Impact of COVID-19 lockdowns on pediatric injury attendances in different population groups in Israel: an interrupted time-series analysis, 2018-2022. (preprint)

ABSTRACT

Background Lockdowns and quarantines during the COVID-19 pandemic influenced healthcare services’ usage patterns such as emergency department (ED) attendances. During the pandemic, Israel issued three lockdowns (March-May 2020, September-October 2020, December 2020-February 2021) to mitigate the spread of COVID-19. Little is known about the impact of these lockdowns on ED attendance for injuries in the diverse population of Northern Israel.Methods We conducted a retrospective time series analysis. We extracted data from medical records of all northern Israeli children aged 0–17 years old who attended Ziv Medical Center (ZMC) emergency department (ED) due to injury, between 01/01/2018 and 10/02/2022. We compared volume and characteristics of ED attendances during lockdown periods to the same time periods in the 2 years before the pandemic and 1 year after the lockdowns, using chi-square tests.Results 7,619 northern children attended ZMC ED during the time periods of the study for injuries and were analyzed. Mean attendance numbers during lockdowns decreased compared to previous years, with an increase in injuries proportion (67.8% (1502/2216) vs. 52.7% (2038/3868) p < 0.001). The proportion of 0–4 years old attending for injuries during the lockdown increased compared to pre-pandemic (39.68% vs. 30.7%, p < 0.0001). Minority populations attendances decreased (27.47% vs. 30.71% p = 0.02). Hospitalization rates increased (13.21% vs. 10.65% p = 0.01). Post-lockdown periods saw a return to the pre-pandemic age and ethnicity distribution.Conclusions Compared to previous years, the volume of injuries was lower during lockdowns for all ages. Older children’s injuries may have been prevented by lockdowns, possibly because of restrictions on outdoor activities. A lower proportion of attendance from minority groups suggest different health seeking behavior patterns during emergencies compared to the general population. Understanding these differences will help better plan for future emergencies.