Objective The World Health Organization declared COVID-19 a pandemic on 11th March 2020. The UK government introduced strict social distancing measures on 23rd March 2020, with the country put into a full lockdown to further halt the spread of the virus. The aims of this article are to ascertain whether there was a rise in the incidence of deliberate self-harm (DSH) presentations to the emergency department at a level one trauma center associated with the introduction of lockdown measures. Method An observational study from a level one trauma center was carried out. Retrospective data from 23rd March 2020 to 1st May 2020 was collected and compared to the same time period in 2019. Data was collected from coded electronic patient records. Results Total attendances to the Emergency Department (ED) reduced from 2019 to 2020 (5198 and 3059 respectively). There was a significant increase in the total number of self-harm presentations between 2019 and 2020 (103 vs 113, p-value <0.001) as well as paracetamol, NSAID and opiate overdoses, with more cases requiring hospital admission in 2020 vs 2019. Conclusions Societal lockdown measures secondary to the COVID-19 pandemic have had a significant effect on the mental health of patients. One way this can be detected is through an increased incidence and severity of deliberate self-harm injuries presenting to the ED. These findings, in conjunction with the available, literature provide valuable implications for community and emergency physicians and psychiatrists for any future wave of disease or pandemic.

This work aimed to identify the lead causes of upper limb injury presenting to a busy hand and major trauma unit during the UK COVID-19 domestic lockdown period, in comparison to a cohort from the same period one year previously. Hand and upper limb injuries presenting to the host organization during a pre-lockdown period (23rd March 2019–11th May 2019) and the formal UK lockdown period (23rd March 2020–11th May 2020) were compared, using data collated from the host institution’s hand surgery database. The UK lockdown period was associated with a 52% fall in the number of patients presenting to the service with hand and upper limb injuries (589 pre-lockdown vs. 284 during lockdown). There was a significant increase in the proportion of injuries due to machinery use during lockdown (38, 6.5% pre-lockdown vs. 33, 11.6% during lockdown, P = 0.009), other etiologies were consistent. The proportion requiring surgical management were similar (n = 272, 46.2% pre-lockdown vs. n = 138, 48.6% during lockdown, P = 0.50). The proportion requiring overnight admission fell (n = 94, 16.0% pre-lockdown vs. 29, 10.2% during lockdown, P = 0.022). COVID-19 related lockdown in the UK resulted in a reduction in the presenting numbers of hand related injuries; however almost half of these patients still required surgery. These data may be of use to other hand surgery centers for resource planning during future lockdown periods, and for injury prevention strategies in the post-COVID-19 world.

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