COVID-19 was declared a global pandemic by the World Health Organization on March 11, 2020 . At the moment I am writing this blog there are close to 2 million documented coronavirus cases. According to the WHO Health Alert on WhatsApp , over 120 thousand people have died of the virus .
Economies, health systems and the life of every individual are heavily disrupted. But what does this change mean for young migraine sufferers, their caregivers and their therapists?
How dangerous is the coronavirus for children?
Children are as likely as adults to become infected with the virus. Yet, the good news is that coronavirus symptoms are generally less severe in children than in adults . A study from China reported that about 94% of infected children developed no to moderate symptoms. Only 0.6% developed i.e. acute respiratory distress syndrome or similar severe symptoms [4, 5].
“Infection in pediatric patients of all ages tends to be associated with significantly lower rates of hospitalization and significantly lower rates of critical and severe illness.” — Kristin Moffitt, MD 
Indirect effects of COIVD-19 on young migraine sufferers
Yet, the pandemic has many indirect effects on children with migraines and their carers, as well as their therapists.
Finding a suitable therapy for pediatric migraine is usually a long and tedious process. These established therapy routines have now been disrupted. Special clinics try to protect patients and staff from further infections. Migraine experts try to reduce human interaction to an absolute minimum. Face-to-face consultations are largely avoided and replaced with telemedicine. However, digital solutions such as telemedicine are still very new for many therapists and patients alike. Getting used to it often involves a lot of uncertainty and extra effort.
And what about young migraine sufferers and their carers?
Well over 200 parents of young migraine sufferers took part in our social media surveys within 24 hours. A clear majority of parents state that the lockdown situation has a very positive influence on their children’s symptoms. In about one in four households no changes were observed. Unfortunately, there is also a dark side to the lockdown. In every tenth young migraine sufferer, the symptoms worsened. According to the parents the worsening is a direct result of the COVID-19 lockdown. Even worse, these parents feel helpless because their routine helping points are closed.
Not only hospitals but also schools have closed their doors. This means for parents that they have to take on three roles at once. Parenting, (remote) working and home-schooling . Parents often feel overwhelmed. They are afraid that their children may fall behind academically. At the same time, parents often have to cope with the transition to the home office themselves. The parents, whose children now suffer more from their migraines, see that the stress level of their children increases. Also, they see that the lack of school routine upsets the sleep rhythm. And when that happens attacks occur more frequently. The lack of direct social contacts would cause more difficulties for the children, according to the parents.
Are there also positive aspects of lockdown and social distancing?
Definitely! A large number of parents told us that their children perceive the school lockdown very positively. The children would enjoy escaping the stress of school. They would enjoy getting up less early and stress related to commuting vanished. Often, migraine attacks would be reduced despite the worrisome situation. One mother reported that her 14-year-old daughter’s regular eating routine seems to benefit her. Another parent reported that currently, her daughter’s rather autonomous lifestyle suits her personality better. She would still do her homework and even takes ballet classes online. Overall, young migraine sufferers seem to get used to the new circumstances very quickly and can even take advantage of them.
We hope that healthcare systems will also be able to adapt to the changes. We hope that novel technology will quickly become the norm. Despite all the barriers of digital healthcare, young migraine patients and their carers would benefit profoundly. Remote therapy could be provided without long waiting or travel times and extra costs !
 WHO, 2020
 WhatsApp Inc., 2020
 Petra Zimmermann & Nigel Curtis, 2020
 Alice McCarthy (Boston Children’s), 2020
 Dong et. al (American Academy of Pediatrics), 2020
 Alice McCarthy (Boston Children’s), 2020
 Yuki Noguchi, 2020
 Christina Szperka, 2020