Rationalizing the Pediatric Emergency Department Workload: an Epidemiological Profile of Presentations Before and During the COVID-19 Pandemic

Abstract

Background: Infectious respiratory disease in children provides a significant seasonal workload burden to paediatric emergency departments. Studies from the Southern hemisphere during the first wave of COVID-19 had shown a decrease in seasonal paediatric respiratory infections. During the COVID-19 pandemic, predicted drops in infectious disease circulating in children led to redeployment of junior doctors in paediatric services to adult services. Methods: We extracted data on children presenting to a tertiary emergency department with a respiratory illness, comparing winter 2019-2020 (pre-COVID-19) to winter 2020-2021 (post-COVID-19). We compiled demographic and epidemiological data and compared the two groups with regards to number and type of infectious respiratory presentations, admissions, days spent in hospital, and whether intensive or high dependency support was required. Results: We have found a reduction in respiratory disease presentations post-COVID-19 compared to pre-COVID-19. These patients were more likely to be admitted but their stay was reduced, and there was a trend towards a reduction in requirement for intensive or high dependency support during their admission. Conclusion: This work supports the redeployment of junior doctors in paediatric departments to adult departments given increased demand in other areas of medical care at that time. In view of the changing landscape, we suggest the introduction of a flexible staffing format to ensure adequate support to areas with higher demand.