Impact of SARS-CoV-2 Pandemic and Strategies for Resumption of Activities During the Second Wave of the Pandemic: A Report From Eight Paediatric Hospitals From the ECHO Network

Abstract

The Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) pandemic impacted the organization of paediatric hospitals. This study aimed to evaluate the preparedness for the pandemic among a European network of children's hospitals and to explore the strategies to restart health care services. A cross-sectional, web-based survey was distributed in May 2020 to the 13 children's tertiary care hospitals belonging to the European Children's Hospitals Organisation. Responses were obtained from eight hospitals (62%). Significant reductions were observed in accesses to the emergency departments (41.7%), outpatient visits (35.7%), intensive and non-intensive care unit inpatient admissions (16.4 and 13%, respectively) between February 1 and April 30, 2020 as compared with the same period of 2019. Overall, 93 children with SARS CoV-2 infection were admitted to inpatient wards. All the hospitals created SARS-CoV-2 preparedness plans for the diagnosis and management of infected patients. Routine activities were re-scheduled. Four hospitals shared their own staff with adult units, two designated bed spaces for adults and only one admitted adults to inpatient wards. The three main components for the resumption of clinical activities were testing, source control, and reorganization of spaces and flows. Telemedicine and telehealth services were used before the SARS-CoV-2 pandemic by three hospitals and by all the hospitals during it.Conclusion: The present study provides a perspective on preparedness to SARS-CoV-2 pandemic among eight large European children's hospitals, on the impact of the pandemic on the hospital activities and on the strategies adopted to restart clinical activities.

COVID-19 Associated Contact Restrictions in Germany: Marked Decline in Children’s Outpatient Visits for Infectious Diseases without Increasing Visits for Mental Health Disorders

“…In adults, infectious diseases declined due to contact being limited by the COVID-19 pandemic [ 4 ], whereas there is a lack of representative data on children. A decrease in inpatient treatment cases in children by up to 45% has been reported in the United States [ 5 ] and by 13–16% in Europe [ 6 ]. A 45% decrease in outpatient pediatric treatment cases has been reported in the city of New York [ 7 ].…”

Impact of adapting paediatric intensive care units for adult care during the COVID-19 pandemic: a scoping review

“… 75 76 This involved creating different areas for donning and doffing personal protective equipment (PPE) for staff, 16 22 and included major construction such as building additional walls to restructure units to accommodate increased patient loads 70 and changing ventilation systems. 16 The introduction of telemedicine and telehealth services were implemented across all hospitals to improve care delivery, 73 and as reported across other studies, clinical support to staff in PICUs was extended. 71 82 …”

“…75 76 This involved creating different areas for donning and doffing personal protective equipment (PPE) for staff, 16 22 and included major construction such as building additional walls to restructure units to accommodate increased patient loads 70 and changing ventilation systems. 16 The introduction of telemedicine and telehealth services were implemented across all hospitals to improve care delivery, 73 and as reported across other studies, clinical support to staff in PICUs was extended. 71 82 Wolfe et al 83 recognised that although staff from PICUs and adult ICUs are not entirely interchangeable, many staff from PICUs could provide safe care to adults with common diseases also seen in PICUs, mirrored in findings by Sachdeva et al 72 Likewise, a retrospective chart review by Gist et al 78 explored the experiences of repurposing a PICU into an adult critical care unit and compared the outcomes for adults admitted to a paediatric (n=9) and adult medical ICU (n=140).…”

Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic

“…Substantial strain on healthcare systems due to anticipated or actual large numbers of patients with COVID-19 requiring care resulted in non-emergency medical and preventive services being curtailed for periods of time in most jurisdictions. [1][2][3][4][5] Cancer screening activities were also suspended or considerably slowed down. [6][7][8] Programmatic screening (where all persons in a target population are invited for screening) is a recommended approach to reducing the burden of cancer incidence, morbidity and mortality.…”

“…The COVID-19 pandemic has had a dramatic impact on healthcare delivery globally. Substantial strain on healthcare systems due to anticipated or actual large numbers of patients with COVID-19 requiring care resulted in non-emergency medical and preventive services being curtailed for periods of time in most jurisdictions 1–5. Cancer screening activities were also suspended or considerably slowed down 6–8.…”