Changes in Children's Healthcare Visits During Coronavirus Disease-2019 Pandemic in Hangzhou, China

Li, Haomin; Yu, Gang; Duan, Huilong; Fu, Junfen; Shu, Qiang

doi:10.1016/j.jpeds.2020.05.013

Cited by 54 publications

(84 citation statements)

References 7 publications

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“…In Hangzhou, China, paediatric healthcare visits dropped by nearly 75% during the peak of the epidemic and lockdown periods. 39 In the USA, vaccination rates in children substantially declined after a national emergency was declared in response to the COVID-19 epidemic. 40 Modelling analyses using Lived Saves Tool have suggested that a 15% reduction in maternal and child health coverage could result in over 250 000 additional deaths.…”

Section: Discussionmentioning

confidence: 99%

Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis

et al. 2020

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ObjectivesWe evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN).DesignObservational cohortSettingData were analysed from 11 primary healthcare clinics in northern KZN.ParticipantsA total of 46 523 individuals made 89 476 clinic visits during the observation period.Exposure of interestWe conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods.Outcome measuresDaily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata.ResultsWe found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI −16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (−7.1 visits/clinic/day, 95% CI −8.9 to 5.3), both for children aged <1 year and 1–5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8).ConclusionsIn rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.

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Section: Discussionmentioning

confidence: 99%

Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis

et al. 2020

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“…35 In Italy, on May 14, only 3.3% of pediatric COVID-19 cases needed hospitalization. 33 Furthermore, closing schools and adopting the Italian government extraordinary measures led to a signi cant reduction of other respiratory infections in children 36 and the fear to refer to the hospital (where probability of infection is high) have led to a substantial decrease (ranging from 73-88%) in Pediatric Emergency Department visits compared with the same time period in 2019 and 2018. 37 These factors created a unique condition in the Pediatric Departments, opposed to Adult Departments, where bed capacity was early saturated.…”

Section: Discussionmentioning

confidence: 99%

A Survey on Mental Health Impact Caused by COVID-19 Pandemic in Italian Pediatric Healthcare Workers.

Filippo

Attanasi

Dodi

et al. 2020

Preprint

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Background: Few studies investigated COVID-19 pandemic psychological effects on pediatric healthcare staff. The aim of this study was to evaluate sleep quality and psychological effects of pediatric healthcare workers during COVID-19 epidemic in Italy and to evaluate potential differences between Primary and Secondary Care operators. Methods: Pediatric healthcare workers were involved in an online survey aimed to characterize responders and to define their clinical expertise in the management of suspected or confirmed COVID-19 patients during pandemic. Using validated scores, the online questionnaire assessed sleep quality, stress and anxiety level, self-efficacy and social support in pediatric healthcare workers. Results: During COVID-19 outbreak, 67.43% of our population were suffering sleep disturbance, and we found a positive correlation between sleep disturbances with stress and anxiety. Furthermore, 19.42% of subjects were suffering anxiety and 53% were at risk of developing an acute stress disorder. Stress resulted inversely correlated with self-efficacy and social support.Secondary care operators were more affected than family pediatricians by sleep disturbances, stress but especially by anxiety. Social support was considerably higher in secondary care operators compared to family pediatricians.Conclusions: Despite the less exposure and the less infection probability, much of pediatric healthcare workers were suffered sleep disturbance, anxiety and potential stress disorder. In the Pediatric Units, these psychological effects could be related to other factors compared to frontline departments, such as the early confused situation, the difficulties in workplaces managing and in finding personal protective equipment, as well as the subsequent sense of helplessness and frustration.

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“…During the past few months, a significant decline in general practitioner appointments, specialized care, and pediatric emergency department attendance has been reported in many countries including the United Kingdom, Ireland, Germany, Canada, Australia, China, and Italy [ 28 - 35 ]. In some cases, delays in seeking treatment and lack of specialized care have had devastating effects on children with serious and life-threatening health complications including those of a psychological nature [ 36 , 37 ].…”

Section: Psychosocial Challengesmentioning

confidence: 99%

Psychosocial Challenges and Opportunities for Youth With Chronic Health Conditions During the COVID-19 Pandemic

Serlachius¹,

Badawy²,

Thabrew³

2020

JMIR Pediatr Parent

110

108

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School closures, altered access to health services, and economic stress during the COVID-19 pandemic have likely had an impact on the mental and physical well-being of youth worldwide, particularly among those with chronic health conditions (CHCs). A number of challenges and opportunities have emerged during the COVID-19 pandemic for youth with CHCs. Challenges include heightened anxiety, disrupted routines, academic and social stresses associated with school closure, increased risk of domestic violence and abuse, and reduced access to physical and psychosocial support. On the other hand, opportunities include reduced academic and social stress, increased time with families, reduced access to substances, easier access to health care using technology, and opportunities to build resilience. This viewpoint paper highlights both challenges and opportunities for youth with CHCs during the pandemic and offers recommendations for further research and clinical care.

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Changes in Children's Healthcare Visits During Coronavirus Disease-2019 Pandemic in Hangzhou, China

Cited by 54 publications

References 7 publications

Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis

Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis

A Survey on Mental Health Impact Caused by COVID-19 Pandemic in Italian Pediatric Healthcare Workers.

Psychosocial Challenges and Opportunities for Youth With Chronic Health Conditions During the COVID-19 Pandemic

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