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Trauma cases fall, gunshot wounds rise during pandemic in Philadelphia

Trauma cases fall, gunshot wounds rise during pandemic in Philadelphia
Trauma cases dropped, but gunshot wounds rose during lockdown in Philadelphia, a new study has found. Photo by paulbr75/Pixabay

Nov. 9 (UPI) -- Hospitalizations for gunshot wounds rose by about 22% during COVID-19 lockdowns in Philadelphia earlier this year, compared to the same period in prior year, according to a study published Monday by the Journal of American College of Surgeons.

Between March 16 and May 23, gunshot patients accounted for almost 23% of all trauma hospitalizations in the city, the data showed.

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The previous high for that time period was 16% in 2018, while in typical years it hovers between 13% and 14%, the researchers said.

During lockdown, the total number of trauma cases -- including "intentional trauma" such as shootings, stabbings and beatings, as well as unintentional trauma, such as falls and motor vehicle crashes -- was 480, or about 4% less than would be seen in a typical year, they said.

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"While emergency department visits fell drastically during the stay-at-home period, visits for intentional injuries reached historic highs and have stayed there since, with gun-related violence increasing most notably," study co-author Dr. Jose Pascual told UPI.

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"Gun violence affects primarily young black males [and] is consistently high in a typical U.S. inner city but the pandemic and stay-at-home orders in Pennsylvania in early 2020 worsened this by a great amount," said Pascual, an associate professor of surgery in trauma and surgical critical care at the University of Pennsylvania's Perelman School of Medicine.

People of color were most affected by the increases of intentional trauma, accounting for 77% of cases, up from 70% in prior years, according to the researchers.

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The percentage of gunshot victims who were Black also rose to 29% in the spring, compared with 18% in prior years.

Pennsylvania issued stay-at-home orders on March 16 in an effort to contain the spread of COVID-19. according to Pascual and his colleagues.

As in most regions across the country, the orders led to the closure of schools and businesses and the banning of large public gatherings, with only so-called "essential workers" -- employees at grocery stores and municipal services -- encouraged to work from home.

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For this study, the researchers compared trauma admissions at Philadelphia hospitals between Feb. 1 and May 30 to data from the same periods in 2015 through 2019.

The 2020 data was split into two periods: Feb. 1 through March 15 -- the time before stay-at-home orders were issued -- and March 16 through May 30, which was during the stay-at-home orders.

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With the stay-at-home orders in place, 480 hospital admissions were recorded for intentional and unintentional trauma, compared with well over 500 during the same period in 2015 through 2019, the data showed.

However, 110 gunshot-related admissions occurred during this period this year, more than the previous extreme of 90 in 2018, the researchers said.

Before stay-at-home orders were issued, 45 gunshot-related cases were reported at city hospitals, which accounted for about 12% of the total number of trauma cases.

In a typical year, trauma cases make up roughly half of hospital admissions in Philadelphia, a number that dropped to 34% during the spring, as the pandemic spread.

This was likely due to declines in fall and motor-vehicle-crash patients as more people stayed home and avoided hospitals, the researchers said.

However, gunshot wounds tend to be complex and can be taxing on a hospital and its trauma teams, they said.

"The study was conducted because more victims of violent injury appeared to present to the Penn Presbyterian emergency room in Philadelphia during the early [lockdown] period," Pascual told UPI.

"Perhaps when such an important global event happens, additional precautions should be taken to address existing inner-city violence and injury which will likely significantly worsen in these conditions," he said.

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