CUPID COVID-19: emergency department attendance by paediatric patients during COVID-19 - project protocol

Thérèse McDonnell; Eilish McAuliffe; Michael Barrett; Ciara Conlon; Fergal Cummins; Conor Deasy; Conor Hensey; Ciara Martin; Emma Nicholson

doi:10.12688/hrbopenres.13066.2

CUPID COVID-19: emergency department attendance by paediatric patients during COVID-19 - project protocol

HRB Open Res. 2020 Aug 10:3:37. doi: 10.12688/hrbopenres.13066.2. eCollection 2020.

Authors

Thérèse McDonnell¹, Eilish McAuliffe¹, Michael Barrett^{2

3

4}, Ciara Conlon¹, Fergal Cummins⁵, Conor Deasy⁶, Conor Hensey⁷, Ciara Martin⁸, Emma Nicholson¹

Affiliations

¹ IRIS Centre, UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
² Children's Health Ireland at Crumlin, Dublin, Ireland.
³ Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland.
⁴ National Children's Research Centre, Dublin, Ireland.
⁵ Limerick University Hospital, Limerick, Ireland.
⁶ Cork University Hospital, Cork, Ireland.
⁷ Children's Health Ireland at Temple St, Dublin, Ireland.
⁸ Children's Health Ireland at Tallaght, Dublin, Ireland.

Abstract

Background: Measures introduced to delay the spread of COVID-19 may result in avoidance of emergency departments (EDs) for non-COVID related illness. Clinicians and medical representative bodies such as the Irish Association for Emergency Medicine (IAEM) have expressed concern that some patients may not seek timely urgent medical intervention. Evidence from previous epidemics found that hospital avoidance during outbreaks of MERS and SARS was common. While ED attendance returned to normal following SARS and MERS, both outbreaks lasted 2-3 months. As the COVID-19 pandemic is forecast to extend into 2021, little is known about the impact COVID-19 will have on paediatric attendance at EDs as the pandemic evolves. Aims: This project aims to assess the impact of COVID-19 on paediatric emergency healthcare utilisation, to understand how the health seeking behaviour of parents may have altered due to the pandemic, and to identify how any barriers to accessing care can be removed. Methods: Administrative data records from five EDs across Ireland and one Urgent Care Centre will be analysed to identify temporal trends in attendances for emergency care. Qualitative inquiry will be utilised to capture the experience of staff providing emergency healthcare to paediatric patients during COVID-19, and their feedback on identified trends will inform the interpretation of findings. A cross-sectional survey of parents will capture experiences, concerns and decision-making on accessing healthcare for their children during the pandemic. Results and Conclusion: This information will help decision makers respond rapidly to meet the clinical needs of paediatric patients as the circumstances of the pandemic unfold and reduce the disruption to normal paediatric ED services during the onset of COVID-19. As the health of a child can deteriorate more rapidly than that of an adult, any delay in seeking care for an acutely ill child may have serious consequences.

Keywords: COVID-19; Paediatric; delayed attendance; emergency care; healthcare avoidance; non-COVID illness.

Grants and funding

The CUPID COVID-19 Project is funded by the Health Research Board (HRB) under the HRB COVID-19 Pandemic Rapid Response Funding call (grant number: COV19-2020-076).