The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

Abstract

Background The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. Methods Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. Results The pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. Conclusions The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

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

“…Hospitalized children expressed fears, uncertainty, anger, helplessness, and anxiety caused by several medical procedures due to a lack of information and an unfamiliar physical and social environment [ 27 – 29 ], which could affect the mental and spiritual health of the child and parent [ 30 ]. A similar negative impact of hospitalization in the pediatric COVID-19 context has also been reported [ 31 – 33 ]. Moreover, restricted physical movement, parental separation, stigma, and social exclusion caused by hospitalized quarantined protocol were shown to complicate the care of pediatric patients with COVID-19 [ 32 , 34 – 36 ].…”

Impact of COVID-19 on child health and healthcare services

“…A substantial reduction in pediatric emergency care utilization has raised concerns regarding potential delays in seeking healthcare services with increased rates of morbidity and mortality. 12 Nationwide lockdown and lack of comprehensive guidelines for maternal and child healthcare (MCH) have left these vulnerable populations in need of essential healthcare services. These have led to an exacerbation of childhood diseases like acute respiratory infections, diarrhea, and other water-borne diseases, not to mention the upsurge of vaccine-preventable diseases, which can claim considerable lives in the days ahead.…”

A retrospective study on disease management in children and adolescents with phenylketonuria during the Covid-19 pandemic lockdown in Austria

“…Although children and adolescents are at less risk for severe courses of COVID-19 disease, they may suffer from indirect effects of the pandemic such as impaired access to chronic and acute care, obesogenic and generally more unhealthy eating and behavioural habits associated with the altered everyday life due to pandemic-associated restrictions and regulations as well as psychological burdens [ 4 – 6 ]. The indirect impact of the pandemic proved even worse for children with chronic health conditions [ 6 ]. Globally, inborn metabolic disease-related services were reduced to 60–80% of normal during 3 months of lockdown in 2020 compared to the same period in 2019 indicating a profound impact of the restrictions on patient management and care [ 7 ].…”