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Rise in the incidence of abusive head trauma during the COVID-19 pandemic
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  • Published on: 8 March 2021
    Change in referral pathway?
    • James Houston, Consultant Paediatrician Royal Hospital for Children, Glasgow

    I submitted this response below and see that it has not been published and have had no response to indicate why this would be so. My email address has changed from jamie.houston@nhs.net .
    In discussion with colleagues from across Scotland, no significant increase in numbers of infants of Abusive Head Trauma have been referred to medical child protection services was noted during 2020.

    My original eLetter was submitted on 08 Jul 2020:

    I share concerns about the impact of Covid, and note that we have seen an increase in NAI referrals over recent months (but not AHT). Given that the number of cases in this institution was so low in previous years, I wonder if there has been a change in referral patterns with GOSH admitting more general PICU cases than usual. Has there been an impact from other PICUs in London that were caring for adults during the peak?

    Conflict of Interest:
    None declared.
  • Published on: 17 July 2020
    Misuse and alarmist use of the word pandemic
    • Jacqueline YQ Mok, Retired consultant paediatrician Retired consultant paediatrician
    • Other Contributors:
      • Timothy J David, Professor of Child Health & Paediatrics

    Sidpra et al1 reported seeing 10 patients with suspected abusive head trauma between 23 March and 23 April 2020, when previously their unit only saw 0.67 cases per month. They concluded that this indicated a pandemic. In support, they cited (providing an incorrect journal name) a published review suggesting an increased risk of family violence2, but in fact the review cited referred to decreasing reports of child abuse and neglect during the Covid-19 pandemic.

    Sidra et al made no mention of the likely explanation for their observations, namely a change in referral patterns. A number of children’s wards in hospitals in London and elsewhere in the UK have been taken over by adult Covid-19 patients, coupled with the closure of some paediatric urgent care centres and emergency departments, resulting in the diversion of ill children to other centres.

    If, as is suggested, the apparent 1493% increase in inflicted head injury cases is indeed the result of adverse psychosocial factors resulting from efforts to reduce Covid-19 transmission, then one would expect paediatric services worldwide to be deluged with other types of inflicted injury, which as yet has not been reported.

    Without other supporting data, and only using information from a single unit, we are not convinced that there is a sound case for the authors' conclusion that these 10 cases represent a ‘pandemic’. The word pandemic means a disease that is prevalent over a whole country or the whole...

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    Conflict of Interest:
    None declared.