Changes in patterns of activity at a tertiary paediatric neurosurgical centre during the first wave of the 2020 pandemic
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LETTER TO THE EDITOR
Changes in patterns of activity at a tertiary paediatric neurosurgical centre during the first wave of the 2020 pandemic Ibrahim Jalloh 1
&
Helen Smart 1 & Katherine S. Holland 1 & Hannah R. Zimmer-Smith 1 & Rachel E. Isba 2
Received: 31 July 2020 / Accepted: 11 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor: On Wednesday March 11, 2020, the World Health Organization (WHO) declared a global pandemic of COVID-19—the disease caused by SARS-CoV-2—a novel coronavirus. In the UK, the first cases had been reported at the end of January 2020 and the first death in early March. Whilst there is evidence that globally children and young people (CYP) so far represent a relatively small proportion of serious infections and deaths from COVID-19 [1], they have been impacted in a myriad of unexpected ways. This is reflected in the way that they have accessed healthcare (or more accurately, had healthcare accessed on their behalf). Changes in patterns of paediatric emergency department attendances [2, 3], accessing of community care [2] and increased acuity at the time of attendance at hospital [2, 4] have all been reported. The epidemiology of specific pathology has also changed, for example, patterns of fractures [5]. In paediatric neurosurgery, some pathology might be expected to decrease as a result of pandemic interventions such as “lockdown”, e.g. head trauma sustained outside of the home, but other pathology would be expected to continue at background rates, e.g. brain tumours. Other measures such as school closures will have resulted in decreased visibility of
* Ibrahim Jalloh [email protected] Rachel E. Isba [email protected] 1
Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
2
Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster LA1 4YT, UK
CYP and disruption of access to normal sources of support, and this may have had an impact on presentations to neurosurgical services, e.g. abusive head trauma. CYP under outpatient care and with direct access to a member of the hospital-based team might also engage with services in a different way during the pandemic, particularly early on when little was known about the impact on this age group. We aimed, therefore, to describe patterns of urgent referrals and specialist nurse access at a UK regional paediatric neurosurgical centre in the first 6 months of 2020. For urgent referrals received by the on-call paediatric neurosurgeon, data were examined for the 6 months January–June in 2020 and the same period in 2019. A 4-year mean for the first half of the years 2016–2019 was also used for comparison, to address the likely variation between years given the small numbers. For the specialist nurse access (phone call data), a comparison was made between 2020 and 2019, and weekly data was also examined to allow for any background increase in calls in the second h
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