Abstract
ObjectiveCOVID-19-associated non-pharmaceutical interventions (NPI) have disrupted respiratory viral transmission. We quantified the changes in pediatric hospital admissions in 2020 from five different NPI phases in Western Australia for acute lower respiratory infections (ALRI) in children in the context of all-cause admissions.Study Design and SettingWe assessed anonymised hospitalization data from Perth Children's Hospital (Jan 2015-Dec 2020) for all-cause admissions, ALRI, febrile illnesses and trauma (negative control) in those <17 years. We evaluated absolute changes in admissions and the weekly change estimated from interrupted time-series models.ResultsThe absolute number of admissions was comparable in 2020 (15,678) vs. 2015 to 2019 average (15,310). Following the introduction of strict NPIs, all-cause admissions declined by 35%, recovered to pre-pandemic levels, then increased by 24% following NPI cessation. ALRI admissions in children <5 years initially declined by 89%, which was sustained throughout the gradual easing of NPI until an increase of 579% (997% in <3 months) following the final easing of NPI. Admissions for trauma showed minimal changes in 2020 compared to preceding years.ConclusionCOVID-19-associated NPI had significant unintended consequences in health service utilization, especially for ALRI and infants <3 months, prompting the need to understand viral transmission dynamics in young children.
Highlights
Non-pharmaceutical interventions (NPIs) were used in many jurisdictions to mitigate the effects of the COVID19 pandemic
acute lower respiratory infections (ALRI) admissions in children
Public health measures used to mitigate the impact of COVID-19 have had significant unintended consequences in pediatric health service utilization, with marked changes for ALRI and especially for ALRI in infants aged less than three months
Summary
There were 15,678 admissions overall in 2020 compared to an annual average of 15,310 from 2015 to 2019. ALRI admissions across all age groups declined following Period 1 by 79% and remained at low levels before increasing in Period 4 by 269% compared with the previous five years (Fig. 1, Table 2). Following the change to Period 4, admissions increased by 24% (IRR=1.24 [95% CI: 1.141.35]) compared to the 2015 to 2019 longitudinal trend (Fig. 4A) These changes were more marked for ALRI in children aged
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