COVID-19 has resulted in a flurry of high-stakes decision-making, at a public health level and an individual patient level, with significant impacts on how children are cared for, and how staff work. Many of these decisions have ethical dimensions.
Blood-clotting complications are rapidly emerging as a significant part of the pathogenesis of COVID-19. There are reports of otherwise well people with COVID-10 having strokes, pulmonary emboli and heart attacks, and children with inflammation of their blood vessels. In recent weeks series of cases of a multi-system inflammatory condition, some resembling Kawasaki disease, have been reported in children in Europe, UK and USA.
COVID-19 is almost always a mild disease in children. Adults are much more likely to become very unwell or die than children. Why is this so?
Data from around the world consistently shows that COVID-19 is essentially a mild disease in children. However, the indirect effects of COVID-19 may have a more profound effect than the direct effects of the infection.
We will hear from 3 speakers on the global and clinical aspects, and the broader social, education and wellbeing impact of COVID-19 on children.
Spleen Australia was established as the Spleen registry in 2003 by Denis Spelman and Penny Jones, from the Alfred Hospital. It is a registry and clinical service for people of all ages who do not have a functioning spleen, and aims to reduce the incidence of overwhelming sepsis.
Electroencephalography (EEG) has a long history at The Royal Children’s Hospital. From its beginnings in the pre-imaging era as simple paper recordings of brain waves in children with various neurological disorders, EEG has evolved to a specialised discipline within neurophysiology, drawing on the many advances in clinical neurology, computerisation and neuroimaging.
Under the leadership of Paul F. Levy, the Beth Israel Deaconess Medical Center in Boston engaged in a program to eliminate preventable harm to patients, with a remarkable level of transparency to the public about the hospital’s progress towards that goal.
The question of long-term ventilation for children with progressive conditions, such as muscular dystrophy or metabolic disease, is one of the enduring puzzles in paediatric ethics. Is it ethical to put a child on invasive mechanical ventilation when they will never be able breathe again on their own, and will inevitably die from their condition?
Several Grand Rounds in 2020, the 150th year of the Children’s Hospital, will highlight the development of services, some looking back and looking forward. This opening Grand Round will review the innovations in diabetes, adolescent health, and links between the hospital and the community. Dr John Court was a paediatrician who had a key role in service development at The Royal Children’s Hospital from the late 1950’s to the 1990’s including research and clinical care.
Today, 80% of children treated for cancer will survive. However, a significant proportion of survivors are at risk of infertility, due to toxicity of their treatment. The Royal Children’s Hospital is a leader worldwide in promoting discussion of fertility issues at the time of treatment, and offering options that might be able to preserve fertility for the future.
