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Lookup NU author(s): Professor Sophie Hambleton
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© 2020 American Academy of Allergy, Asthma & ImmunologyBackground: 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.
Author(s): Krishna MT, Beck S, Gribbin N, Nasser S, Turner PJ, Hambleton S, Sargur R, Whyte A, Bethune C
Publication type: Article
Publication status: Published
Journal: Journal of Allergy and Clinical Immunology: In Practice
Year: 2021
Volume: 9
Issue: 2
Pages: 709-722.e2
Print publication date: 01/02/2021
Online publication date: 30/11/2020
Acceptance date: 14/11/2020
ISSN (print): 2213-2198
Publisher: American Academy of Allergy, Asthma and Immunology
URL: https://doi.org/10.1016/j.jaip.2020.11.038
DOI: 10.1016/j.jaip.2020.11.038
PubMed id: 33271350
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