Germany’s health minister, Jens Spahn, called Friday for COVID-19 vaccine booster shots for anyone who was fully vaccinated at least six months ago, as the nation faces a fourth wave of coronavirus infections. 

Speaking to reporters following a two-day summit in Bavaria with health ministers from the 16 German states, Spahn said Germany’s COVID-19 situation is entering a very difficult period, as the country’s Robert Koch Institute reported a record 37,120 new daily cases Friday. 

Spahn said the “fourth wave” is not only here, but it has “been here for a long time,” and is gaining strength “and has clearly accelerated.”

The minister said some German state leaders have warned the country may need a new lockdown if urgent action is not taken. 

The surge in Germany is part of a rise in COVID-19 cases and deaths in Europe that have made the region the new epicenter of the pandemic, Hans Kluge, the World Health Organization’s (WHO) Europe regional director, said Thursday.

At a regular COVID-19 briefing at the agency headquarters in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus and other experts discussed the surge in Europe, where cases have risen 55% in the past four weeks, despite an ample supply of vaccines. 

“Let me be very clear: This should not be happening. We have all the tools to prevent COVID-19 transmission and save lives, and we continue to call on all countries to use those tools,” Tedros said. 

The WHO chief also decried the fact that the world’s low-income nations have received only 0.4% of the world’s vaccines. He said those nations rely almost exclusively on vaccines distributed through the WHO-managed global vaccine cooperative, COVAX.

Tedros said no more vaccines should go to nations that have vaccinated more than 40% of their populations and no more boosters should be administered, except to patients who are immunocompromised, until COVAX gets the vaccines it needs to inoculate low-income nations to the 40% level.

Separately, in the United States, the Biden administration says it has severed ties with a U.S. company that was awarded a $628 million deal by the Trump administration to produce COVID-19 vaccines. 

Earlier this year, Emergent BioSolutions was found to have contaminated 15 million doses of the Johnson & Johnson vaccine with ingredients designated for the Oxford-AstraZeneca vaccine. The Food and Drug Administration later threw out at least 60 million more Johnson & Johnson shots produced at the Baltimore plant.

Americans who work for companies with at least 100 employees must be fully vaccinated by January 4 or undergo weekly testing for COVID-19, the Biden administration said Thursday. The new rule affects about 84 million workers, but it is not immediately clear how many of those workers are unvaccinated.

WHO has issued an alert about fake AstraZeneca vaccines in Iran. WHO said the “difficult to detect products” are “illicitly refilled vials of used and discarded genuine COVID-19 VACCINE AstraZeneca” and pose a risk for being “illicitly or accidentally inserted into the regulated supply chain or authorized immunization program.” 

Johns Hopkins Coronavirus Resource Center said early Friday that it has recorded 248.7 million global COVID-19 cases and more than 5 million deaths. The center said 7.1 billion vaccine doses have been administered.

Some information for this report came from The Associated Press, Reuters, and Agence-France Presse. 

 
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Editor’s note: Here is a fast take on what the international community has been up to this past week, as seen from the United Nations perch.

Leaders talk global warming in Glasgow 

— World leaders met in Glasgow, Scotland, this week to try to halt global warming. But with some of the world’s biggest emitters like China and Russia skipping the conference, known as COP26, hopes dimmed that leaders will find a way to keep the world from warming more than the goal of 1.5 degrees Celsius this century.

Hope Eroding as COP26 Climate Pledges Fall Short

— Burning coal is the single biggest contributor to climate change. Phasing out its use between 2030 and 2040 is one of the United Nation’s most ambitious appeals. More than 40 countries made coal-related pledges on Thursday at COP26.

COP26: Britain Hails Global Deals to End Coal but Plans New Mine

— The world’s youth have the most at stake as the planet warms, and they have been vocal advocates for change. On Friday, they took center stage during Youth and Public Empowerment Day at COP26.

‘It’s Our Lives on the Line’, Young Marchers Tell UN Climate Talks 

War crimes committed in northern Ethiopia

— The conflict between the Ethiopian federal army and Tigrayan fighters in northern Ethiopia reached the one-year milestone this week. A report written by a joint investigative team from the United Nations and the Ethiopian Human Rights Commission was published Wednesday, saying all belligerents have committed atrocities during the year-long conflict.

UN Report Says Ethiopia’s War Marked by ‘Extreme Brutality’

— The U.S. special envoy for the Horn of Africa, Jeffery Feltman, traveled to Ethiopia on Thursday, as the internal armed conflict intensified. On Tuesday, the Ethiopian federal government declared a state of emergency, saying Tigrayan fighters were advancing toward the capital, Addis Ababa.

US Envoy to Visit Ethiopia After Government Declares State of Emergency

News in brief

World Food Program Executive Director David Beasley has for months been trying to attract the attention of some of the world’s richest men on Twitter, seeking $6 billion to assist 42 million people who are “marching toward starvation” due to conflict, climate change and COVID-19. On Monday, he finally caught the attention of the world’s richest man, Tesla founder Elon Musk.

Quote of note

“We are not drowning, we are fighting. This is our warrior cry to the world.”

— Samoan climate activist Brianna Fruean, 23, of her Pacific Island peers to world leaders at the opening of COP26 on Monday. 

What we are watching next week

An international conference on Libya will be held in Paris on November 12. Libya is set to hold elections on December 24, but concerns are growing that it may not be on track to carry out a free and fair election on time.

Did you know?

The 15 members of the U.N. Security Council take turns being council president for a month at a time. Rotation is in alphabetical order. Kenya was president in October, Mexico took over Monday for November, and Niger will finish out the year in December.

To mark their presidency, Mexico donated a new sculpture now on display at U.N. headquarters in New York City.

 
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U.S. pharmaceutical company Pfizer announced Friday its new COVID-19 pill showed an 89% reduction in risk of COVID-19-related hospitalization or death in clinical trials and they plan to submit the drug to U.S. regulators for emergency use approval.

In a release Friday, Pfizer said the latest clinical trials of its pill, Paxlovid, featured a randomized, double-blind study of non-hospitalized adult patients with COVID-19 who are at high risk of progressing to severe illness. 

The company said interim analysis of the oral antiviral showed an 89% reduction in risk compared to a placebo in patients treated within three days of symptom onset. 

Pfizer said it has received an independent data monitoring committee recommendation to pause enrollment in the Phase 3 trial due to the overwhelming efficacy demonstrated in the latest results. 

The company plans to submit the data as part of its ongoing application to the FDA for Emergency Use Authorization as soon as possible. 

Pfizer is now the second drug manufacturer to develop an oral treatment for COVID-19. U.S. company Merck last month introduced its COVID-19 pill, which clinical studies showed to provide a 50% reduction in hospitalizations and deaths due to COVID-19. It has been submitted to the FDA, and the federal agency is scheduled to rule on it late this month. 

Currently, all COVID-19 treatments approved in the United States require injection or intravenous drip. Pills have the advantage of being distributed by pharmacies and taken at home. 

Britain’s Medicines and Healthcare products Regulatory Agency approved Merck’s pill, known as Molnupiravir, Thursday. The European Union’s drug regulator, the European Medicines Agency (EMA), said it would speed up its review of the Merck pill, and is prepared to give advice to individual EU member states so they can make the pill available for emergency use ahead of the EMA authorization. 

 

When Merck’s pill was submitted for approval last month, White House Coronavirus Response Coordinator Jeff Zients said the U.S. government had already arranged to buy 1.7 million doses of the pill, with an option to acquire more if needed.

 
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Thousands of young campaigners marched through the streets of Glasgow on Friday, chanting their demand that world leaders at the U.N. climate conference safeguard their future against catastrophic climate change.

Inside the COP26 conference venue in the Scottish city, civil society leaders took over discussions at the end of a week of government speeches and pledges that included promises to phase out coal, slash emissions of the potent greenhouse gas methane and reduce deforestation.

“We must not declare victory here,” said former U.S. Vice President Al Gore, who shared the 2007 Nobel Peace Prize for his work informing the world about climate change. “We know that we have made progress, but we are far from the goals that we need to reach.”

Campaigners and pressure groups have been underwhelmed by the commitments made so far, many of which are voluntary, exclude the biggest polluters, or set deadlines decades away.

Swedish teenage activist Greta Thunberg joined the marchers on the streets, who held placards and banners with messages that reflected frustration with what she described as “blah-blah-blah” coming from years of global climate negotiations.

“You don’t care, but I do!” read one sign, carried by a girl sitting on her father’s shoulders.

Sixteen-year-old protester Hannah McInnes called climate change “the most universally devastating problem in the world,” adding: “It’s our lives and our futures that are on the line.”

Promises

The talks aim to secure enough national promises to cut greenhouse gas emissions – mainly from fossil fuels – to keep the rise in the average global temperature to 1.5 degrees Celsius.

Scientists say this is the point at which the already intense storms, heatwaves, droughts and floods that the Earth is experiencing could become catastrophic and irreversible.

To that end, the United Nations wants countries to halve their emissions from 1990 levels by 2030, on their way to net-zero emissions by 2050. That would mean the world would release no more climate-warming gases than the amount it is simultaneously recapturing from the atmosphere.

The summit on Thursday saw 23 additional countries pledge to try to phase out coal – albeit over the next three decades, and without the world’s biggest consumer, China.

A pledge to reduce deforestation brought a hasty about-turn from Indonesia, home to vast and endangered tropical forests.

But a plan to curb emissions of methane by 30% did appear to strike a blow against greenhouse gases that should produce rapid results.

And city mayors have been working out what they can do to advance climate action more quickly and nimbly than governments.

The Glasgow talks also have showcased a jumble of financial pledges, buoying hopes that national commitments to bring down emissions can actually be implemented.

But time was running short. “It is not possible for a large number of unresolved issues to continue into week 2,” COP26 President Alok Sharma said in a note to negotiators published by the United Nations.

Efforts to set a global pricing framework for carbon, as a way to make polluters pay fairly for their emissions and ideally finance efforts to offset them, are likely to continue to the very end of the two-week conference.

The new normal

U.S. climate envoy John Kerry said on Friday it was possible to reach a deal at the summit settling the final details of the rulebook for how to interpret the 2015 Paris Agreement.

He said the United States was in favor of “the most frequent possible” assessments of whether countries were meeting their goals to reduce emissions.

In Washington, President Joe Biden’s mammoth “Build Back Better” package, including $555 billion of measures aimed at hitting the 2030 target and adapting to climate change, looks set to pass eventually. It hit snags on Friday, however, as the House of Representatives was due to vote on it.

Gore, a veteran of such battles, offered conference-goers a scientific video and photo presentation filled with images of climate-fueled natural disasters, from flooding to wildfires.

“We cannot allow this to become the new normal,” Gore said.

One schoolchild’s placard put it just as well.

“The Earth’s climate is changing!” it read, under a hand-painted picture of a globe on fire. “Why aren’t we?”
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Seats are once again packed at professional baseball games in South Korea. Just as in pre-pandemic times, fans can drink beer and eat fried chicken. They can clap their hands, stomp their feet, and wave inflatable noisemakers to support their team.

What they are not allowed to do, though, at least not yet, is shout or sing fight songs, a key feature of Korean baseball crowds.

“If you shout a lot, the virus will leak through your mask,” Prime Minister Kim Boo-kyum pleaded with fans on a radio show this week, after crowds were seen as being too vocally supportive of their teams during tense playoff games.

It is a microcosm of how life is going in South Korea: basically, things are returning to normal, but they are not quite there yet.

Although South Korea never locked down during the coronavirus pandemic, it was never fully open either, especially as the country has battled a fourth wave of infections since July.

However, starting this week, the government rolled out the first step of its “living with COVID-19” plan. Bigger crowds can now gather in Seoul. Restaurants and cafes, including those that serve alcohol, are no longer subject to a nighttime curfew. Sports fans have returned to stadiums and arenas.

Barring setbacks, South Korea will phase out all social distancing rules by the end of February, two years after the country experienced one of the world’s first COVID-19 outbreaks.

South Korea’s COVID-19 approach has unquestionably been a success so far. It is one of very few countries to avoid both mass lockdowns and mass deaths.

Now, after outperforming its global peers at nearly every stage of the pandemic, South Korea hopes it can demonstrate how to live with COVID-19.

A cautious opening

For starters, few in South Korea are declaring victory. That is in contrast to countries such as the United States and Britain, where leaders announced independence from the virus and quickly eased social distancing, only to see the delta variant sweep through their populations, killing tens of thousands more in each country.

“The goal here is to set up a system where the government can relax the restrictions, but at the same time has criteria for moving back,” said Jerome Kim, director-general of the International Vaccine Institute in Seoul.

There are good reasons for caution. Although over 75% of South Koreans are vaccinated, the number of daily confirmed COVID-19 cases has not fallen since the fourth wave began.

“We do, I think at this point, have a realization that the vaccines are doing what they’re supposed to do, which is preventing severe disease, hospitalization, and death. But they don’t necessarily prevent infection,” Kim said.

Officials have repeatedly warned the opening up could be reversed. And they say some precautions, such as mandatory facemasks, may be around for the foreseeable future.

South Koreans seem receptive. According to a recent poll by Seoul National University, about 49% of South Koreans have mixed feelings about the loosened restrictions. Twenty-seven percent think it will be impossible to ever stop wearing masks, according to a survey by Gallup Korea.

Getting public support

Unlike many countries, South Korea has seen almost no domestic backlash to its pandemic approach.

Businesses largely complied with mandatory curfews. There has been no successful anti-vaccine movement. Virtually everyone wears masks, even when running alone outside on empty paths.

That public buy-in has been at the heart of South Korea’s COVID-19 success, according to public health experts. Not only has it given authorities more anti-pandemic tools, those tools are less coercive and more precise.

For instance, no vaccine mandates have been necessary; about 90% of adults have received the COVID-19 vaccine. Mass lockdowns, too, are unheard of; during the pandemic it has always been possible to go shopping or eat at a restaurant.

Perhaps the most invasive tool is South Korea’s system of contact tracing.

Using cellphone, credit card, and other personal data, authorities can quickly determine where those infected with COVID-19 have gone and who they may have contacted.

The contact tracing only became possible after South Korea’s National Assembly loosened privacy laws following a public outcry over the government’s handling of a deadly 2015 outbreak of Middle East respiratory syndrome, or MERS.

“I think there are a number of choices that people here have made in order to have freedom, which is really what it is,” Kim said.

Moving ahead

As South Korea makes the transition toward living with the virus, it will continue to use many of those same tools, which have become a part of daily life.

Customers at every restaurant in Seoul are required to check in either via their phones or on a sign-up sheet at the counter. Temperature checks remain at the entrance of almost every business. Soon, electronic vaccine passes will be required to enter sporting events, concerts, and other large venues.

Some health experts caution that new standards may be necessary for defining COVID-19 success, though.

While many news outlets continue to focus on the number of confirmed daily cases, it will soon be important to pay attention to more meaningful measurements, such as the number of intensive care unit beds available or the number of serious illnesses.

“Even if there are 10,000 confirmed cases, it will still be more important to know the number of serious cases or what the fatality rate is,” said Chun Eun-mi, a respiratory disease specialist at Ewha Womans University Medical Center in Seoul.

Experts also warn inconsistencies may need to be addressed as authorities figure out the best path to follow.

During a previous round of social distancing, many South Korean newspapers mocked the strangely specific guidelines for Seoul fitness centers, which were prohibited from playing music with a tempo higher than 120 beats per minute. Joggers were also prevented from running faster than 6 kph on the treadmill.

More recently, Korean baseball fans are the ones questioning the rules against cheering. Why are they allowed to attend baseball games, they ask, but remain forbidden to vocally support their team?

South Korean officials insist that cheering may be allowed during future rounds of opening up.

For now, South Korea’s prime minister asked fans, “please reduce your shouts by just a little.”

Lee Juhyun contributed to this report.

 

 
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The “end of coal” is in sight, according to Britain — the host of the COP26 climate summit — after dozens of countries pledged to stop using coal and end the financing of fossil fuels. But as Henry Ridgwell reports from the Glasgow summit, weaning economies off coal won’t be easy — even for Britain itself.

Camera: Henry Ridgwell
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Congressional Democrats this week proposed an addition to U.S. President Joe Biden’s climate and social spending legislation that would allow Medicare, the federal government’s health care program for older Americans, to negotiate with drugmakers over the cost of certain prescription medications.

U.S. consumers pay higher prices for prescription medications than almost any of their peers in the developed world, a fact that generations of politicians and advocates have struggled in vain to change. If passed, the proposal working its way through Congress would make a dent, though a relatively small one, in that long-standing problem.

The plan being discussed would give Medicare officials the ability to negotiate pricing on a sliver of the thousands of prescription medications on the market in the United States, beginning with about 10 drugs and capped at 20. Liberal members of Congress at first had hoped to grant Medicare authority to negotiate the prices of up to 250 costly drugs every year.

Though small, the number of drugs that would be covered by the proposal represents a disproportionate amount of the annual “spend” on drugs by Medicare patients.

A study by the Kaiser Family Foundation released this year determined that the 10 top-selling drugs covered under Medicare Part D accounted for 16% of net total spending in 2019. The top 50 drugs — representing just 8.5% of all drugs covered under the program — accounted for 80% of spending.

The top 10 drugs, according to the Kaiser Family Foundation include “three cancer medications, four diabetes medications, two anticoagulants and one rheumatoid arthritis treatment.”

Confusing system 

Unlike many countries outside the U.S., where the government is able to negotiate drug prices and bring down the cost for a single national health care system, the landscape in the U.S. is highly fragmented. Most Americans with health insurance are covered by policies issued by for-profit companies in the private sector.

Americans 65 years and older are eligible for Medicare, which takes the place of a private insurer, but with some critical differences. For many years, Medicare did not offer prescription drug coverage, forcing Medicare patients to pay for medications out of pocket or seek third-party insurance coverage for their medications.

In 2003, Congress created Medicare Part D, under which private insurers offered medication coverage that met minimum requirements established by the federal government. While that program reduced costs for many seniors, cost-sharing provisions and design flaws mean that many recipients continue to face financially crippling bills for medication. A key reason is that each insurance provider must negotiate prices with drug companies individually, rather than using the bargaining power of the entire Medicare population to insist on lower costs.

‘Subsidizing R&D for the world’ 

For years, advocates for change have pointed out that drug companies set prices in the U.S. far above those in other countries in which they sell the same drugs. A study by the Rand Corporation this year comparing the U.S. with 32 other countries found that drugs cost on average 256% more in the U.S.

“American consumers are subsidizing the R&D for the world,” said Lovisa Gustafsson, vice president of the Controlling Health Care Costs program at the Commonwealth Fund, a think tank in Washington, D.C.

Compounding the problem is that Americans also shoulder a much greater share of the cost for their prescription medications.

“Patients in the U.S. face far higher cost-sharing than in a lot of other countries. So, just because they have insurance doesn’t mean that patients can actually afford the drugs that they need currently,” Gustafsson said. “There’s survey after survey showing that 20% to 25% of Americans can’t afford the drugs they’re prescribed by their physician, or split pills, or don’t get the prescription filled, because they just can’t afford it. And that’s even when they have insurance.”

Putting a lid on costs

An important element of the proposal before Congress is that it would place an annual cap of $2,000 on the co-payments that Medicare patients can be charged for their medications.

The prospect of a cap on out-of-pocket costs was well-received by many calling for reforms, such as AARP, a large advocacy group for older Americans.

“There’s no greater issue affecting the pocketbooks of seniors on Medicare than the ever-increasing costs of prescription drugs,” AARP CEO Jo Ann Jenkins said in a statement. “For decades, seniors have been at the mercy of Big Pharma. Allowing Medicare to finally negotiate drug prices is a big win for seniors. Preventing prices from rising faster than inflation and adding a hard out-of-pocket cap to Part D will provide real relief for seniors with the highest drug costs.”

Drug firms unhappy

PhRMA, a powerful trade group representing the pharmaceuticals industry, reacted unhappily to news of the proposal.

“If passed, it will upend the same innovative ecosystem that brought us lifesaving vaccines and therapies to combat COVID-19,” PhRMA President and CEO Stephen J. Ubl said in a statement. “Under the guise of ‘negotiation,’ it gives the government the power to dictate how much a medicine is worth and leaves many patients facing a future with less access to medicines and fewer new treatments.”

“While we’re pleased to see changes to Medicare that cap what seniors pay out of pocket for prescription drugs, the proposal lets insurers and middlemen like pharmacy benefit managers off the hook when it comes to lowering costs for patients at the pharmacy counter,” Ubl continued. “It threatens innovation and makes a broken health care system even worse.”

Industry claims exaggerated?

Numerous supporters of allowing the government to negotiate on drug prices claim that the industry’s insistence that it will stymie innovation is exaggerated.

One piece of evidence they point to is a study released by the Congressional Budget Office in August. The CBO created a model in which pharmaceutical companies were faced with the following scenario: A policy is put in place that reduces the return on their most profitable drugs by 15% to 25%.

The agency estimated that the impact would be a reduction of the number of new drugs coming onto the market by only one-half of 1% over the first 10 years of the new policy. That would increase to as much as an 8% reduction in the first three decades of the program.
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Regularly cursed at and sometimes physically assaulted by patients, nurses in the U.S. have had enough. As VOA’s Veronica Balderas Iglesias reports, the pandemic is accelerating a longstanding problem of violence against frontline health care workers. A warning: some images in this report may be disturbing.
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The World Health Organization’s regional director for Europe said Thursday the continent is now the epicenter of the COVID-19 pandemic, accounting for 59 percent of all cases globally.

At a virtual news briefing from Copenhagen, Hans Kluge said the current pace of transmission across the region’s 53 countries is of grave concern. He said new cases are approaching record levels, with the delta variant of the coronavirus driving the surge.

Kluge said his agency’s latest data shows hospitalizations in the region more than doubled in one week.

He noted officials are seeing increasing trends across all age groups, but that the rapid increase in the older population is of the most concern. He said this is translating into more people having severe cases and dying, with 75 percent of the deaths among persons aged 65 or older.

Kluge said one reliable projection indicates that at the current pace, Europe could see another half a million COVID-19 deaths by the first of February. COVID-19 is caused by the coronavirus.

He also cited uneven vaccination rates and the relaxation of public health and social measures throughout the region as the cause of the surge.

While a billion doses of vaccine have been distributed, in Europe, only 47 percent of the total population are fully vaccinated. He says in eight nations, at least 70 percent of the people have been inoculated fully. Kluge notes the rate remains below 10 percent in two other countries.

Kluge encouraged nations with low vaccination rates to increase coverage, particularly among priority groups such as the elderly. He urged nations with high vaccination rates and ample supply to share with less fortunate nations.

He also said that vaccines are most effective when used with other preventive measures, such as social distancing and mask-wearing. Kluge said if the region achieved universal mask use, 188,000 lives could be saved between now and February.

The WHO region chief said, “We must change our tactics, from reacting to surges” of COVID-19 to “preventing them from happening in the first place.” 

 
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A New Zealand research project is looking at ways to produce hydrogen in Antarctica to reduce carbon emissions.  

A four-month New Zealand project is investigating whether hydrogen could be generated, used and stored at Scott Base, its Antarctic research facility, to reduce its reliance on carbon-based fuels.  Those fuels are currently used for transportation, cooking and heating.  A special grade fuel is shipped in on ice-breakers.  

Surplus power from wind turbines at Scott Base could be used to generate green hydrogen for hydrogen fuel cells that produce electricity by combining hydrogen and oxygen atoms.  

The hydrogen initiative is a collaboration between Antarctica, New Zealand, a government scientific body, and the University of Canterbury in Christchurch.  The project started in August and will finish this month. 

The project faces some obstacles, including geographic isolation and extreme weather. Antarctica is the coldest, windiest and driest continent. In 1983, a temperature of minus 89.2 degrees was recorded. 

Brendon Miller, a consultant chemical engineer, says it is an ambitious plan.  

“We would like to demonstrate that we can use hydrogen effectively as an energy source to replace fossil fuels. It is a very challenging environment to do it in Antarctica. But, actually, there are some things going for it because the alternates like batteries are quite awkward to use for long-term storage particularly at very cold temperatures,” Miller said.  

New Zealand’s work in Antarctica focuses in large part on global warming.    Experts have said the world’s southernmost continent was very sensitive to rising temperatures, and it also influenced the global climate system.  Earlier this year, the New Zealand government said it would spend  $200 million to guarantee the future of its scientific hub at Scott Base. 

Scientific projects in Antarctica are highly collaborative, bringing together researchers from around the world.    
Twenty-nine countries, including Australia, China and the United States, operate bases in Antarctica. 
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No in-person school. Isolation from friends. Lost rites of passage like graduation ceremonies. The COVID-19 pandemic upended the lives of many children in the United States.

“A lot of children’s joy comes from being with friends or from play, and from social interaction. When you ask kids, ‘What’s making you happy?’ 90% of the time, it’s being around friends or doing things with friends,” says Elena Mikalsen, head of the Psychology Section at the Children’s Hospital of San Antonio in Texas. “That was kind of taken away during the pandemic. … For the longest time, all kids had was the academics and no joy.” 

A recent report finds that the uncertainty and disruption caused by COVID-19 has negatively affected the emotional and mental health of about one-third of America’s youth. So much so that the American Academy of Pediatrics (AAP), along with other children’s health organizations, has declared a national emergency in child and adolescent mental health.

“Elevated symptoms of anxiety, depression or stress,” says Nirmita Panchal, a senior policy analyst at the Kaiser Family Foundation (KFF), a nonprofit organization focusing on national health issues. “There’s also been a number of changes in behavior that parents have reported with some children having a poor appetite and difficulty sleeping. For others, it may be fear or irritability and clinginess.”

Panchal co-authored the report, which found that 8% of children between the ages of 3 and 17 currently have anxiety. That number rises to 13% among adolescents ages 12 to 17.

“During the pandemic, children, just like everybody else, have experienced a number of changes and disruptions,” Panchal says. “That includes school closures, possibly financial difficulties at home, isolation, perhaps the loss of loved ones and then difficulty accessing health care. So, all of these factors may be contributing to increased mental health issues among children.” 

Rates of children’s mental health concerns and suicide steadily increased between 2010 and 2020, according to the AAP, which says the pandemic has made the crisis worse with “dramatic increases” in the number of young people visiting hospital emergency rooms for mental health-related concerns, including possible suicide attempts.

Maryland psychologist Mary Karapetian Alvord says uncertainty, as well as losing out on school activities, provoked varying levels of grief in young people.

“Particularly high school students, who really lost out on all of the fun activities, the fun clubs, and also graduations and homecoming, football games and all the social as well as the outlets that they have,” says Alvord, who is also an adjunct associate professor of psychiatry at The George Washington University School of Medicine. “So, those are themes that have dominated this pandemic, I think, grief, loss on all those different levels, and then just constant uncertainty. And we then get a rise in anxiety.”

Alvord says the young people being seen at her practice have a sense that they’re not moving forward, which has led to anger, frustration, sadness and anxiety. 

“It runs the gamut, but kids have lost time,” she says. “They have a sense that they have lost time, and not in terms of only maybe some academic skills, which a lot of the schools are concerned about, but in terms of maturity. How do you mature as a kid? It’s not by being home 24/7.” 

And while children missed being in school with their friends, the idea of returning to in-person classes also triggered some anxiety. 

“Some kids were scared to go back to school because they were afraid of contracting COVID. They were afraid of what school might look like and what that would entail, especially kids that already were more predispositioned to have anxiety or depression,” says psychologist Nekeshia Hammond, former president of the Florida Psychological Association. “It basically made that process a lot more stressful. And not just school but going back into social situations.” 

The pandemic has shaken the sense of safety most children feel. More than 140,000 children in the United States lost a primary and/or secondary caregiver to COVID-19.

“The majority of kids just have this innocence, in a way, that the world is safe. ‘I’m going to be OK. People are here to protect me,’” Hammond says. “And that got stripped away for a lot of kids who don’t feel the world is safe.” 

Children of color have been disproportionately impacted by the losses caused by the pandemic. And not solely because they were more likely to lose a loved one to the virus. 

Mikalsen, who works primarily with minority youth and inner-city youth in Texas, found that many of the children she spoke to were forced to use their smartphones for their schooling because they didn’t have computers at home. Spotty internet connections made it difficult to stay in touch with their schoolwork and to get their assignments. 

 

Some of Mikalsen’s young patients were home alone all day because their parents are essential, front-line workers. 

“A lot of the kids that I was talking to during the pandemic, they were completely alone at home, left to be there by themselves and, ‘Hey, if you can get connected to school, that’d be great, but if you don’t, no big deal,’” Mikalsen says. “So many kids that I talked to, they just slept all day and had nobody to talk to. Things like that can really cause a lot of depression and anxiety.” 

And then there was the societal upheaval caused by the police murder of George Floyd, a 46-year-old Black man in Minneapolis. Video of police officer Derek Chauvin pressing his knee into Floyd’s neck while Floyd struggled to breathe went viral, sparking nationwide protests against police brutality.

“All of that affects kids of color in a different way, on top of a global pandemic, on top of, ‘You can’t go to school, and you lost a loved one.’ It was basically more compounded,” Hammond says. “There were so many different stressors all at one time, which made it extremely difficult as far as coping, and as far as mental health.”

The AAP is calling for more federal funding for mental health screenings and treatment for all children from infancy through adolescence, with an emphasis on making certain kids from less privileged homes get the services they need.

“We don’t want to wait until it’s unmanageable. We want to have scaffolding and services in place to catch kids when they’re having that much trouble,” Alvord says. “We’re all tied to one another, and if your family is doing better, then those kids get sent to school and they’re doing better in school. Which helps the whole health of the classroom. Which helps the teachers do better to teach and do what they need to, instead of having to deal with the mental health crisis.”
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Maintaining the unique environment of the Galápagos Islands and protecting the surrounding marine resources is testing Ecuador. China’s industrial fishing fleet threatens the islands, but China is a key trading partner. Jaime Moreno has this report.

Video: Nelson Abril
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