ABSTRACT
Background Recently there have been high-profile publications about in surge in child abuse cases during the COVID-19 nationwide lockdown beginning on the 23rd of March 2020. Due to limited services and increased isolation, it was difficult to identify this abuse and intervene through the traditional channels. This study used a proxy measure, that is to see if there was an increase in referrals to Paediatricians for child protection medicals. Objectives This study intends to assess the impact of lockdown on child abuse during school closure. Methods We performed a retrospective observational study of all child protection medical examinations undertaken at the Pinderfields General Hospital, England during April and May 2019, in comparison to the same period of 2020. The outcome measurements included the number and sources of referrals, previous contact with social services, risk factors for abuse, and the outcome at discharge. Results The difference in age and gender referrals was insignificant. The highest numbers of referrals were for physical abuse in both years. Although neglect remained the second highest cause for referral in 2020, this could be due to the reasons previously stated. Domestic violence, mental health, and drug abuse in parents have remained the predominant causes of risk factors for abuse in children in both years. The majority of children in 2020 went home with social services' input rather than the support of family members like grandparents (due to isolation or shielding). This caused a high financial impact on the Government. Conclusions COVID-19 has led to a demonstrable increase in child abuse, with the possibility of gross underestimation due to school closures. The results show fewer children are being referred by schools and there are fewer referrals from children who are not under the radar of social services with child protection plans. This may reflect an increase in hidden abuse. The direct impact of the increased presence of children within the home and the indirect impact of the virus on unemployment, mental health, domestic violence and substance abuse may offer some explanation to rising levels of child abuse All Paediatric referrals should be treated with a higher degree of suspicion during this pandemic. School closure risks rising levels of hidden abuse in the UK, this needs to be considered by policymakers.