It’s Monday morning and I’m running my regular children’s sleep clinic. Except it’s not a Monday morning like any other I have had in my 20 years of practice. I am running the clinic on my laptop, seeing patients and their families on a video screen rather than in person, in an eerily quiet children’s outpatient department.
After two months of COVID-19 lockdown and working “all hands on deck” to deal with the pandemic surge, I am allowed to resume my outpatient work. One thing that strikes me in this clinic is another new phenomenon. Parents are reporting that their child’s symptoms have dramatically improved over the last few weeks.
Most of the children I see in my clinic have obstructive sleep apnoea, a condition that leads to a disturbed night’s sleep due to the repeated blocking of the upper airways (apnoeas). This leads to daytime symptoms such as tiredness, behavioural issues and poor concentration. Left untreated, these children may not reach their full academic potential and may go on to develop heart failure in later life.
We often see symptoms improving gradually as children get older, but families were reporting a near-resolution of symptoms over just a few weeks. To my amazement, this trend has continued from lockdown into the period of social distancing we are currently facing.
This has led me to reflect on how unexpectedly quiet our paediatric wards have been since the start of the COVID-19 pandemic. The vast majority of children with SARS-CoV-2 (the virus that causes COVID-19) have very mild symptoms and are not admitted to hospital. But what about all the other acute conditions that normally fill our wards at this time of year, such as asthma?
We usually see a surge in children with acute allergic asthma attacks during the period of May-June, which corresponds to the peak tree-pollen counts [in the UK] . But we have barely seen any cases in this period.