Table 1

Recommendations for paediatric surgery during the COVID-19 pandemic based on the domains identified including justification

DomainRecommendationsJustification
Surgical rationing

  • Consider continuing surgery for paediatric malignancies.

  • Consider adding waiting list length to inform surgical rationing in addition to urgency classifications.

To minimise a precipitous drop in surgical volumes that the service may not recover from
Surgical provision

  • Consider surgical approaches that minimise length of hospital stay.

To minimise the chance of nosocomial spread
HCW welfare

  • HCW life insurance cover in the event of death or incapacitation.19

  • Psychological support.13

  • Frequent personal protective equipment training and retraining.

To protect HCWs
Guardian policy

  • Designate a ‘resident/in-hospital guardian’ who lives on hospital grounds and is isolated from outside visitors.

  • Limit in-hospital guardians to one person to prevent overcrowding.

  • Hand hygiene for in-hospital guardians.49

To facilitate social distancing and minimise the chance of nosocomial spread
Visitor policy

  • Restrict all non-essential visitors.49

  • Restrict visitors for suspected or confirmed cases.49

  • Restrict visitation by any ill individual or family member.49

To reduce the number of vectors and minimise the chance of nosocomial spread
Child protection

  • Designate areas separate from general wards for children who may require protection during the pandemic.

  • Strengthen social service structures during pandemics.

To protect children
Training

  • Training programmes to introduce virtual didactics.

  • Consider altering trainee minimum requirements in light of declines in surgical volume and learning time.

  • Increased collaborative learning between training programmes across borders.

To minimise the disruption to paediatric surgery workforce growth
To strengthen surgical training programs

  • HCW, healthcare worker.