As the COVID-19 pandemic continues to escalate, the World Health Organization (WHO) is concerned about its impact on women, children and young people.

“The indirect effects of COVID-19 on these groups may be greater than the number of deaths due to the virus itself”, agency chief Tedros Adhanom Ghebreyesus said on Friday.

The pandemic has overwhelmed health systems in many parts of the world, which means women may be at greater risk of dying from complications related to pregnancy and childbirth.

Early evidence also suggests that people in their teens and 20s are at increased risk of depression and anxiety, online harassment, physical and sexual violence and unintended pregnancies.

Breastfeeding still best

In response, WHO has published guidelines for health facilities on maintaining essential services during the pandemic, including for newborn care.

Experts have also investigated the risk of COVID-19 being transmitted to babies during breastfeeding.

“Based on the available evidence, WHO’s advice is that the benefits of breastfeeding outweigh any potential risks of transmission of COVID-19”, said Tedros.

“Mothers with suspected or confirmed COVID-19 should be encouraged to initiate and continue breastfeeding and not be separated from their infants, unless the mother is too unwell.”

So far, experts have not been able to detect live virus in breastmilk, though fragments have been identified in several cases, according to Dr. Anshu Banerjee, Director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health and Ageing.

“So, the risk of transmission from mother, to child therefore, so far, has not been established”, he said.

COVID-19 and children: many unknowns

Health experts are working to get a clearer picture of how COVID-19 affects children and adolescents.

Much remains to be known about the disease’s impacts on this population, according to Dr. Maria van Kerkhove, an epidemiologist and WHO’s technical lead on the pandemic.

“We have a number of unknowns that we’re really trying to better understand”, she said, responding to a journalist’s question.

“How often are they infected? Do they play a role in transmission and if so, how much are they playing in that role? What roles do schools potentially have?”

Dr. Michael Ryan, WHO head of emergencies, added that several studies are underway, including into why some children end up with severe outcomes and needing to be hospitalized from the disease.

Lifting lockdowns

Meanwhile, countries coming out of lockdowns to contain COVID-19 spread must strike a “careful balance” between public safety and the need to avert further damage to their economies.

Dr. Ryan said WHO is concerned that some nations, which have passed the peak of the pandemic, are now seeing an uptick in cases.

“There is a careful balance to be struck between keeping everyone at home and continuing to completely suppress transmission of COVID-19, and the untoward effects of that on the economy and the society. And that is not an easy balance”, he said.

Dr. Ryan reiterated WHO advice on the need for strong national public health surveillance to determine where the virus is increasing so that authorities can take action.

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