Several common often low-acuity diagnoses saw disproportionate reductions in visits, including headache, chest pain, and minor injuries. Concerningly, visits for suicidal ideation, suicide Conclusions and highlights Pediatric ED utilization substantially decreased during the early months of the COVID-19 pandemic in New York City but left relatively higher patient acuity. It was concluded that healthcare systems in early epicenters must also prepare for the disproportionate impact a pandemic has on the most vulnerable pediatric patients, particularly those at risk for self-harm
attempt, or self-harm increased by 100% (p < .001), and visits for evaluating abuse or neglect decreased by 89% (p = .01).
of decreased ED visits and increased hospital admission rates. Highlights ● Pediatric hospitalization rates and ED acuity increased with the COVID-19 pandemic. ● Many of the largest decreases in visits were for common, low-acuity diagnoses. ● Visits for self-harm during the pandemic were
or abuse. Further studies will examine the nature of child abuse cases and the acuity/ severity of injuries in the ED with the evidence double what would have been expected. ● Diagnoses of child abuse or neglect were concerningly rare. CHILD MALTREATMENT PREVENTION SERVICE CASES ARE SIGNIFICANTLY REDUCED DURING THE COVID-19 PANDEMIC: A LONGITUDINAL INVESTIGATION INTO UNINTENDED CONSEQUENCES OF QUARANTINE
Another study of note specifically in the New York City area is Child Maltreatment Prevention Service Cases Are Significantly Reduced During the COVID-19 Pandemic: A Longitudinal Investigation into Unintended Consequences of Quarantine (Allen et al., 2021). This study focuses on the use of prevention services during the time frame when most of the United States was placed under quarantine to slow the spread of the virus. This further impacted education due to schools transitioning to virtual/remote learning, which extended into the following school year for many public school systems. Due to COVID-19, individuals reported experiencing a number of adverse mental health effects due to social isolation measures (Rossi et al., 2020; Cao et al., 2020; Williams et al., 2020). In addition to social isolation, other impacts such as job loss, economic struggles, and distress and anxiety about infection further contributed to mental health declines. Further, the unintended consequences of the foregoing impacts can result in family/domestic violence. It should be noted that this study was published in December 2021, and further related research and studies continue to take place. This particular study acknowledges previous related literature and examines the association
between other traumatic and mass casualty events and natural disasters and child abuse or maltreatment (Allen et al., 2021). Seddighi and colleagues (2021) conducted a systematic review that revealed children are more likely to be victims of family violence during disasters due to the risk of families being under more psychological and economic pressures. Given the circumstances of COVID-19 with families spending more time inside and at home due to the economy and school shutdowns, community supports and mandated reporters do not have the same access to youth. Through spending less time at school (virtual learning, limited after-school programs) and as a result being away from school personnel, an increase in child maltreatment may happen. Rosenthal and Thompson (2019) report that on holidays and during the summer, incidents of child maltreatment tend to increase. It also appears that youth and families may be more vulnerable to experiencing violence during school closures (i.e., holidays, summers, and weekends), which also applies to the impact of COVID-19 closures. As a result of the increase in stress on parents and caregivers (also noted above), they may engage in coping skills such as substance use or abuse more often than
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