Imperial College London
Dr Ian Maconochie

DrIanMaconochie

Faculty of Medicine, Department of Infectious Disease

Professor of Practice (Paediatric Emergency Medicine)
 
 
 
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Contact

 

+44 (0)20 3312 3729i.maconochie

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Honeyford:2021:10.5811/westjem.2021.2.49614,
author = {Honeyford, K and Coughlan, C and Nijman, R and Expert, P and Burcea, G and Maconochie, I and Kinderlerer, A and Cooke, G and Costelloe, C},
doi = {10.5811/westjem.2021.2.49614},
journal = {Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health},
pages = {603--607},
title = {Changes in emergency department activity and the first COVID-19 lockdown; a cross sectional study},
url = {http://dx.doi.org/10.5811/westjem.2021.2.49614},
volume = {22},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundEmergency Department (ED) attendances fell across the UK after the ‘lockdown’ introduced on 23rd March 2020 to limit the spread of coronavirus disease 2019 (COVID-19). We hypothesised that reductions would vary by patient age and disease type. We examined pre- and in-lockdown ED attendances for two COVID-19 unrelated diagnoses; one likely to be affected by lockdown measures (gastroenteritis) and one likely to be unaffected (appendicitis).  MethodsRetrospective cross-sectional study conducted across two EDs in one London hospital Trust. We compared all adult and paediatric ED attendances, before (January 2020) and during lockdown (March/April 2020). Key patient demographics, method of arrival and discharge location were compared. We used SNOMED codes to define attendances for gastroenteritis and appendicitis. ResultsED attendances fell from 1129 per day before lockdown to 584 in-lockdown; 51.7% of pre-lockdown rates. In-lockdown attendances were lowest for under-18s (16.0% of pre-lockdown). The proportion of patients admitted to hospital increased from 17.3% to 24.0% and the proportion admitted to intensive care increased four-fold. Attendances for gastroenteritis fell from 511 to 103; 20.2% of pre-lockdown rates. Attendances for appendicitis also decreased, from 144 to 41; 28.5% of pre-lockdown rates.ConclusionED attendances fell substantially following lockdown implementation. The biggest reduction was for under-18s. We observed reductions in attendances for gastroenteritis and appendicitis. This may reflect lower rates of infectious disease transmission, though the fall in appendicitis-related attendances suggests that behavioural factors are also important. Larger studies are urgently needed to understand changing patterns of ED use and access to emergency care during the COVID-19 pandemic.
AU  - Honeyford,K
AU  - Coughlan,C
AU  - Nijman,R
AU  - Expert,P
AU  - Burcea,G
AU  - Maconochie,I
AU  - Kinderlerer,A
AU  - Cooke,G
AU  - Costelloe,C
DO  - 10.5811/westjem.2021.2.49614
EP  - 607
PY  - 2021///
SN  - 1936-900X
SP  - 603
TI  - Changes in emergency department activity and the first COVID-19 lockdown; a cross sectional study
T2  - Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health
UR  - http://dx.doi.org/10.5811/westjem.2021.2.49614
UR  - https://escholarship.org/uc/item/2s7818zq#main
UR  - http://hdl.handle.net/10044/1/86274
VL  - 22
ER  -
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