Statement of Purpose Over the past 18 months, children in the U.S. have experienced two simultaneous public health crises: the endemic of gun violence and the Covid-19 pandemic. Gun violence is the leading cause of death among children in America and Covid-19 is now the sixth leading cause of death among school-aged children. There has not been a cohesive government response to either crisis and public communication about the risk specifically to children during this period has been unclear.

Methods/Approach We conducted a systematic review, drawing on PRISMA guidelines, to identify specific strategies that are known to reduce Covid-19 transmission among children and that are known to reduce rates of community gun violence. We also used the existing literature and available data (via the American Academy of Pediatrics, WISQARS, the FEMA-funded Navel Postgraduate School K-12 School Shooting database, among others) to specifically quantify child illness, injury, and death from Covid-19 and from gun violence from 03/01/2020 through 10/01/2021.

Results Despite their persistence, the federal and state-level responses to these crises have largely avoided using a comprehensive evidence-informed response to stem the tide of injury, illness, and death. Our results underscore that these inadequate responses have placed children – and children of color in particular – at heightened risk.

Conclusions Neither the virus that causes Covid-19 nor the 400 million firearms currently in circulation in the U.S. will likely ever go away. However, there is specific evidence informing a set of solutions that could lead to meaningful reductions in both, that allow us to coexist with these vectors safely, and that consider the health and well-being of children in the process.

Significance Our results provide specific policy and strategy recommendations that are trauma-informed, evidence-based, and could be implemented to reduce the negative impact of Covid-19 and gun violence on children across the U.S.