The COVID-19 pandemic has affected almost all the countries and Nepal is no exception. The country is on lockdown for over 80 days with school closure, restriction on mass gathering and public transportation while the international border has been sealed to break the chain of transmission.
Based on available data older people and people with chronic medical conditions appear to be more at risk of developing severe symptoms. But children and adolescents are also under risk of infection and can spread the disease. Science about COVID-19 is evolving every day with the coronavirus causing it being new. The unpredictable changes by COVID-19 has a great impact on adolescent health which has to be taken under consideration while formulating strategies to handle the pandemic.
The World Health Organization (WHO) defines an adolescent as any individual between 10-19 years. It is transitional phase of growth and development between childhood and adulthood with multiple ups and down. Nothing smooth yet the best stage of life. Adolescent health is determined by multiple factors, which includes caring and meaningful relationship, positive school environment, boundaries of behavior, spiritual beliefs, opportunities of participation, and encouragement of self-expression.
Today’s adolescents are global citizens, the powerful agents of change, and the generation of tomorrow. With the shutdown of the school and colleges, the postponement of classes and exams of the academic year, the uncertainty regarding resuming classes and future is leading to high levels of stress and anxiety in the adolescents. The unsubstantiated news and rumors are the other source of stressors among them. Likewise, lack of physical activity, outdoor sports, and reduced social interactions are also affecting their mental health.
Schools and colleges are not merely a place of learning. School routines are important coping mechanisms for adolescents to deal with mental health issues. Shutdown of schools, interrupted social services and restriction in movement have cut off the interaction of adolescents with teachers, friends, and increased chances of domestic and sexual violence. The horrific side of COVID-19 is children experiencing suffocation, discomfort and anxiousness at their own home.
Adolescents of this era binge on digital stuffs. Increased access to new digital devices (smartphones and tablets) has contributed to a rapid rise in screen exposure in recent years but this has dramatically escalated during the lockdown. They use digital media to socialize with peers using various apps (Facebook, Viber, Twitter, Tiktok) and entertain themselves playing online games (Crossfire, Minecraft, PUBG etc) as outdoor activities are restricted.
Excessive screen time in adolescents is associated with behavioral health problems as unhealthy eating and sleep habits, excessive sadness, and difficulty with attention and concentration. Apart from this, unsupervised access to websites leads to exposure to harmful contents (violent or sexual), engagement in online gambling, development of gaming disorder, and sometimes even cyberbullying.
Provision of e-learning
The COVID-19 pandemic has also brought opportunities and solution along with a plethora of problems for the education system. A handful of schools and colleges are trying their best to bridge the gap adopting e-learning. The method includes assigning reading and writing exercises through audio-video methods, and conducting virtual classes. The sudden shift of learning from the classroom to e-learning is challenging.
The pandemic is transforming the centuries-old, chalk–talk teaching model with technology. Some are clamoring for adoption of the new way of teaching and learning despite some of those even with internet access and technology struggling to participate, while the majority are out of reach. This gap exists throughout the country. There seems to be a mixed opinion about e-learning. Some argue the unplanned and rapid move toward online learning with no training, insufficient bandwidth, and little preparation will result in a poor user experience that is inconducive to sustainable growth while others state a new model of education will emerge, with some benefits.
Nevertheless, e-learning seems effective for students in a number of ways. Learning is possible at their own pace and self-engagement in study is enhanced even though interaction and face-to-face engagement are hard to achieve as in the classroom. Adolescents using digital device for educational purpose with the start of e-learning is an advantage. Conducting formal educational processes online requires both competence and confidence. Effectiveness of learning depends on the level of digital literacy of both the teachers and the students.
Roles of parent
COVID-19 is neither the first and nor will be the last pandemic and learning to live with COVID-19 is important instead of panicking. Parents need to encourage the adolescents for physical activity of at least 60 minutes of moderate to vigorous exercise every day. Outdoor activities like brisk walking, cycling and running whenever possible adopting the safety measures, and getting the children involved in household chores (cooking, cleaning and gardening) are beneficial. Despite some conflicts with the parents, the adolescents rely on parents for emotional support and for setting limits. The role of parents, therefore, is crucial in maintaining the health of adolescents.
Parents are role models to children and the balance between online and offline activities should first be maintained by the parents. Creating an environment of reading books and engaging in creative activities as arts and crafts, singing and dancing reduce the stress and anxiety the adolescents might be going through. Doing yoga and meditation can help a lot. Parents can help children in accessing the online resources that are vital for learning, socializing and playing. At the same time, parents need to be aware and alert to signs of distress that may emerge in children due to online activities.
Social distancing in COVID-19 pandemic is challenging for adolescents who thrive on social connections with peers. The boundary between work and family life is getting blurred when home is also a workplace and school. Afterwork schedule and engaging on social media, interaction within the family is foremost. Parents should be supportive and empathetic toward their children and not force their ideas on the latter. Creating a consistent daily routine is important, with active involvement of children a must during the process.
Diverse health issues are associated with COVID-19 pandemic among the adolescents. Shutdown of educational centers happened suddenly as a measure to break the chain of transmission but resumption is far more uncertain. Schools and colleges being vacated for quarantine, unacceptably big class size, and need for hygiene and social distancing mean they should be amongst the last ones to reopen.
The Ministry of Education should announce start of school education with alternative methods. Initiation of e-learning from the government level in the long run will open the pathway for distance education. The digital divide should be tackled and access to digital devices and internet connectivity for the majority, who are currently out of reach, must be improved before that.
(The author has a master's degree in child health nursing from the Tribhuvan University and is a lecturer in Hamro School of Nursing)