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Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
Hatem O Abdallah1, Cindy Zhao1, Elinore Kaufman2
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Journal of the American College of Surgeons
|November 9, 2020
Summary
During COVID-19 lockdowns, intentional injuries, particularly gun violence, significantly increased. Non-intentional trauma and emergency department visits decreased, highlighting a need for targeted injury prevention strategies.
Area of Science:
- Public Health
- Trauma Surgery
- Epidemiology
Background:
- Public health measures implemented during the COVID-19 pandemic led to a decrease in overall emergency department visits.
- The impact of these measures, including lockdowns and social distancing, on injury patterns, particularly intentional injuries, remained unclear.
Purpose of the Study:
- To investigate the hypothesis that intentional injuries increased during the COVID-19 pandemic.
- To determine if this increase was primarily driven by penetrating trauma.
Main Methods:
- A retrospective review of adult trauma patients at an urban Level I trauma center was conducted.
- Injury patterns were compared between the periods before and after statewide stay-at-home orders, as well as with historical data from 2015-2019.
- Statistical analyses, including Fisher exact and Wilcoxon tests, were used to compare patient characteristics, diagnoses, and injury mechanisms (blunt vs. penetrating, intentional vs. non-intentional).
Main Results:
- A total of 357 trauma patients presented before and 480 after the stay-at-home order, with significant differences in sex, age, and race between the groups.
- The period following stay-at-home orders showed a significant increase in intentional injuries (p=0.0008).
- Compared to previous years, 2020 saw a greater proportion of intentional violent injuries, especially firearm-related incidents, during the peripandemic months.
Conclusions:
- Social isolation policies during COVID-19 were associated with a rise in intentional injuries, notably gun violence.
- Concurrently, emergency department visits for non-intentional trauma declined.
- Public health strategies during pandemics should incorporate measures for the prevention and management of intentional injuries.