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Paediatric patients seen in 18 emergency departments during the COVID-19 pandemic
  1. Ran D Goldman1,2,
  2. Eric Grafstein3,4,
  3. Neil Barclay4,5,
  4. Michael A Irvine2,
  5. Elodie Portales-Casamar2,6
  1. 1 The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
  3. 3 Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4 Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
  5. 5 Fraser Health, Vancouver, British Columbia, Canada
  6. 6 Division of Allergy & Immunology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Ran D Goldman, Pediatrics, The University of British Columbia, Vancouver, BC V4H 3B8, Canada; rgoldman{at}


Background Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians’ offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year.

Methods We analysed records from 18 EDs in British Columbia, Canada, serving 60% of the population. We included children 0–16 years old and excluded those with no recorded acuity or discharge disposition and those left without being seen by a physician. We compared prepandemic (before the first COVID-19 case), early pandemic (after first COVID-19 case) and peak pandemic (during public health emergency) periods as well as a similar time from the previous year.

Results A reduction of 57% and 70% in overall visits was recorded in the children’s hospital ED and the general hospitals EDs, respectively. Average daily visits declined significantly during the peak-pandemic period (167.44±40.72) compared with prepandemic period (543.53±58.8). Admission rates increased mainly due to the decrease in the rate of visits with lower acuity. Children with complaints of ‘fever’ and ‘gastrointestinal’ symptoms had both the largest overall volume and per cent reduction in visits between peak-pandemic and prior year (79% and 74%, respectively).

Conclusion Paediatric emergency medicine attendances were reduced to one-third of normal numbers during the 2020 COVID-19 lockdown in British Columbia, Canada, with the reduction mainly seen in minor illnesses that do not usually require admission.

  • paediatric emergency med

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  • Handling editor Katie Walker

  • Contributors All five authors designed the methodology, reviewed the draft paper and approved the submitted version. RG wrote the first draft of the paper. MI and EP-C analysed the data and conducted the statistical analyses.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Institutional Review Boards (Research Ethics Boards) of BC Children’s Hospital, Vancouver Coastal Health and Fraser Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.