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Supramaniam P, Junus S, Hashim L, Chiew SC, Devesahayam PR. Lost years, mortality burden: the impact of COVID-19 pandemic on premature death due to road traffic accidents in a northern state in Malaysia. BMC Public Health 2024; 24:1520. [PMID: 38844906 PMCID: PMC11155150 DOI: 10.1186/s12889-024-19027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/31/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND This study addresses the persistent global burden of road traffic fatalities, particularly in middle-income countries like Malaysia, by exploring the impact of the COVID-19 pandemic on Road Traffic Accident (RTA) fatalities in Perak state, Malaysia, with a secondary focus on applying Years of Life Lost (YLL) to understand the implications of these premature deaths. METHODOLOGY The cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia. RESULTS This study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018-2019) and pandemic years (2020-2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30-34 during the pandemic. CONCLUSION The decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.
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Affiliation(s)
- Premaa Supramaniam
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC) Building, Jalan Raja Ashman Shah, Ipoh, Perak, 30450, Malaysia.
| | - Suria Junus
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC) Building, Jalan Raja Ashman Shah, Ipoh, Perak, 30450, Malaysia
| | - Lina Hashim
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC) Building, Jalan Raja Ashman Shah, Ipoh, Perak, 30450, Malaysia
| | - Shoen Chuen Chiew
- Clinical Research Centre, Hospital Seri Manjung, Ministry of Health, Seri Manjung, Perak, 32040, Malaysia
| | - Philip Rajan Devesahayam
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC) Building, Jalan Raja Ashman Shah, Ipoh, Perak, 30450, Malaysia
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Petrocelli M, Ruggiero F, Allegri D, Cutrupi S, Baietti AM, Salzano G, Maglitto F, Manfuso A, Copelli C, Barca I, Cristofaro MG, Galvano F, Loche VP, Gemini P, Tewfik K, Burlini D, Bernardi M, Bianchi FA, Catanzaro S, Ascani G, Consorti G, Balercia P, Braconi A, Scozzaro C, Catalfamo L, De Rinaldis D, De Ponte FS, Tarabbia F, Biglioli F, Giovacchini F, Tullio A, Cama A, Di Emidio P, Ferrari S, Perlangeli G, Rossi MB, Biglio A, De Riu G, Califano L, Vaira LA. Changes in hospital admissions for facial fractures during and after COVID 19 pandemic: national multicentric epidemiological analysis on 2938 patients. Oral Maxillofac Surg 2024; 28:753-759. [PMID: 38093155 DOI: 10.1007/s10006-023-01201-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/07/2023] [Indexed: 06/04/2024]
Abstract
PURPOSE The objective of this multicenter study was to examine the differences in maxillo-facial fractures epidemiology across the various phases of the SARS-CoV-2 pandemic. METHODS This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery departments in Italy, spanning from June 23, 2019, to February 23, 2022. Based on the admission date, the data were classified into four chronological periods reflecting distinct periods of restrictions in Italy: pre-pandemic, first wave, partial restrictions, and post-pandemic. Epidemiological differences across the groups were analysed. RESULTS The study included 2938 patients. A statistically significant difference in hospitalization causes was detected between the pre-pandemic and first wave groups (p = 0.005) and between the pre-pandemic and partial restriction groups (p = 0.002). The differences between the pre- and post-pandemic groups were instead not significant (p = 0.106). Compared to the pre-pandemic period, the number of patients of African origin was significantly higher during the first wave and the post-pandemic period. No statistically significant differences were found across the periods concerning gender, age, fracture type, treatment approach, and hospital stay duration CONCLUSIONS: The COVID-19 pandemic brought about significant changes in fracture epidemiology, influenced by the restrictive measures enforced by the government in Italy. Upon the pandemic's conclusion, the fracture epidemiology returned to the patterns observed in the pre-pandemic period.
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Affiliation(s)
- Marzia Petrocelli
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Federica Ruggiero
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Davide Allegri
- Department of Clinical Governance and Quality, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | | | - Anna Maria Baietti
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Giovanni Salzano
- Maxillo-facial Surgery Unit, University Hospital of Naples "Federico II,", Naples, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Alfonso Manfuso
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Ida Barca
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy
| | - Francesca Galvano
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Gemini
- Maxillofacial Surgery Unit, ARNAS Brotzu, Cagliari, Italy
| | - Karim Tewfik
- Pediatric Maxillo-Facial Surgery Unit, Children's Hospital of Brescia - ASST Spedali Civili, Brescia, Italy
| | - Dante Burlini
- Pediatric Maxillo-Facial Surgery Unit, Children's Hospital of Brescia - ASST Spedali Civili, Brescia, Italy
| | - Marco Bernardi
- Maxillo-Facial Surgery Unit, ASO Santa Croce e Carle, Cuneo, Italy
| | | | - Susanna Catanzaro
- Department of Maxillo-Facial Surgery, Spirito Santo Hospital, Pescara, Italy
| | - Giuliano Ascani
- Department of Maxillo-Facial Surgery, Spirito Santo Hospital, Pescara, Italy
| | - Giuseppe Consorti
- Maxillo-Facial Surgery Unit, Marche University Hospital, Ancona, Italy
| | - Paolo Balercia
- Maxillo-Facial Surgery Unit, Marche University Hospital, Ancona, Italy
| | - Andrea Braconi
- Maxillo-Facial Surgery Unit, A.R.N.A.S. Civico di Cristina Bonfratelli Hospital, Palermo, Italy
| | - Calogero Scozzaro
- Maxillo-Facial Surgery Unit, A.R.N.A.S. Civico di Cristina Bonfratelli Hospital, Palermo, Italy
| | - Luciano Catalfamo
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Danilo De Rinaldis
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Francesco Saverio De Ponte
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Filippo Tarabbia
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
| | - Federico Biglioli
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
| | | | - Antonio Tullio
- Maxillo-Facial Surgery Unit, Perugia Hospital, Perugia, Italy
| | - Antonia Cama
- Oral and Maxillo-Facial Unit, ASL Teramo - G. Mazzini Hospital, Teramo, Italy
| | - Paolo Di Emidio
- Oral and Maxillo-Facial Unit, ASL Teramo - G. Mazzini Hospital, Teramo, Italy
| | - Silvano Ferrari
- Head and Neck Department, University Hospital of Parma, Parma, Italy
| | | | - Maria Beatrice Rossi
- Maxillo-Facial Surgery, Surgical Sciences Department, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Andrea Biglio
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Luigi Califano
- Maxillo-facial Surgery Unit, University Hospital of Naples "Federico II,", Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy.
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy.
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Yang T, Kong J, Chen X, Zeng H, Zhou N, Yang X, Miao Q, Liao X, Zhang F, Lan F, Wang H, Li D. Overview of road traffic injuries among migrant workers in Guangzhou, China, from 2017 to 2021. Inj Prev 2024; 30:224-232. [PMID: 38123988 PMCID: PMC11137450 DOI: 10.1136/ip-2023-044986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION There are many migrant workers in China's first-tier cities, but little is known about road safety. This paper systematically analysed road traffic injuries and risk factors among migrant workers in Guangzhou, China. METHODS Road traffic crash data from 2017 to 2021 were obtained from the Guangzhou Public Security Traffic Management Integrated System. We plotted the crash network of road users in road traffic crashes and used logistic regression to analyse the risk factors for migrant workers of motorcycle and four-wheeled vehicle crashes. Moreover, the roles of migrant workers and control individuals as perpetrators in road traffic crashes were also analysed. RESULTS Between 2017 and 2021, 76% of road traffic injuries were migrant workers in Guangzhou. Migrant workers who were motorcyclist drivers most commonly experienced road traffic injuries. Crashes between motorcyclists and car occupants were the most common. The illegal behaviours of migrant worker motorcyclists were closely related to casualties, with driving without a licence only and driving without a licence and drunk driving accounting for the greatest number. Migrant workers were responsible for many injuries of other road users. Motorcycle drivers have a higher proportion of drunk driving. DISCUSSION Migrant workers play an important role in road traffic safety. They were both the leading source of road traffic injuries and the main perpetrators of road traffic crashes. Measures such as strict requirements for migrant workers to drive motorcycles with licences, prohibit drunk driving, greater publicity of road safety regulations, and combining compulsory education with punishment for illegal behaviours.
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Affiliation(s)
- Tengfei Yang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jiangwei Kong
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Xinzhe Chen
- South China University of Technology School of Mechanical and Automotive Engineering, Guangzhou, China
| | - Haotian Zeng
- Guangzhou Public Security Bureau, Guangzhou, China
| | - Nian Zhou
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Xingan Yang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Qifeng Miao
- Guangdong Province Research Center of Traffic Accident Identification Engineering Technology, Guangzhou, China
| | - Xinbiao Liao
- Department of Guangdong Public Security, Forensic Pathology Lab, Guangzhou, China
| | - Fu Zhang
- Department of Guangdong Public Security, Forensic Pathology Lab, Guangzhou, China
| | - Fengchong Lan
- South China University of Technology School of Mechanical and Automotive Engineering, Guangzhou, China
| | - Huijun Wang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Dongri Li
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
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Siu WHS, Peng WS, Chen WM, See LC. The impact of COVID-19 restrictions on motorcycle crashes in Taiwan. Medicine (Baltimore) 2024; 103:e37901. [PMID: 38640266 PMCID: PMC11029935 DOI: 10.1097/md.0000000000037901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/05/2024] [Accepted: 03/22/2024] [Indexed: 04/21/2024] Open
Abstract
Taiwan is one of the countries with the highest motorcycle per capita globally, and motorcycle crashes are predominant among traffic crashes. This study examines the impact of coronavirus disease 2019 restrictions on motorcycle crashes. We analyzed the trend of motorcycle crashes in Taipei City from 2019 to 2020 using the dataset provided by the Department of Transportation, Taipei City Government, Taiwan. We found 47,108 and 51,441 motorcycle crashes in 2019 and 2020, involving 61,141 and 67,093 motorcycles, respectively. Mopeds had the highest risk in 2020, followed by heavy motorcycles [≥550 cubic capacity (cc)] and scooters compared to 2019. Food delivery motorcycle crashes increased for scooters (0.93% in 2019 to 3.45% in 2020, P < .0001) and heavy motorcycles (250 < cc < 550) (0.90% in 2019 to 3.38% in 2020, P < .0001). While fatalities remained under 1%, 30% to 51% of motorcyclists sustained injuries. Food delivery with scooters or heavy motorcycles (250 < cc < 550) was significantly associated with motorcyclist injuries and deaths. Compared with 2019, the adjusted odds ratios of motorcyclist injuries and deaths in 2020 were 1.43 (95% confidence interval = 1.05-1.94) for heavy motorcycles (≥550 cc) and 1.07 (95% confidence interval = 1.04-1.09) for scooters. This study shows that coronavirus disease 2019 restrictions was associated with elevated risks of crashes, injuries, and deaths among motorcyclists, reflecting the general preference for private transport over public transport. The popularity of food delivery services also contributed to increased motorcycle crashes.
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Affiliation(s)
- Wing Hin Stanford Siu
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of Medical Education, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Wei-Sheng Peng
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wei-Min Chen
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan City, Taiwan
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
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Dudde F, Schuck O, Schunk J, Filip B. Influence of COVID-19 pandemic on mandible fracture patterns in a German cranio-maxillofacial trauma center: PreCOVID (2019) versus IntraCOVID (2020). Dent Traumatol 2024. [PMID: 38572818 DOI: 10.1111/edt.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND/AIMS The COVID-19 (Coronavirus Disease-2019) pandemic confronted the global healthcare system with a variety of challenges. The pandemic and the associated lockdowns also had an impact on multiple medical disciplines (i.e. delay of surgery, change of hospital admissions). The aim of this study was to analyze the impact of the COVID-19 pandemic on mandible fracture patterns/distributions and circumstances in a German cranio-maxillofacial trauma center. MATERIALS AND METHODS This retrospective study compared the mandible fracture patterns of patients in the PreCOVID (PC) era (February 2019-January 2020) with patients in the IntraCOVID (IC) era (February 2020-January 2021). In addition to baseline characteristics, the number/type of mandible fractures, location of the mandible fracture, circumstances leading to mandible fracture, and hospital admissions/treatments were analyzed. RESULTS A total of 127 patients was included in this study. In the IC period, the absolute frequencies of mandible fractures decreased (PC = 72 vs. IC = 55). There were minor changes in the mandible fracture locations. An increase of concomitant facial soft tissue injuries (IC = 69.1% vs. PC = 58.3%), as well as higher rates of traumatic tooth loss (IC = 32.7% vs. PC = 22.2%), was observed. Regarding the causes/accidents leading to mandible fractures, there were significant increases in falls and significant decreases in sports accidents as well as interpersonal violence during the IC period. A significant increase in accidents at home and domestic violence during the COVID-19 pandemic, with a simultaneous decrease in weekend and night-time trauma leading to mandible fractures was observed. Furthermore, a significant increase in days from trauma to surgery was recorded. CONCLUSION The COVID-19 pandemic had a significant impact on mandibular fracture patterns. The locations and types of mandibular fractures changed slightly. However, significant differences in the circumstances leading to mandible fractures (increased falls, decreased interpersonal violence) were recorded.
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Affiliation(s)
- Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Oliver Schuck
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Johannes Schunk
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Barbarewicz Filip
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
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Cho SH, Nho WY, Lee DE, Ahn JY, Kim JW, Lim KH, Ryoo HW, Kim JK. Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study. BMC Emerg Med 2024; 24:53. [PMID: 38570762 PMCID: PMC10988904 DOI: 10.1186/s12873-024-00963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the effects of the coronavirus disease 2019 (COVID-19) pandemic on IHT among patients with major trauma was lacking. METHOD This retrospective cohort study was conducted in an urban trauma center (TC) of a tertiary academic affiliated hospital in Daegu, Korea. The COVID-19 period was defined as from February 1, 2020 to January 31, 2021, whereas the pre-COVID-19 period was defined as the same duration of preceding span. Clinical data collected in each period were compared. We hypothesized that the COVID-19 pandemic negatively impacted IHT. RESULTS A total of 2,100 individual patients were included for analysis. During the pandemic, the total number of IHTs decreased from 1,317 to 783 (- 40.5%). Patients were younger (median age, 63 [45-77] vs. 61[44-74] years, p = 0.038), and occupational injury was significantly higher during the pandemic (11.6% vs. 15.7%, p = 0.025). The trauma team activation (TTA) ratio was higher during the pandemic both on major trauma (57.3% vs. 69.6%, p = 0.006) and the total patient cohort (22.2% vs. 30.5%, p < 0.001). In the COVID-19 period, duration from incidence to the TC was longer (218 [158-480] vs. 263[180-674] minutes, p = 0.021), and secondary transfer was lower (2.5% vs. 0.0%, p = 0.025). CONCLUSION We observed that the total number of IHTs to the TC was reduced during the COVID-19 pandemic. Overall, TTA was more frequent, particularly among patients with major trauma. Patients with severe injury experienced longer duration from incident to the TC and lesser secondary transfer from the TC during the COVID-19 pandemic.
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Affiliation(s)
- Sung Hoon Cho
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Woo Young Nho
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Dong Eun Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Joon-Woo Kim
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Kyoung Hoon Lim
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Ahmed S, Anwer A, Abdullah M, Ashraf M, Iqbal J, Siddiq J, Ahmed Khan N, Khan H. Trends in Traumatic Brain Injuries During the COVID-19 Pandemic: A Single-Center Review of Patient Charts From Pakistan. Cureus 2024; 16:e58745. [PMID: 38779274 PMCID: PMC11110921 DOI: 10.7759/cureus.58745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction A traumatic brain injury (TBI) is one of the leading causes of injury-related deaths, making it a public health concern of extreme importance. In a developing country such as Pakistan, TBIs are significantly underreported, with the treatment frequently being delayed and inadequate, especially in rural healthcare setups all across the country. This concern is further magnified by insufficient epidemiological data on TBIs available in Pakistan. The coronavirus disease 2019 (COVID-19) pandemic brought consequential changes to the healthcare system with the priority shifting toward COVID-19 patients, resulting in considerable changes to the workflow and management of TBIs. The primary objective of this study is to offer valuable insights into the epidemiology of TBIs in Pakistan and its relationship with the impact of the COVID-19 pandemic. Methods A retrospective study was conducted at a tertiary care center in a metropolitan city in Pakistan. Patient charts were reviewed from January to August 2020, and data was extracted including demographics, clinical presentation, management, and outcomes for cases of TBI. Results The total number of patients is 2126, male 78% and female 21.4%. The mean age of the patients was 28.85. The state of admissions at the hospital is at 99.7% for EME admissions and 0.282% for OPD admissions. Participants presented with loss of consciousness (70.7%), nosebleeds, (53.2%), vomiting (69.0%), and seizures (11.5%). The majority (51.1%) were related to road traffic accidents, followed by falls (20.7%), and assaults (4%). While 1202 (58.5%) of these were managed conservatively, others underwent surgical treatment in the form of craniotomy (28.0%), Burr holes (3.20%), and fracture elevation and repair (10.5%). A decrease in the number of reported TBI cases was observed with lockdown implementation in Pakistan. Conclusion The transportation sector in Pakistan was severely affected by the COVID-19 pandemic, leading to a decline in road traffic injuries and TBIs. Stringent mobility constraints and changes in societal and cultural norms have contributed to this reduction.
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Affiliation(s)
- Salaar Ahmed
- Medical College, Aga Khan University, Karachi, PAK
| | - Ammar Anwer
- Department of Neurosurgery, University College of Medicine and Dentistry, The University of Lahore, Lahore, PAK
| | | | - Mohammad Ashraf
- Department of Neurological Surgery, Wolfson School of Medicine, University of Glasgow, Glasgow, GBR
| | - Javed Iqbal
- Department of Neurosurgery, Mayo Hospital, Lahore, PAK
| | | | - Naveed Ahmed Khan
- Department of Plastic Surgery, University College of Medicine and Dentistry, The University of Lahore, Lahore, PAK
| | - Hira Khan
- Medical College, Aga Khan University, Karachi, PAK
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Yonai Y, Ben Natan M, Maman D, Ezra O, Berkovich Y. Characteristics of injuries related to traffic crashes in Israel before and during the COVID-19 pandemic. TRAFFIC INJURY PREVENTION 2024; 25:589-593. [PMID: 38546462 DOI: 10.1080/15389588.2024.2331218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES This study explored differences in patient characteristics, injury characteristics, treatment modalities, and treatment outcomes among patients who presented to the Emergency Department (ED) following traffic crashes during the COVID-19 period (from March 15, 2020 to March 15, 2022) in comparison to the previous corresponding period between 2017 and 2019. METHODS The study is a retrospective chart review study. The study included a random sample of 610 patients who presented to the ED of a major hospital located in northern-central Israel following traffic crashes: 305 patients who presented during the COVID-19 period (from March 15, 2020 to March 15, 2022) and 305 patients who presented during the previous corresponding period (from March 15, 2017 to March 15, 2019). Socio-demographic data, data regarding the traffic crashes, and medical data of the patients were collected from their medical records, and the data were compared. RESULTS In the context of the COVID-19 period, a notable surge in the percentage of cyclist victims was evident, marking an increase from 7.5% to 19% compared to the corresponding period. Conversely, the incidence of pedestrian victims during the COVID-19 period dropped to 19.7%, in contrast to 30.8% in the corresponding period. Notably, patients involved in pedestrian crashes amid the COVID-19 period exhibited a shorter hospital stay (M = 2.8 days, SD = 3.3) compared to the corresponding period (M = 4.3 days, SD = 7.1) [t = 1.8 (df = 141), p < 0.05]. However, a higher fatality rate was observed among these patients during the COVID-19 period compared to the corresponding period (6.7% vs. 0%) [χ2 = 6.4 (df = 1), p < 0.05]. CONCLUSIONS The study reveals significant changes in traffic crashes characteristics during the pandemic period, including a notable increase in cyclist victims and a decrease in pedestrian incidents. These shifts may be attributed to factors such as changes in transportation patterns, increased use of bicycles for essential travel. Despite these changes, the proportion of severe crashes remained relatively consistent. These findings underscore the importance of understanding the underlying causes behind these shifts and highlight the ongoing need for public education and awareness initiatives to promote traffic safety, particularly for vulnerable road users, during pandemic periods.
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Affiliation(s)
- Yaniv Yonai
- The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel
| | - Merav Ben Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - David Maman
- The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ofir Ezra
- The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yaron Berkovich
- The Orthopedics B Department, Hillel Yaffe Medical Center, Hadera, Israel
- Medical Department, Technion University, Haifa, Israel
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9
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Kim S, Sung HK, Lee J, Ko E, Kim SJ. Trends in emergency department visits for emergency care-sensitive conditions before and during the COVID-19 pandemic: a nationwide study in Korea, 2019-2021. Clin Exp Emerg Med 2024; 11:88-93. [PMID: 38204160 PMCID: PMC11009707 DOI: 10.15441/ceem.23.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/09/2023] [Accepted: 09/09/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE Emergency care systems worldwide have been significantly affected by the COVID-19 pandemic. This study investigated the trend of emergency department (ED) visits for emergency care-sensitive conditions (ECSCs) in Korea before and during the pandemic. METHODS We performed a longitudinal study using the national ED database in Korea from January 2019 to December 2021. We calculated the number and incidence rate of visits for ECSCs per 100,000 ED visits, and the incidence rate ratio of 2021 relative to the value in 2019. The selected ECSCs were intracranial injury, ischemic heart disease, stroke, and cardiac arrest. RESULTS The number of ED visits for all causes decreased by about 23% during the pandemic. The number of ED visits for intracranial injuries decreased from 166,695 in 2019 to 133,226 in 2020 and then increased to 145,165 in 2021. The number of ED visits for ischemic heart disease and stroke decreased in 2020 but increased to 2019 levels in 2021. In contrast, the number of ED visits for cardiac arrest increased from 23,903 in 2019 to 24,344 in 2020 and to 27,027 in 2021. The incidence rate and incidence rate ratio of these four ECSCs increased from 2019 to 2021, suggesting increasing relative proportions of ECSCs in total ED visits. CONCLUSION During the COVID-19 pandemic, the number of cardiac arrests seen in the EDs increased, but that of other ECSCs decreased. The decrease in ED visits for ECSCs was not as pronounced as the decrease in ED visits for all causes during the pandemic. Further studies are needed to determine clinical outcomes in patients with ECSC during the pandemic.
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Affiliation(s)
- Seonji Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Kyung Sung
- Public Health Research Institute, National Medical Center, Seoul, Korea
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Jeehye Lee
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Eunsil Ko
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Seong Jung Kim
- National Emergency Medical Center, National Medical Center, Seoul, Korea
- Department of Emergency Medicine, Chosun University College of Medicine, Gwangju, Korea
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10
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Frey A, Tilstra AM, Verhagen MD. Inequalities in healthcare use during the COVID-19 pandemic. Nat Commun 2024; 15:1894. [PMID: 38424038 PMCID: PMC10904793 DOI: 10.1038/s41467-024-45720-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
The COVID-19 pandemic led to reductions in non-COVID related healthcare use, but little is known whether this burden is shared equally. This study investigates whether reductions in administered care disproportionately affected certain sociodemographic strata, in particular marginalised groups. Using detailed medical claims data from the Dutch universal health care system and rich full population registry data, we predict expected healthcare use based on pre-pandemic trends (2017 - Feb 2020) and compare these expectations with observed healthcare use in 2020 and 2021. Our findings reveal a 10% decline in the number of weekly treated patients in 2020 and a 3% decline in 2021 relative to prior years. These declines are unequally distributed and are more pronounced for individuals below the poverty line, females, older people, and individuals with a migrant background, particularly during the initial wave of COVID-19 hospitalisations and for middle and low urgency procedures. While reductions in non-COVID related healthcare decreased following the initial shock of the pandemic, inequalities persist throughout 2020 and 2021. Our results demonstrate that the pandemic has not only had an unequal toll in terms of the direct health burden of the pandemic, but has also had a differential impact on the use of non-COVID healthcare.
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Affiliation(s)
- Arun Frey
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK
- Amsterdam Health and Technology Institute, Paasheuvelweg 25, Amsterdam, 1105 BP, The Netherlands
- Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK
| | - Andrea M Tilstra
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK
- Nuffield Department of Population Health, University of Oxford, 42 Park End St, Oxford, OX1 1JD, UK
| | - Mark D Verhagen
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK.
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK.
- Amsterdam Health and Technology Institute, Paasheuvelweg 25, Amsterdam, 1105 BP, The Netherlands.
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK.
- Nuffield Department of Population Health, University of Oxford, 42 Park End St, Oxford, OX1 1JD, UK.
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Pulido J, Barrio G, Donat M, Politi J, Moreno A, Cea-Soriano L, Guerras JM, Huertas L, Mateo-Urdiales A, Ronda E, Martínez D, Lostao L, Belza MJ, Regidor E. Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic. Disaster Med Public Health Prep 2024; 18:e27. [PMID: 38372080 DOI: 10.1017/dmp.2024.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education. METHODS An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison. RESULTS All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people. CONCLUSION Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.
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Affiliation(s)
- José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Huertas
- Instituto Valenciano de Estadística, Valencia, Spain
- National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Ronda
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
| | - David Martínez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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12
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Ayatizadeh SH, Borazjani R, Fereidooni R, Jamali K, Fard HA, Homaeifar R, Shayan L, Saadatjoo Z, Paydar S. Impact of COVID-19 pandemic on trauma mortality patients: A retrospective observational study in an Iranian level 1 trauma center. Health Sci Rep 2024; 7:e1883. [PMID: 38357493 PMCID: PMC10864731 DOI: 10.1002/hsr2.1883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/17/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
Background and Aims The COVID-19 pandemic has reshaped the epidemiology of various clinical conditions, including trauma which is closely tied to social policies. This study examines and compares the characteristics of trauma mortality patients, and their initial prognostic trauma scores, in the pre-pandemic and pandemic periods. Methods We conducted a retrospective observational study involving patients who passed away at a level 1 trauma center from July 23, 2018, to February 19, 2020 (prepandemic), and from February 20, 2020, to September 22, 2021 (pandemic). A subgroup analysis that matched 12 of the same months of the year in the two periods was also done. Patients who arrived deceased or passed away immediately upon arrival were excluded from data analysis. We collected and analyzed demographic and clinical data, employing the Abbreviated Injury Score (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and ISS (TRISS) to compare initial prognoses. Results Our study encompassed 1128 patients, with 529 in the prepandemic group and 599 in the pandemic group. Demographic characteristics showed no significant differences in the number of patients in the two periods. Motor vehicle accidents remained the predominant injury mechanism in both periods. While the mean ISS increased insignificantly (22.80 vs. 22.91, p = 0.902), the mean RTS decreased (6.32 vs. 5.82), and TRISS increased (23.97% vs. 28.93%) during the pandemic (p < 0.05). Hospital length of stay decreased in the pandemic period (15.57 vs. 12.54 days, p < 0.05). Subgroup analysis revealed increased ISS, decreased RTS, and increased TRISS during the pandemic (p < 0.05). Conclusion In conclusion, while overall demographics and injury mechanisms remained virtually unchanged, trauma patients during the pandemic displayed worse estimated clinical prognoses, particularly in physiological trauma scores. The heightened mortality rate was attributed to poorer clinical conditions of patients.
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Affiliation(s)
- Seyyed HamidReza Ayatizadeh
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | - Roham Borazjani
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | - Reza Fereidooni
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Kazem Jamali
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | | | - Reza Homaeifar
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | - Leila Shayan
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | - Zohreh Saadatjoo
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
| | - Shahram Paydar
- Trauma Research Center, Rajaee (Emtiaz) Trauma HospitalShiraz University of Medical SciencesShirazIran
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13
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Pflüger P, Lefering R, Dommasch M, Biberthaler P, Kanz KG. [Impact of the COVID-19 pandemic on the care of major trauma patients: analysis from the TraumaRegister DGU®]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2024; 127:62-68. [PMID: 37341734 PMCID: PMC10786995 DOI: 10.1007/s00113-023-01325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The treatment of major trauma patients requires intensive care capacity, which is a critical resource particularly during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, the aim of this study was to analyze the impact on major trauma care considering the intensive care treatment of COVID-19 positive patients. METHODS Demographic, prehospital, and intensive care treatment data from the TraumaRegister DGU® of the German Trauma Society (DGU) in 2019 and 2020 were analyzed. Only major trauma patients from the state of Bavaria were included. Inpatient treatment data of COVID-19 patients in Bavaria in 2020 were obtained using IVENA eHealth. RESULTS In total, 8307 major trauma patients were treated in the state of Bavaria in the time period investigated. The number of patients in 2020 (n = 4032) compared to 2019 (n = 4275) was not significantly decreased (p = 0.4). Regarding COVID-19 case numbers, maximum values were reached in the months of April and December with more than 800 intensive care unit (ICU) patients per day. In the critical period (> 100 patients with COVID-19 on ICU), a prolonged rescue time was evident (64.8 ± 32.5 vs. 67.4 ± 30.6 min; p = 0.003). The length of stay and ICU treatment of major trauma patients were not negatively affected by the COVID-19 pandemic. CONCLUSION The intensive medical care of major trauma patients could be ensured during the high-incidence phases of the COVID-19 pandemic. The prolonged prehospital rescue times show possible optimization potential of the horizontal integration of prehospital and hospital.
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Affiliation(s)
- Patrick Pflüger
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
| | - Rolf Lefering
- Institut für Forschung in der Operativen Medizin (IFOM), Universität Witten/Herdecke, Witten, Deutschland
| | - Michael Dommasch
- Fakultät für Medizin, Zentrale Interdisziplinäre Notaufnahme, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Peter Biberthaler
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Karl-Georg Kanz
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
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14
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Gunawardena SA, Dassanayake N, Keerawelle BI, Kanthasamy S, Ranganatha H, Gunawardana JW. The effect of the COVID-19 pandemic on the trends and characteristics of natural and unnatural deaths in an urban Sri Lankan cohort viewed through retrospective analysis of forensic death investigations from 2019 to 2022. Osong Public Health Res Perspect 2023; 14:468-482. [PMID: 38204426 PMCID: PMC10788415 DOI: 10.24171/j.phrp.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on global health. Apart from the disease itself, the strict restrictions and lockdowns enforced to minimize its spread have also substantially disrupted personal and public health. METHODS An analysis of forensic autopsy investigations was conducted between 2019 and 2022 on a selected urban population in Colombo, Sri Lanka, assessing the effects of the COVID-19 pandemic on mortality within these communities. RESULTS During the COVID-19 restrictions, there was a 2.5-fold increase in the total number of deaths, with a significantly higher percentage of female deaths than before. The majority of these deaths were due to cardiovascular causes, while COVID-19-related deaths ranked third overall. The highest proportion of COVID-19 deaths occurred among unvaccinated females. The monthly frequency of deaths from traffic accidents, poisoning, and asphyxiation decreased, while deaths from blunt trauma, sharp trauma, burns, and immersion increased. There was also a rise in blunt homicides and a greater number of femicides during the COVID-19 restrictions than in the pre-pandemic period. A significantly higher percentage of males who received the COVID-19 vaccine died from cardiovascular causes compared to those in the unvaccinated group. CONCLUSION The significant changes in mortality demographics and causes of death within this community during the COVID-19 restrictions underscore the disruption in healthcare, healthseeking behavior, and social interactions during this period. The vulnerability of individuals residing in highly urbanized areas with lower socioeconomic status, particularly women, is brought into sharp focus.
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Affiliation(s)
- Sameera Anuruddha Gunawardena
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Pathology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Nishani Dassanayake
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Shivasankarie Kanthasamy
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hasini Ranganatha
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Jayani Wathsala Gunawardana
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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15
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Savinc J, Atherton IM. Have increased deaths at home during the pandemic returned to pre-pandemic levels? An analysis of publicly available Scottish death registrations. J Public Health (Oxf) 2023; 45:e664-e667. [PMID: 37596241 PMCID: PMC10687594 DOI: 10.1093/pubmed/fdad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Deaths at home increased in Scotland at the start of the Coronavirus disease 2019 (COVID-19) pandemic by ~35%. The majority did not involve COVID-19. This has implications for resource allocation and care at the end of life. METHODS Publicly available weekly death registrations by National Records Scotland (NRS) between 2015 and week 25 of 2023 were summarized by place of death. Linear and logistic regressions of the number and proportion of deaths at home, respectively, between 2015 and 2019, were used to estimate the expected number and proportion of deaths in the period 2020-2023 had the pandemic not happened. RESULTS AND CONCLUSION The number of deaths at home continues in 2023 at rates similar to the pandemic period and has not reverted to pre-pandemic levels. Had the pre-pandemic trend of growth in deaths at home continued, the number of deaths observed in 2020 would not be observed until 2025-2032. Deaths at home increased across Local Authorities but the scale of the increase varied. The impact of the increased number of deaths at home on quality of care and quality of death is not known and requires further study.
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Affiliation(s)
- J Savinc
- Edinburgh Napier University, School of Health & Social Care, Edinburgh EH11 4BN, UK
- Scottish Centre for Administrative Data Research, Edinburgh EH8 9BT, UK
| | - I M Atherton
- Edinburgh Napier University, School of Health & Social Care, Edinburgh EH11 4BN, UK
- Scottish Centre for Administrative Data Research, Edinburgh EH8 9BT, UK
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16
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Amado V, Trott S, Möller J, Couto MT, Wallis L, Laflamme L. Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique's central hospitals. BMC Health Serv Res 2023; 23:1071. [PMID: 37803444 PMCID: PMC10559493 DOI: 10.1186/s12913-023-10073-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION There is a substantial body of knowledge on the effects of the COVID-19 pandemic on injuries showing frequent but inconsistent reductions in both volume and pattern. Yet, studies specifically addressing children are less common, not least from low- and middle-income countries. This study investigated whether changes in the pattern and outcome of paediatric injury admissions to Mozambique's four regional referral hospitals during 2020. METHODS Clinical charts of paediatric patients presenting to the targeted hospitals with acute injuries were reviewed using a set of child, injury, and outcome characteristics during each of two consecutive restriction periods in 2020 using as a comparator the same periods in 2019, the year before the pandemic. Differences between 2020 and 2019 proportions for any characteristic were examined using the t-test (significance level 0.05). RESULTS During both restriction periods, compared with the previous year, reductions in the number of injuries were noticed in nearly all aspects investigated, albeit more remarkably during the first restriction period, in particular, greater proportions of injuries in the home setting and from burns (7.2% and 11.5% respectively) and a reduced one of discharged patients (by 2.5%). CONCLUSION During the restrictions implemented to contend the pandemic in Mozambique in 2020, although each restriction period saw a drop in the volume of injury admissions at central hospitals, the pattern of child, injury and outcome characteristics did not change much, except for an excess of home and burn injuries in the first, more restrictive period. Whether this reflects the nature of the restrictions only or, rather, other mechanisms that came into play, individual or health systems related, remains to be determined.
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Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
- Maputo Central Hospital, Maputo, Mozambique.
| | - Sebastien Trott
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Maria Tereza Couto
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Medical Council Maputo, Maputo, Mozambique
| | - Lee Wallis
- Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
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17
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Abu-Zidan FM. Invited commentary on "The impact of the first wave of the COVID-19 pandemic on hospital admissions and treatment management of ectopic pregnancy". Turk J Emerg Med 2023; 23:244-245. [PMID: 38024193 PMCID: PMC10664194 DOI: 10.4103/tjem.tjem_175_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Balčiauskas L, Stratford J, Kučas A, Balčiauskienė L. Lockdown's Silver Lining? Different Levels of Roadkill during the COVID-19 Times in Lithuania. Animals (Basel) 2023; 13:2918. [PMID: 37760319 PMCID: PMC10525093 DOI: 10.3390/ani13182918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The impact of COVID-19 restrictions on human and vehicular mobility on the number of roadkills of wild mammals, and roe deer in particular, was assessed in Lithuania. We statistically analyzed the distribution of all mammals and roe deer (Capreolus capreolus) as the most abundant species annually from 2002 to 2022 and monthly from 2020 to 2021, including during the two restriction periods. Notably, there was a marked decrease in roadkill incidents on main, national and regional roads, particularly in April-May 2020 (the beginning of lockdown period I) and November-December 2020 (the beginning of lockdown period II), 5.1-20.8% and 33.6-54.4%, respectively. During these months, collisions with mammals on the A14 main road were reduced by 75-90%. However, there was a significant increase in the number of roadkills in urban areas, resulting in the total number of mammal-vehicle and roe deer-vehicle collisions in 2020 and 2021 being higher than expected based on long-term trends. However, after restrictions were eased, collision numbers with wildlife on the main, national and regional roads increased again and became higher than expected.
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Affiliation(s)
- Linas Balčiauskas
- Nature Research Centre, Akademijos Str. 2, 08412 Vilnius, Lithuania (L.B.)
| | - Jos Stratford
- Nature Research Centre, Akademijos Str. 2, 08412 Vilnius, Lithuania (L.B.)
| | - Andrius Kučas
- European Commission, Joint Research Centre, Via Fermi 2749, 21027 Ispra, Italy
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19
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Myran DT, Gaudreault A, Pugliese M, Manuel DG, Tanuseputro P. Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization. JAMA Netw Open 2023; 6:e2331551. [PMID: 37672273 PMCID: PMC10483310 DOI: 10.1001/jamanetworkopen.2023.31551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023] Open
Abstract
Importance The impact of nonmedical cannabis legalization on traffic injuries and cannabis involvement in traffic injuries is unclear. Objective To examine changes in the number and characteristics of cannabis-involved traffic injury emergency department (ED) visits from before to after legalization and subsequent commercialization (ie, increased retail store and product availability) of cannabis in Ontario, Canada. Design, Setting, and Participants This repeated cross-sectional study examined changes in cannabis- and alcohol-involved traffic injury ED visits in Ontario, Canada, during 3 time periods: prelegalization (January 2010-September 2018), legalization with product and retail store restrictions (October 2018-February 2020), and commercialization with new products and expanded number of stores, which coincided with the COVID-19 pandemic (March 2020-December 2021). All individuals aged 16 years and older eligible for Ontario's Universal Health Coverage were included. Season- and time-adjusted quasi-Poisson models were used to generate rate ratios with 95% CIs. Data were analyzed from March to April 2023. Main Outcomes and Measures Quarterly counts of cannabis-involved ED visits for traffic injury. Results There were 947 604 traffic injury ED visits, of which 426 (0.04%) had documented cannabis involvement and 7564 (0.8%) had documented alcohol involvement. Of the 418 individuals with documented cannabis involvement, 330 (78.9%) were male, 109 (25.6%) were aged 16 to 21 years (mean [SD] age at visit, 30.6 [12.0] years), and 113 (27.0%) had an ED visit or hospitalization for substance use in the 2 years before their traffic injury ED visit. Annual rates of cannabis-involved traffic injury ED visits increased 475.3% over the study period (0.18 visits per 1000 total motor vehicle collisions in 2010 to 1.01 in 2021). Over the same period, alcohol-involved traffic injury ED visits increased by 9.4% (8.03 in 2010 to 8.79 per 1000 traffic injury ED visits in 2021). Legalization with restrictions was associated with a 94% increase in the quarterly rate of cannabis involvement in traffic injury ED visits relative to prelegalization (adjusted rate ratio [aRR], 1.94; 95% CI, 1.37-2.75). Commercialization/COVID-19 was associated with a greater increase of 223% in rates (aRR, 3.23; 95% CI, 2.42-4.33). After adjusting for time trends before legalization, only commercialization/COVID-19 was associated with increased rates. Male sex (adjusted odds ratio [aOR], 3.38; 95% CI, 2.66-4.29), living in the lowest-income neighborhood (aOR, 1.92; 95% CI, 1.39-2.67), being aged 19 to 21 years (aOR, 4.67; 95% CI, 3.27-6.67), and having a prior cannabis-related ED visit (aOR, 8.03; 95% CI, 5.85-11.02) were all positively associated with cannabis involvement during a traffic injury ED visit. Conclusions and Relevance This cross-sectional study found large increases in cannabis involvement in ED visits for traffic injury over time, which may have accelerated following nonmedical cannabis commercialization. Although the frequency of visits was rare, they may reflect broader changes in cannabis-impaired driving. Greater prevention efforts, including targeted education and policy measures, in regions with legal cannabis are indicated.
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Affiliation(s)
- Daniel T. Myran
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Adrienne Gaudreault
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Michael Pugliese
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Douglas G. Manuel
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Bruyère Research Institute, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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20
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Hernández V, Fuentes CM. Risk exposure factors influencing the frequency of road crashes during the COVID-19 pandemic in Ciudad Juarez, Mexico. A negative binomial spatial regression model. Int J Inj Contr Saf Promot 2023; 30:362-374. [PMID: 36927303 DOI: 10.1080/17457300.2023.2188469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/15/2023] [Accepted: 03/03/2023] [Indexed: 03/17/2023]
Abstract
The article aims to investigate the influence of risk exposure factors on the frequency of road crashes from January to August 2020 in Ciudad Juarez, Mexico. It is a longitudinal study with four data sets: road crashes, population and housing census, location of economic activities, and road network information. Specifically, this study investigates the relationship between exposure factors - demographics, main roads and land use - and road crashes. A mixed method analysis was employed, (1) spatial analysis using GIS techniques; and (2) a negative binomial spatial regression model. The results showed a strong spatial dependence (0.274; p-value 0.00) of road crashes in the census tracts, and this effect was statistically significant (0.007) in the spatial regression model. In the model, a high probability (<0.05) of road crashes in the census tracts was found with the population aged 15 to 65 years, the length of main roads and the level of road coverage (Engel index), land uses with economic activities of an industrial and commercial character. The findings of this study successfully capture the social, economic, and urban conditions during the January-August 2020 period in the context of the COVID-19 pandemic. This new knowledge could help create preventive plans and policies to address the frequency of road crashes.
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Affiliation(s)
- Vladimir Hernández
- Architecture Department, Universidad Autonoma de Ciudad Juarez, Ciudad Juarez, Mexico
| | - César M Fuentes
- Urban and Environmental Studies Department, El Colegio de la Frontera Norte, Ciudad Juarez, Mexico
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21
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Redelmeier DA, Wang J, Thiruchelvam D. The Reply. Am J Med 2023; 136:e180-e181. [PMID: 37612021 DOI: 10.1016/j.amjmed.2023.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Donald A Redelmeier
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada; Center for Leading Injury Prevention Practice Education & Research, Toronto, Ont, Canada.
| | - Jonathan Wang
- Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
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22
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Kempers EK, Chen Q, Visser C, van Gorp ECM, Klok FA, Cannegieter SC, Kruip MJHA. Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020. Sci Rep 2023; 13:12832. [PMID: 37553430 PMCID: PMC10409797 DOI: 10.1038/s41598-023-39573-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
This population-based cohort study aimed to describe changes in incidence of cardiovascular disease (CVD) hospital diagnoses during the COVID-19 pandemic in The Netherlands compared with the pre-pandemic period. We used Dutch nationwide statistics about hospitalizations to estimate incidence rate ratios (IRR) of hospital diagnoses of CVD during the first and second COVID-19 waves in The Netherlands in 2020 versus the same periods in 2019. Compared with 2019, the incidence rate of a hospital diagnosis of ischemic stroke (IRR 0.87; 95% CI 0.79-0.95), major bleeding (IRR 0.74; 95% CI 0.68-0.82), atrial fibrillation (IRR 0.73; 95% CI 0.65-0.82), myocardial infarction (IRR 0.78; 95% CI 0.72-0.84), and heart failure (IRR 0.74; 95% CI 0.65-0.85) declined during the first wave, but returned to pre-pandemic levels throughout 2020. However, the incidence rate of a hospital diagnosis of pulmonary embolism (PE) increased during both the first and second wave in 2020 compared with 2019 (IRR 1.30; 95% CI 1.15-1.48 and IRR 1.31; 95% CI 1.19-1.44, respectively). In conclusion, we observed substantial declines in incidences of CVD during the COVID-19 pandemic in The Netherlands in 2020, especially during the first wave, with an exception for an increase in incidence of PE. This study contributes to quantifying the collateral damage of the COVID-19 pandemic.
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Affiliation(s)
- Eva K Kempers
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Qingui Chen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Chantal Visser
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Eric C M van Gorp
- Department of Viroscience, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Infectious Diseases, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frederikus A Klok
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Suzanne C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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23
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Alkhudhairy MK, Aldhalemi AA. The impact of politics, security and health on the escalation of road traffic accidents and their consequences in Iraq for the period 2015-2020. Niger Postgrad Med J 2023; 30:250-257. [PMID: 37675702 DOI: 10.4103/npmj.npmj_121_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background This study aimed to detect the impact of politics, security and health on the escalation of road traffic accidents (RTAs) and their consequences in Iraq for the period 2015-2020. Methodology The data of this cross-sectional study were obtained from the annual reports of RTA statistics from the Central Statistical Organisation of the Iraqi Ministry of Planning. The statistical analysis of data was done using the Statistical Package for the Social Sciences. Results In this study, it was noted that the rate of RTAs, injuries and deaths increased from 16% to 19.5%, from 16.5% to 17.3% and from 16.2% to 20%, respectively, for the years 2015-2019, while the rates of RTAs, injuries and deaths in 2020 recorded a clear decrease compared to the rest of the years under study, and the rates were as follows: 14.8%, 14.4% and 14.1%, respectively. According to the types of traffic accidents, the rate of crashes recorded the highest rate of 51% in all years of the study compared to the run over, overturn and other unclassified accidents, which were 37%, 10% and 2%, respectively, and it was revealed that crashes, run over and other unclassified incidents increased from 5% to 20%, from 17% to 19% and from 18% to 26%, respectively, for the years 2015-2019, whereas all types of RTAs in 2020 were recorded the lowest rates compared to other years under study. Al-Basra, Baghdad, Al-Najaf and Babylon were recorded the highest rates of traffic accidents for the 6 years under study, with a rate of 13.3%, 11.7%, 11.1% and 10.4%, respectively. Conclusions Although traffic accidents were not recorded in the years 2015, 2016 and 2017 for the governorates of Nineveh and Anbar due to the occupation of the terrorist Islamic State, traffic accidents maintained their levels due to internal migration. It was also noted that the rate of road accidents was the highest in 2019 compared to the years under study due to the liberation of occupied cities, the return of safety and the return of recording accident data again, while the year 2020 recorded a clear decrease in the rate of road accidents, especially in the first half of it due to the October protests that led to the suspension of all government institutions, universities and schools. The second reason for the decrease in the second half of 2020 is attributed to the lockdown of corona. It seems that the political, security, military and health factors have an effective impact on the traffic reality.
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Affiliation(s)
- Miaad K Alkhudhairy
- Department of Community Health Techniques, Health and Medical Technical College, Al-Furat Al-Awsat Technical University, Kufa, Iraq
| | - Ali A Aldhalemi
- Department of Building and Constructions Engineering Techniques, Engineering Technical College/Al-Najaf, Al-Furat Al-Awsat Technical University, Kufa, Iraq
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24
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Soltani A, Azmoodeh M, Roohani Qadikolaei M. Road crashes in Adelaide metropolitan region, the consequences of COVID-19. JOURNAL OF TRANSPORT & HEALTH 2023; 30:101581. [PMID: 36778534 PMCID: PMC9894777 DOI: 10.1016/j.jth.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/28/2022] [Accepted: 01/31/2023] [Indexed: 06/04/2023]
Abstract
Background Many countries instituted lockdown rules as the COVID-19 pandemic progressed, however, the effects of COVID-19 on transportation safety vary widely across countries and regions. In several situations, it has been shown that although the COVID-19 closure has decreased average traffic flow, it has also led to an increase in speeding, which will indeed increase the severity of crashes and the number of fatalities and serious injuries. Methods At the local level, Generalized linear Mixed (GLM) modelling is used to look at how often road crashes changed in the Adelaide metropolitan area before and after the COVID-19 pandemic. The Geographically Weighted Generalized Linear Model (GWGLM) is also used to explore how the association between the number of crashes and the factors that explain them varies across census blocks. Using both no-spatial and spatial models, the effects of urban structure elements like land use mix, road network design, distance to CBD, and proximity to public transit on the frequency of crashes at the local level were studied. Results This research showed that lockdown orders led to a mild reduction (approximately 7%) in crash frequency. However, this decrease, which has occurred mostly during the first three months of the lockdown, has not systematically alleviated traffic safety risks in the Greater Adelaide Metropolitan Area. Crash hotspots shifted from areas adjacent to workplaces and education centres to green spaces and city fringes, while crash incidence periods switched from weekdays to weekends and winter to summer. Implications The outcomes of this research provided insights into the impact of shifting driving behaviour on safety during disorderly catastrophes such as COVID-19.
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Key Words
- ABS, Australian bureau of statistics
- Adelaide
- CBD, Central business district
- COVID-19
- COVID19, Coronavirus disease of 2019
- GLM
- GLM, Generalized linear model
- GWGLM
- GWGLM, Geographically weighted generalized linear model
- GWR, Geographically weighted regression
- Injury
- LGA, Local government area
- PDO, Property damage only
- RV, Response variable
- SA1, Statistical area level 1
- TAZ, Traffic analysis zone
- Traffic crash
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Affiliation(s)
- Ali Soltani
- Injury Studies, Flinders Health and Medical Research Institute, Bedford Park, SA, 5042, Australia
- UniSA Business, University of South Australia, North Terrace, Adelaide, SA, 5001, Australia
- Faculty of Art and Architecture, Shiraz University, Shiraz, Iran
| | - Mohammad Azmoodeh
- Department of Transportation and Highway, Babol Noshirvani University of Technology, Babol, Iran
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25
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Mavragani A, Blizzard CL, Palmer A, Nguyen HT, Cong Quyet T, Tran V, Nelson M. COVID-19 in Vietnam and Its Impact on Road Trauma: Retrospective Study Based on National Data. Interact J Med Res 2023; 12:e40883. [PMID: 36718815 PMCID: PMC9907775 DOI: 10.2196/40883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/19/2022] [Accepted: 01/31/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Despite significant improvement in the last decade, road trauma remains a substantial contributor to deaths in Vietnam. The COVID-19 pandemic necessitated public health measures that had an unforeseen benefit on road trauma in high-income countries. We investigate if this reduction was also seen in a low- to middle-income country like Vietnam. OBJECTIVE Our aim was to investigate how the COVID-19 pandemic and the government policies implemented in response to it impacted road trauma fatalities in Vietnam. We also compared this impact to other government policies related to road trauma implemented in the preceding 14 years (2007-2020). METHODS COVID-19 data were extracted from the Vietnamese Ministry of Health database. Road traffic deaths from 2007 to 2021 were derived from the Vietnamese General Statistical Office. We used Stata software (version 17; StataCorp) for statistical analysis. Poisson regression modeling was used to estimate trends in road fatality rates based on annual national mortality data for the 2007-2021 period. The actual change in road traffic mortality in 2021 was compared with calculated figures to demonstrate the effect of COVID-19 on road trauma fatalities. We also compared this impact to other government policies that aimed to reduce traffic-related fatalities from 2007 to 2020. RESULTS Between 2007 and 2020, the number of annual road traffic deaths decreased by more than 50%, from 15.3 to 7 per 100,000 population, resulting in an average reduction of 5.4% per annum. We estimated that the road traffic mortality rate declined by 12.1% (95% CI 8.9-15.3%) in 2021 relative to this trend. The actual number of road trauma deaths fell by 16.4%. This reduction was largely seen from August to October 2021 when lockdown and social distancing measures were in force. CONCLUSIONS In 2021, the road traffic-related death reduction in Vietnam was 3 times greater than the trend seen in the preceding 14 years. The public health response to the COVID-19 pandemic in Vietnam was associated with a third of this reduction. It can thus be concluded that government policies implemented to address the COVID-19 pandemic resulted in a 4.3% decrease in road traffic deaths in 2021. This has been observed in high-income countries, but we have demonstrated this for the first time in a low- and middle-income country.
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Affiliation(s)
| | | | - Andrew Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | | | - Viet Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Tasmanian School of Medicine, University of Tasmania, Hobart, Australia.,Tasmanian Health Service, Hobart, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Heuveline P. The Covid-19 pandemic and the expansion of the mortality gap between the United States and its European peers. PLoS One 2023; 18:e0283153. [PMID: 36989259 PMCID: PMC10057752 DOI: 10.1371/journal.pone.0283153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
The mortality gap between the United States and other high-income nations substantially expanded during the first two decades of the 21st century. International comparisons of Covid-19 mortality suggest this gap might have grown during the Covid-19 pandemic. Applying population-weighted average mortality rates of the five largest West European countries to the US population reveals that this mortality gap increased the number of US deaths by 34.8% in 2021, causing 892,491 "excess deaths" that year. Controlling for population size, the annual number of excess deaths has nearly doubled between 2019 and 2021 (+84.9%). Diverging trends in Covid-19 mortality contributed to this increase in excess deaths, especially towards the end of 2021 as US vaccination rates plateaued at lower levels than in European countries. In 2021, the number of excess deaths involving Covid-19 in the United States reached 223,266 deaths, representing 25.0% of all excess deaths that year. However, 45.5% of the population-standardized increase in excess deaths between 2019 and 2021 is due to other causes of deaths. While the contribution of Covid-19 to excess mortality might be transient, divergent trends in mortality from other causes persistently separates the United States from West European countries. Excess mortality is particularly high between ages 15 and 64. In 2021, nearly half of all US deaths in this age range are excess deaths (48.0%).
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Affiliation(s)
- Patrick Heuveline
- Faculty Associate Director, California Center for Population Research at UCLA, Los Angeles, CA, United States of America
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27
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Ansari S, Du H, Naghdy F, Sattar A. Impact of Post-Covid-19 on driver behaviour: A perspective towards pandemic-sustained transportation. JOURNAL OF TRANSPORT & HEALTH 2023; 28:101563. [PMID: 36619698 PMCID: PMC9808417 DOI: 10.1016/j.jth.2022.101563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 12/01/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION With the announcement of novel Coronavirus disease 2019 (Covid-19) as a pandemic by World Health Organization (WHO) in March 2020, the whole world went into a lockdown that heavily affected human economic and social life. Since December 2020, with the discovery of effective vaccines, the world is now returning to some normality, particularly for those who are vaccinated. The multimodal transportation has resumed with majority of vaccinated drivers being back on road, driving to their work, and providing transport services. However, there are still several long-term Post-Covid-19 factors, affecting driver health and psychology. METHODS The study deployed a systematic search strategy and selected 62 research publications after rigorous evaluation of the literature. The review was based on (1) forming the inclusion and exclusion criteria, (2) selecting the appropriate keywords, and (3) searching of relevant publications and assessing the eligible articles. RESULTS A broad perspective study is carried out to gauge the impact of Post-Covid-19 scenarios on the driver physical health and mindset in the context of road safety and pandemic-sustained transportation. It was found that the Post-Covid-19 factors such as wearing face-mask during driving, taking oral anti-viral drugs, and fear of contracting disease, significantly impact the driver's performance and situation awareness skills. The analysis suggested that driver's health vitals and psychological driving awareness can be precisely detected through hybrid driver state monitoring methods. CONCLUSIONS The paper conducts a comprehensive review of the published work and provides unique research opportunities to counteract the challenges involved in precise monitoring of driver behaviour under the effects of different Post-Covid-19 factors. The perspective suggested the possible solutions to live with the pandemic in the context of pandemic-sustained transportation.
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Affiliation(s)
- Shahzeb Ansari
- School of Electrical, Computer and Telecommunication Engineering (SECTE), Faculty of Engineering and Information Sciences (EIS), University of Wollongong, New South Wales, Australia
| | - Haiping Du
- School of Electrical, Computer and Telecommunication Engineering (SECTE), Faculty of Engineering and Information Sciences (EIS), University of Wollongong, New South Wales, Australia
| | - Fazel Naghdy
- School of Electrical, Computer and Telecommunication Engineering (SECTE), Faculty of Engineering and Information Sciences (EIS), University of Wollongong, New South Wales, Australia
| | - Abdul Sattar
- School of Engineering, RMIT University, Victoria, Australia
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28
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Zińczuk A, Rorat M, Jurek T. COVID-19-related excess mortality - an overview of the current evidence. ARCHIVES OF FORENSIC MEDICINE AND CRIMINOLOGY 2023; 73:33-44. [PMID: 38186033 DOI: 10.4467/16891716amsik.22.004.18214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 01/09/2024] Open
Abstract
Analysis of excess deaths, defined as the difference in the total number of deaths in an emergency compared to the number of deaths expected under normal conditions, allows a more reliable assessment of the impact on health systems caused by the global threat of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). So far, data for the two years of the pandemic (2020-2021) indicates the occurrence of 14.9 million excess deaths according to WHO (World Health Organization) estimates. The purpose of the analysis conducted was to define the concept and identify the causes of excess mortality during the COVID-19 pandemic. Inconsistent and unreliable death registration systems; overburdened health systems in low- and middle-income countries; reduced access to medical services for patients with health problems other than COVID-19; the introduction of social distancing and lockdown rules, which translated into increased deaths from psychiatric illnesses and addictions; political considerations and media messages that interfered with vaccination acceptance and adherence; and the additional impact of other natural disasters (hurricanes, floods, drought) were identified as the most important reasons for excess deaths occurrence. The correct identification of country-specific factors and the correct response and countermeasures taken appear crucial in terms of limiting the negative impact of the current pandemic, but also of future threats of a similar nature, in order to reduce excess deaths.
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Affiliation(s)
| | - Maria Rorat
- Department of Forensic Medicine, Wroclaw Medical University, Poland
| | - Tomasz Jurek
- Department of Forensic Medicine, Wroclaw Medical University, Poland
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29
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Gatt T, Zammit S, Chircop KL, Gatt D, Sultana L, Micallef T, Grech A, Esposito I. The Impact of the COVID-19 Pandemic on Injury Patterns in Inpatient and Outpatient Orthopaedic Trauma. Surg J (N Y) 2022; 8:e302-e307. [PMID: 36578468 PMCID: PMC9792219 DOI: 10.1055/s-0042-1757427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 12/28/2022] Open
Abstract
The effect of banning of nonessential services during the novel coronavirus disease 2019 (COVID-19) pandemic led to a perceived change in the volume of trauma cases and injury patterns. Literature indicates trends toward less trauma overall, with a decrease in outdoor, sporting, and motor vehicle injuries. However, studies focusing on outpatient orthopaedic trauma are less common. The main aim of this study was to assess the effect of COVID-19 pandemic on differences in inpatient and outpatient injury patterns and mechanisms. Patients requiring orthopaedic inpatient admission to Mater Dei Hospital, Malta, were analyzed between March 15 and June 17 between 2019 and 2021. For outpatients, all newly referred patients seen at the fresh trauma clinic (FTC) on the first 5 clinic days of each month from April to June between 2019 and 2021 were assessed. There were a total of 503, 362, and 603 hospital admissions during the data collection period from 2019, 2020 and 2021, respectively. There was a decrease in elbow ( p = 0.015) and pelvis ( p = 0.038) pathology since COVID-19 pandemic. In contrast, there was an increase in shoulder injuries ( p = 0.036) and lacerated wounds ( p = 0.012) in 2021. The most frequent mechanisms of injury for inpatients were low impact falls, and fall from heights greater than 1 m. Machine-related injuries ( p = 0.002), blunt trauma ( p = 0.004), and twisting injuries ( p = 0.029) increased in 2021. In the outpatient setting, there were a total of 367, 232, and 299 new referrals in 2019, 2020, and 2021, respectively. Injury patterns in this cohort were similar throughout, except for a significant increase in shoulder injuries during 2020 ( p = 0.009). There appears to be some minor variation in injury mechanisms due to lifestyle changes; however, most injury patterns have remained fairly constant. Further research should focus on the use of public awareness campaigns to decrease home-related trauma during enforced periods of lockdown.
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Affiliation(s)
- Thomas Gatt
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta,Address for correspondence Thomas Gatt, MD, MRCS Department of Orthopaedics and Trauma, Mater Dei Hospital, Triq Dun KarmL-Imsida, Malta, MSD2090
| | - Sharon Zammit
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Kurt L. Chircop
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Denise Gatt
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Luke Sultana
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Terence Micallef
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Adriana Grech
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
| | - Ivan Esposito
- Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
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Sarı Doğan F, Öztürk TC. The effect of the COVID-19 pandemic on forensic cases admitted to an emergency department. Forensic Sci Med Pathol 2022:10.1007/s12024-022-00565-3. [PMID: 36520378 PMCID: PMC9753859 DOI: 10.1007/s12024-022-00565-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 disease has given rise to various negative effects on human life in terms of health and economic and social well-being. We believe that these negative effects may have led to increased forensic incidents such as violence and suicide. Therefore, in this study, we sought to examine the effects of COVID-19 in forensic cases admitted to an emergency department. Methods: This is a retrospective observational study, performed at the emergency department of Fatih Sultan Mehmet Education and Research Hospital. Forensic cases admitted between March and June 2020 (pandemic period) and forensic cases admitted between March and June 2019 (pre-pandemic period) were compared in the study. Results: A total of 4296 patients were included in the study, of which 3011 were admitted during the pre-pandemic period and 1285 during the time of the COVID-19 pandemic. While the percentages of suicide attempts (3.6%), motorcycle traffic accidents (7.4%), and violent incidents (29.4%) were higher during the pandemic period, the percentages of in-vehicle traffic accidents (5.4%) and pedestrian traffic accidents (2.2%) were lower (respectively, p = 0.035, p = 0.005, p < 0.001, p = 0.015, p = 0.008). At the time of the pandemic, the percentages of incidents of violence against women (44.2%) and traffic accidents with a motorcycle involving men (9.3%) were higher than during the time before the pandemic (p < 0.001 and p < 0.001, respectively). Conclusions: The effects of the pandemic on our lifestyle are indisputable. This study reveals that the pandemic also affected patients who were admitted to the emergency department for forensic reasons. In addition, the increase in the percentages of suicide and violent events indicates that pandemics probably increase feelings of fear, loss, and hopelessness, and special precautions should be taken to maintain order in the society.
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Affiliation(s)
- Fatma Sarı Doğan
- Emergency Medicine Clinic, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Tuba Cimilli Öztürk
- Emergency Medicine Clinic, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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Shearston JA, Cerna-Turoff I, Hilpert M, Kioumourtzoglou MA. Quantifying diurnal changes in NO 2 due to COVID-19 stay-at-home orders in New York City. HYGIENE AND ENVIRONMENTAL HEALTH ADVANCES 2022; 4:100032. [PMID: 36926117 PMCID: PMC9580220 DOI: 10.1016/j.heha.2022.100032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
Abstract
Introduction Policy responses to the COVID-19 pandemic, such as the NY on Pause stay-at-home order (March 22 - June 8, 2020), substantially reduced traffic and traffic-related air pollution (TRAP) in New York City (NYC). We evaluated the magnitude of TRAP decreases and examined the role of modifying factors such as weekend/weekday, road proximity, location, and time-of-day. Methods Hourly nitrogen dioxide (NO2) concentrations from January 1, 2018 through June 8, 2020 were obtained from the Environmental Protection Agency's Air Quality System for all six hourly monitors in the NYC area. We used an interrupted time series design to determine the impact of NY on Pause on NO2 concentrations, using a mixed effects model with random intercepts for monitor location, adjusted for meteorology and long-term trends. We evaluated effect modification through stratification. Results NO2 concentrations decreased during NY on Pause by 19% (-3.2 ppb, 95% confidence interval [CI]: -3.5, -3.0), on average, compared to pre-Pause time trends. We found no evidence for modification by weekend/weekday, but greater decreases in NO2 at non-roadside monitors and weak evidence for modification by location. For time-of-day, we found the largest decreases for 5 am (27%, -4.5 ppb, 95% CI: -5.7, -3.3) through 7 am (24%, -4.0 ppb, 95% CI: -5.2, -2.8), followed by 6 pm and 7 pm (22%, -3.7 ppb, 95% CI: -4.8, -2.6 and 22%, -4.8, -2.5, respectively), while the smallest decreases occurred at 11 pm and 1 am (both: 11%, -1.9 ppb, 95% CI: -3.1, -0.7). Conclusion NY on Pause's impact on TRAP varied greatly diurnally. Decreases during early morning and evening time periods are likely due to decreases in traffic. Our results may be useful for planning traffic policies that vary by time of day, such as congestion tolling policies.
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Affiliation(s)
- Jenni A Shearston
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St., 11th Floor, New York, NY, 10032, USA
| | - Ilan Cerna-Turoff
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St., 11th Floor, New York, NY, 10032, USA
| | - Markus Hilpert
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St., 11th Floor, New York, NY, 10032, USA
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St., 11th Floor, New York, NY, 10032, USA
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Seresirikachorn K, Singhanetr P, Soonthornworasiri N, Amornpetchsathaporn A, Theeramunkong T. Characteristics of road traffic mortality and distribution of healthcare resources in Thailand. Sci Rep 2022; 12:20255. [PMID: 36424407 PMCID: PMC9686261 DOI: 10.1038/s41598-022-24811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022] Open
Abstract
Road traffic mortalities (RTMs), a leading cause of death globally, mostly occur in low- and middle-income countries, and having sufficient healthcare resources could lower the number of these fatalities. Our study aimed to illustrate the incidence of RTMs per 100,000 population and to compare the distribution of healthcare resources from 2011 to 2021 with rates of RTMs in the 77 provinces of Thailand. We divided the population into adults (≥ 15 years) and children (0-14 years). Lorenz curve and Gini coefficient were used to measure the level of distribution and equality of hospital resources and in relation to RTMs across the country. The average number of deaths was 30.34 per 100,000 per year, with male predominance. The RTM rates for adults and children were 32.71 and 19.08 per 100,000 respectively, and motorcycle accidents accounted for the largest percentage of deaths across all age groups. The Gini coefficient showed that operating rooms (0.42) were the least equally distributed hospital resource, while physicians were the most equally distributed (0.34). Anomalies were identified between the distribution of RTMs and available hospital resources. We hope our study will be beneficial in reallocating these resources more fairly to reflect the different numbers of traffic accidents in each province with the aim of reducing lower traffic-related deaths.
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Affiliation(s)
- Kasem Seresirikachorn
- grid.412434.40000 0004 1937 1127Sirindhorn International Institute of Technology, Thammasat University, Pathumthani, Thailand
| | - Panisa Singhanetr
- Mettapracharak Eye Institute, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand
| | - Ngamphol Soonthornworasiri
- grid.10223.320000 0004 1937 0490Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Anyarak Amornpetchsathaporn
- grid.412665.20000 0000 9427 298XDepartment of Ophthalmology, College of Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand
| | - Thanaruk Theeramunkong
- grid.412434.40000 0004 1937 1127Sirindhorn International Institute of Technology, Thammasat University, Pathumthani, Thailand
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Strassle PD, Kinlaw AC, Ko JS, Quintero SM, Bonilla J, Ponder M, Nápoles AM, Schiro SE. Effect of Stay-at-Home orders and other COVID-related policies on trauma hospitalization rates and disparities in the USA: a statewide time-series analysis. Inj Epidemiol 2022; 9:33. [PMID: 36414998 PMCID: PMC9680127 DOI: 10.1186/s40621-022-00409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To combat the coronavirus pandemic, states implemented several public health policies to reduce infection and transmission. Increasing evidence suggests that these prevention strategies also have had a profound impact on non-COVID healthcare utilization. The goal of this study was to determine the impact of a statewide Stay-at-Home order and other COVID-related policies on trauma hospitalizations, stratified by race/ethnicity, age, and sex. METHODS We used the North Carolina Trauma Registry, a statewide registry of trauma hospitalizations for 18 hospitals across North Carolina, including all North Carolina trauma centers, to calculate weekly rates of assault, self-inflicted, unintentional motor vehicle collision (MVC), and other unintentional injury hospitalizations between January 1, 2019, and December 31, 2020. Interrupted time-series design and segmented linear regression were used to estimate changes in hospitalization rates after several COVID-related executive orders, overall and stratified by race/ethnicity, age, and sex. Changes in hospitalization rates were assessed after 1) USA declaration of a public health emergency; 2) North Carolina statewide Stay-at-Home order; 3) Stay-at-Home order lifted with restrictions (Phase 2: Safer-at-Home); and 4) further lifting of restrictions (Phase 2.5: Safer-at-Home). RESULTS There were 70,478 trauma hospitalizations in North Carolina, 2019-2020. In 2020, median age was 53 years old and 59% were male. Assault hospitalization rates (per 1,000,000 NC residents) increased after the Stay-at-Home order, but substantial increases were only observed among Black/African American residents (weekly trend change = 1.147, 95% CI = 0.634 to 1.662) and 18-44-year-old males (weekly trend change = 1.708, 95% CI = 0.870 to 2.545). After major restrictions were lifted, assault rates decreased but remained elevated compared to pre-COVID levels. Unintentional non-MVC injury hospitalizations decreased after the USA declared a public health emergency, especially among women ≥ 65 years old (weekly trend change = -4.010, 95% CI = -6.166 to -1.855), but returned to pre-pandemic levels within several months. CONCLUSIONS Statewide Stay-at-Home orders placed Black/African American residents at higher risk of assault hospitalizations, exacerbating pre-existing disparities. Males 18-44 years old were also at higher risk of assault hospitalization. Fear of COVID-19 may have led to decreases in unintentional non-MVC hospitalization rates, particularly among older females. Policy makers must anticipate policy-related harms that may disproportionately affect already disadvantaged communities and develop mitigation approaches.
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Affiliation(s)
- Paula D. Strassle
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Alan C. Kinlaw
- grid.10698.360000000122483208Division of Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, Chapel Hill, NC USA ,grid.10698.360000000122483208Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Jamie S. Ko
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Stephanie M. Quintero
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Jackie Bonilla
- grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Madison Ponder
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Anna María Nápoles
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Sharon E. Schiro
- grid.10698.360000000122483208Division of General, Acute Care, and Trauma Surgery, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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Pikala M, Krzywicka M, Burzyńska M. Excess mortality in Poland during the first and second wave of the COVID-19 pandemic in 2020. Front Public Health 2022; 10:1048659. [PMID: 36466544 PMCID: PMC9713822 DOI: 10.3389/fpubh.2022.1048659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of the study was to analyse excess deaths by major causes of death and associated changes in the mortality pattern of the Polish population in 2020 due to the impact of the COVID-19 pandemic. Methods The study used data on all deaths in Poland which occurred between 2010 and 2020 (N = 3,912,237). 10-year mortality trends for 2010-2019 were determined. An analysis of time trends has been carried out with joinpoint models and Joinpoint Regression Program. Based on the determined regression models, the number of deaths expected in 2020 and the number of excess deaths due to selected causes were calculated. Results The crude death rates of all-cause deaths increased from 2000 to 2019 at an average annual rate of 1% (p = 0.0007). The determined regression model revealed that the number of deaths in 2020 should have been 413,318 (95% CI: 411,252 to 415,385). In reality, 477,355 people died in Poland that year. The number of excess deaths was therefore 64,037 (15.5%). According to data from Statistics Poland the number of COVID-19-related deaths was 40,028, the number of non-COVID-19 deaths was 24,009. The largest percentage increase over the expected number of deaths was observed for suicide (12.5%), mental and behavioral disorders (7.2%) and diseases of circulatory system (5.9%). A lower than expected number of deaths was observed for malignant neoplasms (-3.2%) and transport accidents (-0.1%). Conclusion The difference between expected and observed non-COVID-19 deaths in 2020 indicates a need for further analysis of the causes of excess mortality.
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Affiliation(s)
- Małgorzata Pikala
- Department of Epidemiology and Biostatistics, The Chair of Social and Preventive Medicine of the Medical University of Lodz, Łódź, Poland
| | - Małgorzata Krzywicka
- Faculty of Technical Physics, Information Technology, and Applied Mathematics, Lodz University of Technology, Łódź, Poland
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, The Chair of Social and Preventive Medicine of the Medical University of Lodz, Łódź, Poland,*Correspondence: Monika Burzyńska
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Jiang S, You C, Zhang S, Chen F, Peng G, Liu J, Xie D, Li Y, Guo X. Using search trends to analyze web-based users' behavior profiles connected with COVID-19 in mainland China: infodemiology study based on hot words and Baidu Index. PeerJ 2022; 10:e14343. [PMID: 36389414 PMCID: PMC9653070 DOI: 10.7717/peerj.14343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mainland China, the world's most populous region, experienced a large-scale coronavirus disease 2019 (COVID-19) outbreak in 2020 and 2021, respectively. Existing infodemiology studies have primarily concentrated on the prospective surveillance of confirmed cases or symptoms which met the criterion for investigators; nevertheless, the actual impact regarding COVID-19 on the public and subsequent attitudes of different groups towards the COVID-19 epidemic were neglected. Methods This study aimed to examine the public web-based search trends and behavior patterns related to COVID-19 outbreaks in mainland China by using hot words and Baidu Index (BI). The initial hot words (the high-frequency words on the Internet) and the epidemic data (2019/12/01-2021/11/30) were mined from infodemiology platforms. The final hot words table was established by two-rounds of hot words screening and double-level hot words classification. Temporal distribution and demographic portraits of COVID-19 were queried by search trends service supplied from BI to perform the correlation analysis. Further, we used the parameter estimation to quantitatively forecast the geographical distribution of COVID-19 in the future. Results The final English-Chinese bilingual table was established including six domains and 32 subordinate hot words. According to the temporal distribution of domains and subordinate hot words in 2020 and 2021, the peaks of searching subordinate hot words and COVID-19 outbreak periods had significant temporal correlation and the subordinate hot words in COVID-19 Related and Territory domains were reliable for COVID-19 surveillance. Gender distribution results showed that Territory domain (the male proportion: 67.69%; standard deviation (SD): 5.88%) and Symptoms/Symptom and Public Health (the female proportion: 57.95%, 56.61%; SD: 0, 9.06%) domains were searched more by male and female groups respectively. The results of age distribution of hot words showed that people aged 20-50 (middle-aged people) had a higher online search intensity, and the group of 20-29, 30-39 years old focused more on Media and Symptoms/Symptom (proportion: 45.43%, 51.66%; SD: 15.37%, 16.59%) domains respectively. Finally, based on frequency rankings of searching hot words and confirmed cases in Mainland China, the epidemic situation of provinces and Chinese administrative divisions were divided into 5 levels of early-warning regions. Central, East and South China regions would be impacted again by the COVID-19 in the future.
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Affiliation(s)
- Shuai Jiang
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Changqiao You
- NanHua Bio-medicine Co.,Ltd., Changsha, Hunan, China
| | - Sheng Zhang
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Fenglin Chen
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Guo Peng
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Jiajie Liu
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Daolong Xie
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Yongliang Li
- College of Biology, Hunan University, Changsha, Hunan Province, China
| | - Xinhong Guo
- College of Biology, Hunan University, Changsha, Hunan Province, China
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Igarashi Y, Mizobuchi T, Nakae R, Yokobori S. Trends in the number of patients from traffic accidents and the state of emergency. Acute Med Surg 2022; 9:e799. [PMID: 36248914 PMCID: PMC9548511 DOI: 10.1002/ams2.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Aim During the coronavirus disease 2019 pandemic, the number of traffic accidents and injured patients was reported to be lower than that before the pandemic. However, little is known regarding the relationship between periods of the state of emergency and the number of patients who met with traffic accidents. Methods The numbers of trauma patients and deaths due to traffic accidents in Tokyo and Osaka were collected monthly from the statistics published by the police department. A state of emergency was declared four times in both cities. The number of trauma patients and deaths was compared between the emergency and other periods. Results The number of monthly patients per 100,000 due to traffic accidents during the state of emergency was significantly lower than that during other periods in Tokyo (16.56 versus 18.20; P = 0.008) and Osaka (24.12 versus 28.79; P = 0.002). However, the monthly number of deaths during the state of emergency was not significantly different compared with those during the other periods in Tokyo (0.08 versus 0.08; P = 0.65) and Osaka (0.10 versus 0.14; P = 0.082). A decrease in the number of trauma patients was observed before the emergency period; however, the reduction rate dropped as the period passed. Conclusion There were significantly fewer trauma patients due to traffic accidents during the state of emergency than during the other periods, with no significant difference in the number of deaths.
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Affiliation(s)
- Yutaka Igarashi
- Department of Emergency and Critical Care MedicineNippon Medical SchoolTokyoJapan
| | - Taiki Mizobuchi
- Department of Emergency and Critical Care MedicineNippon Medical SchoolTokyoJapan
| | - Ryuta Nakae
- Department of Emergency and Critical Care MedicineNippon Medical SchoolTokyoJapan
| | - Shoji Yokobori
- Department of Emergency and Critical Care MedicineNippon Medical SchoolTokyoJapan
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Sanmarchi F, Esposito F, Adorno E, De Dominicis F, Fantini MP, Golinelli D. The impact of the SARS-CoV-2 pandemic on cause-specific mortality patterns: a systematic literature review. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-19. [PMID: 36188447 PMCID: PMC9510758 DOI: 10.1007/s10389-022-01755-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022]
Abstract
Background Understanding the effects of the COVID-19 pandemic on cause-specific mortality should be a priority, as this metric allows for a detailed analysis of the true burden of the pandemic. The aim of this systematic literature review is to estimate the impact of the pandemic on different causes of death, providing a quantitative and qualitative analysis of the phenomenon. Methods We searched MEDLINE, Scopus, and ProQuest for studies that reported cause-specific mortality during the COVID-19 pandemic, extracting relevant data. Results A total of 2413 articles were retrieved, and after screening 22 were selected for data extraction. Cause-specific mortality results were reported using different units of measurement. The most frequently analyzed cause of death was cardiovascular diseases (n = 16), followed by cancer (n = 14) and diabetes (n = 11). We reported heterogeneous patterns of cause-specific mortality, except for suicide and road accident. Conclusions Evidence on non-COVID-19 cause-specific deaths is not exhaustive. Reliable scientific evidence is needed by policymakers to make the best decisions in an unprecedented and extremely uncertain historical period. We advocate for the urgent need to find an international consensus to define reliable methodological approaches to establish the true burden of the COVID-19 pandemic on non-COVID-19 mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-022-01755-7.
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Affiliation(s)
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Emanuele Adorno
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Francesco De Dominicis
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
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Kowsalya A, Chaudhary S, Sen S, Shanmugam M, Narayanamoorthy JK, Jain S, Sundar B. Neuro-ophthalmological manifestations of diabetes mellitus during COVID-19-related lockdown in India. Indian J Ophthalmol 2022; 70:3398-3402. [PMID: 36018129 DOI: 10.4103/ijo.ijo_558_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The coronavirus disease 19 (COVID-19) pandemic has resulted in a huge impact on the health care system. Diversion of health care workforce toward management of a high number of COVID-19 cases and lockdown restrictions have affected the follow-up of patients. The objective of this study was to analyze the impact of this situation on the control of diabetes, eventually resulting in related neuro-ophthalmological complications. Methods This retrospective case series included diabetic patients visiting the neuro-ophthalmology clinic at a tertiary care eye center in India from 25 March 2020 to 25 September 2020 during the lockdown. The incidence of diabetes-related neuro-ophthalmological complications, including third, fourth, sixth nerve palsies and non-arteritic anterior ischemic optic neuropathy (NAION) was evaluated and compared with that of the same period during 2019. Results Overall disease incidence rate was significantly higher in the year 2020 (60.2%) compared to the previous year of 2019 (29.8%). The proportion of third nerve palsy (4.8% vs 16.3%, P < 0.001) and NAION (0.3% vs 14.3%, P < 0.001) had increased. Even though the percentage of sixth nerve palsy was 25% in 2020, this was not significantly different from 2019. There was a reduction in the percentage of fourth nerve palsy cases from the year 2019 to 2020. Conclusion There was a significant increase in diabetes-related neuro-ophthalmic complications during the COVID-19 lockdown. This can possibly be attributed to worsening of glycemic control in diabetic patients.
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Affiliation(s)
- Akkayasamy Kowsalya
- Department of Neuro Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Sameer Chaudhary
- Department of Neuro Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Sagnik Sen
- Department of Neuro Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | | | - Shreya Jain
- Department of Neuro Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Balagiri Sundar
- Department of Neuro Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Das AV, Kommu DR, Chilukuri R, Chilukuri H, Chaurasia S. Impact of the COVID-19 pandemic on the trends in corneal donor mortality data from Eye Bank records in India. Indian J Ophthalmol 2022; 70:3289-3293. [PMID: 36018105 PMCID: PMC9675537 DOI: 10.4103/ijo.ijo_778_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records. Results: Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 ± 20.54 years, whereas the median age was 51 (inter-quartile range: 35–68) years. The mean age of males (49.3 ± 19.47 years) was lesser than the mean age of females (56.72 ± 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 ± 20.51 years in 2018 to 44.35 ± 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021. Conclusion: Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye; Indian Health Outcomes, Public Health and Economics Research Center, Hyderabad, Telangana, India
| | - Deepti Raj Kommu
- Department of Psychiatry, Bhaskar Medical College, Hyderabad, Telangana, India
| | | | - Harihar Chilukuri
- Department of Psychiatry, Bhaskar Medical College, Hyderabad, Telangana, India
| | - Sunita Chaurasia
- Cornea and Anterior Segment services; Ramayamma International Eye Bank, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Feng T, Zheng Z, Xu J, Liu M, Li M, Jia H, Yu X. The comparative analysis of SARIMA, Facebook Prophet, and LSTM for road traffic injury prediction in Northeast China. Front Public Health 2022; 10:946563. [PMID: 35937210 PMCID: PMC9354624 DOI: 10.3389/fpubh.2022.946563] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This cross-sectional research aims to develop reliable predictive short-term prediction models to predict the number of RTIs in Northeast China through comparative studies. Methodology Seasonal auto-regressive integrated moving average (SARIMA), Long Short-Term Memory (LSTM), and Facebook Prophet (Prophet) models were used for time series prediction of the number of RTIs inpatients. The three models were trained using data from 2015 to 2019, and their prediction accuracy was compared using data from 2020 as a test set. The parameters of the SARIMA model were determined using the autocorrelation function (ACF) and the partial autocorrelation function (PACF). The LSTM uses linear as the activation function, the mean square error (MSE) as the loss function and the Adam optimizer to construct the model, while the Prophet model is built on the Python platform. The root mean squared error (RMSE), mean absolute error (MAE) and Mean Absolute Percentage Error (MAPE) are used to measure the predictive performance of the model. Findings In this research, the LSTM model had the highest prediction accuracy, followed by the Prophet model, and the SARIMA model had the lowest prediction accuracy. The trend in medical expenditure of RTIs inpatients overlapped highly with the number of RTIs inpatients. Conclusion By adjusting the activation function and optimizer, the LSTM predicts the number of RTIs inpatients more accurately and robustly than other models. Compared with other models, LSTM models still show excellent prediction performance in the face of data with seasonal and drastic changes. The LSTM can provide a better basis for planning and management in healthcare administration. Implication The results of this research show that it is feasible to accurately forecast the demand for healthcare resources with seasonal distribution using a suitable forecasting model. The prediction of specific medical service volumes will be an important basis for medical management to allocate medical and health resources.
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Strassle PD, Kinlaw AC, Ko JS, Quintero SM, Bonilla J, Ponder M, María Nápoles A, Schiro SE. Effect of Stay-at-Home Orders and Other COVID-Related Policies on Trauma Hospitalization Rates and Disparities in the United States: A Statewide Time-Series Analysis.. [PMID: 35898348 PMCID: PMC9327631 DOI: 10.1101/2022.07.11.22277511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: To combat the coronavirus pandemic, states implemented several public health policies to reduce infection and transmission. Increasing evidence suggests that these prevention strategies also have had a profound impact on non-COVID healthcare utilization. The goal of this study was to determine the impact of a statewide Stay-at-Home and other COVID-related policies on trauma hospitalizations, stratified by race/ethnicity, age, and sex. Methods: We used the North Carolina Trauma Registry, a statewide registry of trauma hospitalizations to 18 hospitals across North Carolina, including all North Carolina trauma centers, to calculate weekly assault, self-inflicted, unintentional motor vehicle collision (MVC), and other unintentional injury hospitalization rates between January 1, 2019 and December 31, 2020. Interrupted time-series design and segmented linear regression were used to estimate changes in hospitalizations rates after several COVID-related executive orders, overall and stratified by race/ethnicity, age, and gender. Hospitalization rates were compared after 1) U.S. declaration of a public health emergency; 2) North Carolina statewide Stay-at-Home order; 3) Stay-at-Home order lifted with restrictions (Phase 2: Safer-at-Home); and 4) further lifting of restrictions (Phase 2.5: Safer-at-Home). Results. There were 70,478 trauma hospitalizations in North Carolina from 2019–2020. In 2020, median age was 53 years old and 59% were male. Assault hospitalization rates (per 1,000,000 NC residents) increased after the Stay-at-Home order, but only among Black/African American residents (incidence rate difference [IRD]=7.9; other racial/ethnic groups’ IRDs ranged 0.9 to 1.7) and 18–44 year-old males (IRD=11.9; other sex/age groups’ IRDs ranged −0.5 to 3.6). After major restrictions were lifted, assault rates returned to pre-COVID levels. Unintentional injury hospitalizations decreased after the public health emergency, especially among older adults, but returned to 2019 levels within several months. Conclusions: Statewide Stay-at-Home orders put Black/African American residents at higher risk for assault hospitalizations, exacerbating pre-existing disparities. Fear of COVID-19 may have also led to decreases in unintentional non-MVC hospitalization rates, particularly among older adults. Policy makers must anticipate possible negative effects and develop approaches for mitigating harms that may disproportionately affect already disadvantaged communities.
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A GIS-Based Spatiotemporal Modelling of Urban Traffic Accidents in Tabriz City during the COVID-19 Pandemic. SUSTAINABILITY 2022. [DOI: 10.3390/su14127468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The main aim of the present study was to investigate the spatiotemporal trends of urban traffic accident hotspots during the COVID-19 pandemic. The severity index was used to determine high-risk areas, and the kernel density estimation method was used to identify risk of traffic accident hotspots. Accident data for the time period of April 2018 to November 2020 were obtained from the traffic police of Tabriz (Iran) and analyzed using GIS spatial and network analysis procedures. To evaluate the impacts of COVID-19, we used the seasonal variation in car accidents to analyze the change in the total number or urban traffic accidents. Eventually, the sustainability of urban transport was analyzed based on the demographic and land use data to identify the areas with a high number of accidents and its respective impacts for the local residences. Based on the results, the lockdown measures in response to the pandemic have led to significant reductions in road traffic accidents. From the perspective of urban planning, the spatiotemporal urban traffic accident analysis indicated that areas with high numbers of elderly people and children were most affected by car accidents. As we identified the hotspots of urban traffic accidents and evaluated their spatiotemporal correlation with land use and demography characteristics, we conclude that the results of this study can be used by urban managers and support decision making to improve the situation, so that fewer accidents will happen in the future.
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An Integrated DPSIR-SD Framework for Sustainability Assessment of Roads in Australia. SUSTAINABILITY 2022. [DOI: 10.3390/su14127142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The Australian Sustainability Development Goals (SDGs) Summit in 2018 attracted much-needed national attention towards environmental goals and targets compared with other aspects of sustainability. Road infrastructure is the backbone of modern society and plays a crucial role in accomplishing a targeted balance between these aspects of sustainability and achieving the SDGs. This article presents an integrated sustainability performance assessment methodology that acts as a decision support tool. A series of two conceptual modelling techniques—drivers—pressure—state—impact—response (DPSIR) and system dynamics (SD)—is employed, with the cause-and-effect relationships of the sustainability indicators developed utilising the DPSIR framework, and a quantitative analysis carried out through a subsequent SD model. The end result is the generation of a Sustainability Performance Index (SPI) for road infrastructure created by analysing the SD model and DPSIR index layer relationship. The benefits and applicability of the proposed methodology are validated through case study analysis. The overall aim is to determine restricting factors and response strategies influencing road infrastructure and transport sustainability performance during the operation and maintenance phase. Thus, a significant contribution is made through the proposed methodology for assessing factors influencing the long-term achievement of the SDGs.
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Ghanim MS, Muley D, Kharbeche M. ANN-Based traffic volume prediction models in response to COVID-19 imposed measures. SUSTAINABLE CITIES AND SOCIETY 2022; 81:103830. [PMID: 35291578 PMCID: PMC8906893 DOI: 10.1016/j.scs.2022.103830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 05/14/2023]
Abstract
Many countries around the globe have imposed several response measures to suppress the rapid spread of the COVID-19 pandemic since the beginning of 2020. These measures have impacted routine daily activities, along with their impact on economy, education, social and recreational activities, and domestic and international travels. Intuitively, the different imposed policies and measures have indirect impacts on urban traffic mobility. As a result of those imposed measures and policies, urban traffic flows have changed. However, those impacts are neither measured nor quantified. Therefore, estimating the impact of these combined yet different policies and measures on urban traffic flows is a challenging task. This paper demonstrates the development of an artificial neural networks (ANN) model which correlates the impact of the imposed response measure and other factors on urban traffic flows. The results show that the adopted ANN model is capable of mapping the complex relationship between traffic flows and the response measures with a high level of accuracy and good performance. The predicted values are closed to the observed ones. They are clustered around the regression line, with a coefficient of determination ( R 2 ) of 0.9761. Furthermore, the developed model can be generalized to determine the anticipated demand levels resulted from imposing any of the response measures in the post-pandemic era. This model can be used to manage traffic during mega-events. It can be also utilized for disaster or emergency situations, where traffic flow estimates are highly required for operational and planning purposes.
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Affiliation(s)
| | - Deepti Muley
- Qatar Transportation and Traffic Safety Center, Department of Civil Engineering, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mohamed Kharbeche
- Qatar Transportation and Traffic Safety Center, Qatar University, P.O. Box 2713, Doha, Qatar
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Affiliation(s)
- Kimberlyn McGrail
- School of Population and Public Health, University of British Columbia, Vancouver, BC
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46
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Animal-vehicle collisions during the COVID-19 lockdown in early 2020 in the Krakow metropolitan region, Poland. Sci Rep 2022; 12:7572. [PMID: 35534651 PMCID: PMC9082987 DOI: 10.1038/s41598-022-11526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/11/2022] [Indexed: 11/21/2022] Open
Abstract
The interrelations between human activity and animal populations are of increasing interest due to the emergence of the novel COVID-19 and the consequent pandemic across the world. Anthropogenic impacts of the pandemic on animals in urban-suburban environments are largely unknown. In this study, the temporal and spatial patterns of urban animal response to the COVID-19 lockdown were assessed using animal-vehicle collisions (AVC) data. We collected AVC data over two 6-month periods in 2019 and 2020 (January to June) from the largest metropolis in southern Poland, which included lockdown months. Furthermore, we used traffic data to understand the impact of lockdown on AVC in the urban area. Our analysis of 1063 AVC incidents revealed that COVID-19 related lockdown decreased AVC rates in suburban areas. However, in the urban area, even though traffic volume had significantly reduced, AVC did not decrease significantly, suggesting that lockdown did not influence the collision rates in the urban area. Our results suggest that there is a need to focus on understanding the effects of changes in traffic volume on both human behaviour and wildlife space use on the resulting impacts on AVC in the urban area.
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Impact of COVID-19 Lockdown on Wildlife-Vehicle Collisions in NW of Spain. SUSTAINABILITY 2022. [DOI: 10.3390/su14084849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Wildlife–vehicle collisions (WVCs) in many places have a significant impact on wildlife management and road safety. The COVID-19 lockdown enabled the study of the specific impact that traffic has on these events. WVC variation in the Asturias and Cantabria regions (NW of Spain) because of the COVID-19 lockdown reached a maximum reduction of −64.77% during strict confinement but it was minimal or nonexistent during “soft” confinement. The global average value was −30.22% compared with the WVCs registered in the same period in 2019, but only −4.69% considering the average throughout the period 2010–2019. There are huge differences between conventional roads, where the traffic reduction was greater, and highways, where the traffic reduction was lesser during the COVID-19 lockdown. The results depend on the season, the day of the week and the time of day, but mainly on the traffic reduction occurring. The results obtained highlight the need to include the traffic factor in WVC reduction strategies.
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Jacobs JW, Adkins BD, Booth GS. Massive transfusion protocols during the
COVID
‐19 pandemic. Vox Sang 2022; 117:869. [PMID: 35352351 PMCID: PMC9115436 DOI: 10.1111/vox.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA
| | - Brian D. Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis The University of Texas Southwestern Medical Center Dallas Texas USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology & Immunology Vanderbilt University Medical Center Nashville Tennessee USA
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Walkowiak MP, Walkowiak D. Underestimation in Reporting Excess COVID-19 Death Data in Poland during the First Three Pandemic Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063692. [PMID: 35329378 PMCID: PMC8954142 DOI: 10.3390/ijerph19063692] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022]
Abstract
The issue whether official Polish COVID-19 death statistics correctly reflect the actual number of deaths is a contentious issue in public discourse and an important policy-wise question in Poland although it has not been the subject of thorough research so far. There had been clearly elevated excess mortality—5100 (death rate of 2.3 per 10,000) during the first wave, 77,500 (21.0 per 10,000) during the second one, and 48,900 (13.5 per 10,000) in the third. This study finds that during the second and the third pandemic wave, our data on excess mortality will match very well the somewhat belatedly officially reported COVID-19 deaths if we assume that only 60% of cases were officially detected. Based on principal component analysis of death timing, except for the age bracket below 40, where COVID-19 deaths calculated on the basis of our model explain 55% of excess mortality, for the remaining age groups, combined COVID-19 deaths explain 95% of excess mortality. Based on the share of excess mortality attributable to COVID-19 during the second wave, this infection in Poland caused the death of 73,300 people and not of 37,600 as officially reported. The third wave caused 46,200 deaths instead of the reported 34,700. The first wave was, indeed, as officially reported, very mild, and the number of excess deaths was too low to be used to calculate COVID-19 deaths directly. However, assuming that the detection rate remained comparable to the average in subsequent waves, we can set the number of deaths at 3500 instead of the reported 2100.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-356 Poznan, Poland;
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, 60-356 Poznan, Poland
- Correspondence: ; Tel./Fax: +48-61-658-44-93
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Ackley CA, Lundberg DJ, Ma L, Elo IT, Preston SH, Stokes AC. County-level estimates of excess mortality associated with COVID-19 in the United States. SSM Popul Health 2022. [PMID: 35018297 DOI: 10.1101/2021.04.23.21255564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
The COVID-19 pandemic in the U.S. has been largely monitored using death certificates containing reference to COVID-19. However, prior analyses reveal that a significant percentage of excess deaths associated with the pandemic were not directly assigned to COVID-19. In this study, we estimated a generalized linear model of expected mortality based on historical trends in deaths by county of residence between 2011 and 2019. We used the results of the model to generate estimates of excess mortality and excess deaths not assigned to COVID-19 in 2020 for 1470 county sets in the U.S. representing 3138 counties. Across the country, we estimated that 438,386 excess deaths occurred in 2020, among which 87.5% were assigned to COVID-19. Some regions (Mideast, Great Lakes, New England, and Far West) reported the most excess deaths in large central metros, whereas other regions (Southwest, Southeast, Plains, and Rocky Mountains) reported the highest excess mortality in nonmetro areas. The proportion assigned to COVID-19 was lowest in large central metro areas (79.3%). Regionally, the proportion of excess deaths assigned to COVID-19 was lowest in the Southeast (81.6%), Southwest (82.6%), Far West (83.7%), and Rocky Mountains (86.7%). Across the regions, the number of excess deaths exceeded the number of directly assigned COVID-19 deaths in most counties. The exception to this pattern occurred in New England, which reported more directly assigned COVID-19 deaths than excess deaths in metro and nonmetro areas. Many county sets had substantial numbers of excess deaths that were not accounted for in direct COVID-19 death counts. Estimates of excess mortality at the local level can inform the allocation of resources to areas most impacted by the pandemic and contribute to positive behavior feedback loops, such as increases in mask-wearing and vaccine uptake.
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Affiliation(s)
| | - Dielle J Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Lei Ma
- Department of Economics, Boston University, Boston, MA, USA
| | - Irma T Elo
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel H Preston
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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