Agencies that serve abused children are bracing for an increase in abuse cases as they reduce their services because of COVID-19.

With governments calling for people to stay home, and schools and some social support services closing, many who work with abused children are worried.

For some children, home is not a safe or healthy place.

Many parents and workers are saying kids are more agitated with these changes, according to Dr. Roxanne Goldade, a Calgary pediatrician and the physician lead for the Pediatric Kids in Care program.

"They're upset. Everyone is crammed together in their homes," she said. "I'm getting panicked phone calls from child protection workers. The reality is that these kids are at such high risk."

Others agree.

The Ottawa Police Service issued a statement Friday calling for the public to "remain vigilant about the potential for abuse towards women and children." They asked the public to "pay special attention to the well-being of children and to report any suspicious incident."

"Life is already tough for many families," said Christina Tortorelli, assistant professor of social work at Mount Royal University and a former senior administrator in child welfare. "There is a group that is already struggling and living on the edge of their resources. The increased stress, the mental health challenges that this presents for kids and parents 螕Ǫ That whole thing is like a powder keg."

Boost Child and Youth Advocacy Centre in Toronto investigates 1,200 to 1,500 cases of child abuse each year. Last weekend, with social distancing just getting started, it had 10 new cases -- an unusually busy weekend says Karyn Kennedy, the centre's CEO.

"I'm not surprised abuse is going on but I am surprised it's being reported so quickly," Kennedy said.

She said she is aware of a few children who are coming into foster care because usual supports are no longer available, worsening the situation.

The Calgary and Area Child Advocacy Centre's case numbers were on track to increase from 1,500 per year to 2,000 this year even before COVID-19, said CEO Karen Orser.

"It's fair to say that we are worried about what all of this is going to mean for families and we expect to see more cases," she said.

Kennedy says she didn't expect a spike in cases until children had been out of school and daycare longer.

"We know that stress is a contributing factor for abuse, especially physical abuse," she said.

That combined with schools being closed, one of the main sources of referrals, she says, is a recipe for disaster.

A recently released Ontario report with data from 2018 showed that of the more than 148,500 child protection investigations that year, nearly 48,000 were initiated by concerns from schools. The most common age group referred for investigations was four- to 11-year-olds.

Overall, six per cent of children were involved with a child protection investigation with the final conclusion being substantiated or suspected maltreatment in 30 per cent of cases, representing more than 10,000 children in Ontario.

Child welfare agencies are being challenged to deliver their services while social distancing is required, protective equipment is needed to go into some homes, and non-essential services are reduced.

In a written statement, the Ontario Association of Children's Aid Societies (OACAS) and the Association of Native Child and Family Services Agencies of Ontario (ANCFSAO) said, "Like other organizations across the province, (we) are taking precautionary measure for social distancing ... Phone lines are open and trained child welfare professionals are answering each call and responding appropriately."

"How each organization is offering support may look a bit different in each community, depending on local circumstances."

Most of the work of child welfare agencies is in supporting families in order to keep children safe at home. The Ontario study showed that only three per cent of investigations resulted in the child having to move homes. But these are the types of activities being curtailed.

Janet Handy, executive director of the Kristen French Child Advocacy Centre Niagara, says she has had to cancel supportive services like creative arts programs and trauma treatment groups.

"All our programming is suspended, the programs that help kids move on after abuse, the programs that help keep kids and families going," she said.

Tara Ettinger, director of Big Bear Child and Youth Advocacy Centre in Kamloops, B.C., and a trained trauma counsellor, says that school and extracurricular activities are often seen as safe places for children. Many also have connections with counsellors or workers at places like community centres or Boys and Girls clubs.

"Sometimes kids and youth tell me that breaks aren't that good," she said. "Home is a place where they're exposed to domestic violence or child abuse. Without kids having a place to escape to and to engage with supportive adults, we will see an increase in child abuse. That is expected."

This week, Goldade says a case of suspected abuse in a child with serious developmental issues was shelved because it didn't have a high enough acuity rating for the current triaging of cases.

"It tortures me," Goldade said. "What's going to happen when the next call comes in for that child?"

-- Michelle Ward is a pediatrician, associate professor and journalist in Ottawa. She is currently a fellow in global journalism at the Dalla Lana School of Public Health at the University of Toronto.

This report by The Canadian Press was first published March 20, 2020.