With schools closed and millions of teenagers trapped indoors, their lives suddenly on hold and revolving around social media, lockdown is the worst possible environment for anyone at risk from eating disorders.
My hospital has seen no cases of schoolchildren directly ill with serious Covid-19 infections – but it has seen a significant number of potentially life-threatening conditions in young people, caused by the secondary effects of lockdown.
Some of the most common of these are eating disorders such as anorexia.
Back in April, during the first impact of this nationwide disruption, half of our in-patient admissions were children struggling with food issues.
With schools closed and millions of teenagers trapped indoors, their lives suddenly on hold and revolving around social media, lockdown is the worst possible environment for anyone at risk from eating disorders, writes paediatric consultant DR KAREN STREET
No one was expecting this, but with hindsight it is not so surprising.
All the most dangerous factors – loneliness, loss of control, shattered routines, misinformation, the disintegration of peer groups – came together in a perfect storm.
I used to see perhaps one new referral a week for eating disorders. Now I get three, four or five a week.
Anorexia and other restrictive eating disorders can be exceptionally serious, with a mortality rate of one in ten cases.
The implication is stark: young people are developing mental health illnesses that could last years, and that will kill some of them, because of lockdown and school closures.
At the beginning of the pandemic, those most affected were young people with a history of mental health problems.
The suspension of normal life was immediately overwhelming, and some reacted with a rush of distress, by refusing to eat at all.
These cases were impossible for families, and very challenging for paediatric wards in general hospitals.
Working in tandem with mental health specialists, we had to find ways of getting fluid and nutrition into these patients.
If a child flatly refuses to co-operate, doctors face a complex decision about the use of restraint – effectively securing the patient in bed against their will and attaching intravenous drips or nasogastric tubes.