Pandemic brought ‘dramatic’ fall in English hospital admissions for childhood infections

Hospital admissions for common childhood infections in England dropped by as much as 94% during the first year of the Covid-19 pandemic, according to the first major study of its kind.

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Photograph: Andy Rain/EPA

Doctors have previously reported anecdotally how Covid measures such as lockdowns inadvertently led to children being better protected against other illnesses.


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Now a large study by the University of Oxford has revealed the sheer scale of the “dramatic” fall in hospital admissions for a whole range of non-Covid infections in the 12 months after March 2020.

Researchers found there were “substantial and sustained” reductions in admissions for common and severe childhood infections, most likely due to social distancing measures, school and workplace closures, and travel restrictions. Other measures such as enhanced cleaning, better hand hygiene, and the use of face masks may have also contributed to the reduction.

Altogether, tens of thousands fewer children were admitted for bronchiolitis, meningitis, flu, tonsillitis and pneumonia and other conditions as England went into lockdown, schools closed and children’s social contacts significantly reduced. The findings were published in The BMJ.

Some children with pre-existing conditions such as asthma were also “protected from severe and potentially life-threatening infection”, the study found. Before the pandemic, exacerbation of asthma caused by acute respiratory infections was one of the most common reasons for hospital admission in children.

Related: Rise in non-Covid virus that can leave children struggling to breathe

Many of the measures seen in the first year of Covid in England are unsustainable outside the pandemic, the researchers acknowledged. Such measures have also significantly had an effect on other areas of health, such as mental health. However, the researchers said the huge fall in admissions meant there should be a further evaluation of interventions that could be continued, especially during winter months, to minimise the burden on health systems and protect vulnerable children.

It was previously known that child immunisation programmes globally have been disrupted since the onset of the pandemic owing to barriers in accessing or administering vaccines. Data from lab surveillance studies indicated worldwide reductions in some childhood infections.

In the new study, researchers found that 12 months after the onset of the pandemic, large and sustained reductions were found in rates of hospital admissions for “a wide range of severe, respiratory, and vaccine preventable childhood infections” in England. Absolute numbers of deaths within 60 days of hospital admission for sepsis, meningitis, bronchiolitis, pneumonia, viral wheeze and upper respiratory tract infections also decreased.

The researchers examined hospital admissions for children up to the age of 14 for common and severe childhood infections in England between March 2017 and the end of June 2021.

They examined information on admissions for common respiratory infections including tonsillitis, influenza and bronchiolitis, severe invasive infections including sepsis, meningitis and a bone infection called osteomyelitis. The team also looked at admissions data for vaccine preventable diseases included measles, mumps and several bacterial causes of serious illnesses.

Researchers found “substantial and sustained” reductions in hospital admissions were found for all but one – kidney infections – of the 19 conditions studied.

The largest fall in admissions was for flu, with a 94% reduction in admissions from an average of 5,379 each year before the pandemic to 304 in 2020/21. For bronchiolitis, admissions decreased by more than 80% from an average of 51,655 to 9,423 in 2020/21. Tonsillitis admissions fell by 66% from more than 54,000 each year before the pandemic to just over 18,000. Meningitis admissions dropped by almost 50% from an average of 3,917 before the pandemic to 1,964 in 2020/21.

“This study has shown dramatic overall reductions in hospital admissions for respiratory, severe invasive, and vaccine preventable infections in children during the Covid-19 pandemic in England,” the researchers wrote in The BMJ. “Children with potentially life threatening co-morbidities were also substantially protected.

“Further evaluation of non-pharmacological interventions that could be sustained beyond the pandemic is required to inform policymakers about potential strategies, especially during winter months, to minimise the burden on health systems and protect vulnerable children. Continued monitoring of hospital admissions for these infections is required as social restrictions evolve.”

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