Isolation silver lining? Drop in road trauma, assaults and injuries

While the drop varies from hospital to hospital, experts acknowledge the fact there has been a real impact, with Sydney’s Westmead Hospital reporting reductions in trauma and sports injuries, and Melbourne’s The Austin reporting a 30% drop in emergency presentations, according to Nine Newspapers.
 
Major trauma numbers at Melbourne’s main trauma hospital, The Alfred, are down by a quarter in recent weeks, with a 40% drop in overall trauma.
 
Professor Peter Cameron, Academic Director of the hospital’s emergency and trauma centre, said the drop is in part due to a reduced need for attendance.
 
‘If you tell people to stay at home and that they can’t even go fishing, they don’t hurt themselves,’ he told newsGP.
 
On average, it’s a lot safer to be at home. We’ve had less car accidents and less recreational incidents.’
 
With bars and pubs shut across the nation, alcohol-linked violence and injury has also plummeted at The Alfred, as has assault more broadly. Drug-related violence and injury has also reduced.
 
The feared spike in family violence has not played out as a major increase in trauma, according to Professor Cameron.
 
‘There was a lot of concern about what might be happening in the privacy of people’s homes with domestic violence, but it hasn’t shown up as major trauma,’ he said. ‘It may be occurring as psychological or nonphysical violence.’
 
Infectious disease presentations have also fallen sharply, with dropping rates of influenza, rotaviruses, and other infections meaning fewer hospital attendances.
 
There has been a small increase in home injuries, such as falls from ladders or burns from cooking.
 
‘People with relatively minor problems have steered clear of emergency,’ he said.
 
Attendances for mental health issues are slightly down, which Professor Cameron suggests might be due to a drop in drug-related issues combined with a rise in anxiety and depression due to the lockdown, as well broader anxieties regarding the pandemic and its impact on society.
 
‘There may be a rebound as people recover from the psychological trauma of this event,’ he said.
 
Professor Cameron said there is likely to be a challenging flow-on effect given the reduction in strokes, heart attacks, and chronic obstructive pulmonary disease (COPD) exacerbations.
 
‘With these more severe issues the question is, has there been a real reduction in the incidence of these things because people were at home? Or is it a problem, where people didn’t attend hospital when they should have?’ he said.
 
Numbers of new cancer patients and heart attacks are also down significantly in Victoria, as newsGP has previously reported.
 
Professor Cameron said there is initial evidence suggesting there a genuine deterrent effect for some patients, particularly those who are immunosuppressed or who have cancer.
 
‘People with existing illness who need treatment have been staying away – and some with good reason, as they are scared they may contract COVID-19,’ he said. ‘You’re pretty unlikely to catch it in hospital in Australia.’
 
But the trauma reprieve may be ending, according to The Alfred’s director of trauma services, Professor Mark Fitzgerald.
 
He told newsGP the dip has started to revert back to normal numbers, with more trucks back on the road and an increase in mental health issues causing trauma.
 
‘We’ve had fewer car accidents, but a slight increase in pedestrian trauma and a few truck crashes,’ he said.
 
‘After the first three weeks of shutdown, though, it seems to be getting back to normal.’
 
Doctors are bracing for a surge of serious medical issues once the lockdown eases, as patients who may have put off treatment return to the healthcare system, MJA Insight reports.
 
GPs have also seen patient numbers drop significantly, even with the new telehealth Medicare expansion.
 
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