Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge.

Study Objective: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening emergencies using upper extremity injuries as a model for other potentially emergent presentation as compared to pre-pandemic times. We do this using the epidemiology of pre-defined significant upper extremity injuries at our facility as a specific example of what occurred at an urban trauma center. Methods: We conducted a comparison of two 6-month periods: between March 2019 and August 2019 (prior to COVID-19) and between March 2020 and August 2020 after the onset of the initial COVID-19 wave. We performed a retrospective chart review of patients who presented with upper extremity injury chief complaints using analysis of the electronic medical record at a single urban tertiary care trauma center in the Midwestern United States. We investigated examination findings, imaging, frequency of surgical procedures and final diagnosis. Results: In the 2019 study period, there were 31,157 ED patients, including 429 with upper extremity injuries, of which 108 patients had significant injuries. In the 2020 study period, there were 24,295 patient presentations, of which 118 of 296 upper extremity presentations were significant. We a priori defined significant injury as follows: fractures, dislocations, neurovascular injuries, or need for operative intervention within 24 hours of ED presentation. Specifically, 25.2% of injuries were significant pre-COVID-19 and 39.9% (p < 0.001) during the initial COVID-19 surge. The absolute number and percentage of significant injuries increased from pre-COVID-19 compared to the initial COVID-19 surge despite an overall 22% decrease in total patient volume. Conclusion: The incidence of significant upper extremity musculoskeletal injuries increased during the pandemic even though the overall number of ED presentations for upper extremity musculoskeletal injuries decreased.

Utilizing a CBPR approach to assess the impact of COVID-19 on individuals who receive publicly funded behavioral health services.

The coronavirus disease pandemic has highlighted significant gaps in community mental health services, placing vulnerable individuals at greater risk for mental health and substance use difficulties via disrupting their wellness journey. Guided by a wellness framework, a needs assessment was conducted among adult consumers of behavioral health services to understand their needs during the pandemic and to help develop and strengthen service delivery strategies. A team of three university researchers and four Consumer Researchers, who receive services at a publicly funded community mental health center, engaged in a community-based participatory project in which 13 focus groups were conducted with 51 consumers. Several themes emerged from a thematic analysis of transcripts regarding consumer well-being and healthcare needs, coping strategies employed, and the accessibility, benefits, and perception of clinical and support services during the pandemic. Results highlighted strengths in service delivery and areas in need of enhancement. Findings may inform similar community services that seek to enhance delivery of care among vulnerable populations.