**6. Challenges faced with age, sex and profession**

Even though the SARS-CoV-2 was considered a public health calamity, certain sections of the society were at clearly defined risk and the morbidity as well as mortality correlated well with age, sex, profession and socio-economic conditions. This exposed the existing socio-economic, gender, ethnic and health inequities present in the social determinants of health community and exacerbated it some extent [35].

#### **6.1 Children**

In March 2020, schools across India were shut down to curb the transmission of infection. But now, children have been at home for longer periods of time than ever before in recent memory. Closure of schools led to disruption of their daily routine along with lack of extracurricular and outdoor activities. This sudden unexpected

*The COVID-19 Pandemic and Mental Health DOI: http://dx.doi.org/10.5772/intechopen.102947*

**Figure 1.**

*Depicting the domino effect of school closure on children.*

change caused altered eating and sleep habits, anguish, irritation and lack of peer time fostering monotony and diverse neuropsychiatric symptoms in them. Commonly reported psychological problems among them were inattention, clinginess, boredom, irritability, restlessness, nervousness, distraction and stress about the pandemic with the risk greatly increasing in those already suffering from some form of mental disorder. The domino effect of school closure on children is shown in **Figure 1**.

The social disruption which happened due to job loss, progressed to financial insecurity and threatened loss of loved ones impacting the quality of family relationship between parents and children causing a significant risk of adjustment to more than 370 million children in India, given their dependence on positive family processes for a host of developmental outcomes [30]. As COVID deaths among adults occurred within weeks, the families had little or no time to prepare for mental trauma and agony that a child underwent in a case of death of a parent or caregiver. An estimated 1.5 million children globally, experienced orphanhood either due to sudden death of their parents or death of their custodian grandparents or kin due to COVID-19. Such children usually face poverty, physical, emotional and sexual violence apart from depression, family separation and institutionalization in upcoming days [36]. Although home is the safest place for a child, physical, sexual and psychological abuse saw a significant rise in numbers and severity during the pandemic leading to heightened child abuse related hospitalizations. Child abuse leads to immediate emotional and psychological problems and an adverse childhood experience linked to possible mental illness, substance abuse and suicidal ideation later in life.
