Increases in Violence and Changes in Trauma Admissions During the COVID Quarantine.

BACKGROUND: The COVID-19 pandemic caused an abrupt change to societal norms. We anecdotally noticed an increase in penetrating and violent trauma during the period of stay-at-home orders. Studying these changes will allow trauma centers to better prepare for future waves of COVID-19 or other global catastrophes. METHODS: We queried our institutional database for all level 1 and 2 trauma activations presenting from the scene within our local county from March 18 to May 21, 2020 and matched time periods from 2016 to 2019. Primary outcomes were overall trauma volume, rates of penetrating trauma, rates of violent trauma, and transfusion requirements. RESULTS: The number of penetrating and violent traumas at our trauma center during the period of societal quarantine for the COVID-19 pandemic was more than any historical total. During the COVID-19 time period, we saw 39 penetrating traumas, while the mean value for the same time period from 2016 to 2019 was 26 (P = .03). We saw 45 violent traumas during COVID; the mean value from 2016 to 2019 was 32 (P = .05). There was also a higher rate of trauma patients requiring transfusion in the COVID cohort (6.7% vs 12.2%). DISCUSSION: Societal quarantine increased the number of penetrating and violent traumas, with a concurrent increased percentage of patients transfused. Despite this, there was no change in outcomes. Given the continuation of the COVID-19 pandemic, quarantine measures could be re-implemented. Data from this study can help guide expectations and utilization of hospital resources in the future.

COVID-19 Is Connected with Lower Health Literacy in Rural Areas.

The relationship between social determinants of health (SDoH) and health outcomes is established and extends to a higher risk of contracting COVID-19. Given the factors included in SDoH, such as education level, race, rurality, and socioeconomic status are interconnected, it is unclear how individual SDoH factors may uniquely impact risk. Lower socioeconomic status often occurs in concert with lower educational attainment, for example. Because literacy provides access to information needed to avoid infection and content can be made more accessible, it is essential to determine to what extent health literacy contributes to successful containment of a pandemic. By incorporating this information into clinical data, we have isolated literacy and geographic location as SDoH factors uniquely related to the risk of COVID-19 infection. For patients with comorbidities linked to higher illness severity, residents of rural areas associated with lower health literacy at the zip code level had a greater likelihood of positive COVID-19 results unrelated to their economic status.