COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors

Abstract

Background There is little information on care-seeking patterns for sexual assault and domestic violence during the COVID-19 pandemic. The objective of this study was to examine the changes in emergency department (ED) admissions for sexual assault and domestic violence since the COVID-19 pandemic was declared. Methods Observational ED admissions data from The Ottawa Hospital were analyzed from March 4 to May 5 (62 days) in 2020 (COVID-19 period) and compared to the same period in 2018 (pre-COVID-19). Total and mean weekly admissions were calculated for all-cause ED admissions and for sexual and domestic violence cases. A Poisson regression (without offset term) was used to calculate the weekly case count ratio and 95% confidence intervals (CI) between the two time periods. Case characteristics were compared using chi-square tests, and percent differences were calculated. Results Compared to pre-COVID-19, total ED admissions dropped by 1111.22 cases per week (32.9% reduction), and the Sexual Assault and Domestic Violence Program cases dropped 4.66 cases per week. The weekly case count ratio for sexual assault cases was 0.47 (95% CI 0.79–0.27), equivalent of 53.49% reduction in cases, and 0.52 (95% CI 0.93–0.29), equivalent to a 48.45% reduction in physical assault cases. The characteristics of presenting cases were similar by age (median 25 years), sex (88.57% female), assault type (57.14% sexual assault, 48.57% physical assault), and location (31.43% patient’s home, 40.00% assailant’s home). There was a significant increase in psychological abuse (11.69% vs 28.57%) and assaults occurring outdoors (5.19% vs 22.86%). Conclusion This study found a decrease in ED admissions for sexual assault and domestic violence during COVID-19, despite societal conditions that elevate risk of violence. Trends in care-seeking and assault patterns will require ongoing monitoring to inform the provision of optimal support for individuals experiencing violence, particularly as countries begin to re-open or lock-down again.

COVID-19 and perinatal intimate partner violence: a cross-sectional survey of pregnant and postpartum individuals in the early stages of the COVID-19 pandemic

“…Most EDs saw drastic decreases in all-cause admissions immediately following the COVID-19 lockdown. [13][14][15] Investigations of cause-specific ED admissions varied, where some studies identified increases in IPV or assaultbased cases, 16 17 while others reported decreases. 18 19 Mixed patterns have also been observed in crime data from police departments, where some settings reported increases in domestic violence cases, [20][21][22] some found decreases 23 24 and others identified no detectable changes.…”

Domestic violence during the pandemic

“…Calls to support services and to the police have varied over the past year, with large increases in most countries, including the UK,3 Brazil,4 and Nepal. Yet, emergency department attendance for domestic violence and non-partner sexual violence has fallen substantially, along with general emergency department attendance 5…”

A Hospital-Based Independent Domestic Violence Advisor Service: Demand and Response During the COVID-19 Pandemic

“…These ndings echo others' concerns about DVA victims during lockdown [17], and evidence of decreased hospital admissions for DVA, despite social conditions that increase the risk of violence. [22] After the initial drop in referrals at the start of lockdown, both the quantitative and qualitative ndings showed a busy service with increased referrals; the IDVAs continued to provide a robust response, taking on and supporting all cases referred to them. This is notable, particularly considering that DVA is often a hidden problem and detection relies on staff retaining focus on the signs and making sensitive enquiries; staff at the Trust continued to this during lockdown, with intense pressure on hospital services and severe disruption to usual methods of communication.…”