Paediatric burns epidemiology during COVID-19 pandemic and ‘stay home’ era

Abstract

significant changes to society. It has changed the way people behave and how healthcare is provided. In our study, we seek to evaluate the impact of the pandemic on the epidemiology of burns in the paediatric population. Government-implemented lockdown measures and school closures have led to reduced outdoor activities and lifestyle changes. Our regional Paediatric Burns Centre introduced a new standard operating protocol involving a new phone consultation pathway, a secure email platform for effective communication with parents and tertiary referring hospitals. The aim is to reduce physical attendance to hospital where possible, streamline our referral service, avoid unnecessary admissions and empower parents where appropriate. We performed a retrospective comparison over five weeks in which the government imposed lockdown instructions from 23/3/2020 to 30/04/2020 (lockdown period) and compared it to a similar period from a year ago 23/03/2019 to 30/04/2019 (control period). During this period, the total attendance to our Emergency Department (ED) has decreased by 60% in the lockdown period (7127 versus 2936), as expected due to the national advice to avoid unnecessary visits to hospital. The incidence of burn injuries reported was instead greater in proportion-2.8% of all ED attendances, compared to 1.5% in the previous year, despite the overall decrease in total number of burn injuries (n = 83) by 24%. This could be due to a combination of the closure of some local and minor injury facilities, reduced faceto-face consultations with general practitioners and the advice given to the general public that even minor burn injuries still require medical attention for adequate treatment. This instruction is crucial for the well-known potentially lifethreatening complications of burns in children [1]. Concerns were raised by the Royal College of Paediatrics and Child Health that children may be coming to harm from delayed presentation to emergency departments for fears of contracting COVID-19 in hospital. In our cohort of burns patients, only 2 were deemed to have come to harm by delaying presentation. We also noted that the number of referrals to children social care increased from 4% (5/123) in the control period to 12% (12/ 95) in the lockdown period. The reduced opportunity to liaise with allied health professionals and education settings to share information and concerns and to finally agree on a plan for follow up might have been due to a more vigilant approach for the fear of missing child protection concerns. The mean age of patients presenting with burns increased from 2.9 to 4.8 years. School-age children are now spending more time at home due to school closures, and UK statistics have suggested that most burns happen at home [2]. Gender distribution is similar in both periods. The number of inpatients in our centre decreased by 37%. All patients required COVID-19 testing prior to admission to

Burn visits to a pediatric burn center during the COVID-19 pandemic and ‘Stay at home’ period

“…We found a 66.6% reduction in overall ED visits (SHO: 7871 vs non SHO: 23,521) and a 35% reduction in burn visits (SHO: 74 vs non SHO: 114) during SHO period. However, similar to a previous report [ 4 ], burn visits contributed to a higher proportion of total ED visits during SHO compared to non SHO (0.94% vs 0.48%, 95% CI: 0.2 to 0.7). We speculate that this increase might have been secondary to closure of most pediatrician offices for direct in-person visits resulting in children presenting to the ED for even minor burns.…”

St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience

“…Of the relevant manuscripts, 4 were written as full length journal articles, and 10 were “Letters to the Editor” regarding various aspects of burn care during the pandemic. Geographical distribution of articles reflected the global nature of the pandemic, with publications from the UK (4) [ [23] , [24] , [25] , [26] ], mainland Europe (3) [ [27] , [28] , [29] ], USA (2) [ 30 , 31 ], China (2) [ 12 , 32 ], Malaysia (1) [ 33 ], India (1) [ 34 ], and one article with intercontinental authorship [ 35 ].…”

Increased admissions and hospitalizations to pediatric burn center during COVID 19 pandemic

“…In conclusion, all kind of trauma except burns in children decreased during the first three months of pandemic and the increased admissions and hospitalizations of pediatric burns is going on, therefore all burn care staffs must be ready this situation with taking high preventive measures against COVID-19 [1] , [2] .…”