“All deaths are not equal” is the thesis for this presentation about weighing children's interests during a pandemic.

During the COVID-19 epidemic, we have had to learn about the epidemiological characteristics of the virus, such as transmissibility and lethality by counting cases and counting deaths. Gathering this data has not been easy and reporting it is even more complex.

I will present the story of my experience during the H1N1 epidemic in 2009 and apply some lessons learned to present and future situations. During H1N1, I worked in a large tertiary paediatric health system as the physician director of hospice and palliative care. I came to realize that the majority of the paediatric deaths attributed toj H1N1 were patients already under my team's care. A legitimate question was whether these children died from H1N1 or with H1N1. I will reflect on this experience and make the case that counting the number of deaths does not give health professionals or the public adequate information to make informed decisions. I propose that the estimated number of lost “life-years” would be a more appropriate measure of the impact of an infectious disease outbreak. I will reflect on the probable impact of this change on societal decision-making and will postulate that using this measurement would have a beneficial effect on planning for children's health and wellness.