ABSTRACT
Background The COVID-19 containment measures, implemented to curb the pandemic, impacted health of children and adolescents by numerous pathways. We present the impact on health care utilization and provision. Methods A systematic review on secondary health impact is ongoing (PubMed, PsychInfo, Embase). Literature is screened (title, , full-text) by 2 researchers, and data of interest extracted systematically.. Inclusion criteria are age (0 - 25 yrs.), exposure: containment measures, outcome: secondary health outcome, and European data origin. Results Jan. 2020 - Aug. 2021 10112 studies were identified, 337 were included. n = 60 were on health care utilization and provision. Utilization studies relied on objective hospital or registry data, care provision studies more often on survey data (professionals, parents). Data yields a large but varying decrease in emergency department visits during the lockdown: Italy ∼75%, Spain ∼65%, France ∼60%, and Germany ∼64%, and a substantial change in case mix and severity compared to comparable pre-COVID. Specialized and primary pediatric practices report that elective interventions were postponed, state of the art diagnostics withheld, and rehabilitation services disrupted. Vaccinations in infants, children, and adolescents dropped during the lockdown inversely proportional to children's age. Studies repeatedly suggest patients’ health services avoidance out of fear of infection and stay-at-home rules.Results on catch-up utilization and provision to follow (ongoing study). Conclusions COVID-19 measures exerted a measurable impact on health utilization and provision in children and adolescents. The utilization was comparatively lower and service provision disrupted across Europe. So far little can be said about a potential recovery in terms of catch-up of visits, diagnostics, or treatments. Analyses of the long-term health impact of the observed effects is recommended and can serve to improve future pandemic preparedness. Key messages • COVID-19 confinement measures had measurable secondary health impact on children and adolescents. • Data on catch-up healthcare is important to establish long term impact and learnings.
ABSTRACT
The Covid-19 Pandemic has brought society abruptly to a halt, interfering with many activities and social interactions. Palliative Programs haven't been spared, necessitating major changes. In the Balearic Islands several entities working for Palliative Care (AECC, Angeles Sin Alas, the Coordinating Center for Palliative Care Programs, DIME and Illespal) have not been sidelined by these changes. These companies had to re-invent ways to reach the population in order to provide the necessary help, causing major changes in their dynamics. This article calls for a moment of reflection on the experiences of the above-mentioned companies and their adjustability to changes which brought about health crises on a daily basis. Their resilience and commitment to face and deal with new circumstances are truly awe-inspiring. Faced with new challenges, responses have been variable, giving opportunities for the introduction of new concepts, training and attention to different end of life services such as Emergency Department, ICU and nursing homes which have never viewed Palliative Care as a priority before.