“Impact of COVID-19 among/on children, adolescents and elderly people in Bangladesh”
In Bangladesh the first three patients were reported on March 08, 2020, and as of May 05, 2020, there were 10,929 confirmed cases of COVID-19, including 183 deaths. Of all COVID-19 cases, approximately 3%, 8%, and 26% were aged under 10 years, 11-20 years and 21-30 years, respectively. Apart from the risk of being exposed to the infection, these children and young people are at higher risk of adverse health outcomes including obesity, neglect and abuse by parents, and thus more prone to increased mental health and chronic health issues such as obesity[1].
To prevent the rapid outbreak of the pandemic, the Government of Bangladesh first decided to close all educational institutions on March 16, and all other economic sectors (except some emergency services) on March 26, with strict enforcement to stay at home. The present situation amid COVID-19 has led the children and young people into a sedentary lifestyle, idleness, and physical inactivity which may increase the incidence of obesity, and other chronic diseases such as diabetes mellitus, cardiovascular diseases, and some types of cancers. The lack of social contact, loss of income of parents, continuous media coverage, and anxiety of uncertainty related to COVID-19 pandemic may have adverse psychological effects leading to post-traumatic stress disorder (PTSD). Family violence can also rise during restrictions because of an economic crisis which will increase the risk of child abuse. They can also be highly addicted to social media, pornography websites, and video games; and long-term closure of educational institutes may adversely affect their learning. The Government of Bangladesh has adopted to telecast educational programs for primary and high school students through Television, which is appreciated. However, this might lead to extra pressure on students from low-income families who do not own a medium to connect to those programs[2].
Socioeconomically disadvantaged people are at a higher risk for poor physical and mental health in Bangladesh. About 9.2% of people in Bangladesh live in extreme poverty (daily income below $1.90). The economic shutdown due to COVID-19 pandemic threatens millions of people. The prevalence of under nutrition among Bangladeshi children is relatively higher compared to other developing countries, which can rise due to the food crisis. The children of extremely low-income families often involve in the diverse workforce like the construction sector, agriculture, garment industry, waste-picking, transportation, among others for a little amount of money. Child labour is common in both rural and urban areas in Bangladesh, with almost 1.2 million children aged between 5 and 14 engaged in the workforce. These child labourers cannot earn to support their family[3].
Moreover, many children in Bangladesh are homeless and live on the street and in rail stations, making them more vulnerable to infection. However, the child labourer and street children are already abused as well as neglected, and COVID-19 might have a severe impact on their daily life, physical and mental health. Furthermore, the youth unemployment rate in Bangladesh was 12% in 2018. Also, many young people will lose their job due to COVID-19. The unemployed young people are also at higher risk for engaging in different crimes, drug addiction and mental disorders.
Children and young people in Bangladeshi are concerned about adverse emotional and physical outcome due to COVID-19. Community-based programs and strategies are needed to reduce the risk of adverse outcome among them, especially in those who live with poverty, engage in the labour force and are currently unemployed[4].
Impact of COVID -19 on children: special focus on the psychosocial aspect
Although medical literature shows that children are minimally susceptible to 2019-Corona virus disease (COVID-19), they are hit the hardest by psychosocial impact of this pandemic. Being quarantined in homes and institutions may impose greater psychological burden than the physical sufferings caused by the virus. School closure, lack of outdoor activity, aberrant dietary and sleeping habits are likely to disrupt children’s usual lifestyle and can potentially promote monotony, distress, impatience, annoyance and varied neuropsychiatric manifestations. Incidences of domestic violence, child abuse, adulterated online contents are on the rise. Children of single parent and frontline workers suffer unique problems. The children from marginalized communities are particularly susceptible to the infection and may suffer from extended ill-consequences of this pandemic, such as child labor, child trafficking, child marriage, sexual exploitation and death etc. Parents, pediatricians, psychologists, social workers, hospital authorities, government and non-governmental organizations have important roles to play to mitigate the psychosocial ill-effects of COVID-19 on children and adolescents. To provide the basic amenities, social security, medical care, and to minimize the educational inequities among the children of the different strata of the society are foremost priorities[5].
The Effects of COVID-19 among the Adolescents
Although most respondents believed the government acted in the interest of the people by imposing a lockdown, they had mixed opinions about the restrictions extending to mosques. A 14-year-old girl from Community C complained, ‘It is not right for men to pray at home. So I think the mosque should allow all the men to go there for prayer.’ Later into the lockdown when the government allowed shops to open on a limited scale before the Eid holidays, a few respondents criticised what they viewed as a contradiction, saying that if malls and other businesses were open, going to mosques should be safe if people maintain proper hygiene and social distancing[6].
A significant number of adolescents, mostly from low-income backgrounds but not necessarily poor, reported that they have not received any food, relief or cash aid from the government or NGOs. Slums, like any other community, do not constitute homogenous socio-economic classes, with residents ranging from small businessmen to rickshaw-pullers, there are many layers to the structure of a slum population. Hence, officially the relief support that is being provided by the government and NGOs is mostly targeted towards the ‘extreme poor’ (The Daily Star, 12 April 2020), causing the low income families suffering from the financial crisis to fall through the cracks. A 17-year-old girl from Community B, whose parents own a small shop and live in their own house, underscored such challenges, ‘Yes, they are distributing these things [relief] but only to those people who are very needy and helpless, such as the rickshaw-pullers or the beggars but they don’t give anything to people like us.’ Some adolescents mentioned that they were asked by the local government bodies to submit photo IDs in order to receive relief. However, despite submitting the required documents, they still wait in uncertainty. Some adolescents have reportedly heard about the availability of cash assistance from the government provided through mobile money transferring services, such as bKash. Similarly to in-kind aid, however, many adolescents in our sample were not the intended recipients. A 19-year-old girl from Community A said ‘they came from the Counselor’s office and took our bKash numbers. But nothing was done.’ A few respondents, all of whom are girls, cited embarrassment and the likelihood of humiliation upon being turned down as the main reasons for not asking for support from anyone. ‘My mother told me to tell my [school] teacher about our financial crisis and ask for some help. I feel shy and uncomfortable walking on the street holding the relief bag, because people might say bad things about me, like “a poor girl, a beggar,”’ explained a 14-year-old girl from Community C. A 17-year-old girl from Community B said, ‘I feel that it is better to starve than ask for help from anyone. People say bad things about those who are getting relief.’ There are some different voices, however, and an older female adolescent described how her father had encouraged her to ask for relief, since it is the government’s duty to provide assistance[7].
The Effects of COVID-19 among the Elderly Population
The COVID-19 pandemic has had huge effects on the daily lives of most individuals in the first half of 2020. Widespread lockdown and preventative measures have isolated individuals, affected the world economy, and limited access to physical and mental healthcare. While these measures may be necessary to minimize the spread of the virus, the negative physical, psychological, and social effects are evident. In response, technology has been adapted to try and mitigate these effects, offering individuals digital alternatives to many of the day-to-day activities which can no longer be completed normally. However, the elderly population, which has been worst affected by both the virus, and the lockdown measures, has seen the least benefits from these digital solutions. The age based digital divide describes a longstanding inequality in the access to, and skills to make use of, new technology. While this problem is not new, during the COVID-19 pandemic it has created a large portion of the population suffering from the negative effects of the crisis, and unable to make use of many of the digital measures put in place to help. This paper aims to explore the increased negative effects the digital divide is having in the elderly population during the COVID-19 pandemic. It also aims to highlight the need for increased attention and resources to go toward improving digital literacy in the elderly, and the need to put in place measures to offer immediate solutions during the COVID-19 crisis, and solutions to close the digital divide for good in the long-term[8].
Although it is currently unclear what the full extent of the effects of this pandemic will be, its negative impact on psychological well-being has become very evident. Early studies have already reported an increase in anxiety, and depression in the general population, especially those facing extended lockdowns. These effects are magnified in the elderly population due largely to stricter lockdowns, higher threat of illness, and loss of social support. Prior studies have also reported that even outside of crisis times, the elderly population have relatively high rates of depressive symptoms, which is troubling in the face of evidence that those suffering from pre-existing mental health conditions have been most affected by the negative psychological consequences of lockdowns. While increased mental health problems in the general population may already be a cause for concern, these concerns go beyond psychological well-being in the elderly. Studies have shown that depression in the elderly is linked the subsequent cognitive decline, and risk of Alzheimer’s Disease. This means that while many societies now face the immediate threat of increasing mental health concerns, the long-term effects could be devastating, as depression and stress result in the older generation facing hastened cognitive decline, and increased rates of Alzheimer’s Disease. This problem will likely be even further worsened by the physical limitations put on the movement of individuals outside their homes, resulting in less exercise opportunities for many individuals. Several studies have shown that exercise, even in light to moderate doses and intensities, can have a significant positive effect on cognitive function in the elderly, especially in those with cognitive impairments, or neuropsychiatric disorders. Looking at this prior research, loss of socialization, increased mental strain and general mental health problems, and decreased exercise, could have substantial negative effects on the elderly population. Although the lockdowns may be temporary, these effects are likely to be long lasting, and could pose significant risks to the quality of life of the elderly population in the coming years.
However, the changes many countries have seen come into place since the start of the COVID-19 pandemic extend far beyond loss of socialization, and increased depression. Lockdowns have resulted in a significant shift in the functioning of day-to-day life: the world has gone digital. As hospitals have filled with COVID-19 patients, access to regular healthcare for non-COVID related disorders has been interrupted. Those who do not seek care for non-COVID related disorders may be at higher risk of illness and fatality during this period. This risk is likely to disproportionately affect the elderly, who have higher rates of health problems than younger populations and are more likely to be encouraged to avoid areas where they could contract the disease. In response to this problem, there has been a significant shift in healthcare into the digital world. Telehealth, or the act of providing healthcare digitally, and remotely, has become commonplace in many countries. However, this shift has had fewer positive effects in the elderly than other populations. A recent study showed that about 40% of elderly individuals were unprepared to use telehealth resources, predominantly due to lack of skills to effectively make use of the technology. This has been further shown during the pandemic, as the group with the highest adoption of telemedicine use has been those aged 20–44, despite the fact that the elderly population generally has the highest yearly number of doctor and hospital visits. Although there have been some recent efforts to create virtual geriatric clinics to support the elderly during the pandemic, research has shown these have had varying success, and have been met with a variety of problems related to difficulties with technology use. Therefore, despite being the group most in need of telehealth solutions, the elderly community has benefited from their implementation the least[9].
This shift into the digital realm extends beyond just the healthcare sector. Online access to COVID-19 related news, education, grocery delivery services, group socialization, and many more services have become commonplace. The world has adapted to try and make up for the loss of access to everyday resources, and in many areas, and for many people, this has been fairly effective. However, one group likely to benefit the least from these digital alternatives are the elderly population, who have significantly lower rates of internet usage and acceptance than other age groups. This results in a worrying paradox: the population most negatively affected by the COVID-19 pandemic, are also the least likely to be able to access the resources put in place to mitigate the effects. This paradox can largely be attributed to the poor digital literacy skills found amongst the elderly population compared to younger groups, most commonly described as the digital divide.
Example
For more clarification regarding Impact of COVID-19 among/on children, adolescents and elderly people in Bangladesh I try to set an example like,
In my home I stay with my mother aged 65 years, one child aged 3 years, one brother aged 14 years. My mother is a patient of stroke she needs physical therapy, regular physical check up, regular different types of medication but in the period of lockdown this services are not available as a result she needs extra care which was very difficult to achieve. Beside this stay home as well as shortage of recreation creates mental pressure on her in the event of COVID-19 pandemic.
Younger brother who is student of class eight become more violent due to stay at home full time. He cannot meet with his friends and peers also his study become more vulnerable. He always busy with video game because there is no alternative. He always tries to go outside to release mental pressure. Sometimes when he found that his peer group go outside but he cannot then he claimed to go outside but that was not possible due to physical safety and family security from the COVID-19.
The child whose aged 3 years become aggressive due to full time stay at home, it cannot go outside from home, also suffer with malnutrition because of lock down it is hard to buy something from local bazaar.
Conclusion
As the COVID-19 pandemic has progressed, the unforeseen side-effects have started to make themselves known. As lockdowns across the world change the day-to-day life of billions of people, the world has had to adapt to the changes. The shift to a focus on digital tools has been successful in minimizing many of the problems faced during the pandemic, and many individuals have continued to socialize, study, work and access healthcare via digital tools. However, the elderly population, who have historically faced a large inequality in access to, and ability to make use of technology, has not seen the same benefits as many other younger groups. In fine I want to say that the COVID-19 pandemic creates crisis in economy, social relations, day to day life style, etc. which directly affected on children, adolescents and elderly people in Bangladesh.
[1] https://www.bmj.com/content/369/bmj.m1669/rr-2, accessed on 12.2.2021, at 12.30 PM
[2] https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19schools, accessed on 12.2.2021, at 12.35 PM
[3] https://www.who.int/news-room/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome—physical-activity?gc lid=Cj0KCQiAyJOBBhDCARIsAJG2h5dCW1au1Ms7TVGJGflFAxDMZ_zDnfnxamRr7tzmI_u wBl8hpnbReS0aAmL8EALw_wcB, accessed on 12.2.2021, at 12.40 PM
[4] https://www.bmj.com/content/369/bmj.m1669/rapid-responses, accessed on 12.2.2021, at 12.37 PM
[5] https://www.researchgate.net/publication/341214452_Impact_of_COVID-19_on_children_Special_focus_on_psych osocial _aspect, accessed on 12.2.2021, at 12.32 PM
[6] www.gage.odi.org › wp-content › uploads › 2020/06, accessed on 12.2.2021, at 11.30 AM
[7] core.ac.uk › download › pdf, accessed on 12.2.2021, at 12.30 PM
[8] https://www.who.int/publications/i/item/9789240003927?gclid=Cj0KCQiAyJOBBhDCARIsAJG2h5c49nhJmhI9Sznj2lQeTJnRGV-ok6fhKKU0hEmCcrF vP8hts6USxNkaAqrUEALw_wcB, accessed on 12.2.2021, at 13.30 PM
[9] https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome?gclid=Cj0KCQiAyJOB BhDCARIsAJG2h5fetdYRekb YnXxF7b9SPSIAZF70TrtpAg3PpiTiQ6x_7-qnrbo6GMAaAg98EALw_wcB, accessed on 12.2.2021, at 14.30 PM
