Davide Pata1, Antonio Gatto2, Danilo Buonsenso2,3, Antonio Chiaretti1,2. 1. Istituto di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy. 2. Dipartimento Scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. 3. Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
We thank Paolo Manzoni et al for their reflections
on our report.We agree that the COVID‐19 epidemic has changed the use of the Pediatric Emergency Room, and the access to healthcare facilities in general.The data described by the authors confirm our report: the epidemic led to a reduction in Pediatric Emergency Room access.The causes of this phenomenon are different. Certainly, thanks to social distancing, the lockdown and the closure of schools led to a reduction in the number of paediatric infectious diseases.
Instead, the prohibition of movements reduced the amount of road accidents. However, we believe that the most important cause of the drop in hospital visits is the fear of contagion. Due to the apprehension of contracting COVID‐19, parents avoid conducting their children in the emergency room.Several experts and scientific societies had already highlighted how this attitude can lead to a diagnostic and therapeutic delay of serious pathologies.In our article, we found a decrease in the number of important diseases; however, we highlighted that especially non‐serious pathologies, treatable by a family paediatrician, and access for visits and programmable specialist examinations decreased. In the period examined by our manuscript, the drop in urgent diseases (‘yellow codes’) was 36.3%, while that of non‐urgent diseases (‘green codes’) was 79.5%.We believe that one of the lessons of this outbreak was the optimisation of available resources:healthcare consumerism must be avoided. This aspect did not previously highlighted in the literature.However, we specify that in the presence of serious diseases, patients should not hesitate: it is necessary to go to the emergency room.Every tool must be activated to sensitise and inform parents, pushing them to overcome all fears, immediately contacting emergency services.We agree with the conclusions of Manzoni P et al on the need to continue monitoring the situation, to avoid creating collateral damage from COVID‐19. The risk is that people, even if they have not been directly affected by COVID‐19, may see their health deteriorating due to the lack of treatment.