The Current Status of Pediatric Neurology: Navigating against the COVID-19 Pandemic

Abstract

On December 31, 2019, a cluster of severe pneumonia infection of uncertain etiology was reported in Wuhan, China which later was determined to be due to a novel coronavirus and was termed the SARS-CoV-2 causing COVID-19 infection. In a media briefing by WHO Director General Dr. Tedros Adhanom Ghebreyesus on the 11th of March 2020, he acknowledged the increasing number of cases of COVID-19 outside of China which had increased 13-fold and the number of affected countries had tripled. With approximately 118,000 cases identified in 114 countries and 4,291 people who lost their lives from this virus, WHO declared COVID-19 a pandemic.1 In the Philippines, as of the 2nd day of March 2020, there were 43 admitted cases classified as “persons under investigation” (PUI) with no confirmed cases. By the 15th of March 2020, with the hope of controlling the spread of the infection, Metro Manila and several provinces were placed in community “lockdowns” and international travel coming in and going out of the Philippines was curtailed. By the 20th of March 2020, there were already 230 confirmed cases and 18 deaths nationwide.2 The Philippine General Hospital (PGH) was designated as the COVID 19-referral hospital for the National Capital Region. The medical and surgical wards were retrofitted in preparation for the first group of patients diagnosed with COVID-19 to be admitted. By the first day of April 2020, PGH officially began operating as the COVID-19 referral center. However, by this time, the country has lost several medical practitioners who were either affiliated with the Philippine General Hospital and/or were University of the Philippines-College of Medicine alumni – adult cardiologists Dr. Francisco Lukban and Dr. Raul Jara, anesthesiologist Dr. Greg Macasaet, pediatric surgeon Dr. Leandro Resurreccion, and pediatrician and then current Philippine Pediatric Society President Dr. Salvacion Gatchalian. In the neurosciences, the Division of Pediatric Neurology, one of the busiest divisions of the Department of Pediatrics, had to adapt to the COVID-19 pandemic in service delivery, teaching, and research. Figures 1-3 show the comparison of 2019 to 2020 census of inpatient admissions/referrals to the Neurology Service and outpatient consultations. To give way for the creation of a COVID Pediatric team of residents for COVID-related admissions, the 15 Pediatric Neurology Service beds were dissolved and were put under the General Pediatrics Service. There was a 61.7%drop in inpatient cases from 193 patients in 2019 to 74 patients in 2020 with a maximum of 208 inpatients in the month of January to a minimum of 23 inpatients in the month of June.3,4