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It must be noted at the outset that the pandemic is a fluid and evolving, and some of what will be found here might be superseded- or even obsolete- just hours after its writing.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)

www.ssai.info            

 

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

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html?topic=tilelink

 

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