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UK coronavirus guidance could cause spike in child deaths, doctors warn

Experts demand change in public messaging, warning that confused parents are too scared to take sick kids to hospital or GPs.

James Cusick
James Cusick
5 April 2020
Shouldn't come to this
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Artur Widak/NurPhoto/PA Images. All rights reserved.

The government’s stay-at-home message on coronavirus is putting sick children at risk, according to disturbing evidence gathered by the UK’s child health professional body.

Regular child infections and illnesses are now in danger of becoming life-threatening, specialist doctors have warned, as parents confused by the government’s messaging are in many cases too afraid to come to hospital.

The president of Royal College of Paediatrics and Child Health (RCPCH), Russell Viner, has privately contacted the Chief Medical Officer for England, Chris Whitty, urging an immediate change in the government’s public information strategy.

Children could become the 'collateral damage' of the COVID-19 outbreak in the UK

Central to Viner’s concern is the very low number of children now coming to hospitals and the massively reduced numbers being referred by GPs.

Senior paediatricians have contacted the RCPCH with reports of children arriving at hospitals with illnesses at a far more advanced stage than they would normally see. Although not officially confirmed, some child deaths since the ordered lockdown are understood to be down to their unusually late access to intensive care.

Children as collateral damage

Cases over the past two weeks include children with life-threatening infections, asthma, appendicitis and other surgical complications, who were only examined by a doctor when the illness or infection was already at an advanced stage. The underlying reason for many of the delays, included in recent reports to the RCPCH, was the overwhelming fear among families that coming to hospital would mean a risk of contracting the coronavirus.

Although not officially confirmed, some child deaths since the ordered lockdown are understood to be down to their unusually late access to intensive care

Although the RCPCH is lobbying the government to urgently tailor its isolation advice and reassure families worried about their sick children, the high demand and long waiting time to access the 111 helpline is seen as a serious problem.

Other reports to the college include families with sick children who are both afraid to come to hospital because of fear of contact with the virus, and also “do not want to bother very busy healthcare workers”.

Staying open – plus child vaccination concerns

In a recent letter to colleagues, Viner has advised: “We need to make sure our services remain open and accessible to families and that we maintain strong rapid links with local primary care.”

Viner said the RCPCH’s growing concern had been shared with the Chief Medical Officer for England. In a letter to RCPCH members, he said: “Parents want to do the right thing and stay at home… but children get sick and we want to see them.”

Contained in one report to the RCPCH is a warning that unless the government changes its general message on self-isolation and begins to offer age-appropriate advice, both in its public messages and on the NHS 111 helpline, then children could become the “collateral damage” of the COVID-19 outbreak in the UK.

The current government advice – that you should stay at home if you have a fever and self-isolate for seven days – contradicts official national guidelines for infants, which says they should be seen within a few hours if they have a high temperature. Although older children can wait longer, any fever lasting five days should be seen quickly as well.

It is vital that we record incidents where we think a child has died due to delayed care

Russell Viner, president of Royal College of Paediatrics and Child Health

Collateral damage to children from the government’s current strategy is regarded as so serious that Viner has called for increased vigilance on child deaths. In his letter to members of the RCPCH he said: “It is vital that we record incidents where we think a child has died due to delayed care.”

Although the RCPCH has urged Whitty to make changes to the government’s information on self-isolation, there is also a longer-term worry about the effect of the lockdown on the UK’s child vaccination programme. GP surgeries have effectively stopped doing routine infant vaccination – and families have yet to be offered advice as to when this will restart.

One leading paediatrician in a London teaching hospital, who asked not to be named, said: “This could be storing up very severe consequences for children over the next year.”

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