The Emergency Department acts as a gateway to the health and social care system for many children, while also providing critical care when other services are overburdened. As the COVID-19 pandemic progressed across the globe, changes in patterns of paediatric attendances at the ED indicated the pandemic was impacting children’s access to healthcare. A substantial reduction in paediatric emergency care utilization followed public health measures aimed at halting the spread of the virus, including school closures and restrictions on movement and social interactions. This has raised concerns regarding potential delays in seeking healthcare [1, 2], and increased rates of morbidity and mortality due to delayed presentations have been reported [3–5]. In Italy, paediatric presentations reduced by 73–88% compared to the previous two years [5], while in Ireland paediatric attendances fell by 46% between March and May 2020, compared to the same period in 2019 and 2018 [6]. Some studies have examined the scale of delayed presentations [7, 8], with one study finding that 32% of paediatricians working in EDs and Paediatric Assessment Units in Ireland and the UK observed delayed presentations during the initial phase of the pandemic [8]. Lower attendance rates have been attributed to reduced infectious diseases and injuries due to public health measures implemented. Furthermore, parental hesitancy to attend hospitals due to fear of COVID-19 and a misinterpretation of public health messaging may have also contributed to reduced presentations [9]…Readmore