How did the covid-19 pandemic affect lower respiratory tract infections in young children in England? : Kimberley Foley

Background Social distancing policies to reduce transmission of covid-19 also reduced children's exposures to endemic respiratory viruses. We aimed to examine the impact of the covid-19 pandemic on lower respiratory tract infections in under 5s presenting to primary care in England. Methods Longitudinal trends analysis using electronic health records from a nationally representative primary care database. Our target population was children aged <5 years registered with a primary care practice from January 2015 to March 2021. Our main outcome was total weekly contacts with primary care for a lower respiratory tract infection (LRTI). We defined three pandemic phases from March 2020 - March 2021: i) first national lockdown (late March to early June 2020), ii) childcare settings reopened and second national lockdown with schools open (mid-June to mid-December 2020) and iii) third national lockdown with schools closed (late December 2020 to end of March 2021). We compared outcomes during each of the three phases with corresponding calendar weeks during pre-pandemic years 2015 to 2019. Results Our study population included 843 020 children <5 years who had 1 076 181 contacts with primary care for LRTIs. During the first phase (first lockdown) there were falls of 79.3% (95% CI: 73.6 to 84.5) from an average of 28 547 primary care contacts for LRTI in 2015 - 2019 to 5915 in 2020;there was a 78.9% (95% CI: 73.7 to 83.9) fall in phase two (childcare settings reopened and second lockdown) from 107 873 to 22 792 contacts;and a 77.7% (95% CI: 73.5 to 81.4) fall in phase three (third lockdown) from 57 200 to 12 764 contacts. Conclusions Children under 5 in England had fewer contacts with primary care for LRTIs during the covid-19 pandemic. This change likely reflects lower prevalence of respiratory illness due to fewer social contacts. This may impact on future health service use as these children have had less exposure, and therefore may have less immunity, to respiratory diseases. Key messages • Children under 5 had fewer contacts with primary care for lower respiratory tract infections during the covid-19 pandemic in England likely due to the restrictions in place to reduce social contacts. • The falls in lower respiratory tract infections during the covid-19 pandemic in under 5s may mean they have less immunity to respiratory viruses which may impact upon their future health service use.

Gp Events before and after Covid-19 Infection among Children and Young People in Northwest London

Aims Covid testing and primary care data for Children and Young People (CYP) has not yet been linked at the national level in England. However, such linkage has been established using the Discover Whole System Integrated Care (WSIC) database in Northwest London (NWL). We describe pattern of primary care utilisation, among CYP of 0 - 24 years of age in NWL before and after testing positive for Covid-19 infection. The insights are needed in understanding the impact of Covid-19 infection on both the patient and the health care system. Methods We conducted a retrospective cohort study using routinely collected primary care health care data in NWL from the Discover WSIC de-identified database. It is a local warehouse of electronic patient records for research, the database is de-identified. Four cohorts were studied to represent CYP at various key Covid-19 vaccination focused age groups of 0-4 years, 5-11 years, 12-15 years and 16-24 years. Their GP events 180 days preceding and following the confirmed PCR positive test result were analysed. GP events were counted as number of distinct days with one recorded activity. Results By 16th February 2022, positive PCR results were obtained for 104,702 CYP, 14% (d=745,268) of registered CYP population in NWL. The frequency of GP events in the first seven days of the post-test period was similar to the frequency in the seven days preceding, however outside this period they differed substantially, from 279 per 1,000 pre-test to 92 per 1,000 post-test. The 16-24 year age group showed the largest decrease at 150 to 180 days after a confirmed positive PCR test result, from 1,290 GP events pre-test to 195 post-tests. There was no increase in GP events for any age group from two weeks post confirmed PCR positive test. Conclusion Our analyses showed that there is evidence of increase GP activity by CYP a week before and after a Covid- 19 infection diagnosis. However, we did not find any evidence at population level of prolonged post Covid-19 infection symptoms for which GPs were contacted.

Preparing Engineers for 2035: Transforming Australia’s Engineering Education for Emerging Roles and Expectations

The Australian Council of Engineering Deans (ACED) recently concluded a project (‘Engineering 2035’) to reshape Australian engineering education for future professional engineering graduates. Consultations with industry leaders and others identified the need to strengthen graduate engineers’ capacity for multi-disciplinary and cross-functional teamwork, with greater public accountability. Focus groups of prospective students revealed weak understanding of the growing range of opportunities offered by an engineering qualification of this nature. The corresponding curriculum transformation must ensure greater focus on transferable skills and contexts are delivered alongside technical content. We envisage more industry-based, problem and project-based pedagogies. We found that the engineering academic workforce is positive to such changes. Its recent adaptation of teaching methods to accommodate COVID-19 restrictions gives confidence of a good response to the emerging needs. The project identified 22 Calls for Action to the schools of engineering and ACED, and to industry, government and the professional accrediting body, Engineers Australia. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.