility to the virus. Many rehabilitation centres shut down along with the rest of the world, leaving them without a way to get critical therapy. Dr Pavone notes in addition to the increased physical risks, children also had to deal with decreasing endurance, tighter muscles, and potential weight gain. The issues could present even more difficulties for children as they return to their therapeutic routine and physical mobility. “The delay of non-emergent surgeries caused some children with cerebral palsy to suffer while waiting for hospitals to be opened again to perform these operations,” Dr McLaughlin states. Many patients faced delays when trying to get wheelchairs, bathing aids, and other therapeutic equipment. Parents have had to do more of the therapy exercises with their children, while also trying to do distance learning, manage their household, and for many, work from home
Several surveys highlighted the negative effects of the lockdown on the children’s wellbeing and their mental and social health (morale, behaviour, social interaction and physical activity), similar to a recent report on children without disabilities. The psychological effects of the lockdown, including post-traumatic stress symptoms, confusion and anger have been reported in the general population and are related to the duration of the lockdown. Children with physical disabilities have an increased risk of mental health symptoms, which could exacerbate during the pandemic. The lack of social interaction may not only affect their morale but may also lead to a regression in their communication ability. Moreover, the development or worsening of behavioural disorders could further affect their wellbeing and increase the parental sensation of helplessness. Children with physical disabilities have a higher risk of sedentarism and its consequences than other children. As was found for children without disability, the results of the present survey showed that during the lockdown, the level of physical activity of children with disabilities reduced considerably. Furthermore, these children are likely to experience a loss of motor skills because motor capacity is related to physical activity and sedentary time negatively affects motor skills .
The most frequent parental concern is the lack of rehabilitation during the lockdown. The purpose of regular rehabilitation is to maintain or monitor the progress of motor skills and to prevent complications that could further alter mobility and increase difficulties in daily life, such as orthopaedic deformities or physical deconditioning. Therefore, the interruption or modification of medical care and rehabilitation could inevitably deteriorate the child’s physical status and functional ability.
A cross sectional, mixed-methods approach, using a purposive snowballing technique was adopted to study the impact of COVID-19 on persons with disabilities in India. The article has been authored by Murthy GVS, Kamalakannan S, Lewis MG, Sadanand S and Tetali S. Among the 17% needing rehabilitation services, 59.4% failed to access the same. Reported difficulties in access were same across the different groups of disability, thereby highlighting that the concerns of persons with disabilities are similar across disabilities. Mental health concerns of caregivers for persons with disabilities were also ascertained and important leads were observed. Half of them felt moderately stressed caring for children or other family members with disability. 58.2% were unhappy that the therapy sessions for their child with disability had ceased during the lockdown. Our main concern as rehabilitation professionals is to examine and recreate possibilities regarding the present situation in order to bring a balanced psycho-social and physical health to the children. As Late Prime Minister Jawaharlal Nehru said, ‘ Children are the reflection of our society as they show the thought and mentality of society. They are the purest souls and take shape in the way we nurture them’.
(The writer is Occupational therapist at Meghalaya Institute of Mental Health and Neurological Science (MIMHANS). She can be reached at [email protected])