Innovating and adapting in pediatric pulmonology and sleep medicine during the COVID‐19 pandemic: ATS pediatric assembly web committee consensus statement for initial COVID‐19 virtual response

Abstract

Coronavirus disease 2019 (COVID-19) has been an unprecedented and continuously evolving healthcare crisis. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spread rapidly and initially little was known about the virus or the clinical course for infected children. In the United States of America, the medical response has been regionalized, based on variation in community transmission of the virus and localized outbreaks. Pediatric pulmonary and sleep divisions evolved in response to administrative and clinical challenges. As the workforce transitioned to working remotely, video conferencing technology and multicenter collaborative efforts were implemented to create clinical protocols. The COVID-19 pandemic challenges the framework of current medical practice but also highlights the dynamic and cooperative nature of pediatric pulmonology and sleep medicine. Our response to this pandemic has laid the groundwork for future challenges.

Impact of COVID‐19 on pediatric pulmonology healthcare practice

“…Early in the pandemic, for our patient group with chronic lung disease, the National Institute for Health and Care Excellence recommended minimizing face‐to‐face contact by pausing unnecessary outpatient checkups 15,16 . Later, many professional societies published recommendations for precautions during pediatric pulmonology procedures 17–19 . Similarly, in this study, we saw that our outpatient clinic visits and pediatric pulmonology procedures significantly decreased and COVID‐19 preevaluations of children before their routine clinical outpatient visits protected other patients and staff from the spread of the virus.…”

“…15,16 Later, many professional societies published recommendations for precautions during pediatric pulmonology procedures. [17][18][19] Similarly, in this study, we saw that our outpatient clinic visits and pediatric pulmonology procedures significantly decreased and COVID-19 preevaluations of children before their routine clinical outpatient visits protected other patients and staff from the spread of the virus. In addition, telephone visits helped us to make decisions about pulmonary exacerbations and direct these patients to hospitals where they lived.…”

Behavioral problems of pediatric patients recovered from COVID-19 in Wuhan, China

“…In response to the transmission of the COVID-19 outbreak, the Chinese Government has implemented strict domestic quarantine policies. Children infected with or suspected of being infected with COVID-19 will be quarantined for professional treatment in the local hospital, and some may be separated from their caregivers ( Beck et al, 2021 ; Cui et al, 2020 ; Efendi et al, 2022 ; Jain et al, 2020 ; Taylor et al, 2021 ; Uscdc, 2020 , Uscdc, 2022 ). Stressors such as temporary separation from their caregivers, social isolation, loneliness and fears of progression of the disease might push them into a state of crisis, which will not disappear immediately after discharge ( Golberstein et al, 2020 ; Liu, Bao, et al, 2020 ).…”

Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review

“…Use of technology as telemedicine/telehealth for follow-up and fulfillment of patient needs [ 61 , 64 , 65 , 87 , 90 , 92 , 113 , 146 , 161 – 168 ] after discharge, seems to be the main issue in providing child services that can reduce physical contact and maintain distance during the period of social isolation or quarantine. Similar to the management of COVID-19 cases in children, the application of a safe distance in the clinical service setting [ 168 ] can limit direct contact with health workers.…”