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Utilisation of Children's Emergency Care Services During Epidemics and Pandemics: A Systematic Review

663 Figure 1[Figure omitted. See PDF] 663 Figure 2[Figure omitted. See PDF]ConclusionThis systematic review demonstrates that pandemics have significantly different impacts on paediatric emergency service utilisation depending on the epidemic/pandemic. Evidence from 80 papers that across the world demonstrates children’s attendances to Emergency Departments significantly fell during the COVID19 pandemic. The reasons for this are not entirely clear but are likely related to the public health response and parent/carer concern about the severity of the disease process.As public health messaging can impact on public behaviours, public health departments and related healthcare organisations must be aware how fear of viruses amongst the general public may influence their response to public health advice. There is inequality between low-middle and high income countries in reporting the impact of emergency service utilisation for children.