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We are interested to read this paper highlighting changes in dog bite attendance during the COVID-19 pandemic at Alder Hey Hospital, particularly as our own experiences of dog bite attendances experiences for the Midlands tertiary paediatric referral centre during the COVID-19 pandemic has been different.
Liverpool and Birmingham have had similar overall numbers of Accident and Emergency (A&E) attendances over the last few years. Birmingham Children’s Hospital (BCH) had 5017 mean monthly attendances January 2016-March 2020 compared to 5035 mean monthly attendances over the same period at Alder Hey. At the start of the COVID-19 public health restrictions, a similar drop in A&E attendances was seen with 2236 A&E attendances in April 2020 at BCH, compared to 2056 A&E attendances in April 2020 at Alder Hey.
During July 2020, however, in contrast to the Liverpool experience, numbers of attendances to A&E with dog bites at BCH remained consistent with previous years (15 attendances in July 2020, compared to 15 in July 2019, 16 in July 2018, 14 in July 2017 and <5 in July 2016). We did see greater variability in other months, with higher levels of attendances with dog bites in May 2020 (12 attendances compared to <5 in 2019 and 2018, and 6 in 2017 and 2016), and in August 2020 (17 attendances compared to 13 in 2019, 12 in 2018, 9 in 2017 and 6 in 2016), but the overall impact was not significant.
The contrast be...
The contrast between our experiences may suggest different urban environments experienced the impact of COVID-19 public health restrictions on dog bites in children in different ways. We agree that the lack of sensitive data definitions adds complexity to monitoring these life changing injuries, and it is important that there is accurate and systematic capture of emergency department data at NHS Trusts to inform policy and practice. We also share your concern that strategies to prevent dog bites in at risk groups are important, particularly with increased dog ownership in the UK associated with the COVID-19 pandemic.
Dr Majel McGranahan, Public Health Specialty Registrar
Dr Chris Chiswell, Consultant in Public Health Medicine
Ms Andrea Jester, Consultant Surgeon
Birmingham Women’s and Children’s NHS Foundation Trust