Change in spectrum of hand injuries during COVID-19 lockdown period: Increase in mixer grinder and domestic violence related injuries in lieu of trauma sustained in outdoor activities

Abstract

Objectives: There has been a rapid increase in respiratory infections due to COVID-19, caused by SARS-CoV-2, a novel coronavirus, which is believed to have originated from Wuhan in China. The disease has taken a form of pandemic and is now present in all countries across the globe with nearly 5.4 million infections and 344,000 fatalities till date. In late March, the Indian government initiated a lockdown, which confined nearly 1.3 billion people, around one-sixth of humanity to home, in an effort to decrease the community transmission of COVID-19 disease and flatten the curve so that Indian health care is able to deal with a manageable number of cases. This lockdown, which started on March 25, 2020, has now been extended to May 17, 2020, a duration of 54 days, with further planned extension to May 31. During this lockdown, the authors noted an increase in the number of mixer grinder injuries and a change in the demography of suicidal attempts due to frustration resulting in injuries to upper limb. The authors have studied this phenomenon and compared the data with cases from previous year. Material and Methods: The case records of all patients coming to the emergency department and department of plastic surgery in the period of March 25, 2020, to May 17, 2020 (54 days), with injuries of upper limb were analyzed and data compared with data from 2019. The demography and mode of injuries were studied. Results: There was an unusual increase in hand injuries due to mixer grinder in kitchen, 32 cases in 54 days (17.78/month) compared to 28 cases in 12 months in 2019 (2.34/month) with P < 0.001. There was also an increase in number of intended self-inflicted injuries in upper limb, as a result of psychological effects of rage and frustration with spouse due to long periods of confinement at home (3.89/month during lockdown period compared to 0.58 during 2019, P < 0.005) with change in demography compared to previous year. There was a decrease in upper limb injuries due to road traffic accidents, industrial accidents, assaults, sports, school, and work-related injuries, during the lockdown period, and this was along the expected lines. Conclusion: The period of lockdown initiated in India, to slow the community transmission of COVID-19 caused long periods of confinement together at home for families and forced the young adults to carry out some unaccustomed work, which resulted in a spike in mixer grinder injuries of hand. It also led to some rage and frustration, especially with spouses with a spike in suicidal attempt upper limb injuries.

COVID-19 pandemic: Continuum of adjustments and reorganizations justified

“…frequent hand washing or using an alcohol-based rub frequently, social distancing, staying self-isolated at home, avoiding crowded places, adhering to respiratory etiquette, and not touching eyes, nose, or mouth and face with unwashed hands have been implemented to limit the transmission. [3][4][5][6][7]…”

“…The aim is to preserve emergency medical or surgical services with stringent control measures to check the disease transmission amongst healthcare workers. [1][2][3][4][5][6][7][8][9][10] All elective surgeries are being canceled and other disciplines are necessitated to curtail routine admissions. Surgical emergencies, oncologic surgeries, and vital organ transplantations were continued unabated.…”

“…People tend to recognize hospitals as a major potential source of the virus, and as such, almost all hospital services, including emergency department traffic, experienced a significant decline. [5][6][7] Private-public partnerships are being ratified to enhance the preparedness capacity. Community centres, recreational establishments, hotels and lodges are being upgraded such that they may be easily converted into screening centers or community isolation facilities.…”

“…Late presentations of common conditions, changes in the injury patterns and causation with enhanced morbidity in patients with associated COVID-19 infection are some of the consequences. [1][2][3][4][5][6][7][8][9][10]13 Changes in the behavior of the masses bring about attendant changes in the injury pattern. 7 There has been a change in the pattern of the emergencies.…”

“…The reduction in sports-related injuries can be attributed to the cessation of group sports activities as well as the closure of fitness centers, aerobic studios, sports clubs, and recreational centers. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] In view of social distancing and isolation, there is an expected decline in injuries related to disputes, assaults, and interpersonal violence. In contrast, certain reports from the USA and Europe indicated a rise in trauma due to assaults.…”