Trends in Violent Penetrating Injuries During the First Year of the COVID-19 Pandemic

Abstract

IMPORTANCEPublic health measures instituted to reduce the spread of COVID-19 led to severe disruptions to the structure of daily life, and the resultant social and financial impact may have contributed to an increase in violence. OBJECTIVE To examine the trends in violent penetrating injuries during the first COVID-19 pandemic year compared with previous years. DESIGN, SETTING, AND PARTICIPANTS This retrospective cross-sectional study was performed to compare the prevalence of violent penetrating injuries during the first COVID-19 pandemic year, March 2020 to February 2021, with the previous 5 years, March 2015 to February 2020. This study was performed among all patients with a violent penetrating injury presenting at Boston Medical Center, an urban, level I trauma center that is the largest safety-net hospital and busiest trauma center in New England. Data were analyzed from January 4 to November 29, 2021. MAIN OUTCOMES AND MEASURES The primary outcomes were the incidence and timing of emergency department presentation for violent penetrating injuries during the first year of the COVID-19 pandemic compared with the previous 5 years. Patient demographics and injury characteristics were also assessed. RESULTS A total of 2383 patients (median [IQR] age, 29.5 [23.4-39.3] years; 2032 [85.4%] men and 351 [14.6%] women) presenting for a violent penetrating injury were evaluated, including 1567 Black patients (65.7%), 448 Hispanic patients (18.8%), and 210 White patients (8.8%). There was an increase in injuries during the first pandemic year compared with the previous 5 years, with an increase in shootings (mean [SD], 0.61 [0.89] injuries per day vs 0.46 [0.76] injuries per day; P = .002) but not stabbings (mean [SD], 0.60 [0.79] injuries per day vs 0.60 [0.82] injuries per day; P = .78). This surge in firearm violence began while Massachusetts was still under a stay-at-home advisory and before large-scale racial justice protests began. Patients presenting with violent penetrating injuries in the pandemic surge months (April-October 2020) compared with the same period in previous years were disproportionately male (153 patients [93.3%] vs 510 patients [87.6%]; P = .04), unemployed (70 patients [57.4%] vs 221 patients [46.6%]; P = .03), and Hispanic (40 patients [26.0%] vs 99 patients [17.9%]; P = .009), with a concurrent decrease in White patients (0 patients vs 26 patients [4.7%]), and were more likely to have no previous history of violent penetrating injury (146 patients [89.0%] vs 471 patients [80.9%]; P = .02). CONCLUSIONS AND RELEVANCEThese findings suggest that unprecedented measures implemented to mitigate the spread of COVID-19 were associated with an increase in gun violence.As the pandemic abates, efforts at community violence prevention and intervention must be redoubled to defend communities against the epidemic of violence.

Analysis of Firearm Violence During the COVID-19 Pandemic in the US

“…This finding is consistent with an analysis of patients presenting with violent penetrating injuries to the emergency department of a large hospital in Boston, which noted that excess firearm injuries peaked in July 2020. 18 …”

“…Worsening economic conditions, psychological strain, and trauma associated with the pandemic, combined with an increase in firearm sales, 7 could potentially increase the risk of firearm violence in association with the pandemic, thus exacerbating another major public health crisis in the US. 8 However, only a few studies have examined changes in gun violence associated with the pandemic period, 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 and most of these were limited to a small number of locations. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 To our knowledge, no study has quantified the spatial and temporal changes in firearm violence associated with the pandemic at a national scale after controlling for long-term trends and seasonality.…”

“… 8 However, only a few studies have examined changes in gun violence associated with the pandemic period, 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 and most of these were limited to a small number of locations. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 To our knowledge, no study has quantified the spatial and temporal changes in firearm violence associated with the pandemic at a national scale after controlling for long-term trends and seasonality.…”

Assessment of the Effects of the COVID-19 Lockdown on Trauma at AaBET Hospital in Addis Ababa, Ethiopia

“…17 The increase in interpersonal violence during the COVID-19 pandemic has been witnessed globally because of intrafamilial and domestic violence during home confinement. [18][19][20][21] This study also reveals an increase in injuries to the extremities and pelvis, which are common in falls and interpersonal violence. 22,23 The number of trauma patients in our hospital who were admitted decreased significantly during the lockdown period, while discharges and referrals to another healthcare facility increased during the same period.…”

Evaluating the change in patterns of traumatic injury in the setting of pandemic and social distancing restrictions: An analysis of a level 1 trauma center

“… 26 , 28 , 29 Furthermore, within times of pandemic, violence involving firearms is more likely. 27 With this acute rise in new gun owners, we can hypothesize that that such a rise has led to increased injuries due to unfamiliarity with safety protocols or introduction of firearms into households without proper measures in place to secure guns against accidental discharge. This continues to provide opportunities to target risk reduction not only through implementation of educational initiatives regarding gun safety and firearm injury prevention, but also include a nationwide initiative for providing safety devices for storage.…”