Objective:
Understanding how paediatric emergency departments (PED) across Europe adapted their health care pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave.
Design:
This cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured 1) study site characteristics, 2) departmental changes, 3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January - May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared to peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres.
Results:
Overall 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18/28 (68%) short-stay units decreased; in contrast 2 units (7%) increased their capacity. In 12 (31%) PEDs they reported acting as receiving centres for diverted children during the pandemic.
There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs.
There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.12).
Conclusion
Overall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.