Opinion: Rescuing Our Children from Covid Trauma Vital to Healing America

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Editor's Note: Dr. Nadine Burke Harris is California's Chief Health Officer.

She is a physician, researcher, and advocate for childhood trauma issues.

The opinions expressed in this comment are yours. 

(CNN) -

Now that Pfizer vaccines have been licensed for emergency use in children ages 5 to 11, I, like many parents across the United States, breathe a sigh of relief that my little ones can finally be protected against covid-19.

We still have a lot of work to do to ensure that we get out of this pandemic as soon as possible, but as a pediatrician and California Chief Health Officer, I recognize that controlling the virus cannot be the end of the story.

If we want to truly heal from the impacts of COVID-19, we must once again let medicine guide our decision-making and recognize the role that trauma caused by the pandemic and other cumulative stressors plays on personal and public health. especially when experienced during childhood.

In its recent deliberations, the U.S. Centers for Disease Control and Prevention (CDC) rightly noted that the covid-19 pandemic has led to an increase in adverse experiences in childhood ( ACE), or potentially traumatic events that are related to health problems, and an increased risk of many of the leading causes of death in the United States.

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Unfortunately, most medical professionals have yet to incorporate this powerful research into the way we manage care for children and adults.

In fact, far too many physicians I have spoken to continue to think that ACEs are social problems that do not have a direct impact on health and do not require medical interventions.

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It's about time we changed that.

The research is clear and if we don't address the long-term effects of ACEs, I fear our country will be battling the lingering consequences of COVID-19 for decades.

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ACEs refer to 10 categories of adversity or traumatic events experienced before the age of 18, such as parental mental illness, witnessing domestic violence, or growing up in a home where there is substance abuse. Exposure to these stressors in childhood, without the necessary buffers to deal with them, leads to a prolonged activation of the body's stress response. This is known as the toxic stress response and is particularly detrimental to a child's brain, immune, and hormonal development.

The effects of toxic stress can persist through all stages of our life.

The more ACEs an individual experiences, the more likely that person will develop acute and chronic illnesses, such as asthma, cardiovascular disease, or depression, in both childhood and adulthood.

According to a study published in the American Journal of Preventive Medicine, in 2009, people with six or more ACEs had a shorter life span, 19 years shorter on average than people without any ACEs.

ACEs have increased during the pandemic, as have other risk factors for toxic stress that can harm long-term physical and mental health, such as the death of a family member, which tens of thousands of children have experienced as a result of COVID-19. 19. And while the pandemic itself is not one of the traditional criteria for ACEs, it is likely to cause toxic stress.

For much of the pandemic we have been isolated from the everyday supports and social interactions that we need to turn off the body's stress response.

It is no wonder, therefore, that the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association recently declared a national emergency for the mental health of children and adolescents due to enormous adversity and hardships. disorders they have experienced as a result of the pandemic.

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People raised in homes where adversity is already present are especially at risk.

Communities of color were already more likely to experience ACEs, but have now endured most of the COVID-19 infections and deaths, as well as economic hardship during the pandemic.

This could lead to even higher rates of health conditions, such as cardiovascular disease.

The sharp rise in ACEs due to COVID-19 will likely lead to a massive wave of sequelae that will threaten not only our healthcare system, but also our economy and our education and criminal justice systems.

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A study, published in early 2020, estimated the annual cost of ACEs in California at $ 10.5 billion for just eight health conditions and risk factors, with another $ 102 billion lost to the burden of disease, which it estimates. the cost of premature death and years of productive life lost to disability.

And children with four or more ACEs are significantly less likely to graduate from high school and are 3.1 times more likely to be arrested as minors compared to their peers without ACEs, according to a 2016 study published in the journal. Pediatrics.

All of these are pre-pandemic figures.

We still do not know how harmful ACEs caused or aggravated by covid-19 will be.

But we do know that with the right infrastructure, ACE prevention, detection and treatment can prevent individual suffering, as well as persistent societal problems, before they take root.

Toxic stress is treatable when ACEs are identified early and managed with high-quality interventions.

Therefore, we need a coordinated and cross-sectoral approach that provides health service providers with adequate training and support to address ACEs effectively and equitably.

Here in California, we are making great progress in creating our own ACE infrastructure, which I hope the rest of the nation can learn from.

As CEO of Health, I developed a report to serve as a model for how communities can scale up ACE interventions.

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In January 2020, California launched the ACE Aware initiative, and since then more than 20,000 healthcare providers have been trained to detect ACEs and treat toxic stress with evidence-based interventions.

And now, with the recent passage of the ECA Fairness Act, more Californians will have insurance coverage for high-quality ACE screening, a crucial step for our state's public health.

And this is just the beginning.

This year's California state budget is spending more than $ 4 billion over five years to transform youth behavioral health, a once-in-a-generation investment in health care, education, public safety and beyond. in our society who suffer because we are not treating people for toxic stress.

It's the kind of system-wide policy we need at the state and federal level to reduce the interrelated and multifaceted impacts of ACEs.

As our nation works to better rebuild one of the greatest collective traumas of our time, government leaders must equally adopt a trauma response approach to policy making.

This country will never fully advance, and never fully heal, if we don't learn the lessons of this pandemic and let medicine guide us.

I like to say that adverse childhood experiences don't have to dictate a person's destiny.

Now is the time to address the root of the challenges before us and ensure a different destiny for ourselves, our children and our country.

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