Pediatric Visits to Emergency Departments During COVID-19 Pandemic Drop

January 9, 2021

Pediatric visits to hospital emergency departments declined dramatically during the COVID-19 pandemic, outpacing a similar decline in adult visits, according to a study led by three Allegheny Health Network (AHN) emergency medicine physicians, recently published in the American Journal of Emergency Medicine.

Comparing January-June 2020 to a similar period in 2019, using data from 148 emergency departments, children’s hospitals emergency departments and urgent care centers, the researchers found that pediatric visits declined by as much as 72 percent, compared to a 60 percent decline for adults.

The study was led by Jesse Pines, MD, an emergency physician at Allegheny General Hospital (AGH), Arvind Venkat, MD, an emergency physician at AGH and AHN-McCandless, and Jestin Carlson, MD, an emergency physician at AHN Saint Vincent, along with researchers from Brandeis University, Northwestern University, George Washington University and U.S. Acute Care Solutions.

“Our research showed declines in pediatric ED usage across all geographic areas, and for all conditions from serious to relatively minor,” Dr. Pines said. “While some of the declines are the natural result of social distancing and school closures, we are concerned parents may be putting off care for their children’s serious or potentially serious conditions.”

Emergency pediatric visits for upper respiratory infections and the flu dropped as much as 84 percent, compared to 2019, during the early months of the pandemic. Visits for arm fractures declined by 43 percent and for open head wounds by 31 percent.

“With school buildings closed and group sports activities limited, it’s expected that we would see fewer emergency visits for contagious diseases like the flu, and for conditions such as fractures that typically happen on the playing field,” Dr. Carlson said. “We also found that the number of emergency visits for influenza was about a fifth of 2019 levels, giving us hope that this may portend a milder-than-usual influenza season for 2020-2021.”

The lower-than-usual numbers for pediatric emergency visits continued into June 2020. Further investigation will be needed to determine the impact of this phenomenon on children’s health, the researchers said.

“Our greatest concern is that parents may be avoiding emergency care when their children definitively need it during the pandemic for conditions like appendicitis. This could worsen outcomes,” Dr. Pines said. “The clear message to parents is to not avoid emergency care, particularly in situations that could be potentially serious.”

“Emergency departments are open 24 hours a day, 365 days a year, providing needed medical care to a diverse array of individuals,” Dr. Venkat said. “We take numerous precautions to prevent the spread of COVID-19 in our facilities, including mandatory mask wearing, social distancing in waiting rooms, expedited check-in and around-the-clock disinfecting, and we want to assure parents that it is safe to bring their children in for emergency care.”

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