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COVID-19 reveals, deepens mental, physical and educational crises among young people

Troubling trends in education, physical health and mental well-being among young people predate COVID-19.

But the pandemic’s disruptions of daily routines, emotional support networks and vaccination rates have raised those concerns to crisis levels.

“This is really not just a story of an initial shock, then recovery. What we've seen are patterns of lost learning persistent, and in some cases being even stronger, in 2020-21,” said Jim Soland of University of Virginia, an affiliated research fellow at the assessment nonprofit Northwest Evaluation Association (NWEA).

“We certainly don't see this as in some way being an indictment of teachers; far from it. We really see it as a story of teaching being a very difficult job that just got innumerably harder in the context of the pandemic,” he said.

NWEA’s national study of grades three through eight shows math scores fell ominously between 2019 and 2020, and again from 2020-21.

“So this is a story of an immediate impact from the pandemic and then that negative impact on achievement continued,” said Soland.

Soland said reading scores at first held steady or improved, then saw large declines.

“If you compare them to something like study results from kids who were affected by Hurricane Katrina, some of these declines are similar in magnitude,” he said.

Reading skills measured by a Virginia assessment during the critical kindergarten through third grade period painted an equally grim picture.

“We see a 10 percentage point increase in the number of students who need some sort of reading intervention, which to my knowledge is unprecedented in the history of this exam,” said Soland.

To stem that troubling tide, some suggest extending school days, reducing class sizes or offering tutoring.

But the pandemic also compounded worsening mental health trends among minors.

Mental toll

“What we have with COVID really is this perfect storm of increased stress and trauma and those risk factors combined with a decrease in the protective factors,” said Tali Raviv of Northwestern University.

Raviv, who is also associate director of the Center for Childhood Resilience at Lurie Children's Hospital of Chicago, said the right stressors — such as the pressure to make a clutch play or tolerate hurt feelings — can benefit kids by helping them develop coping skills.

Under the right conditions, even dealing with the pandemic could improve mental resilience.

“If it's buffered by protective factors, like adults and supportive relationships, it can be OK,” she said.

But knock out those supports — and pile on months of adversity, food insecurity, or sick or dying family members — and mental health can founder, especially among minors already facing abuse, violence or mental illness.

“That's when their stress comes into this level of toxic stress, which has really significant impacts on the developing brain and longstanding consequences — potentially, if it's not supported — for health and mental health,” said Raviv.

Adults can provide such support in a variety of ways.

“What we like to say is, ‘You don't have to be a therapist to be therapeutic,’ meaning that every adult in a child's life has a role to play in building that coping,” she said.

For now, studies show in-person time with friends falling and screen time rising.

During the pandemic, one Chicago study reported more than one-third of K-12 students were lonely and a quarter were anxious, stressed, agitated or angry.

“Really significant increases in every metric of mental health concerns after school closure as compared to before,” said Raviv.

Such patterns extended far beyond the Lake Michigan shore or the U.S. border. A global meta-analysis shows youth depression and anxiety rates doubled during coronavirus.

Those rates began ramping up in the U.S. prior to the pandemic.

“Even more concerning, recent data reported by the CDC has showed increases in emergency department visits for suspected suicide attempts,” said Raviv.

Teen suicide rates in the U.S. have climbed since 2007, especially among African Americans.

While risk factors like poverty, violence or trauma occur across lines of race, ethnicity, geography or income, they remain unequally distributed.

“Structural racism, classism and longstanding inequities in health and wealth in our country really do determine not only who is more likely to experience those stressors or risk factors, but also who's likely to have access to the resources they need to cope or recover,” said Raviv.

"Structural racism, classism and longstanding inequities in health and wealth in our country really do determine not only who is more likely to experience those stressors or risk factors, but also who's likely to have access to the resources they need to cope or recover." — Tali Raviv, Northwestern University

Physical effects

Social stressors can take a physical toll as well.

Research ties adverse childhood experiences to heart disease and cancer, possibly due to chronic stress triggering inflammatory responses.

What’s more, childhood vaccinations fell markedly during the pandemic, especially during lockdowns.

“Thankfully, less-than-2-year-olds seem to have a pretty good bounce-back in terms of their rates of vaccination, most likely because they're seeing the doctor more frequently anyway,” said Dr. Alexandra Yonts, an attending physician at Children's National Hospital and assistant professor of pediatrics at the George Washington University.

Still, as precautions relax, fewer vaccinated kids could lead to more cases of chickenpox or measles, in addition to more commonplace infections.

“Masks and social physical distancing and quarantine have decreased the rates of all infections over the course of the pandemic. So I think the next several months to years as things loosen up is going to be very enlightening,” said Yonts.

Studies also show increases in sedentary behavior, which raises risks of obesity , type 2 diabetes and heart disease.

“This is very concerning, and something that we need to see improve,” said Yonts.

That’s to say nothing of the millions of COVID-19 cases among children, not all of which can be written off as mild.

“There have been over 112,000 hospitalizations of children with COVID-19, and over 800 children have died,” said Yonts.

Thousands of those cases could develop the lingering flulike illness called multi-system inflammatory syndrome in children (MIS-C).

“The disturbing thing about MIS-C, while more rare, is it is often more severe in terms of leading to children being hospitalized or put in the ICU needing blood pressure support and actually has a higher rate of fatalities,” said Yonts.

Young children also can develop long COVID, although it’s more common in teens.

“We have seen children as young as two in our clinic presenting with symptoms. There may be some reporting differences in terms of what teenagers are able to vocalize and in terms of impact on their daily lives,” said Yonts.

Care and recovery

The diagnosis sounds bleak, but experts say the prognosis remains hopeful if we dedicate the time, resources and effort needed to support the inherent resilience of young people.

“Helping kids regain some of what they have missed is going to be a long-term process. It's going to require long-term strategies and some optimism to go with it. It's certainly going to be a process that extends far beyond schools,” said Soland.

Nor can societies rely solely on mental health experts to carry the load.

“It's not enough for just the mental health professionals to handle this; it's really going to need a much broader approach,” said Raviv.

Analysts say dealing with these mental tolls, physical impacts and educational shortfalls will mean addressing shortages of counselors, social workers and psychologists in schools, and releasing teachers from their roles as de facto mental health workers.

More broadly, it will entail doing more than plastering over the longstanding cracks in the mental health and educational systems COVID-19 helped reveal.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.

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Nicholas Gerbis was a senior field correspondent for KJZZ’s Arizona Science Desk from 2016 to 2024.