Key Results
This service evaluation has demonstrated a significant reduction in
recurrent tonsillitis in our paediatric patients following the
introduction of Public Health measures designed to reduce the spread of
COVID-19 . We hypothesise that social distancing and repeated hand
washing will have led to reduced viral exposure in this population;
which could be the driving factor behind this reduction in recurrent
tonsillitis rates.
In addition to the reduced rate of tonsillitis during the lockdown
period, we have demonstrated that antibiotic demand for acute
tonsillitis was significantly less and presentations to hospital fell
during the lockdown period. The reduced frequency of tonsillitis and
public concern regarding hospital attendance during the COVID-19
outbreak may have contributed to these changes.
Household smoking has been linked to increased risk of developing
recurrent tonsillitis in adults(10). In our population
there was no difference in the number of episodes of tonsillitis per
year for children living in households with or without smokers. In the
paediatric population passive smoking may not be as irritative to the
mucosa of the upper airway as active smoking seen in adults.
It could be assumed that families’ with more children in the household
would have a higher risk of developing tonsillitis due to viral exposure
from their siblings during the lockdown period. Our results have shown
this is not the case and that the number of siblings in a household did
not increase the risk of developing tonsillitis during lockdown. The
lockdown family ‘bubble’ seems to have limited infection from external
sources so preventing transmission between siblings.
Despite the reduction in rates of recurrent tonsillitis all parents and
guardians wanted to proceed with tonsillectomy with the majority
preferring an operative date during the COVID-19 outbreak. This could be
as a result of the relatively short period of improvement that their
child has experienced when compared to the overall course of their
disease. The results show that those who wanted to postpone their
operation date until after the COVID-19 outbreak had significantly less
episodes of tonsillitis during the lockdown period than those who wanted
to proceed during the outbreak (figure 4). This likely explains the
differing parental decision.
We were unable to reduce the burden on our waiting list as a result of
this evaluation as all parents/guardians opted to proceed with the
tonsillectomy in spite of reduced episodes of recurrent tonsillitis and
the COVID19 pandemic.