The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
Emerg Med J. 2020 Dec;37(12):773-777. doi: 10.1136/emermed-2020-210273. Epub 2020 Oct 29.
Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians' offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year.
We analysed records from 18 EDs in British Columbia, Canada, serving 60% of the population. We included children 0-16 years old and excluded those with no recorded acuity or discharge disposition and those left without being seen by a physician. We compared prepandemic (before the first COVID-19 case), early pandemic (after first COVID-19 case) and peak pandemic (during public health emergency) periods as well as a similar time from the previous year.
A reduction of 57% and 70% in overall visits was recorded in the children's hospital ED and the general hospitals EDs, respectively. Average daily visits declined significantly during the peak-pandemic period (167.44±40.72) compared with prepandemic period (543.53±58.8). Admission rates increased mainly due to the decrease in the rate of visits with lower acuity. Children with complaints of 'fever' and 'gastrointestinal' symptoms had both the largest overall volume and per cent reduction in visits between peak-pandemic and prior year (79% and 74%, respectively).
Paediatric emergency medicine attendances were reduced to one-third of normal numbers during the 2020 COVID-19 lockdown in British Columbia, Canada, with the reduction mainly seen in minor illnesses that do not usually require admission.
不列颠哥伦比亚省在大流行期间采取了公共卫生缓解策略，包括居家令和关闭非必要服务。虽然大多数初级医生的办公室关闭了，但医院为大流行激增做了准备，急诊部 (ED) 仍然开放，以满足紧急需求。我们试图确定在 COVID-19 大流行之前和期间，ED 儿科就诊是否发生了变化，并与前一年的季节性调整进行比较。
我们分析了加拿大不列颠哥伦比亚省 18 个急诊部的记录，这些急诊部为 60%的人口提供服务。我们纳入了 0-16 岁的儿童，排除了那些没有记录 acuity 或出院处置的儿童，以及那些没有被医生看到的儿童。我们比较了大流行前（首例 COVID-19 病例之前）、大流行早期（首例 COVID-19 病例之后）和大流行高峰期（公共卫生紧急状态期间）以及前一年同期的情况。
儿童医院 ED 和综合医院 ED 的总就诊量分别减少了 57%和 70%。在高峰期（167.44±40.72），平均每日就诊量与大流行前（543.53±58.8）相比显著下降。由于较低 acuity 就诊率的下降，入院率显著增加。因“发热”和“胃肠道”症状就诊的儿童就诊量均为就诊总量和就诊百分比降幅最大的群体（分别为 79%和 74%）。
2020 年加拿大不列颠哥伦比亚省 COVID-19 封锁期间，儿科急诊就诊量减少到正常水平的三分之一，减少主要见于通常不需要住院的轻度疾病。
