Experiences of a Child Abuse Program in the Time of COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has changed the medical landscape, and the field of child abuse pediatrics has not been exempt from the reach of this disease. Previous widespread disease outbreaks and natural disasters have been associated with increased violence toward women and children,¹ and child abuse programs noted increased rates of abusive head trauma during the 2007–2009 recession.² The COVID-19 pandemic has led to increases in similar risk factors for child maltreatment, including employment instability, financial strain, reduced child care, and fewer available support structures.^3–6 Marginalized populations (eg, those in child protection systems, who already experience preexisting disparities) may be at particular risk because of widening inequalities with the pandemic.⁷

Child abuse programs across North America have reported variable impacts of the COVID-19 pandemic, including changes to incoming referrals and modifications to clinical and educational activities. These impacts have yet to be described in the medical literature and are crucial to understand as child abuse clinicians and pediatric hospitalists adapt to the current context. In this commentary, we describe the impacts of the pandemic experienced by 1 interdisciplinary child abuse program practicing in a 300-bed tertiary care academic pediatric urban hospital in North America. This will include a discussion of necessary adjustments made by the program related to clinical practice, team functioning, clinician wellness, and medical education.