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Five years have passed since the World Health Organization declared COVID-19 a global pandemic. Experts continue to draw lessons from it to prepare for future health crises, particularly concerning children's needs.

Dr. Yvonne Maldonado, who led Stanford Medicine's COVID-19 response, has been at the forefront of these discussions. She recently co-edited a special issue of Pediatric Clinics of North America focusing on pandemic readiness planning for children. The issue includes 13 reviews from over three dozen experts across North America addressing how to cater to children's needs during medical disasters.

"We learned during COVID that everything in a disaster response tends to be one-size-fits-all," Maldonado said. She emphasized that while pandemic preparedness relies on pre-set protocols for quick responses, these often overlook children's unique requirements.

Maldonado pointed out that "a quarter of the U.S. population is under age 18; they have distinct needs." Children depend on adults and require consideration in emergency response policies.

During COVID-19, although children were less severely affected by the virus than adults, they faced other challenges such as educational losses and mental health issues. This experience highlights important considerations for future pandemics.

On the medical front, it's uncommon for infectious diseases to spare children as COVID-19 did. Typically, young children are among those most affected by circulating germs due to their smaller size and inexperienced immune systems.

"The epidemiology of infectious diseases in kids is very different," Maldonado explained. Preparing for surges in sick children requires trained personnel and appropriate facilities, as well as specific medications and equipment tailored for pediatric care.

The impact of school closures during the pandemic was significant. "One of the most shocking things around kids was that we just fell flat on our faces when it came to school preparedness," Maldonado noted. She advocates for shorter or no school closures in future pandemics and stresses the need for schools to be equipped with materials and knowledge for infection control practices.

Maldonado also highlighted disparities among children during pandemics: "People who don’t have resources are the hardest hit." Families with fewer resources face greater challenges due to caregiving difficulties and increased disease exposure risks.

Finally, she stressed considering families as units in pandemic plans: "If children are affected, parents are going to be affected." The illness of large numbers of children can significantly impact society's workforce.

"It can really amplify the impact on society when kids are ill," Maldonado concluded. Preparing thoughtfully in advance is essential to mitigate these challenges effectively.

This article was originally published by Stanford Medicine.