Informing future policy for trauma prevention: The effect of the COVID-19 ‘National state of disaster lockdown’ on the trauma burden of a tertiary trauma centre in the Western Cape of South Africa

Introduction: Strategies to reduce the burden of trauma are not only a global priority, but also a South African public health priority due to a disproportionately large trauma burden. Identification of the contributors to preventable injuries would assist in guiding policy and prevention strategies at a local and international level. In response to SARS-nCOV-2 (COVID19), a national restrictive lockdown was implemented in South Africa with, amongst other restrictions, a complete ban on non-essential travel and alcohol sales. With the most intensive restrictions implemented between March to May 2020, this period offers an unprecedented opportunity for the assessment of social restrictions on possible effects of trauma burdens. Methods: A retrospective chart review was conducted between March to May 2019 and compared to data from the same period in 2020. Descriptive analysis was undertaken to understand the influence of lockdown on demographics and injury causation in trauma presentations. Results: The results showed a 51.42% decline in trauma during the early lockdown period. Sub-analyses however, revealed little change in the mechanism of injury ratios and the demographics of presenting patients. Conclusion: This study shows that although all cause presentation of trauma cases was reduced following the implementation of lockdown procedures in 2020, the injury patterns and ratios of intentional to accidental harm remained largely unchanged. This prompts the need for further research and root cause analysis into how trauma prevention strategies can be improved. This will assist with the improved efficacy of trauma prevention policies in a country with a well-documented trauma burden and thus a pressing need for an implementable and nationwide harm reduction policy.