COVID-19 Lockdowns Linked to Initial Drop in Child Maltreatment Hospitalizations, Followed by ICU Admission Increase

Hospital admissions for child maltreatment among children under two years of age in Canada decreased significantly during the initial 16-week lockdown period of the COVID-19 pandemic, but rates rebounded and intensive care unit (ICU) admissions subsequently rose, according to a pan-Canadian study published this month.

Researchers analyzed health data from April 3, 2016, to March 25, 2023, examining hospital admissions for maltreatment across all Canadian provinces and territories. The study, which involved an analysis of 1,518 hospital admissions, revealed a 31% reduction in hospital admissions for maltreatment during the first 16 weeks of the pandemic. This reduction is reflected in an adjusted rate ratio of 0.69, with a 95% confidence interval ranging from 0.58 to 0.83.

The decline in hospitalizations was even more pronounced for ICU admissions, with a 56% reduction observed during the same period. The adjusted rate ratio for ICU admissions was 0.44, with a 95% confidence interval between 0.25 and 0.78. However, the study found that while hospital admission rates returned to pre-pandemic levels after the initial lockdown phase, ICU admission rates increased significantly. Following the period of restricted healthcare access, ICU admissions demonstrated an adjusted rate ratio of 1.80, with a 95% confidence interval from 1.23 to 2.63.

The findings suggest that public health measures implemented during the pandemic, including lockdowns and restricted healthcare access, initially led to a decrease in the detection of child maltreatment. Researchers hypothesize that this decrease may be due to reduced opportunities for detection, as children were less visible to mandated reporters such as teachers and healthcare providers due to school closures and limited medical appointments.

The subsequent increase in ICU admissions, however, raises concerns about the potential for more severe cases of child maltreatment going undetected for longer periods. This could result in delayed intervention and increased medical complications, necessitating intensive care. The Offord Centre for Child Studies spearheaded efforts to provide researchers with data to study the health and well-being of children and youth in Canada before and after the pandemic, with a $3.1-million grant from the Canadian Institutes of Health Research supporting the longitudinal study.

Experts note that the long-term effects of the pandemic on children are still unfolding, with reports of lags in math and literacy performance, as well as social and emotional health challenges. A recent report from CBC News indicated that parents are increasingly seeking tutoring and support for their children to address learning deficits stemming from pandemic-related disruptions.

The study’s authors emphasize the need for increased attention to the identification and treatment of child maltreatment in future pandemic settings, highlighting the importance of proactive measures to ensure the safety and well-being of vulnerable children. Further research is planned to investigate the factors contributing to the increase in ICU admissions and to develop strategies for early detection and intervention.