Trauma Trends in COVID - 19 Pandemic at level 1 Trauma Center in India - An Observational Study

ABSTRACT

Introduction: COVID-19 has pushed Government of India to take various public health measures for curtailing transmission of infection. It included imposition of total lockdown on all non-essential services across the country when number of cases started increasing during the first wave. The first lockdown lasted from March 25th to may 31st 2020, following which a period of gradual unlocking began. Thereafter during the second wave of the COVID pandemic in India, lockdowns of varying intensities were imposed at different intervals by individual states. Near complete lockdown was implemented in the National Capital from April 19th 2021 to 31st May 2021, in response to a sharp rise in the number of cases. These lockdowns along with the pandemic itself has had a major impact on the healthcare system, including trauma care. There are limited number of studies specifically from India, which have examined the effect of these restrictions on trauma admissions. Objectives: Objective of this study is to assess the effect of COVID related lockdowns on trend of trauma admissions in a tertiary care facility of North India. Material and Methods: In this retrospective study, data on trauma admissions were ed from the Health Management Information system of All India Institute of Medical Sciences, Trauma Center, New Delhi corresponding to the following time periods (1) April 15, 2019, to May 31, 2019 - which corresponds with the pre-COVID phase (2) April 15, 2020, to May 31, 2020- which corresponds with first nationwide lockdown imposed in India during the first wave of the COVID outbreak and (3) April 15, 2021, to May 31, 2021- which corresponded with the near complete lockdown in state of Delhi during the second wave of COVID outbreak in India. Results: During the first-time interval (pre-COVID), a total of 8847 trauma casualty cases were reported in the Emergency Department of the level 1 Trauma Center. Due to lock down, number of patients presenting to trauma emergency had significantly reduced to 2185 during second interval. However, trauma casualty cases slightly increased during the third interval. Conclusion: This study showed that during the pandemic lockdown trauma admissions had been significantly reduced. However, the volume of trauma admissions was greater during the 2nd Peak of COVID-19, as the lockdown was partial. This study demonstrated that self-quarantines and lockdowns had led to a significant decrease in trauma footfall.