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.