Five years after the World Health Organization declared COVID-19 a global pandemic, experts in infectious diseases are reflecting on the lessons learned to better prepare for future health crises. Yvonne Maldonado, MD, a leading figure in pediatric and epidemiological research at Stanford Medicine, has highlighted the unique challenges faced by children during pandemics. She emphasizes the importance of tailored emergency response plans that address the specific needs of this vulnerable population. Through her recent work, Maldonado has underscored the necessity of integrating children’s requirements into broader disaster preparedness strategies, ensuring their safety and well-being.

Maldonado's insights stem from her extensive experience leading Stanford Medicine’s response to COVID-19. As co-editor of a special issue in Pediatric Clinics of North America, she has gathered contributions from over three dozen North American experts. This issue focuses on pandemic readiness planning with an emphasis on children. The publication contains 13 invited reviews that explore how to plan for kids’ needs during medical emergencies. One key takeaway is that traditional one-size-fits-all protocols often overlook the distinct vulnerabilities of children, who make up a significant portion of the U.S. population.

Children have unique physical and developmental characteristics that set them apart in crisis situations. Their smaller size and less mature immune systems mean they can become ill more quickly and may struggle to communicate their symptoms effectively. During the “tripledemic” winter of 2022, when influenza, COVID-19, and respiratory syncytial virus (RSV) surged simultaneously, RSV particularly affected young children, leading to numerous hospitalizations. This scenario underscores the need for specialized medical care and facilities equipped to handle pediatric cases.

Beyond medical considerations, the impact of pandemics extends into various aspects of children's lives. Education was significantly disrupted during the early stages of the pandemic, with many students transitioning to remote learning. This shift led to mental health issues, learning losses, and widened achievement gaps between different socioeconomic groups. Maldonado advocates for minimizing school closures and ensuring schools have the resources to implement effective infection control measures. Public health infrastructure must support schools in providing necessary materials and policies that safeguard student health without compromising education.

The effects of pandemics on children also ripple through families and society. Parents face increased stress when their children fall ill, potentially affecting workforce productivity. Vulnerable populations, such as those with limited resources, experience greater hardships due to lack of caregiving options and higher exposure risks. To mitigate these challenges, comprehensive planning must consider families as units, recognizing that the health of children directly influences parental well-being and societal stability.

In conclusion, preparing for future pandemics requires a nuanced approach that prioritizes the needs of children. By addressing both medical and social factors, planners can develop more effective strategies that protect this vulnerable group and, in turn, strengthen overall community resilience. Maldonado's work highlights the critical importance of integrating children's perspectives into disaster preparedness efforts, ensuring no one is left behind in times of crisis.