Covid-19: The four levels that changed New Zealand. Video / NZ Herald
Avoiding hospitals and reduced access to healthcare contributed to moderate and severe harm for Kiwi children during last year's Covid-19 lockdown, a new study has revealed.
During New Zealand's six-week national level-4 coronavirus lockdown period, there were about 55 instances where paediatricians believed a child's care may have been compromised due to a delay in seeking medical help, according to the University of Otago findings.
In 56 per cent of the cases, the child was less than 7 weeks old.
The main reasons for the delays appear to be hospital avoidance due to the fear of Covid-19 exposure, reduced access to primary healthcare services and the lack of face-to-face post-natal visits.
Published in the Journal of Paediatrics and Child Health, the study, undertaken by Otago's New Zealand Paediatric Surveillance Unit, undertook weekly surveillance of delayed access or presentation to health services during the lockdown.
The unit's co-director, Dr Mavis Duncanson, of the Department of Women and Children's Health, said the survey showed that "despite clear messaging, hospital avoidance and reduced access to primary and secondary care were associated with significant potential harm for children during the strict lockdown, with new-borns disproportionately affected".
The most serious cases arising in the perinatal period included hypoxic-ischaemic encephalopathy (brain injury caused by oxygen deprivation), following delayed delivery, and necrotising enterocolitis (a serious intestinal disease) because some treatment options were not available.
The majority of cases in the neonatal period were due to a combination of failure to gain weight, jaundice and dehydration.
A University of Otago study has looked at harm to children during last year's lockdown due to delayed access to care. Photo / File
"The 'bubble' concept that was credited with making New Zealanders aware of the importance of social distancing may have had the unintended consequence of parents excluding midwives from their homes and their infants not having important post-natal observation," Duncanson said.
A range of conditions were impacted by a delay in paediatric care in older children, including a case with gastroenteritis when hospital avoidance resulted in severe hyponatraemic dehydration and metabolic acidosis (a serious electrolyte disorder).
"While this is just a snapshot, the information highlights that the interests and wellbeing of children and young people need to be front and centre of health planning," she said.
"Lockdown may result in significant hidden harms for infants and young children that vary depending on family background and circumstances."
As the cases were reported only by paediatricians, the figures are likely to be higher as more issues may have been dealt with in primary care or by other hospital specialists, Duncanson said.
"In particular, family violence and child abuse may have been under reported while families were isolated at home.
"These data suggest a more nuanced and balanced message to primary care and the community about access to care, particularly given the ongoing nature of the Covid-19 pandemic.
"Future pandemic responses will need adequate funding of public health services so that essential and time-critical child health surveillance can continue without redeployment of this workforce to other functions."
