The effect of national lockdown due to COVID-19 on emergency department visits

Kuitunen, Ilari; Ponkilainen, Ville; Launonen, Antti P; Reito, Aleksi; Hevonkorpi, Teemu P.; Paloneva, Juha; Mattila, Ville M.

doi:10.1186/s13049-020-00810-0

Cited by 95 publications

(121 citation statements)

References 11 publications

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“…A proposed reason for reduction in ED visits is fear of contracting COVID-19 in the ED among patients [ [39] , [40] , [41] ]. However, other authors propose a more complex interaction related to unanticipated effects of government enforced lockdowns including fewer traffic accidents, fewer accidents related to nightlife and intoxication, fewer elective procedures reducing ED visits for complications, and reduced spread of infectious diseases of all sorts due to social distancing [ 42 , 43 ]. Additional mitigating factors that have been proposed include increased use of telehealth services and patient triaging [ 8 , 18 , [44] , [45] , [46] ].…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers

Alwood

Musso

Jones

et al. 2021

The American Journal of Emergency Medicine

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Background Despite the trend of rising Emergency Department (ED) visits over the past decade, researchers have observed drastic declines in number of ED visits due to the COVID-19 pandemic. The purpose of the current study was to examine the impact of the COVID-19 pandemic and governor mandated Stay at Home Order on ED super utilizers. Methods This was a retrospective chart review of patients presenting to the 12 emergency departments of the Franciscan Mission of Our Lady Hospital System in Louisiana between January 1, 2018 and December 31, 2020. Patients who were 18 years of age or older and had four ED visits within a one-year period (2018, 2019, or 2020) were classified as super-utilizers. We examined number and category of visits for the baseline period (January 2018 – March 2020), the governor's Stay at Home Order, and the subsequent Reopening Phases through December 31, 2020. Results The number of visits by super utilizers decreased by over 16% when the Stay at Home Order was issued. The average number of visits per week rose from 1010.63 during the Stay at Home Order to 1198.09 after the Stay at Home Order was lifted, but they did not return to Pre-COVID levels of approximately 1400 visits per week in 2018 and 2019. When categories of visits were examined, this trend was found for emergent visits ( p < 0.001) and visits related to injuries (p < 0.001). Non-emergent visits declined during the Stay at Home Order compared to the baseline period (p < 0.001), and did not increase significantly during reopening compared to the Stay at Home Order ( p = 0.87). There were no changes in number of visits for psychiatric purposes, alcohol use, or drug use during the pandemic. Conclusions Significant declines in emergent visits raise concerns that individuals who needed ED treatment did not seek it due to COVID-19. However, the finding that super utilizers with non-emergent visits continued to visit the ED less after the Stay at Home Order was lifted raises questions for future research that may inform policy and interventions for inappropriate ED use.

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Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers

Alwood

Musso

Jones

et al. 2021

The American Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…There have been numerous articles analysing trauma patterns during the COVID-19 outbreak with the pattern of injury changing depending on the country, region and age of the patients [14][15]. During the COVID-19 pandemic emergency departments internationally saw a reported reduction in patients attending during relative periods of lockdown in each country [16][17][18][19][20][21][22][23][24]. Overall attendances to emergency departments were reported to have declined by as much as 68% in Italy [18][19] and 60% in parts of the United States of America [20].…”

Section: Year 2019 2020mentioning

confidence: 99%

“…Overall attendances to emergency departments were reported to have declined by as much as 68% in Italy [18][19] and 60% in parts of the United States of America [20]. An article from Finland reported that although overall attendances reduced by 17%, attendance related to MSK pain or injury reduced by 31% [21]. In places such as Barcelona (Spain), trauma attendances reduced by as much as 86.1% [22].…”

Section: Year 2019 2020mentioning

confidence: 99%

Musculoskeletal Attendances to a Minor Injury Department During a Pandemic

Dowell¹,

Ashwood²,

Hind³

2021

Cureus

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Introduction: As coronavirus disease 2019 (COVID-19) became a public health emergency of international concern, countries across the globe began to instate strict social distancing restrictions or “lockdowns”. During these times emergency departments in the United Kingdom (UK) recorded a significant drop in patients attending when compared to the same months of previous years. Attendances related to musculoskeletal (MSK) trauma also saw a significant drop in numbers Objective: The purpose of this retrospective audit was to investigate patterns of injuries attending during the pandemic and more specifically during times of lockdown. Method: Retrospective audit data was collected from an electronic medical record system (MediTech V6) during the time period of the first lockdown in the UK. Data was collected for patients attending the emergency department at the Queens Hospital Burton site of the University Hospitals of Derby and Burton National Health Service (NHS) Trust. Presenting complaints were recorded for the entire emergency department, and diagnosis on discharge and activity status was recorded for minor injuries only. This data was then compared to the same date from 2019. Results: Overall attendances in the emergency department decreased by 45.42% during the first lockdown when compared to the same time period in 2019. MSK problems also saw a significant drop as back pain decreased by 58.88%, neck pain fell by 78.52% and limb problems decreased by 59.74%. When comparing data from the minor injury department, limb problems decreased by 20.45%. The number of soft tissue injuries decreased by 24.05% and fractures decreased by 7.96%. Conclusion: Attendances in the emergency department were greatly reduced during the COVID-19 pandemic, especially during the first lockdown. The rates of fractures and soft tissue injuries within the minors’ area of the emergency department were also reduced but not at the same rate as the overall attendance. A large number of fractures and soft tissue injuries still presented to the emergency department despite reduced national activity. These attendances may be as a result of the increased rate of Do It Yourself (DIY)-related injuries and altered patient/social behaviour due to lockdown, social distancing, and seasons/weather. Further research would be required to investigate the changing patterns of behaviour especially as we enter a second wave of cases.

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“…Haskel et al (2020) reported a 77% reduction in ankle fractures in New York and Lubbe et al (2020) reported a reduction in the number of orthopedic trauma and foot injuries in Las Vegas during a 45-day period in March-April. Kuitunen et al (2020) described a substantial decrease in Finland in the number of visits to A&E due to orthopedic conditions during the 1st wave of the pandemic.…”

mentioning

confidence: 99%

Does the Covid-19 pandemic affect ankle fracture incidence? Moderate decrease in Sweden

et al. 2021

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Background and purpose — While many other countries implemented strict regulations and restrictions for their citizens during the 1st wave of the Covid-19 pandemic, Sweden maintained a more restrained approach. The Swedish Public Health Agency emphasized individual responsibility and pushed for behavioral changes. With strict lockdown a 77% decrease in ankle fracture incidence has been reported. We investigated whether there was a change in the incidence of ankle fractures seen at 7 selected hospitals during the Covid-19 pandemic 2020. Patients and methods — Data on all ankle fractures treated at 7 selected departments during March 15 through June 15, 2020, and for the same period in the preceding 3 years (2017–2019), was retrieved from the Swedish Fracture Register. The number of fractures during the whole period and subsequent 30-day periods were compared between 2020 and 2017–2019, including subgroup analyses of age and sex. Results — The monthly rate of ankle fractures was reduced by 14% in 2020 (139 fractures) compared with 2017–2019 (161 fractures). Women had a 16% decrease and patients aged > 70 years had a 29% decrease. During the 1st 30-day period, a 26% decrease in fractures was seen. Interpretation — During the 1st wave of the Covid-19 pandemic, a moderate decline in the number of ankle fractures was seen. Women and patients aged > 70 years displayed the greatest reduction. The greatest reduction in incidence of fractures was seen during the 1st 30-day period. This indicates greater adherence to government recommendations regarding social distancing in these subgroups and during the 1st month of the pandemic. Changes in ankle fracture incidence may be a measure of lockdown extent.

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The effect of national lockdown due to COVID-19 on emergency department visits

Cited by 95 publications

References 11 publications

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers

Musculoskeletal Attendances to a Minor Injury Department During a Pandemic

Does the Covid-19 pandemic affect ankle fracture incidence? Moderate decrease in Sweden

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