Violence-related injury ED visits decreased following UK’s COVID-19 lockdown
ED visits for violence-related injuries appeared to decrease during the UK’s COVID-19 lockdown, according to study results conducted in Wales and published in JAMA.
“The unmet research need [addressed in our study] was lack of knowledge about the effects of COVID-19 and its lockdowns on violence in and outside the home,” Jonathan P. Shepherd, PhD, of the Crime and Security Research Institute at Cardiff University in Wales, told Healio Psychiatry. “There was also an urgent need to highlight the use of depersonalized, Cardiff Model data from EDs to measure violence accurately and to prevent it.”
Shepherd and colleagues examined ED attendances for violence-related injury, excluding self-injury, in Cardiff, Wales, which is served by a single ED, for each week between January 2019 and June 9, 2020, for all analyses. They defined pre-lockdown as the beginning of the study period through week 11 of 2020 and post-lockdown as week 12 of 2020 through week 23 of 2020. Further, they used a difference-in-differences regression model to assess statistically significant changes before and after lockdown in violence-related injury ED visits among two groups, which were patients injured outside the home and those injured at home. Using the same model, they also explored change in weekly mean number of violence-related ED visits after lockdown according to age, perpetrator type, sex and weapon involvement.
Results showed a decrease in mean number of total ED attendances per week from 2,889 before lockdown to 1,629 after lockdown, as well as a decrease from 28.4 before lockdown to 16.5 after lockdown for the modeled mean number of violence-related ED attendances per week. Before and after lockdown, the researchers did not observe a significant difference in mean weekly counts of injury at home; however, they noted a significant decline in injury outside the home.
Moreover, they reported no significant changes among subgroups for injury at home after they stratified analysis of characteristics of violent events before and after lockdown by injury location. However, they did note significant decreases in ED visits related to injury outside the home for female individuals aged younger than 18 years and by male individuals in all groups, as well as those injured with weapons and those in which a stranger, acquaintance or security officer perpetrated the violence.
“Violence in and outside the home together with weapon use, perpetrators and age and sex of the injured can be understood using Cardiff Model data collected in EDs,” Shepherd said. “A recent study in Georgia demonstrated that only 10% of violence in that state is known to law enforcement, a finding likely to be representative across the United States. ED physicians and trauma surgeons in the US and elsewhere can therefore contribute uniquely to the safety of people in their cities by leading the collection and sharing of these depersonalized ED data.”