UCD Covid-19 Response

The UCD Community is rising to the challenge posed by the global pandemic

CUPID COVID-19: Paediatric emergency department attendance during Covid-19

Lead Researchers: Dr Emma NicholsonDr Therese McDonnellUCD School of Nursing, Midwifery and Health Systems

In collaboration with Professor Eilish McAuliffe, Dr Michael Barrett, Dr Conor Hensey, Professor Fergal Cummins

The Irish Medical Organisation (IMO) has expressed concern that measures introduced to delay the spread of Covid-19 may result in avoidance of emergency departments for non-Covid related illness. Evidence from previous epidemics found that hospital avoidance during outbreaks of MERS and SARS was common.

Moreover, the decrease in high-acuity attendances (present challenging medical conditions, often with significant, unpredictable needs) at the ED during the SARS outbreak in Toronto was 3-times greater than low-acuity, suggesting that access to healthcare for critically ill patients was seriously affected.


Evidence on paediatric patients at a mixed adult/paediatric hospital in South Korea found that, although attendance fell by 42.3 per cent during the MERS epidemic, visits for trauma and the rate of admissions increased.

While ED attendance returned to normal following SARS and MERS, both outbreaks lasted two to three months. As the Covid-19 pandemic is forecast to extend into 2021, little is known about the impact Covid-19 will have on paediatric attendance at EDs in Ireland as the pandemic evolves.

Dr Nicholson's project aims to reduce the disruption to normal paediatric ED services during the onset of Covid-19.

As the health of a child can deteriorate more rapidly than that of an adult, any delay in seeking care for an acutely ill child may have serious consequences. This research will assess the impact of the pandemic on the care-seeking behaviour of parents to identify how barriers to accessing care can be removed.

The provision of timely statistics on attendance at five EDs throughout the pandemic, supported by feedback from frontline staff, will inform the health service response to Covid-19. By leveraging the expertise available on an existing project, this information will help the Health Service Executive (HSE) and the Department of Health respond rapidly to meet the clinical needs of paediatric patients as the circumstances of the pandemic unfold.


In addition, as part of the CUPID COVID-19 study, a survey was conducted to explore parents’ experience of seeking healthcare for their children during the Covid-19 lockdown.This survey aims to understand how the health seeking behaviour of parents may have altered due to the pandemic and to identify how any barriers to accessing care can be removed. 


Dr Nicholson commented: "The demands of Covid-19 on the health system, coupled with people's reluctance to bring young kids to the Emergency Department, could impact care. CUPID COVID-19 will help identify the consequences of service changes and understand which patients are at high risk and what their needs are."


Read the paper 'Understanding the Impact of Public Health Advice on Paediatric Healthcare Use During COVID-19: A Cross-sectional Survey of Parents' in BMC Public Health.