Abstract
Background:
Internationally the lockdown measures taken to mitigate the COVID-19 pandemic were associated with delays in presentation to acute care and potentially contributed to serious adverse health outcomes for children with conditions including diabetes mellitus, sepsis and malignancy. This NZ Paediatric Surveillance Unit research project set out to describe paediatricians’ experience of the impact of the 2020 Alert Level 4 response in Aotearoa.
Methods:
Weekly national survey of paediatricians in Aotearoa with an open-ended questionnaire, modelled on a similar survey in Wales.
Results:
There were 33 reports detailing 55 cases where paediatricians believed care may have been compromised due to the COVID-19 response, during the 6-week study survey period. About half of the cases (56%) were infants in the first six weeks of life. Compromised care was for acute presentations in 75%, acute complications of a chronic illness in 14%, with 11% for chronic conditions. Paediatricians reported the outcome as moderately severe (short-term morbidity, increased length of stay, higher level of care) in 38 cases (69%) and in a further 4 (7%) as severe (potential to be life-threatening or result in permanent disability). There were no reports of moderate or severe harm arising from delayed outpatient appointments. The Welsh study reported a wide range of presentations, including two deaths from diabetes and noted paediatricians’ concerns at a widespread and entrenched view that hospitals and other health facilities pose a threat to the health of children during a pandemic.
Conclusion:
In addition to issues identified overseas, this NZ snapshot highlighted the importance of face-to-face post-natal visits for newborns to avoid serious health outcomes. For older infants and children, hospital avoidance and reduced access to primary and secondary care were associated with significant potential harm for children during a strict lockdown.