Impact of school closures on pediatric ambulance transport in Japan.

ABSTRACT

BACKGROUND: After the coronavirus disease (COVID-19) pandemic, nationwide school closures were implemented in many countries. This study aimed to determine the impact of the school closure on pediatric ambulance transport, comparing the situation before and after the COVID-19 pandemic. METHODS: This retrospective observational study was conducted using data from the Kochi-Iryo-Net database. In Kochi Prefecture, schools were closed from March 6 to May 24, 2020. Pediatric emergency transports during the school closure period in 2020 was compared to that of the same period in 2019 (before the COVID-19 pandemic) and in 2021 (schools are not closed). Chi-squared tests and correction for multiple testing was performed by Bonferroni adjustments. To adjust for patient backgrounds, we also performed multiple logistic regression analyses for cases of pediatric ambulance transports. RESULTS: The rate of pediatric ambulance transports was significantly lower (p=0.008) in 2020 (276; 3.97%) than in 2019 (391; 4.87%), but there was no significant difference (p=0.360) between 2019 (391; 4.87%) and 2021 (352; 4.56%). Multivariable analysis revealed similar trends (2019 vs. 2020 odds ratio [OR] 0.86, 95% confidence interval [CI] 0.73-1.00; 2019 vs. 2021 OR 0.96, 95% CI 0.82-1.11). Regarding the characteristics of pediatric ambulance transport cases, there were no significant differences in 2019, 2020, and 2021 in terms of sex, severity, locations of fire stations, and injury mechanism. CONCLUSIONS: There was a decrease in pediatric ambulance transportation due to the public health interventions for COVID-19, including school closures. However, this decrease was not solely due to school closures.