Each week, we answer frequently asked questions about life during the coronavirus crisis. This week, we look at some of the questions being posed by children in India, which is in the midst of the world's worst outbreak. If you have a question you'd like us to consider for a future post, email us at email@example.com with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.
As Ritesh Banglani and his family sat down to dinner one evening at their home in Bengaluru in southern India, his younger son asked an unusual question.
"How do orphans live?" the 6-year-old wanted to know.
"[My wife and I] were really taken aback," 43-year-old Banglani, who works in finance, tells NPR.
This was in late April when India was near the peak of its second coronavirus outbreak, the largest in the world. The country was seeing as many as 400,000 new cases in a day and more than 4,000 daily deaths from COVID-19. Shortages of hospital beds, medical oxygen and medicines were rampant, and mass cremations were underway in many cities.
Banglani's younger son had developed a habit of tracking the pandemic. "It's very unnatural and unsettling when a 6-year-old comes to you every day and says, 'show me the number of deaths today in the country,' " Banglani says.
His older son was showing signs of hypochondria. The 8-year-old was asking to have his temperature checked frequently, googling symptoms of COVID-19 and washing hands obsessively — 10 minutes at a time — Banglani says.
"Every half an hour he would go and try to sniff things to see whether he could still smell," he says.
It was obvious to Banglani that the pandemic was affecting his sons' mental health.
"Children are constantly worrying about their own health, about their parents' health. And this is on top of all the social issues of not being able to meet their friends, play with their friends, go to school," Banglani says. "It's a huge issue."
How do you reassure children when they're hearing about so many people dying? How do parents help them cope with anxiety when the parents are also anxious?
We asked clinical psychologist Mimansa Singh Tanwar, head of the Fortis School Mental Health Program in Gurugram, a suburb of New Delhi, and the mother of one, for advice on how to comfort worried kids and answer their troubling questions.
What if I get COVID-19? Will I die?
The first thing to do is normalize children's feelings and tell them it's OK to be anxious, says Singh Tanwar, adding that it's important to redirect children's energies away from the pandemic.
"Take out time to do some physical exercise together, take out time to maybe have some conversations on a book you've read together," Singh Tanwar says. "Involve them in household work. Give them some responsibility."
It also helps to talk about other things, not just the pandemic, she says.
But ignoring it altogether can backfire, as in Banglani's case.
When Banglani and his wife noticed their son's hypochondria-like behavior, they thought it was because he was being exposed to too much talk of the pandemic. So they stopped talking about it. That didn't work.
"Children are very perceptive," Banglani says. "We can hide the topic of conversation, but it is very difficult to hide your own mental state from kids."
So Banglani tried a different approach: talk about COVID-19 but in a reassuring manner. He and his wife would show the 8-year-old articles about ongoing clinical trials of vaccines in children or give examples of kids who were infected and then recovered.
"Several of his friends got COVID," says Banglani. "We told him about those children, how they got better, how long their symptoms lasted."
That way his son could see COVID-19 as a manageable disease rather than something that would kill him, Banglani says. This tactic worked better than the earlier one, he says, and while his son may still be fearful about getting COVID-19, the boy certainly seemed less scared of dying from the disease.
What will happen if Mom or Dad gets COVID-19? Is Grandpa going to die?
Banglani is heartbroken that his children have to contemplate their parents' mortality at such a young age. When they asked if their "tatha," or grandfather, would die, Banglani said it was hard to answer.
"Kids ask very direct and often very painful questions," Banglani says. "As much as we try to remain mature, my wife and I are also emotional. We are also afraid for our parents."
Singh Tanwar says it's important for parents and caregivers to maintain a sense of calm and composure while talking to kids during a crisis. If you don't have an answer, respond to their question with another question, she says, to gauge what they are thinking.
"You can ask them: 'What made you ask this?' " says Singh Tanwar. "That's how you get your cues on how to go forward in the conversation."
Banglani says he tried to reassure his kids by telling them that their grandparents had received the vaccine and that the vaccines have been shown to be effective.
Singh Tanwar says a lot of her patients are having a hard time talking to their kids about grief and death. She advises them to be honest and avoid euphemisms about death like saying "so-and-so has gone into a deep sleep." She also tells them to take care of their own mental well-being.
"Because if we don't, it is going to come out in our behavior, in our emotions and on our children," Singh Tanwar says. "It's very important to give yourself little doses of well-being where you listen to music or do some breathing exercises. Before sleeping, have some 'me time.'"
When is the pandemic going to end? When can I meet my friends or go to school?
To answer questions like this for which there isn't a clear answer, Singh Tanwar says it's best to be honest with children rather than giving them false hope.
"Tell them: 'We don't know when this is going to [be] over but what we can do is take one day at a time. So let's focus on what we can control,'" she says.
Sometimes stories can help children come to terms with the uncertainty.
"In my 8-year-old's version of Little Red Riding Hood, she distributes COVID vaccines!" a Twitter user named Meera Prashant wrote in response to a thread Banglani posted about his kids.
Singh Tanwar has also done a special storytelling exercise with her 8-year-old daughter: Singh Tanwar drew the coronavirus as a monster on a whiteboard and asked her daughter to weave a story around it.
"She came up with her own story and brought in different elements," says Singh Tanwar, adding that her daughter even gave a funny name to people who didn't follow COVID-19 precautions. She says how children complete the story can give parents clues about what they're going through. They also allow children to imagine happy endings.
"[My 8-year-old daughter and I] also sometimes wrestle where she plays "dettol" [a hand sanitizer brand] or another sanitizer and I play "c virus" and I put up a good fight as she throws punches. Releases her pent up energy and maybe even is cathartic for a child — defeating a villain," another Twitter user named Arshi Sharma Bajaj wrote in a comment on Banglani's thread.
Singh Tanwar says parents and caregivers need to make sure that kids are in a supportive environment. That means avoid nagging or scolding kids if, for example, they're not up to date with their homework or exceeding their screen time.
One crucial lesson Banglani says he has learned is to not overuse fear to encourage his children to take protective measures. This past winter, when new coronavirus cases were declining in India and everything was opening up, Banglani and his wife worried that their sons would become careless about wearing masks or washing hands frequently. So they warned their kids that they could still catch the virus to ensure that they took precautions. That may have contributed to their sons' anxiety, he says.
"Fear is often a good motivator but if it is overdone, instead of motivating, fear itself becomes a problem," says Banglani.
Now Banglani and his wife use a different approach. "Rather than saying 'wear your mask or you will catch COVID,' we're saying 'wear your mask because that's the rule,' " he says.
It's too soon to tell how well their strategy is working, says Banglani, but trial and error is a part of good parenting.
"It's not as if we have been able to completely crack the psychology of our kids, but that's how you learn as a parent," Banglani says. "You make some mistakes and you course-correct."
To learn more about how to talk to children about COVID-19, check out these tips from UNICEF. The Inter-Agency Standing Committee, a humanitarian forum, has an illustrated story called "My Hero Is You" to explain the pandemic to kids ages 6 to 11. A sequel is in the works.