Dramatic fall in hospital admissions for child infections during pandemic

Steps taken in the first year of the pandemic to reduce the spread of Covid-19 also led to dramatic reductions in hospital admissions for common and severe childhood infections in England, researchers have concluded.

While many of the measures would be unsustainable outside of a pandemic, further research is needed to work out what interventions could continue, especially during winter months to reduce healthcare burden and protect vulnerable children, the researchers concluded in the BMJ.

The analysis looked at hospital admission rates and mortality outcomes for 19 common childhood respiratory infections, including tonsillitis and bronchiolitis and severe invasive infections including meningitis and sepsis.

After 1 March 2020, substantial and sustained reductions in hospital admissions were found for all but one of the 19 infectious conditions studied. 

Among the common respiratory infections, hospital admissions for influenza fell by 94% from an annual mean of 5,379 to 304 and for bronchiolitis, admissions decreased by more than 80% from 51,655 to 9,423 in 2020-21. 

For severe invasive infections, percentage reductions ranged from 26% for osteomyelitis to 50% for meningitis.

The researchers from Oxford University also looked at vaccine-preventable infections, where reductions ranged from 53% for mumps to 90% for measles.

More in-depth analysis showed reductions were similar across all geographical regions, deprivation and ethnic groups, as well as among children with existing conditions.

Absolute numbers of deaths within 60 days of hospital admission for sepsis, meningitis, bronchiolitis, pneumonia, viral wheeze, and upper respiratory tract infections also decreased but the proportion of children admitted for pneumonia who died within 60 days increased. 

The only infection that didn’t show a reduction in hospital admissions was pyelonephritis where non-drug interventions and social restrictions have no impact.

Researchers are continuing to track the data and note that some respiratory infections increased to higher levels than usual after May 2021.

‘Further evaluation of non-pharmacological interventions that could be sustained beyond the pandemic is required to inform policy makers about potential strategies, especially during winter months, to minimise the burden on health systems and protect vulnerable children,’ they concluded.

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