This week has been one of the strangest I can remember as a paediatrician. Our EDs are empty, and our paediatricians are working in new and uncomfortable ways. The number of children infected with COVID-19 remains low but some are needing intensive care. But we are increasingly recognising that the incredible transformation of our health system and society to fight COVID-19, amazing as it has been, means that there have been delays in sick children presenting to hospital. I’ve written before about this ‘collateral damage’ to our children – but many of you are starting to see the reality of it this week.
It’s never been more important to look after ourselves and each other
Our members are starting to be affected by the response to COVID-19 as well. The death of any child is a tragedy, although recognising that children die is part of what we do as paediatricians. Yet many of you are working with adults during this crisis, and this will expose paediatricians to death on a scale we are entirely unused to. We are very aware of the many strains our members are under at the moment. We’ve been working for weeks on providing guidance to help you and our services cope and adjust to what we knew was coming. This systemic support is crucial, but systems only work if we support the people within them. I know the pressure, stress and intensity have been very significant. This week we published a resource page with tips and tools for wellbeing. There’s information from Dr Sanjay Suri about mindfulness and managing anxiety, free access to wellbeing apps, and information about how to access the free frontline distress service. It’s never been more important to look after ourselves and each other and I know you’ll find these resources helpful.
This week we’ve done a lot of work to get the message out about late presentations. As I wrote last Friday, we’re worried about the children we’re not seeing. I want to thank everyone who helped us get this message out, especially on social media where it was . This is an evolving story and we’re working hard to get the right messages to parents. Government is also receptive. We were very pleased that a message on this was delivered at the UK Government’s 5pm briefing yesterday from the NHS England National Medical Director.
We’re working to get credible, reassuring and responsible messaging out to parents
The reasons for late presentations are many and varied; we know that it’s not solely or even mostly a question of access. A lot of parents are understandably concerned about infection and, in serious cases, some parents are anxious about separation from their child. We’re consulting with NHS England and governments in the nations to look at the emerging evidence base but, in the meantime, our job is to reassure parents that the lights are very much on in primary care and in emergency departments. We’re also aware of a lot of disinformation circulating on social media. We’re working to get credible, reassuring and responsible messaging out to parents. You’ll see more from us on this in the coming week.
These issues are also transforming how we all work. I mentioned before that our services are having to respond rapidly to the challenge of COVID-19, with possible redeployments to adult services, repurposing of paediatric intensive care and the risk of ‘collateral damage’ to children who may be presenting late. To support our members in their response where they work, we will launch a data collection tool next week to show the real-time impact of COVID-19 on child health services. Sharing this information will be vital so that we know what needs to be done to return services to normal post-pandemic. We will ask Trusts and Health Boards to submit key indicators on a weekly basis. Submitted data will then be accessible to members to support their service planning.
The College has been working hard to provide members with up-to-date and accurate information relating to the COVID-19 pandemic on our website. It includes the dissemination of data collected through NHS England’s service evaluation and audit. Data will be updated regularly to provide up-to-date information to clinicians relating to the clinical aspects of COVID-19 while also determining the care needs of children admitted to hospital with COVID-19. Also available is a summary of the latest scientific literature regarding COVID-19, developed in collaboration with Don’t Forget the Bubbles and NHS England. It will be updated frequently to capture the latest research evidence [no longer available].
Finally, the BPSU has facilitated surveillance of neonatal complications of coronavirus disease via a weekly report card. We would like to thank those who have already reported. Study details can be found here.
Thank you again for everything that you are doing. If there are other things you feel we should be doing, please get in touch.
I hope that you get at least some time with loved ones (even if only on Zoom) during the Easter break. In the meantime, stay safe and well.
Russell
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