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COVID-19 and Pediatric Anesthesia
The COVID-19 pandemic has quickly become the primary clinical focus of physicians and health care systems around the world. The rapid onset and spread of the virus and the equally rapid depletion of clinical and material resources needed to effectively deal with a global medical crisis that is unprecedented in the modern era threatens every medical institution. Since the majority of morbidity and mortality has been seen in adults, there is at this time a paucity of information about pediatric cases, and how pediatric clinicians and health systems are preparing and managing the rapidly changing situation. Even less information is available about what our specialty and its health care environment is doing to cope and plan. Because airway management creates such a high risk of transmission the impact of the pandemic on perioperative processes and resources is immense and is fraught with many unknowns. Furthermore, the clinical and resource interface between anesthesia and critical care imposes sudden and severe restraints on operating room and anesthetic capacities, demanding that resources be available for an expected influx of critically ill patients with respiratory failure. It is important that pediatric anesthesiologists be involved in these discussions and plans, and in order to do so in a meaningful manner, effective communication between pediatric anesthesiologists around the world can promote sharing of experience. It has become apparent that developing a clearing house and common information center for the pandemic that is specific to pediatric anesthesia would be of help to clinicians seeking information from both experience and looking for what has been published to date that is pertinent to our practice.
The editors of Pediatric Anesthesia have decided to rapidly publish this resource online in order to help facilitate this goal. It must be noted at the outset that the pandemic is a fluid and evolving, and some of what will be found here might be superseded- or even obsolete- just hours after its writing. It also must be stated that we do not intend to promulgate guidelines for care or systems management. There is simply a lack of evidence at this time to do so with any degree of confidence. Rather, we envision this as a way of sharing information about what others have done- the steps, and missteps, that they have taken, and to provide links to the data that has been developed thus far and to the data and recommendations generated by national societies and public health entities. Some of what is here is anecdotal, but by gathering the experience of those whose countries are deeper in the crisis we hope that those locations not yet as hard hit may gain some insight as to how to proceed.
SPA, SPANZA, APA, ESPA and Pediatric Anesthesia are working together to get streamlined information readily available for everyone. Since information is changing very fast, we have decided to use weblinks. A general overview is hosted on the SPA website which will be the focus of any updates: https://www.pedsanesthesia.org/covid-19-resources/
LitCOVID is a curated database with recent COVID manuscripts https://www.ncbi.nlm.nih.gov/research/coronavirus/docsum?filters=topics.Treatment
Below are the links to country specific information. We are still in the process of gathering information for more countries and will add them continuously.
Please take care and stay safe
Britta von Ungern-Sternberg and David Polaner for the editors of Pediatric Anesthesia
WHO https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
Our World in Data https://ourworldindata.org/coronavirus-data
Pedanesthesia Net https://www.pedsanesthesia.net/
Australia / New Zealand
Coronavirus in Australia – case numbers https://www.covid19data.com.au/
Department of Health Australia https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert
Department of Health NZ https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus
ANZCA (College of Anaesthetists) daily updates http://www.anzca.edu.au/front-page-news/covid-19-impact-on-anzca
ANZICS (College of Intensivists) https://www.anzics.com.au/coronavirus/
Europe
ESA-homepage https://www.esahq.org/coronavirus-covid-19/
European Society of Intensive Care Medicine and the Society of Critical Care Medicine
Surviving Sepsis Campaign COVID guidelines https://d311i5pe49swog.cloudfront.net/web-assets/spanza/assets/uploads/2020/03/24105913/SSC-COVID19-GUIDELINES.pdf
Germany
RKI-Übersicht https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/nCoV.html
Dashboard Deutschland https://experience.arcgis.com/experience/478220a4c454480e823b17327b2bf1d4
Switzerland
Institut für Intensivmedizin (in English)
http://www.intensivmedizin.usz.ch/fachwissen/seiten/covid-19-epidemics.aspx
Netherlands
Ministry of Health, Welfare and Sport https://www.government.nl/ministries/ministry-of-health-welfare-and-sport/contact
Bureau of Statistics: CBS https://www.cbs.nl/en-g ; [email protected]
Dutch Society of Anesthesiology https://www.anesthesiologie.nl/ ; [email protected]
RIVM (National Institute for Public Health and the Environment https://www.rivm.nl/en
UK
Association of Anaesthetists https://anaesthetists.org/Home/Resources-publications/COVID-19-guidance
Gov.uk https://www.gov.uk/government/collections/wuhan-novel-coronavirus
Faculty of Intensive Care https://icmanaesthesiacovid-19.org/clinical-guidance
Italy
Italian epidemiological data on a daily basis by the ISS (Superior Institute of Heath) and Civil Protection https://www.epicentro.iss.it/coronavirus/ and
http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1
Italian Society of Anesthesia and Intensive Care (SIAARTI) protocols endorsed by ESA, available in ENGLISH: http://www.siaarti.it/News/COVID19%20-%20documenti%20SIAARTI.aspx
Norway
Norwegian Institute of Public Health (norwegian and English) www.fhi.no
Norwegian Society of Anaesthesiology (Norwegian). www.nafweb.no
Norwegian Government (different languages). www.regjeringen.no
Statistics Norway (Norwegian, English) www.ssb.no
The Scandinavian Society of Anaesthesiology and Intensive Care Medicine (English)
Sweden
The Public Health Agency of Sweden www.folkhalsomyndigheten.se
The Swedish Civil Contingencies Agency (issues contingency plans on a national level, provides information and advice for the public and other agencies) www.krisinformation.se/en
The Swedish Board of Health and Welfare (issues strategic plans for various scenarios and settings in hospitals). www.socialstyrelsen.se/en/
The Swedish Association for Anaesthesia and Intensive Care (only links to government and international sites). www.sfai.se
Statistics Sweden (government statistics agency). www.scb.se
Denmark
Danish National Board of Health https://www.sst.dk/da/corona/tal-og-overvaagning
In English www.sst.dk/en/English<http://www.sst.dk/en/English
Greece
The National Organization of Public Health (EODY) https://eody.gov.gr/
The Hellenic Society of Anesthesiology https://anaesthesiology.gr/pages/gr.php
France
COVID 19 – Fiches pratiques https://covid.com-scape.fr/
SFAR COVID 19. sfar.org/covid-19/
SRLF srlf.org/recommandations-dexperts-sars-cov2/
Ministère des Solidatrés et de la Santé. https://solidarites-sante.gouv.fr/
Ile De France COVID 19. http://www.iledefrance.ars.sante.fr/
Belgium
Belgian guidelines https://www.sarb.be/site/assets/files/1/sarb_communication_covid19_version19032020_3.pdf
US/ Canada
USA
SPA website. https://www.pedsanesthesia.org/covid-19-resources/
Johns Hopkins Coronavirus Resource Center (best site) https://coronavirus.jhu.edu/map.html
Washington State coronavirus information site https://www.coronavirus.wa.gov/
CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html
ASA statement on surgical decision making and triage: https://www.asahq.org/about-asa/newsroom/news-releases/2020/03/joint-statement-recommending-a-surgical-review-committee-for-covid-19-related-surgical-triage-decision-making
ASA home page: https://www.asahq.org
American Academy of Pediatrics: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/
https://covid19.healthdata.org/projections
Canada
Canada wide COVID-19 cases
Government of Canada. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/epidemiological-summary-covid-19-cases.html
Canadian Anesthesia Society. https://www.cas.ca/en/practice-resources/news/cas-articles/2020/coronavirus-tips-and-guidelines
Canadian Pediatric Anesthesia Society (webinars available on the website). https://www.pediatricanesthesia.ca
University of Toronto. https://www.anesthesia.utoronto.ca/node/1025
India
COVID India http://www.covid19india.org/
Africa
South Africa
Department of Health. www.health.gov.za
SASA: https://www.sasaweb.com/
National Institute for Communicable Diseases
http://www.nicd.ac.za/
Recommendations of anaesthesia and surgery for surgery for elective procedures 25th March 2020 click here
Tips to avoid bringing COVID home https://sasaapi.sasaweb.com/Newsletters/Document/Don'tBringCovidHome_637207544241849211.jpg
China
Chinese Society of Anesthesiology on the protocol/guideline for pediatric anesthesia in patients with confirmed or suspected COVID-19 http://www.csahq.cn/guide/detail_1048.html
The CSA also published a long list of guidelines in various scenarios, also they have published their experience in the Anesthesiology online first section (https://anesthesiology.pubs.asahq.org/onlinefirst.aspx)
Israel
COVID 19 Information(available in Hebrew, English, Russian, Arabic, Amharic; epidemiological maps are labelled only in Hebrew). https://govextra.gov.il/ministry-of-health/corona/corona-virus/ David