Penetrating trauma during a global pandemic: Changing patterns in interpersonal violence, self harm and domestic violence in the Covid 19 outbreak
Abstract Introduction The restrictions imposed on social activity in response to the Covid 19 pandemic have had a profound impact globally. In the UK, the NHS was placed on a war footing, with elective surgery, face to face outpatient clinics, and community care facilities all scaled back as a temporary measure to redistribute scarce resources. There has been concern during this period over increasing levels of violence in the domestic setting, as well as self harm. Methods Data was collected on all patients presenting with traumatic penetrating injuries during the 'lockdown' period of 23rd March to 29th April 2020. Demographics and injury details were compared with the same period in the two preceding years. Results Overall trauma fell by 35% compared with the previous year. Over one in four penetrating injuries seen were a result of self harm, which was significantly higher than in previous years (11% in 2019, 2% in 2018) There were two cases of injuries due to domestic violence, while a total of 4 cases of injury arose in separate violent domestic incidents. Self harm commonly involved penetrating injury to the neck. Discussion Our centre has seen an increase in the proportion of penetrating injuries as a result of both self harm and violence in the domestic setting. The number of penetrating neck injury cases, which can represent suicidal intent or a major presentation of psychiatric illness, is of particular concern. We must further investigate the effect of social restrictions on violent injury, and how home confinement may influence a changing demographic picture of victims.
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