Paediatricians report ‘delayed presentations’ in children seeking emergency care during lockdown

Almost a third of UK paediatricians reported a delay in children seeking emergency care during the coronavirus lockdown, according to a new survey.

Some 241 doctors said they had dealt with children who turned up for treatment or diagnosis later than would have been expected before the pandemic.

The so-called “delayed presentations” were most common among children with diabetes and sepsis (blood poisoning).

The British Paediatric Surveillance Unit (BPSU) carried out a snapshot survey on April 24 asking 4,075 consultants whether they had seen any delayed presentations in children over the past 14 days.

It was undertaken amid reports of falling attendances at emergency care departments during the Covid-19 lockdown in the UK.

The survey authors said: “Parents should continue to access medical care if they are concerned and must not delay getting emergency treatment if their child appears seriously ill.

“Otherwise, the unintended consequences of the lockdown will do more harm and claim more children’s lives than Covid-19.”

The survey, published online in the Archives of Disease in Childhood, found that delayed presentation was thought to be a contributory factor in the deaths of nine children.

Some 2,433 (60%) paediatricians replied to the BPSU’s survey, of which 241 out of 752 (32%) consultants working in emergency care and paediatric admissions said they had dealt with delayed presentations.

A total of 57 (eight per cent) respondents said they had seen more than three children present for diagnosis or treatment later than would be expected.

The survey authors acknowledged the responses were subjective and based on opinion, adding there was no baseline data for comparison.

They said: “Our findings highlight an urgent need to improve public health messaging for parents, which until recently instructed everyone to stay at home.

“Children attending primary care and hospitals remain at very low risk of SARS-CoV-2 [the virus that causes Covid-19] infection.”

The number of reports of delayed presentations varied across the UK, ranging from 14% in Wales to 47% in the Midlands and the east of England – where it was the highest.

The 4,075 consultants surveyed represent more than 90% of all those working in the UK and Ireland.

Professor Russell Viner (pictured), president of the Royal College of Paediatrics and Child Health, which co-owns Archives of Disease in Childhood with the British Medical Journal, said: “We know that parents adhered very strongly to the ‘stay at home advice’ and we need to say clearly that this doesn’t apply if you’re child is very sick.

“Should we experience a second wave or regional outbreaks, it is vital that we get the message out to parents that we want to see unwell children at the earliest possible stage.”

Professor Simon Kenny, NHS national clinical director for children and young people, said the health service staff were “working hard” to ensure all patients can access essential services.

He added: “If your child has worrying symptoms the NHS is here for them, and you can help us to help you by coming forward for care, using the NHS 111 phone or online service or contacting your GP as the first port of call for non-emergencies.”

Copyright (c) PA Media Ltd. 2020, All Rights Reserved. Picture (c) The Royal College of Paediatrics and Child Health.