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UNICEF warns child mortality rate could rise for first time in 60 years, not due to COVID-19 but caused by disruptions of the medical system in poor countries: NYT

2020-05-14

photo by Jakub Orisek courtesy of pixabay.com

According to an article in the New York Times (NYT) published May 14 on their world updates page, the UNICEF has warned of an increase in child mortality rates, not directly due to novel coronavirus infections (which rarely affect children severely), but due to lack of routine medical care and vaccinations.  Poor nations, especially in Africa, are dependent upon overstressed clinics for preventative medical care for children.  These heavily subsidized or fully funded clinics provide vaccinations, physicals, and medical care for most illnesses, especially for children, all over Africa.

Workers at these clinics report that parents are afraid to bring their children in because they may come in contact with infected people and come down with the virus themselves.  At the same time, medical services are “overstressed or curtailed” because of the pandemic (this quote references a news release from UNICEF and research published in Lancet Global Health):

About 1.2 million children in more than 100 countries are at risk of dying from preventable causes every six months because health services are overstressed or curtailed by the coronavirus pandemic, UNICEF said this week.

The figure is in addition to the 2.5 million children age 5 or younger who already die every six months in 118 low- and middle-income countries.

Put another way, the roughly 13,800 young children who die every day will be joined by more than 6,000 others whose lives could have been saved.

UNICEF said the estimate was based on a study published in the Lancet Global Health journal by researchers at the Johns Hopkins Bloomberg School of Public Health.

The Lancet study models decreased access to maternal and early childhood medical care, giving a broad range of estimates for increased mortality.  The findings are reproduced here:

Our least severe scenario (coverage reductions of 9·8–18·5% and wasting increase of 10%) over 6 months would result in 253 500 additional child deaths and 12 200 additional maternal deaths. Our most severe scenario (coverage reductions of 39·3–51·9% and wasting increase of 50%) over 6 months would result in 1 157 000 additional child deaths and 56 700 additional maternal deaths. These additional deaths would represent an increase of 9·8–44·7% in under-5 child deaths per month, and an 8·3–38·6% increase in maternal deaths per month, across the 118 countries. Across our three scenarios, the reduced coverage of four childbirth interventions (parenteral administration of uterotonics, antibiotics, and anticonvulsants, and clean birth environments) would account for approximately 60% of additional maternal deaths. The increase in wasting prevalence would account for 18–23% of additional child deaths and reduced coverage of antibiotics for pneumonia and neonatal sepsis and of oral rehydration solution for diarrhoea would together account for around 41% of additional child deaths.

These broad ranges of mortality are produced from three separate scenarios that describe different responses and time courses for the pandemic.  They account for maternal deaths and mortality in children under 5.  They predict fewer interventions to reduce mortality during pregnancy and in childbirth, loss of newborns, reduction in antibiotic treatment for pneumonia and neonatal sepsis, lack of oral rehydration therapy for diarrhea (a major source of mortality in children, surprising to us in the developed world), and lack of food supplement programs (without food, medicine would be useless).

These figures are predictions, not certainties.  Much could be done to fight this risk of higher death rates in mothers and children.  One thing that would help is increased financial support from the US federal government for overseas medical and food supplement programs.  During this time, when the purse strings have been loosened for federal spending, increased foreign aid would be a minimal additional expense that would save many more lives.

According to Wikipedia, the US spent about $20 billion on foreign aid through USAID (the United States Agency for International Development) and a total of $35 billion for economic aid in 2018; another $15 billion went to military aid.  By comparison, $100 billion of the $2.9 trillion obligated so far to economic stimulus packages by Congress is going to reimburse US hospitals for their expenses in treating the virus, according to this story in Politico on March 25.  Another $34 billion was sent to the airline industry in the last package, enacted into law March 27.  (Since then, Congress has taken no other formal actions, which is fodder for another story. — Referencing a web site called “gov tracker” that calls itself “the leading non-governmental source of legislative information and statistics”.)

 

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