Rationalizing the Pediatric Emergency Department Workload: An Epidemiological Profile of Presentations Before and During the COVID-19 Pandemic
DOI:
https://doi.org/10.5195/ijms.2022.1156Keywords:
COVID-19, Workforce, Workload, Communicable Diseases, Respiratory Tract DiseasesAbstract
Background: Infectious respiratory disease in children provides a significant seasonal workload burden to pediatric emergency departments. Studies from the Southern hemisphere during the first wave of coronavirus (COVID-19) had shown a decrease in seasonal pediatric respiratory infections. During the COVID-19 pandemic, predicted drops in infectious disease circulating in children led to redeployment of junior doctors in pediatric services to adult services.
Methods: We extracted data on children presenting to a tertiary emergency department with a respiratory illness, comparing winter 2019-2020 (pre-COVID-19) to winter 2020-2021 (post-COVID-19). We compiled demographic and epidemiological data and compared the two groups with regards to number and type of infectious respiratory presentations, admissions, days spent in hospital, and whether intensive or high dependency support was required.
Results: We have found a reduction in respiratory disease presentations post-COVID-19 compared to pre-COVID-19. These patients were more likely to be admitted but their stay was reduced, and there was a trend towards a reduction in requirement for intensive or high dependency support during their admission. Conclusion: This work supports the redeployment of junior doctors in pediatric departments to adult departments given increased demand in other areas of medical care at that time. In view of the changing landscape, we suggest the introduction of a flexible staffing format to ensure adequate support to areas with higher demand.
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References
WHO. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020; updated 2020 Mar 11; accessed 2021 Aug 12.
Isba R, Edge R, Jenner R, Broughton E, Francis N, Butler J. Where have all the children gone? Decreases in paediatric emergency department attendances at the start of the COVID-19 pandemic of 2020. Archives of Disease in Childhood 2020; 105.
Shanmugavadivel D, Liu J, Gilhooley C, Elsaadany L, Wood D. Changing patterns of emergency paediatric presentations during the first wave of COVID-19: learning for the second wave from a UK tertiary emergency department. BMJ Paediatrics Open 2021;5:e000967
Buntsma D, Lithgow A, O'Neill E, Palmer D, Morris P, Acworth J et al. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Patterns of paediatric emergency presentations to a tertiary referral centre in the Northern Territory. Emerg Med Australas. 2017 Dec;29(6):678-685.
D'Souza RM, Bambrick HJ, Kjellstrom TE, Kelsall LM, Guest CS, Hanigan I. Seasonal variation in acute hospital admissions and emergency room presentations among children in the Australian Capital Territory. J Paediatr Child Health. 2007 May;43(5):359-65.
Pattemore PK, Jennings LC. Epidemiology of Respiratory Infections. Pediatric Respiratory Medicine 2008; 435–52.
Goldman RD, Grafstein E, Barclay N, Irvine M, Portales-Casamar E. Paediatric patients seen in 18 emergency departments during the COVID-19 pandemic. Emergency Medicine Journal 2020;37:773-777.
Boodhun N, Jay N, Carzedda D, Rogers M. Prioritising paediatric staff and space so every child has access to care. Archives of Disease in Childhood 2020; 106:622–3.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008 Apr;61(4):344-9.
Brueggemann AB, van Rensburg MJJ, Shaw D, McCarthy ND, Jolley KA, Maiden MCJ et al. Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data. Lancet Digital Health 2021; 3:6, E360-E370.
van Summeren J, Meijer A, Aspelund G, Casalegno JS, Erna G, Hoang U et al. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Euro Surveill. 2021 Jul;26(29):2100639. Erratum in: Euro Surveill. 2021 Jul;26(30)
Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics. 2021
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