Violence is also surging. Compared to the same month last year, firearm-related injuries are up from 11% to 19% in our department, similar to other reports. In Georgia, gun and ammunition sales are spiking, according to AJC reports. In Baltimore, the mayor begged its residents to stop shooting each other so that hospital beds could be conserved for coronavirus patients. Domestic violence and child abuse have also flourished in lockdown. Substance-use rates are climbing, likely compounding the domestic violence surge. Drug-overdose deaths have increased, as have suicide hotline calls. The effects of the pandemic on violence, substance use, and mental health are likely far greater than most realize.
Prior to the pandemic, trauma was the third-costliest medical condition in the U.S., according to Business Insider.com. Many of the expensive resources required to provide trauma care are the same as those that are now precious during the pandemic, including personal protective equipment (PPE), operating room time, ventilators, intensive care unit beds, and blood transfusions.
The American College of Surgeons recently revised its longstanding trauma protocol to help conserve resources. As part of this, the initial “trauma activation” – which is the first evaluation a patient receives when they arrive to the hospital – has been modified. This used to be a highly interactive orchestration between multiple specialists, and is now restricted to a core group. Many specialists (including orthopaedics) were previously considered “essential” to the process, but are now asked to refrain from participating, unless specifically called, to conserve PPE. Further, due to social distancing and the fear of donation and disease transmission, there has been a drop in the available blood supply across the country. Blood transfusion is a key component of trauma resuscitation, and unless donors increase or need drops, trauma care may soon be impacted.
As the spring weather arrives, and our states are starting to reopen, we as trauma care providers ask you all to be safe. Traumatic injury, including that from reckless driving and violence, is using many of the precious resources that we need to defeat this pandemic. Please slow down while driving, and by all means, we beg you, please stop shooting each other.
Dr. Mara L. Schenker practices at Grady Memorial Hospital and is affiliated with Emory University’s Orthopaedic Surgery Department, where she is director of orthopaedic trauma research and an assistant professor.