Statement on healthcare system preparedness in response to COVID-19 Omicron subvariants BA.4 and BA.5 surge in Korea from the Korean Pediatric Society and Korean Society of Pediatric Infectious Diseases

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Clin Exp Pediatr. 2022;65(11):510-511

Publication date (electronic) : 2022 September 23

doi : https://doi.org/10.3345/cep.2022.01088

Eun Young Cho, MD¹, Dong Hyun Kim, MD², Soo-Han Choi, MD, PhD³, Ki Wook Yun, MD, PhD⁴, Jong Gyun Ahn, MD, PhD⁵, Hye-Kyung Cho, MD, PhD⁶, Hyunju Lee, MD, PhD⁴, Jina Lee, MD, PhD⁷, Taek-Jin Lee, MD, PhD⁸, Byung-Wook Eun, MD, PhD⁹, Jin Lee, MD, PhD¹⁰, Dae Sun Jo, MD, PhD¹¹, Yun-Kyung Kim, MD, PhD¹², Yae-Jean Kim, MD, PhD^,13, Committee on Infectious Diseases of the Korean Pediatric Society

¹Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea

²Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea

³Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea

⁴Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

⁵Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea

⁶Department of Pediatrics, Ewha Womans University Mokdong Hospital, Seoul, Korea

⁷Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

⁸Department of Pediatrics, CHA University School of Medicine, Pocheon, Korea

⁹Department of Pediatrics, School of Medicine, Eulji University, Daejeon, Korea

¹⁰Department of Pediatrics, The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, Korea

¹¹Department of Pediatrics, Jeonbuk National University Medical School, Jeonju, Korea

¹²Department of Pediatrics, Korea University College of Medicine, Seoul, Korea

¹³Department of Pediatrics, Samsung Medical Center, Sungkyunkwan Universtiy School of Medicine, Seoul, Korea

Corresponding author: Yae-Jean Kim, MD, PhD. Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Email: yaejeankim@skku.edu

Received 2022 August 31; Revised 2022 August 31; Accepted 2022 September 17.

1. We request a more proactive response to the surge in confirmed pediatric COVID-19 cases

Although most children and adolescents have a mild disease course, severe infections or complications may occur among those with underlying diseases. In addition, as the number of confirmed cases increases, various manifestations of COVID-19 infection, including croup, bronchiolitis, and febrile convulsions, are expected to occur among previously healthy children and adolescents. Severe cases such as myocarditis and encephalitis are also expected to occur. Therefore, the health authority must reassess the medical system in response to rapidly increasing pediatric COVID-19 cases. To accomplish this, we must establish a collaborative system among pediatricians, pediatric infectious disease specialists, and health authorities that develops effective and proactive policies based on the understanding of the rapidly changing daily healthcare situations of the pediatric population with COVID-19.

2. Healthcare facilities and professional staff for pediatric COVID-19 cases should be secured

The medical needs of pediatric patients differ from those of adults. Children often do not express their symptoms clearly, most require a guardian when hospitalized, and many have high nursing needs. The current medical situation is challenging, especially in tertiary hospitals, operating rooms, intensive care units, and emergency medical services, due to the shortage of on-call pediatricians. Therefore, policy support from the healthcare authorities should be provided for preparing professional medical personnel to treat serious pediatric COVID-19 patients. A systematic approach and prompt countermeasures should be applied to establish an appropriate healthcare system for pediatric COVID-19 patients.

3. Adequate home and outpatient care should be provided for pediatric COVID-19 patients, and patient referral and emergency care systems should operate properly

Pediatric COVID-19 patients often require medical care during the isolation periods. Despite the efforts of health authorities, the system requires improvement.

One-stop COVID-19 care should also be available for pediatric patients. Accordingly, health policies such as health insurance cost support and compensation should be improved to encourage primary care pediatricians to actively provide COVID-19 patient care. Moreover, local infrastructure and medical staff should be secured when blood tests, chest radiography, or fluid therapy are required for pediatric patients. Above all, national coordination and support systems are required to enable the referral of pediatric patients with severe or critical status to emergency rooms or secondary or tertiary care centers to ensure appropriate and timely care.

4. General and essential non-COVID-19–related care should be appropriately provided without delay

The importance of preventing the spread of COVID-19 cannot be overemphasized. However, the delivery of essential medical care such as delivery, emergency surgery, and other illnesses should not be delayed, and long-distance patient transportation resulting from isolation issues should be avoided.

In addition, national support and efforts are required to ensure that general and essential medical care related to the health of children and adolescents can be maintained appropriately despite the surge in COVID-19 patients.

In response to the Omicron subvariant epidemic, we request that the medical system be reassessed to secure the healthcare system for the pediatric population.

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