The research, led by Lochner Marais of the University of the Free State with colleagues from South Africa, the United Kingdom and Brazil, formed part of a larger project examining how young people adapted to the pandemic in South Africa, Brazil and England. Choosing those three countries allowed the team to compare responses across different income settings and governance traditions, while the South African analysis itself drew on a review of government regulations, media reports from the pandemic period and the emerging scholarly literature. It focused on children and young people up to the age of 24 and examined three interconnected domains—education, play and leisure, and food—using what the authors call a nexus approach, which emphasises the links between these sectors rather than treating them in isolation. That framing is significant, because much of the early policy debate around lockdowns considered each domain separately: schooling was weighed against infection risk, nutrition was treated as a welfare question, and recreation as a luxury. The nexus approach insists instead that a child who is not in school is also a child who may not be eating properly, and a hungry child without exercise cannot be expected to learn.

To interpret the findings, the team applied the capabilities approach developed by economist Amartya Sen and philosopher Martha Nussbaum. Sen distinguished between “functionings”—the things a person may value doing or being, such as a child’s ability to read—and “capabilities,” the real freedoms people have to lead lives they value. The distinction matters because a resource handed to a person does not automatically translate into a meaningful opportunity: a tablet delivered to a household without electricity or internet access does not, by itself, create the capability of being educated. Nussbaum identified ten basic capabilities that she considered universal thresholds for human flourishing: life, bodily health, bodily integrity, senses and imagination, emotion, practical reason, affiliation, connection with other species, play, and control over one’s environment. While the framework was originally designed for adults, a substantial body of scholarship has extended it to children, who develop their capabilities through interaction with families, schools, peers and communities. The researchers treated the pandemic regulations as environmental constraints that blocked the “conversion factors”—personal, physical, social and cultural conditions—that children need to turn resources into genuine capabilities. In practical terms, a school place is only a capability for learning if the school is open, the child can attend safely, and the child is nourished enough to concentrate.

The context in which these restrictions landed matters enormously. South Africa is one of the most unequal countries in the world, with a Gini coefficient of 0.67, a measure of income distribution in which 0 represents perfect equality and 1 represents maximum inequality. In 2019, 62.1 percent of children aged 0 to 17 were multidimensionally poor, and about 26.5 percent of children did not receive their daily nutritional needs. Stunting affects an estimated 27 percent of children under five, with the highest levels in rural areas and urban informal settlements—a sign of chronic deprivation that begins well before a child ever enters a classroom. Before the pandemic, youth unemployment already exceeded 50 percent, meaning that many young people were leaving school into an economy with little to offer them. Schools served roughly 13 million pupils, and the National School Nutrition Programme provided daily meals to millions of vulnerable children—an explicit acknowledgement by the state that learning depends on food. When that programme was suspended, the effect was not confined to nutrition; it removed a powerful incentive for attendance and placed an added strain on household budgets that were already stretched.

South Africa recorded its first official COVID-19 case on 5 March 2020 and declared a state of disaster ten days later. A “hard” lockdown, initially planned for 21 days but extended to the end of April, required everyone to stay home, closed schools and universities with no remote teaching plan in place, banned large gatherings and organised sport, prohibited the sale of alcohol and cigarettes, and even barred NGOs from distributing food until the end of May 2020. The army was deployed to enforce the rules. The country subsequently moved through five alert levels and five infection waves, recording about 103,000 official COVID-19 deaths. For households already dependent on informal work, social grants and school feeding, the sudden closure of schools and the freeze on food distribution removed several safety nets at once.

The disproportionate burden on children is stark in the numbers. People aged 19 or younger make up nearly 15 percent of the population; they accounted for 12.5 percent of laboratory-confirmed cases but only 0.7 percent of COVID-19-associated in-hospital deaths. UNICEF data show that children constituted just 0.4 percent of total COVID-19 deaths worldwide. Yet South African children lost an estimated 54 percent of learning time and fell about one year behind their expected schedule. Attendance at early childhood development centres collapsed from more than 90 percent in 2018 to 33 percent in 2020, a particularly serious setback because the early years are when foundational language and social skills are formed. Out-of-school children aged 5 to 18 rose from 260,000 in 2019 to nearly 880,000 in 2020. Language outcomes in 2022 were 40 to 70 percent worse than in 2019, and Grade 9 mathematics literacy results in the Western Cape were 95 to 106 percent below 2019 levels. For a country where mathematics performance was already a national concern, such a decline threatens to narrow the pipeline of young people qualified for technical and scientific careers for decades.

The study highlights how decisions about schooling marginalised children’s voices. Choices about closures and reopening were made by the national Department of Basic Education, often in consultation with teachers’ unions, whose concerns about staff health dominated deliberations. One media report described school closures as a union victory. The authors found little evidence that pupils were consulted; children were largely treated as people for whom decisions could simply be made. When schools partially reopened in July 2020, governing bodies adopted rotational schedules that kept children out of classrooms for alternating weeks, effectively halving contact teaching time even after the acute danger had passed. Many pupils went without meals because feeding schemes initially did not resume—it took a court order, brought following legal pressure by education rights groups, to compel the Minister of Education to continue school feeding. Mask mandates, meanwhile, made language learning extremely difficult in the lower grades, where young children rely on seeing teachers’ mouths to develop phonics and speech, and made singing lessons impossible.

Food insecurity deepened through multiple channels. About nine million pupils lost their daily school meals during the hard lockdown, and by mid-2022 feeding schemes had still not returned to pre-pandemic reach. Job losses compounded the problem: one study found that adults who lost their jobs during the pandemic were 5.4 times more likely to report child hunger in the previous seven days, underlining how quickly household shocks translate into deprivation for the youngest members of a family. Online learning, the common alternative to in-person teaching, widened racial and class divides—18.3 percent of white pupils accessed online learning compared with 5.3 percent of black pupils—and homeschooling was realistically available only to middle- and higher-income families with space, technology and parental capacity. In effect, the pandemic created two parallel education systems: a degraded one for the poor and a cushioned one for those who could afford alternatives.

The consequences extended into every corner of children’s development. Play and outdoor recreation were curtailed even though outdoor spaces were known to carry low transmission risk; parks, beaches and dams were off-limits under the highest alert levels. Researchers documented higher levels of alcohol misuse, sexual abuse and physical violence against and among children during the lockdown, along with behavioural problems such as difficulty showing affection—harms consistent with the isolation and loss of routine that children experienced. The authors mapped these harms onto Nussbaum’s ten capabilities, finding plausible negative effects across all of them, from impaired bodily health and integrity to weakened emotional attachment, diminished imagination and thought, reduced ability to form relationships, and long-term constraints on employment prospects and control over one’s environment. Youth unemployment among 15- to 24-year-olds jumped to 63.9 percent in 2022 from 43.5 percent in 2019, meaning that the cohort leaving school during the pandemic faced one of the harshest labour markets in the country’s recorded history.

The authors are candid about the study’s limitations. It is based on a desktop review rather than direct interviews, and it does not include responses from children themselves—a gap the team acknowledges explicitly, given that the paper’s central critique is precisely that children were not heard. They also note that some feared consequences, such as a rise in stunting caused by lockdown-related food deprivation, have yet to appear in the data, and that a few children might even have developed enhanced capabilities in practical reasoning or affiliation as a reaction to how they were treated. Some harms, they caution, may only become visible with the passage of time.

Nevertheless, the overall verdict is severe. The one-dimensional government response prioritised physical health, the safeguarding of adults and the protection of the health system, while treating children’s education, nutrition and play as secondary concerns. The restrictions exacerbated South Africa’s deep racial and economic inequalities, hitting poor households hardest because they started from the lowest base. The authors argue that policymakers failed to grasp the interdependence of learning, play and food—hungry children without exercise cannot learn—and they warn that South African society will, in the years ahead, reap the consequences of having sacrificed children’s well-being to safeguard adult lives.

The study, conducted by Andreoli, Kirsch, Peluso, and their colleagues, delves into the “subjective treatment effects” of the pandemic on children, a methodological approach that emphasizes the personal perceptions and lived experiences of young individuals rather than relying solely on objective indices. This angle is particularly important because child well-being is inherently multidimensional and deeply influenced by psychological, familial, and social factors that are often not fully captured in quantitative health data alone. By capturing subjective experiences, the researchers illuminate how children themselves interpret and internalize the transformations caused by COVID-19.

Central to this investigation is the use of comprehensive survey data collected in Luxembourg, a small but economically advanced European country that experienced various lockdown phases and educational disruptions akin to other parts of the world. The researchers employ sophisticated econometric techniques, including difference-in-differences models and propensity score matching, to isolate the causal effects of the pandemic from confounding variables. This rigorous analysis affirms that the changes observed in child well-being are not coincidental but directly attributable to the pandemic’s socio-environmental shocks.

One of the striking findings of the study is the heterogeneous impact across different dimensions of child well-being. Emotional health, social connectedness, and educational engagement were all influenced differently by the pandemic conditions. For example, while some children reported increased anxiety and social isolation, others indicated a strengthened sense of familial bonds, possibly due to increased time spent at home. This complexity underscores the need for finely tuned policy responses that can address varied outcomes rather than one-size-fits-all solutions.

The research also highlights the erosion of social support structures, which previous generations might have taken for granted. In normal circumstances, school environments serve as critical nodes for social interaction, mentoring, and psychological support. However, with schools intermittently closed or forced into distance learning, many children experienced a pronounced reduction in peer interaction, a factor strongly linked to deteriorating mental health indicators. This disruption has long-term implications, as social skills and networks formed during childhood lay the foundation for adult psychosocial functioning.

Furthermore, the researchers draw attention to the disparities rooted in socio-economic status and family background. Children from lower-income households or those with pre-existing vulnerabilities faced disproportionate challenges. Lack of access to digital learning tools, constrained living spaces, and heightened parental stress compounded the negative effects on well-being. This finding speaks to the pandemic’s role in exacerbating existing inequalities and highlights the importance of inclusive recovery measures that prioritize the most affected groups.

Educational engagement, often measured through attendance and academic performance in typical studies, is reconsidered here through a subjective lens. Children’s own assessments of their motivation, concentration, and perceived learning outcomes during lockdown periods were markedly diminished. This decline has serious ramifications for their future educational trajectories and, by extension, long-term labor market prospects. The subjective approach reveals emotional and cognitive barriers that numbers alone cannot quantify, such as frustration with remote learning or feelings of detachment from school communities.

Moreover, the study investigates the temporal dynamics of these subjective effects, observing how children’s well-being evolved throughout different stages of the pandemic. Initial phases marked by sudden changes and uncertainty elicited acute distress, but some adaptation occurred over time, reflecting resilience mechanisms and coping strategies employed by families and individuals. Nonetheless, the persistence of certain negative impacts into later periods suggests that recovery will require sustained intervention and support.

Another critical dimension documented is the interplay between mental health and physical health behaviors. The researchers found that decreased well-being was often accompanied by altered sleep patterns, reduced physical activity, and changes in dietary habits among children. These behavioral shifts are concerning because they can establish patterns leading to chronic health issues, thereby compounding the pandemic’s indirect burden on younger populations.

Importantly, the methodology and findings also contribute to a growing body of literature encouraging the inclusion of subjective well-being indicators in public health and economic policy assessments. Traditional metrics like GDP or hospitalization rates do not fully capture human experiences and social costs. By integrating subjective data, policymakers can gain a richer understanding of the true cost of crises like COVID-19, enabling more effective, compassionate, and targeted policies.

The Luxembourg-based evidence serves as a microcosm for broader global challenges, while also highlighting the role of specific sociopolitical contexts. Luxembourg’s robust social welfare systems and high living standards potentially mitigated some adverse effects, suggesting that outcomes in less resource-rich environments could be even more severe. This comparative perspective reinforces the urgency of international cooperation and knowledge-sharing in addressing post-pandemic child well-being globally.

Intriguingly, the study also gestures toward the potential benefits of some pandemic-induced changes, such as increased family time fostering stronger emotional connections for certain children. This nuanced perspective balances the narrative, emphasizing the complexity of human adaptation and the potential for positive transformations emerging from crisis conditions if properly nurtured.

Looking ahead, the study’s authors advocate for longitudinal research to track these subjective effects over extended periods, as the full ramifications may only become evident years after the initial shock. Furthermore, they encourage the integration of psychological support services within educational settings to proactively address children’s mental health needs, as well as investment in digital infrastructure to avoid educational disparities in future crises.

The findings raise critical questions about societal priorities in a post-pandemic world, urging governments, educators, and health professionals to recognize children’s voices in designing recovery and resilience strategies. By centering subjective well-being, the research champions a more holistic and empathetic approach to public policy, one that acknowledges children not only as future adults but as individuals with immediate rights and needs.

In conclusion, the research emerging from Luxembourg offers a pioneering and data-driven narrative on the subjective treatment effects of COVID-19 on child well-being. Its multifaceted insights challenge policymakers to rethink recovery frameworks and remind society that the unseen psychological toll on youth warrants as much attention and resources as the physical health repercussions. The study’s implications ripple beyond Luxembourg’s borders, providing a critical foundation for global efforts aimed at healing, rebuilding, and safeguarding the well-being of the youngest generation affected by this unprecedented crisis.

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Subject of Research: The subjective treatment effects of COVID-19 on child well-being, focusing on psychological, social, and educational dimensions and their socio-economic determinants.

Article Title: The subjective treatment effects of COVID-19 on child well-being: evidence from Luxembourg.

Article References:

Andreoli, F., Kirsch, C., Peluso, E. et al. The subjective treatment effects of COVID-19 on child well-being: evidence from Luxembourg.
Int Rev Econ 71, 575–596 (2024). https://doi.org/10.1007/s12232-024-00453-y

Image Credits: AI Generated

DOI: https://doi.org/10.1007/s12232-024-00453-y