Parents of seriously ill children are not taking them to hospital because of fears over the coronavirus, according to a leading doctor.
Dr Sanjay Patel, a consultant in paediatric infectious diseases at Southampton Children’s Hospital, said fewer children were being brought to the emergency department with conditions such as appendicitis, dehydration and sepsis – but those who are being brought in are more severely ill.
Dr Patel said: “These are extremely challenging and worrying times for families and I can’t stress how important it is to follow the government advice about social distancing in order to slow down the speed of COVID-19.
“However, I’m really worried there is a very real risk that some children with illnesses such as appendicitis, dehydration or even sepsis are not being brought to see healthcare professionals as quickly as they would be normally.
“We are seeing fewer children than we would expect to see at this time of year, particularly through our emergency department, and those we are seeing who do not have COVID-19 are more severely unwell.
“We’ve seen evidence of this in Hampshire as well as across the country.”
Dr Patel has helped to develop national guidance on children’s health which will allow parents to assess when they should seek medical help.
A red, amber and green traffic light system advises them when they should seek urgent medical advice.
According to the guidance, produced in conjunction with the Royal College of Paediatrics and Child Health, parents should take their child to A&E or call 999 if they have any of the following symptoms:
• Becomes pale, mottled and feels abnormally cold to the touch
• Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
• Severe difficulty in breathing, becoming agitated or unresponsive
• Is going blue round the lips
• Has a fit/seizure
• Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
• Develops a rash that does not disappear with pressure (the ‘glass test’)
• Has testicular pain, especially in teenage boys
Parents should contact their GP surgery or call NHS 111 if their child has any of the following symptoms:
• Is finding it hard to breathe including drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession) or head bobbing
• Seems dehydrated (dry mouth, sunken eyes, no tears, drowsy or passing less urine than usual)
• Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
• Has extreme shivering or complains of muscle pain
• Babies under three months of age with a temperature above 38C (100.4F)
• Infants three to six months of age with a temperature above 39C (102.2F)
• For all infants and children with a fever above 38C for more than five days
• Is getting worse or if you are worried
• Has persistent vomiting and/or persistent severe abdominal pain
• Has blood in their poo or wee
• Any limb injury causing reduced movement, persistent pain or head injury causing persistent crying or drowsiness
The guidance acknowledges that access to a healthcare professional may be delayed, so if symptoms persist for four hours or more and parents have been unable to speak to a GP or 111, they should take their child to the nearest A&E.
Dr Patel added: “We know that the message about COVID-19 is so powerful and parents are putting most children’s illnesses down to this.
“It is really important for parents to recognise that COVID-19 is not causing severe infection and illness in most children.”
He added: “If your child is unwell don’t assume they have COVID-19, please take a look at the resources we’ve developed and if your child has any of the red or amber features seek help urgently.”