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Oxford research finds sharp reduction in children’s hospital admissions

Research conducted at Oxford University has revealed that as a result of the Covid-19 pandemic there has been a dramatic reduction in hospital admissions for children. 

The study, published in the BMJ, analysed NHS hospital admissions in England for children aged 0-14 for 19 common and severe childhood infections between 1st March 2017 and 30th June 2021.

Common respiratory infections included tonsillitis and the flu, whilst the more severe infections included sepsis and meningitis. The study also looked at the effect on vaccine preventable diseases including measles, mumps and several other bacterial infections. This is of particular interest after childhood immunisation programmes were disrupted by Covid-19. In spring 2020 in the WHO European region, 22% of infants had their vaccination courses interrupted.

Researchers found that “after 1st March 2020, substantial and sustained reductions in hospital admissions were found for all but one of the 19 infective conditions studied”. The exception was kidney infections, which did not fall. 

On the other hand, meningitis admissions fell by nearly 50%, from an average of 3,917 annual cases before the pandemic to 1,964 in 2020/21. 

The greatest percentage reduction was found for influenza, which decreased by 94%, from 5,379 admissions to 304 in the twelve months after 1st March 2020. Similarly, for bronchiolitis, admissions decreased by over 80% from an average of 51,655 to 9,423 in 2020/21. 

These reductions were similar across “all geographical regions, deprivation and ethnic groups, as well as among children with existing conditions who are at greatest risk of severe illness and death from infection”.

Researchers also discovered that the number of deaths recorded within 60 days of hospital admissions for sepsis, meningitis, bronchiolitis, pneumonia, viral wheeze and upper respiratory tract infections also decreased. However, researchers highlight that the proportion of children admitted for pneumonia who died within 60 days increased. 

As an observational study, its authors were unable to highlight a cause, but researchers have concluded that a range of human behavioural changes, non-drug interventions, and governmental societal restrictions have not only reduced the transmission of Covid-19 but also for many other childhood infections. 

This highlights one of the positive side-effects of lockdown, protecting children from the spread of common and severe childhood infections in England. This comes as a result of social distancing measures and school closures. 

However, whilst school closures might have contributed to some of the reductions seen in the study, it is not possible to disentangle the evidence from standard physical distancing. Travel restrictions may have also contributed to this decrease with its associated reduced air pollution.  

Whilst such measures are unsustainable in life after the pandemic, researchers are encouraged by this decrease in childhood illness and call for a further evaluation of how this reduction in childhood infections can be sustained. 

They also acknowledge that “there will probably be an increase in the incidence of primarily, but not exclusively, viral infections” after measures to prevent the spread of Covid-19 are lifted. 

Image: Darko Stojanovic

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