ISPCAN COVID-19 WEBINAR SERIES · ISPCAN COVID-19 WEBINAR SERIES Child Welfare and Pandemics: What We Know and What We Can Do Webinar Presentation Child Welfare and Pandemics Friday

ISPCAN COVID-19 WEBINAR SERIES

Child Welfare and Pandemics:

What We Know and What We Can Do

Webinar Presentation

Child Welfare and Pandemics

Friday April 3, 2020

10:00 a.m. MDT / 12:00 p.m. EDT

https://www.ispcan.org/

Child Welfare

and Pandemics

D R . B A R B A R A FA L L O N 1

D R . D E L P H I N E C O L L I N - V É Z I N A 2

D R . S T E V E N M I L L E R 3

D R . M A R I N A S I S T O V A R I S 1

1 U N I V E R S I T Y O F T O R O N T O

2 M C G I L L U N I V E R S I T Y

3 T H E H O S P I T A L F O R S I C K C H I L D R E N & T H E U N I V E R S I T Y O F T O R O N T O

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Policy Bench Co-Leads:

Barbara Fallon, Ph.D.

Professor

Factor-Inwentash Faculty of Social Work

University of Toronto

Steven Miller, M.D.

Head of Neurology

Division of Neurology

The Hospital for Sick Children

Policy Bench Advisory Committee:

Catherine Birken, M.D.

Staff Pediatrician

Pediatric Medicine

The Hospital for Sick Children

Jennifer Jenkins, Ph.D

Professor

Department of Applied Psychology and

Human Development

University of Toronto

Faye Mishna, Ph.D.

Professor

Factor-Inwentash Faculty of Social Work

University of Toronto

Avram Denburg, M.D.

Staff Oncologist and Clinical Scientist

The Hospital for Sick Children

Joel Levine, Ph.D.

Professor

Department of Biology

University of Toronto

Marla Sokolowski, Ph.D.

Professor

Department of Cell and Systems Biology

University of Toronto

Barbara Fallon, Ph.D.

Professor

Factor-Inwentash Faculty of Social Work

University of Toronto

Steven Miller, M.D.

Head of Neurology

The Hospital for Sick Children

Suzanne Stewart, Associate Professor

Director of the Waakebiness-Bryce Institute for

Indigenous Health

Social and Behavioural Health Sciences Division

Dalla Lana School of Public Health

University of Toronto

Principal Researcher:

Marina Sistovaris, Ph.D.

Research Associate

Factor-Inwentash Faculty of Social Work

University of Toronto

Policy Bench Committee

• The Policy Bench is an initiative of the Fraser Mustard Institute for Human Development (FMIHD). Dr. J. Fraser Mustard (1927-2011) galvanized the international community with his belief that interventions in the early years of life offer unparalleled potential for improved quality of life.

• The FMIHD honours Dr. Mustard’s legacy through key initiatives such as the Policy Bench that support the University of Toronto academic community by providing transdisciplinary opportunities for collaboration and knowledge mobilization in the area of human development.

• The Policy Bench brings together leaders at the University of Toronto and SickKids with transdisciplinary expertise from an array of academic disciplines─ranging from health, psychology, education, economics and medical sciences─to support optimal human development and health equity across the life course, from the early years into adulthood. This involves the synthesis, creation and dissemination of knowledge designed to assist decision makers, practitioners and relevant stakeholders in making evidence based policy decisions that improve outcomes for children and youth.

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

POLICY BENCH

Fraser Mustard Institute for

Human Development

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

1. Methodology

2. The Dynamics of a Pandemic

3. COVID-19 Pandemic

4. A Socio-Ecological Approach to Child Protection During Pandemics

5. Leading Child Protection Risks During Pandemics, UNICEF

6. Emerging COVID-19 Concerns: A Child Welfare Perspective from the U.S.

7. Policy Implications: Designing Appropriate Child Protection Strategies

8. Concluding Remarks

Presentation Overview

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Introduction

Child Welfare and Pandemics: Literature Scan

• Literature scan was conducted on the topic of child welfare and

pandemics, focused on potential policy solutions that could mitigate the

impact on children in the care of Canada’s child welfare system.

•Document available online: https://cwrp.ca/publications/child-welfare-

and-pandemics-literature-scan

•Brief summary also available online: https://cwrp.ca/publications/child-

welfare-and-pandemics-information-sheet

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

• Search Time Frame: Literature search conducted between March 16, 2020 and March 19,

2020.

• Search Keywords/Phrases: pandemics; COVID-19; children; policy; mitigation

• List of keywords/search terms was developed by examining: abstracts; government

documents; and subject headings and phrases.

• Throughout the search process, keywords/search terms were added, deleted or modified as

different terms were discovered to improve the search strategy.

• Data Sources: peer-reviewed journals found in electronic databases; internet based grey

literature

Methodology

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Global disease outbreak.

Compared to an outbreak or epidemic, a pandemic:

affects a wider geographical area, often

worldwide;

infects a greater number of people than an

epidemic;

is often caused by a new virus or a strain of

virus is wider in scope because humans usually

have little to no immunity against it;

spreads quickly from person-to-person

worldwide;

causes much higher numbers of deaths than

epidemics; and

creates social disruption, economic loss, and

general hardship.1

The Dynamics of a Pandemic

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

COVID-19 Pandemic

Origin: Wuhan, China (2019)2

Pandemic

Status:

March 11, 2020 declared pandemic by

World Health Organization3

Description: highly transmittable and pathogenic

viral infection caused SARS-CoV-22

Symptoms: flu-like symptoms, cough, fever, can be

asymptomatic4

Countries

Affected:

200 countries and territories (as of

March 30, 2020)4

Infected: 785,712 (as of March 30, 2020)4

Recovered: 165,606 (as of March 30, 2020)4

Deaths: 37,814 (as of March 30, 2020)4

Mortality Rate: 3.4% (as of March 30, 2020)4

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Socio-Ecological Impact of COVID-1918

Heightened risks to child of

abuse, neglect, violence,

exploitation, psychological

distress and negative

impact on development

Breakdown of trust; Competition over scarce

resources; Limited access to community support

services, education and play spaces

Family separation, reduced access to

social supports, caregiver distress,

heightened risk of violence/domestic

abuse

Disruption to livelihood; Disrupted family

connections and support; Fear of the

disease

Erosion of social capital;

Disruption or limited access

to basic services

Stigma against

certain groups

ChildFamilyCommunitySocietySociocultural

Norms

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Leading Child Protection Risks During

Pandemics, UNICEF7

Neglect and Lack of Parental Care

Mental Health and Psychosocial Distress

Increased Exposure to Violence, Including Sexual Violence, Physical and Emotional Abuse

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

• Increase in Maltreatment Cases

• Poor Nutrition

• Decrease in Home Services

• Reduced Availability of Substance Use Disorders Programs

• Reduced Visitation and Reunification Services

• Delays in Court Appearances/Proceedings

• Decreased Protection of Youth with Pre-Existing Conditions

• Foster Parent Employment

• Possible Spike in “Re-Placement” Needs

• Health of Elder Caregivers

• Outbreaks at Institutional Settings

• Displaced Foster Youth Living on College Campuses5

Emerging COVID-19 Concerns:

A Child Welfare Perspective from the U.S.

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Policy Implications: Designing Appropriate

Child Protection Strategies

• Increased Coordination and

Collaboration

• Child Specific Programming

• Residential Care

• Strengthening Child Welfare Systems

Before, During and After Pandemics8,9

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Increased Coordination and Collaboration8,9

Child Protection

Food Security

Livelihoods

Education

HealthNutrition

Water, Sanitation,

Hygiene

Shelter

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Child Specific Programming

• Individual and Group

Activities for Child Well

Being

• Strengthening Family and

Caregiving Environments

• Community-Level

Approaches

• Case Management

• Alternative Care8,9

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Residential Care

• Youth living in residential facilities

have a high risk of infection with

viruses because of communal living

arrangements.

• Children and youth with pre-existing

health conditions are at a heightened

risk of infection.

• Pandemic plans should include

measures:

• for dealing with the need to

quarantine youth or staff;

• for large relocation of children; and

• with agreed-upon medical centers

to take children to in an emergency

situation.10,11,12

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Strengthening Child Welfare Systems:

Before a Pandemic

• When formulating a plan, child welfare agencies should take into

consideration how they will:

• identify, locate, and continue the availability of services for children

under care or supervision who are displaced or adversely affected;

• respond to new child welfare cases in areas adversely affected by a

disaster, and provide services in those cases;

• remain in communication with caseworkers and other essential child

welfare personnel who are displaced;

• preserve essential program records; and

• coordinate services and share information with other levels of

government.13

• Plans should ensure that critical infrastructure is in place to allow for:

the coordination with key players; the communication of vital

information; and the preparation of staff, families, youth, and service

providers.14

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Strengthening Child Welfare Systems:

During a Pandemic

• Effective implementation of a

pandemic plan requires:

• good management of

resources, essential

functions and assigned

roles;

• coordination with key

partners;

• communication of vital

information; and

• access to critical information

systems by staff.15

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Strengthening Child Welfare Systems:

After a Pandemic

• The period after a pandemic

provides an opportunity for

child welfare agencies to:

• assess experiences;

• revise plans; and

• rebuild stronger and more

effective systems.16

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Concluding Remarks• Children in care are at a heightened risk of harm from not only the current COVID-19 pandemic, but in many cases,

from government policies being implemented to contain the pandemic.

• Pandemics can significantly limit the capacity of public agencies to operate and provide services and supports to

populations during a period of heightened demand and uncertainty.

• Early feedback from key stakeholders—children, youth, parents, foster and adoptive parents, caseworkers,

probation officers, judges and others—suggests system resources and capacity are under considerable pressure as

agencies and child protection workers struggle to provide services and supports to clients.

• Child welfare systems and agencies, require policy makers to formulate, articulate and implement child protection

strategies that: allow for and encourage increased coordination across all sectors that involve children in care; build

on the strengths and positive coping mechanisms of communities, families, caregivers and children; address the

challenges of highly vulnerable populations such as youth in residential care; and provide for the required

resources and supports to function not only during a pandemic but also in pre- and post-pandemic environments.

• It is especially important for child welfare agencies responsible for vulnerable populations to ensure continuity of

care during this period.

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Acronyms

COVID-19 Coronavirus Disease 2019

SARS-CoV-2 Severe Acute Respiratory Syndrome Corona Virus 2

UNICEF United Nations International Children’s Emergency Fund

US United States

WHO World Health Organization

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Resources: Websites

Canadian Child Welfare Research Portal https://cwrp.ca/

Government of Canada

COVID-19 Updates

https://www.canada.ca/en/public-

health/services/diseases/2019-novel-coronavirus-

infection.html

Ontario Ministry of Children, Community

and Social Services

http://www.children.gov.on.ca/

Government of Ontario COVID-19 Updates https://covid-19.ontario.ca/index.html

SickKids Hospital COVID-19 Information

http://www.sickkids.ca/VisitingSickKids/Infection-

Prevention-and-Control/Infection-Prevention-and-

Control.html

Social Work Blog https://www.socialwork.career/2020/03/covid-19-

resources-social-workers-therapists.html

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Resources: Publications

Coronavirus (COVID-19) Pandemic Coping

Strategies for Youth with a History of Complex

Trauma

(Report)

https://www.attachment-and-trauma-treatment-centre-for-

healing.com/uploads/4/0/5/4/4054075/covid-

19_coping_stragies_for_youth_complex_trauma_survivors_an

d_their_caregivers_foundation_trust.pdf

Trauma Informed Approach to Teaching

(Newspaper Article)

https://www.washingtonpost.com/education/2020/03/26/tr

auma-informed-approach-teaching-through-coronavirus-

students-everywhere-online-or-not/

Trauma Informed Care

(Presentation Slides)

https://www.socialwork.career/2017/09/trauma-talking-not-

enough.html

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Endnotes1 Association for Professionals in Infection Control and Epidemiology. (n.d.). Outbreaks, Epidemics And Pandemics—What You Need To Know.

Arlington, Virginia: Association for Professionals in Infection Control and Epidemiology. (No page). Retrieved from

https://apic.org/monthly_alerts/outbreaks-epidemics-and-pandemics-what-you-need-to-know/

2 Shereen, M.A., Khan, S., Kazmi, A. et al. (2020). “COVID-19 Infection: Origin, Transmission, and Characteristics of Human Coronaviruses,”

Journal of Advanced Research, 24: 91-98. (Page 91). https://doi.org/10.1016/j.jare.2020.03.005

3 Bedford, J., Enria, D., Giesecke, J. et al. (2020). “Comment: COVID-19: Towards Controlling of a Pandemic. Comment.,” The Lancet, 395

(10229): 1015-1018, (Page 1015). https://doi.org/10.1016/S0140-6736(20)30673-5

4 Worldometer. (2020). COVID-19 Coronavirus Pandemic. (31 March), (No page). Retrieved from https://www.worldometers.info/coronavirus/

5 Kelly, J. and Hansel, H. (2020). “Coronavirus: What Child Welfare Systems Need to Think About,” The Chronicle of Social Change, (11 March),

(No page). Retrieved from https://chronicleofsocialchange.org/child-welfare-2/coronavirus-what-child-welfare-systems-need-to-think-

about/41220

6 Alliance for Child Protection in Humanitarian Action. (2019b). Technical Note: Protection Of Children During The Coronavirus Pandemic,

Version 1. (March). Pages 1-2. Retrieved from

https://alliancecpha.org/system/tdf/library/attachments/the_alliance_covid_19_brief_version_1.pdf?file=1&type=node&id=37184

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Endnotes7 United Nations International Children's Emergency Fund. (n.d.). Child Protection Emergency Preparedness and Response Guidance to The

COVID-19. Page 1. New York, New York: UNICEF. Retrieved from

https://www.dropbox.com/s/o0l2rmzyhipqwbk/EAPR%20CP%20Preparedness%20and%20Response%20to%20COVID-19.pdf?dl=0

8 Alliance for Child Protection in Humanitarian Action. (2019a). Minimum Standards for Child Protection in Humanitarian Action. Retrieved from

https://alliancecpha.org/system/tdf/library/attachments/cpms_2019_final_en.pdf?file=1&type=node&id=35094

9 Alliance for Child Protection in Humanitarian Action(2019b). Technical Note: Protection Of Children During The Coronavirus Pandemic, Version

1. (March). Retrieved from

https://alliancecpha.org/system/tdf/library/attachments/the_alliance_covid_19_brief_version_1.pdf?file=1&type=node&id=37184

10 Fecteau, O. (2020). “Foster Care Children at Risk During COVID-19 Pandemic,” News5, (19 March), (No page). Retrieved from

https://www.news5cleveland.com/news/coronavirus/foster-care-children-at-risk-during-covid-19-pandemic

11 Kelly, J. and Hansel, H. (2020). “Coronavirus: What Child Welfare Systems Need to Think About,” The Chronicle of Social Change, (11 March),

(No page). Retrieved from https://chronicleofsocialchange.org/child-welfare-2/coronavirus-what-child-welfare-systems-need-to-think-

about/41220

12 Hyslop, K. (2020). “People in Group Homes: What Is Government Doing to Keep Them Safe?,” The Tyeee. (19 March), (No page). Retrieved

from https://thetyee.ca/News/2020/03/19/Few-Specific-COVID-19-Youth-In-Care-Measures-Group-Homes/

POLICY BENCH, FRASER MUSTARD INSTITUTE FOR HUMAN DEVELOPMENT, UNIVERSITY OF TORONTO

Endnotes13 Child Welfare Information Gateway. (2016). Disaster Planning For Child Welfare Agencies. Washington, DC: U.S. Department of Health and

Human Services, Children’s Bureau. Page 2. Retrieved from https://www.childwelfare.gov/pubPDFs/disasterplanning.pdf

14 O’Brien, M., Webster, S. and Herrick, A. (2007). Coping With Disasters and Strengthening Systems: A Framework for Child Welfare Agencies.

Washington, D.C.: U.S. Department of Health and Human Services. Pages 3-29. Retrieved from https://www.hsdl.org/?view&did=480685

15 O’Brien, M., Webster, S. and Herrick, A. (2007). Coping With Disasters and Strengthening Systems: A Framework for Child Welfare Agencies.

Washington, D.C.: U.S. Department of Health and Human Services. Pages 30-37. Retrieved from https://www.hsdl.org/?view&did=480685

16 O’Brien, M., Webster, S. and Herrick, A. (2007). Coping With Disasters and Strengthening Systems: A Framework for Child Welfare Agencies.

Washington, D.C.: U.S. Department of Health and Human Services. Pages 2, 38-42. Retrieved from https://www.hsdl.org/?view&did=480685

17 Centers for Disease Control and Prevention. (n.d.). The Social-Ecological Model: A Framework for Prevention. No page. Retrieved from

https://www.cdc.gov/violenceprevention/publichealthissue/social-ecologicalmodel.html

18 Alliance for Child Protection in Humanitarian Action. (2019b). Technical Note: Protection of Children during the Coronavirus Pandemic,

Version 1. (March). Page 2. Retrieved from

https://alliancecpha.org/system/tdf/library/attachments/the_alliance_covid_19_brief_version_1.pdf?file=1&type=node&id=37184