TY - JOUR
T1 - The Impact of COVID-19 Pandemic on Adult and Pediatric Allergy & Immunology Services in the UK National Health Service
AU - Krishna, Mamidipudi Thirumala
AU - Beck, Sarah
AU - Gribbin, Nathan
AU - Nasser, Shuaib
AU - Turner, Paul J.
AU - Hambleton, Sophie
AU - Sargur, Ravishankar
AU - Whyte, Andrew
AU - Bethune, Claire
N1 - Publisher Copyright:
© 2020 American Academy of Allergy, Asthma & Immunology
PY - 2021/2
Y1 - 2021/2
N2 - Background: The coronavirus disease 2019 pandemic imposed multiple restrictions on health care services. Objective: To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the United Kingdom. Methods: A national survey of all A&I services registered with the Royal College of Physicians and/or the British Society for Allergy and Clinical Immunology was carried out. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments, and research activity. Weeks commencing February 3, 2020 (pre–coronavirus disease), April 6, 2020, and May 8, 2020, were used as reference points for the data set. Results: A total of 99 services participated. There was a reduction in nursing, medical, administrative, and allied health professional staff during the pandemic; 86% and 92% of A&I services continued to accept nonurgent and urgent referrals, respectively, during the pandemic. There were changes in immunoglobulin dose and infusion regimen in 67% and 14% of adult and pediatric services, respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, P ≤.0001) reduction in the following: face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing, and hospital procedures (food challenges, immunoglobulin and omalizumab administration); and a significant increase (P ≤.0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious. Conclusions: The pandemic had a significant impact on A&I services, leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long-term to achieve equitable, safe, and standardized health care.
AB - Background: The coronavirus disease 2019 pandemic imposed multiple restrictions on health care services. Objective: To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the United Kingdom. Methods: A national survey of all A&I services registered with the Royal College of Physicians and/or the British Society for Allergy and Clinical Immunology was carried out. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments, and research activity. Weeks commencing February 3, 2020 (pre–coronavirus disease), April 6, 2020, and May 8, 2020, were used as reference points for the data set. Results: A total of 99 services participated. There was a reduction in nursing, medical, administrative, and allied health professional staff during the pandemic; 86% and 92% of A&I services continued to accept nonurgent and urgent referrals, respectively, during the pandemic. There were changes in immunoglobulin dose and infusion regimen in 67% and 14% of adult and pediatric services, respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, P ≤.0001) reduction in the following: face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing, and hospital procedures (food challenges, immunoglobulin and omalizumab administration); and a significant increase (P ≤.0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious. Conclusions: The pandemic had a significant impact on A&I services, leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long-term to achieve equitable, safe, and standardized health care.
KW - Allergy
KW - COVID-19
KW - Immunodeficiency
KW - Immunology
KW - Impact
KW - Service
UR - http://www.scopus.com/inward/record.url?scp=85098632041&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2020.11.038
DO - 10.1016/j.jaip.2020.11.038
M3 - Article
C2 - 33271350
AN - SCOPUS:85098632041
SN - 2213-2198
VL - 9
SP - 709-722.e2
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 2
ER -
