As all of our systems and institutions react and respond to the COVID-19 pandemic, we should also keep an eye out for changes in the frequency of preventable, unintentional injuries and violence. Just as the coronavirus can cause mild to severe and even fatal illness, the energy transfer resulting from car crashes, falls, and violence can cause significant injury to children and adolescents. Let me explain.
On the Road
We expect to see a reduction in motor vehicle crashes as well as a reduction in occupant injury, because both children and adults are staying home. Fewer people are driving cars, so roads and highways are less crowded. Fewer cars on the road will likely result in a reduction in pedestrian injuries, even though more people will be out walking, running, and exercising. This is a very good thing since we have observed a recent dramatic increase in pedestrian collisions both nationally and in Connecticut.
We also expect to see a reduction in bicycle injuries, since there will be less of a chance that bicyclists will collide with motor vehicles. However, there will likely be more falls off bikes with the chance of extremity and head injuries. Helmet use should be a priority for bicyclists.
With spring here and motorcycle riders eager to get out on the road, we expect to see a similar pattern – fewer collisions with motor vehicles, but more riders who fall and sustain extremity and head injuries. As with bicycles, the use of a helmet and other protective gear is important to prevent traumatic brain and extremity injury among motorcycle riders.
With spring youth and high school sports shut down and teams not practicing or playing games, we will likely witness a significant reduction in injuries related to basketball, baseball, softball, soccer, tennis, and golf. More children will be walking, hiking, and running, which will provide much needed recreation and relief that will hopefully result in few injuries. I hope and expect to see some new and innovative games and recreational activities as our children will need to find some relief and fun from the stress.
With more children home because of closed childcare centers, pre-schools, elementary schools, middle schools and high schools, we are apt to see more burn injuries related to scalds or touching hot objects. We are also likely to see more stair and window falls, as well as toddler poisoning from eating medications and household products.
For younger children, parents should review the room or rooms that children will spend time in to ensure that only age-appropriate toys are within reach, that outlets are covered to protect from electrical shock, and that small objects that can be choking hazards or poisons are placed up and away.
As the weather warms up and we open more windows, parents can prevent young children from falling out of those windows by keeping furniture that they can climb on away from windows, and by limiting windows to being opened no more than only four inches. These are important steps, as many parents will be distracted by multi-tasking between childcare and working remotely, if they are able to.
Firearms present another injury risk for children at home. Gun stores have seen a significant increase in gun and ammunition purchases. With more guns in homes, we will likely observe an increase in unintentional, so-called “accidental” firearm injury resulting from children who play with guns and shoot either themselves or their playmates. It is important that all firearm owners with children in their homes understand Connecticut’s safe storage laws. Keep your firearms locked up or within your control – never leave a firearm unattended.
With the loss of daily routines, and even jobs, as well as an associated increase in stress and conflict, we might see an increase in child abuse or neglect, suicide attempts, arguments leading to fights and assaults, and domestic violence. There are resources to help in these times of stress. If you or someone you care for needs help, call 2-1-1 to connect with appropriate resources.
A mixed picture of injury risk for the workplace forms as well. Fewer people are at work, so we can expect to see reduced occupational injuries for many. However, some industries are very busy, such as package delivery businesses, with workers who may experience back and extremity injuries from falls, collisions with objects, or overexertion. Fortunately, most of these injuries are relatively minor.
For healthcare and hospital workers such a myself, we will be busy providing care for patients who are sick with COVID-19, as well as the normal flow of people who become sick from other illnesses and diseases such as cancer, heart disease, and diabetes. We will need to remain vigilant to avoid needle stick injuries or exposures to viral and bacterial pathogens.
Fortunately, most injuries and violence are predictable and preventable through education, design changes to consumer products and vehicles, and environmental modifications, such as the utilization of energy absorbing surfaces at playgrounds.
Connecticut Children’s Injury Prevention Center will remain focused on learning more about the impact of the COVID-19 pandemic on injury rates and will seek to reduce the impact to keep our children and adults safe and injury free.
Finally, on a personal note, we are all experiencing a loss of our normal routines and activities. In some cases, we are experiencing the severe illness of co-workers, friends and family from the COVID-19 pandemic. One of my great joys is music. My jazz bands are not practicing or performing during this time of concern. However, I have found great comfort in playing my drums and laying down a steady, deep groove. Da beat does on.
Garry Lapidus, PA-C, MPH, is the director of Connecticut Children’s Injury Prevention Center, which is a program of Connecticut Children’s Office for Community Child health. Lapidus is also an associate professor of pediatrics and public health at the UConn School of Medicine.
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