THE Covid pandemic has had a “profoundly disruptive” impact on hospital-based care across NHS Scotland, researchers have warned.

They said the response to the crisis has “likely led to an adverse effect on non-Covid-19-related illnesses” and that the long-term impact on avoidable deaths and disease should be monitored.

A detailed analysis of the impact of the virus on patient numbers reveals that A&E attendance fell to 41 per cent below average between the World Health Organisation declaring a pandemic on March 11 and the announcement of a UK-wide lockdown on March 23.

Surgery on adults and children showed some of the biggest reductions during the first phase of the pandemic, up to the end of June

 

The same time period also saw emergency hospital admissions drop by 26% and a 61% plunge in planned hospital admissions for elective procedures.

READ MORE: As Scotland's life expectancy stalls - why does Ireland have the fastest growing in western Europe

In some cases, including adult and paediatric surgery, gynaecology, and cardiology, the number of planned procedures being carried out remained “very low” - at least 50% below normal - by the end of June, with “little evidence of a quick return” to the 2018-2019 average.

Emergency cancer and medical paediatric admissions also continued to lag below the two-year average.

Surgery on adults and children showed some of the biggest reductions during the first phase of the pandemic, up to the end of JuneChange in emergency admissions by department, January 5 to June 28 (Blue line = March 11 WHO declare pandemic; Purple line = March 23 lockdown)

The findings, published today in the journal of the Royal Society of Medicine, add to the evidence of the wider consequences of the virus for public health.

The authors write: “Covid-19 has had a profoundly disruptive impact on hospital-based care across National Health Service Scotland

“This has likely led to an adverse effect on non-Covid-19-related illnesses, increasing the possibility of potentially avoidable morbidity and mortality.”

Surgery on adults and children showed some of the biggest reductions during the first phase of the pandemic, up to the end of JuneChange in planned admissions by department over same 26-week period

The study, led by Edinburgh University and Public Health Scotland, is described as the “most inclusive investigation” to date into the impact of coronavirus on the uptake of hospital care in Scotland, covering the period from January 5 to June 28.

The researchers found that Covid-related admissions peaked at 1,272 in the week ending April 5, and represented 17% of all emergency hospital admissions in Scotland at that time.

READ MORE: Death toll figures 'underplay' cost of pandemic to public health, says medic

Non-Covid A&E attendances fell most dramatically - and have been slowest to recover - in the five to 14 age group.

The researchers said this could be explained by a “few potential reasons”.

They write: “Social distancing in children could have reduced the risk of non-Covid-19 infections and injuries, which are the most common reasons for emergency admissions in children.

“Other more speculative reasons could be the change in behaviour from parents, who may have avoided attending medical facilities to protect their children from the virus, or possible alternative routes set up by hospitals to avoid paediatric admissions.”

Surgery on adults and children showed some of the biggest reductions during the first phase of the pandemic, up to the end of JuneChanges in A&E attendance compared to 2018/2019 average, by age group

The researchers said “fear of contracting the virus or overwhelming the NHS” could explain the overall decline in A&E attendance, which remains around 16% lower than average, as well as a “lack of public awareness” that medical help should still be sought.

READ MORE: Why trying to 'shield the vulnerable' while the rest of us carry on is doomed to fail

They also point to Google mobility data showing a 63% reduction in movement during lockdown“suggesting reduced risks of accidents and other infections” which would bring people to hospital.

They noted that similar patterns occurred in England, while in France there has been a “major rise in deaths related to out-of-hospital cardiac arrests”.

In Italy the overall number of urgent surgical procedures performed “dropped substantially from February to March 2020” compared to 2019, and in Austria the number of hospital admissions for acute coronary syndrome “had significantly declined throughout the pandemic”.

READ MORE: Cancer referrals down by 22% during first wave of Covid 

The study concludes that Covid-19 led to “profound drops in A&E attendances, and emergency and planned hospital admissions across Scotland”.

“Our findings also raise important questions about the resilience of hospital services in NHS Scotland.

"There is now a need to investigate the impact of this disruption on preventable morbidity and mortality.”

They add that future analyses should also encompass GP consultations, use of out-of-hours, community, and “specialised care such as mental health services” during the pandemic.