Understanding the Pandemic’s Impact on Children and Teens

A Collaboration Among Surveillance and Mental Health Experts

To better understand the COVID-19 pandemic’s profound effect on the physical and mental well-being of children and teens, experts delve into the science, guided by near real-time data from emergency department (ED) visits. Scientists from CDC’s National Syndromic Surveillance Program (NSSP),1,2 state and local health departments, and several federal agencies use these data to look for emerging health threats, including mental and behavioral health concerns.

To determine if health-seeking behaviors had changed, NSSP experts began collaborating with colleagues across CDC centers in November 2022 to study pediatric ED data before and during the pandemic. This collaboration among syndromic surveillance and mental and behavioral health experts produced two reports that give insight into the pandemic’s impact. The reports were published in CDC’s Morbidity and Mortality Weekly Report in February 2022.

Both studies examine data for pediatrics (age 0–17 years) from 2019 through January 2022. The first report3 examines overall pediatric ED visits. Findings indicate that although pediatric ED visits decreased overall, the weekly number and proportion of ED visits increased for certain injuries, some chronic diseases, and behavioral health concerns. For example, weekly visits among older children (5–11) and teens (12–17) increased for self-harm, drug poisoning, and psychosocial concerns during 2020, 2021, and 2022 when compared to 2019.3 The other report4 shows that teenage girls may have experienced the largest overall increase in behavioral and psychosocial concerns. The proportion of ED visits for eating disorders doubled and tic disorders more than tripled in this population as well. Other studies have also noticed increases in tic-like symptoms among girls during the pandemic.5,6

NSSP data are excellent for monitoring health and behavioral trends in emergency care-seeking behavior, and the program will continue to monitor ED visits and use these data to inform interventions. Surveillance and mental health experts are improving their understanding of the pandemic’s impact on people’s physical and mental well-being through collaboration.

Adolescents at Doctor Office in Masks

The intent of this work was to raise awareness of the pandemic’s impact on children and teens—and that’s exactly what happened.

Clinicians are treating these findings as a call to action. More work is needed to understand the differences between tics and functional tic-like symptoms and why more girls than boys were affected during the pandemic.

As more is learned about this topic, clinicians will be able to develop targeted interventions. Parents and caregivers will be better prepared to recognize the warning signs in children and teens and seek the right help at the right time.

1. CDC’s National Syndromic Surveillance Program (NSSP) makes the tools and processes for conducting syndromic surveillance available to public health departments at no cost. CDC NSSP provides a large repository of guidance and user documents, technical and analytic support, and assistance with onboarding facilities to ensure data quality and transmittal comply with standards. CDC supports a highly engaged NSSP Community of Practice facilitated by the Council of State and Territorial Epidemiologists (CSTE).
2. A syndrome is a grouping of related symptoms that, taken together, is a good indicator of a specific disease or health event (an injury, chronic disease, infectious disease, etc.). As surveillance experts learn more about health events, they will refine the syndromes and data-searching parameters.
3. Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic—United States, January 2019–January 2022.
4. Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic—United States, January 2019–January 2022.
5. Rapid Onset Functional Tic‐Like Behaviors in Young Females During the COVID‐19 Pandemic – Pringsheim – 2021 – Movement Disorders – Wiley Online Libraryexternal icon
6. Stop that! It’s not Tourette’s but a new type of mass sociogenic illness | Brain | Oxford Academic (oup.com)external icon

More on Tic-like Behaviors:
Rising Incidence of Functional Tic-Like Behaviors. What’s happening? Why now?”external icon

Page last reviewed: March 22, 2022