Consumer advocates say Congress has not done enough yet to protect children from getting COVID-19, facing delays in other care or suffering from the pandemic’s societal impacts, despite three new laws to respond to the disease.

Children are far less likely to contract a serious case of the disease, but advocates argue more can be done to alleviate its many effects, from illnesses in their families to the economic fallout.

“The myth that kids are not really impacted by COVID-19 really contributed to some enormous gaps and failings in the first three packages,” said Bruce Lesley, president of the children’s advocacy organization First Focus. “Kids are being impacted in every facet of their lives.”

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Many families are delaying routine physical exams and vaccinations for their children, often on the advice of physicians. Vulnerable populations such as foster children and those in the juvenile justice system are at an increased risk of abuse or neglect.

The advocates want Congress to focus in the next aid law on improving data collection on children’s well-being, boosting economic aid to families, and providing more paid leave to parents caring for children out of school.

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Preliminary data released by the Centers for Disease Control and Prevention on Monday found that “relatively few children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of breath,” but severe outcomes, including death, have occurred.

Some children, including those with preexisting medical conditions, are at higher risk for contracting the virus.

Lesley also warns that foster children, minors in the juvenile justice system, homeless children, and immigrant youth in detention centers have little to no protections in place and that these facilities do not have the training or resources necessary to protect both children and workers.

“Homelessness policy already discounts protections for children” while protecting adults more, said Lesley, “but now families with children cannot go to shelters” because of the risk of contracting the disease.

Other youth, he says, face risks through dangerous living situations: “We are seeing evidence that child abuse and domestic abuse is rising.”

Meanwhile, Rahul Gupta, chief medical and health officer at the March of Dimes, worries that pregnant women are skipping prenatal appointments.

There is little data on the effects of the virus on pregnant women or their unborn children. But experts know stress levels, prenatal visits, diet, exercise, and sleep contribute to the health of pregnant women. Gupta says that women afraid to leave their homes, even for exercise, for fear of the virus, may suffer on those metrics. He emphasized that telehealth is an alternative to an in-person doctor’s visit in some cases.

But in others, in-person visits should continue, he said. Many pediatricians discourage bringing in children for well-visits during the public health emergency, for example, but Gupta says it’s still important for people to stick to vaccination schedules to protect children from other diseases. “The diseases are still going to be out there, whether it’s flu or a number of other diseases,” he said.

Policy requests

Advocates have a variety of concerns that they hope to see addressed in future legislation.

Lesley said the economic benefits of the most recent COVID-19 law do not benefit children and families equally.

“It is clear that kids are more impacted by COVID-19 than initially thought. But more importantly, we would argue that children may be the group most negatively impacted by the economic recession,” he said. “Families are struggling with newborns, the lack of paid leave, lack of child care, etc., and desperately need the help.”

Lesley said the aid differential in the law for adults and children — with most families getting $1,200 per adult and $500 per child under 17 years old —  is “ludicrous.”

Two adults with no children get a bigger check than a single mother with two kids, Lesley noted.

He would also like to see relief for older teens. Lesley said these children face big challenges with their schools and jobs closed. He advocated for a bill by Rep. Angie Craig, D-Minn., that would extend benefits to this age group.

Gupta would also like to see Congress require a form of real-time surveillance that would provide data to medical professionals in different states on health outcomes of pregnant mothers, rather than waiting months for published data.

“If we had a system that is real time on a daily basis or a 24-hour basis, we’ll be able to tell what has happened to these infants that have been delivered, what has happened to mom, what percentage of those moms are suffering from underdeveloped or preterm births,” he said.

Real-time data gathered in New York, for example, could be accessed in other counties or states, he said. “A real time surveillance system for pregnant moms and babies could be then applied to every novel disease, not just COVID-19,” said Gupta.

The American Academy of Pediatrics is also worried about shortages of infant formula for babies, and urged Congress in a recent letter to make it more easily available for those in need through the Special Supplemental Nutrition Program for Women, Infants, and Children or WIC.

“We are hearing reports of infant formula shortages at retailers around the country, mostly due to people overbuying or stockpiling formula,” the organization wrote. “We remain deeply concerned that shortages can lead to families making homemade formula or diluting formula with extra water.”

Children’s hospitals seek aid

The third COVID-19 law provides an approximately $100 billion fund for hospitals and children’s hospitals argue that they deserve a piece of that, even as they are, in some ways, doing less work than normal.

That’s because state and federal officials have called for scaling back elective procedures, and hospitals are dealing with lost revenue. They’re also incurring costs as they ramp up COVID-19 testing and provide more personal protective equipment to patients and staff. 

The decline in elective procedures prompted some children’s hospitals to begin admitting adult patients with COVID-19 and other ailments.

Cohen Children’s Hospital in New York, which is adjacent to the Long Island Jewish Medical Center, is currently housing four units of adults, said Amy Knight, the chief operating officer of the Children’s Hospital Association. Knight said that nearly all of her member hospitals are talking about starting to accept older patients, though not elderly ones.

Children’s specialists will require some retraining to deal with adult populations, but the shift is easier if they are treating younger adults, she said.

“There’s a lot of protocols being developed for adult COVID care many feel like they can successfully perform, but it’s probably easier on a relatively healthy 28-year-old than, you know, an 80-year-old with underlying health conditions.”