Child Abuse in COVID-19 — Why ICU Admissions Rose as Cases Fell

Child abuse during COVID-19 pandemic: why ICU admissions rose as overall child maltreatment hospital admissions fell Unique CMAJ-based analysis of COVID-19 lockdown impact on child abuse, PICU admissions, and hidden maltreatment in infants Understand how pandemic effects on children changed abuse patterns and what it means for child protection during lockdowns and stay-at-home orders What You'll Learn: How a 31% decrease in Canadian hospital admissions for child maltreatment among children under 2 during the March–June 2020 lockdown can mask ongoing abuse Why admissions for child maltreatment rebounded to baseline from July–October 2020 while ICU admissions for maltreatment rose above baseline (rate ratio ≈1.3) What the 27% drop in Québec child-protection reports in spring 2020 reveals about hidden child abuse during the pandemic How COVID-19 stay-at-home orders changed who noticed and reported infant abuse and neglect—and who didn’t Ways clinicians and hospitals can interpret declining maltreatment admissions without assuming real decreases in abuse How to use hospital data, child-protection reports, and community signals together to detect pandemic-era child abuse patterns Implications of these findings for designing child protection strategies in future lockdowns and public health emergencies