Introduction:  The impact of the COVID 19 crisis can be felt throughout all facets of society but the impact is felt most greatly in the healthcare community. Caring for increasing number of patients stricken with the SARS-CoV2-2 virus has placed a significant strain on available manpower and healthcare resources. Most medical centers in large cities had to scale back normal operations to include: outpatient services, routine admissions and elective surgery to accommodate influx of patients infected with COVID 19. The state of North Carolina extended a stay-at-home executive order on April 24, 2020 which mandated school closures which resulted in all schools in the state being closed since March 10, 2020. We wanted to examine the impact of school closures on admission rates of school age children and compare it with summer recess period of the previous year.

Methods: We queried our local burn registry for all patients ages 6-17 years of age that were admitted to the burn center between March 10th to May 22nd of 2020. All diagnosis were included in this investigation. We compared this cohort to identical cohort admitted between June 12th and August 25 of 2019 (summer recess). Other variables that were examined were sex and race/ethnicity. Statistical analysis was performed by using χ2 test. Significance was accepted as p<0.05.  The study was approved by our institutional review board.

Results:  The burn center admitted 89 pediatric patients between March 10th and May 20th of 2020, roughly one-quarter of total burn center admission. School age children comprised 36% (32patients) of pediatric admissions. Between June 12th and August 25th of 2019 the burn center admitted 84 pediatric patients with 42% (35 patients) that were school aged children. There was no statistical difference in race, sex, burn etiology or type of insurance. None of the patients tested positive for COVID 19 during their hospitalization.

Discussion: The closure of schools extended through the spring recess into the end of the school year. The impact of this was significant and had financial, psycho-social and educational implications we won’t fully realize for years to come. The period of the school closure was similar to the summer recess for most counties in the state. It is during this time the burn center is most active and admission rates, especially in school age children, increase significantly. The admission rates during the school closure was comparable to that of the summer recess of 2019. Also, this likely contributed to steady activity of the burn center as compared to other services within the institution.

Conclusion: The shelter-in-place executive order and subsequent school closures had a profound effect on our community and communities around the country. School age children are a vulnerable population and efforts geared at outreach and preventive medicine should continue to be directed them and their families even during a pandemic.

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References and Resources 

1. Forrester JD, Liou R, Knowlton LM, Jou RM, Spain DA. Impact of shelter-in-place order for COVID-19 on trauma activations: Santa Clara County, California, March 2020. Trauma Surg Acute Care Open 2020;5:e000505.
2. Williams FN, Sljivic S, Chrisco L, Nizamani R, Cairns BA, Jones SW. Acuity Is Seasonal in a Tertiary Care Burn Center. J Burn Care Res 2020;41:359-62.