The impact of the UK national lockdown on trauma patterns and the pre-hospital advanced trauma team response within metropolitan London

Abstract

Introduction: The societal changes triggered by the COVID-19 pandemic and resultant lockdowns have the potential to alter the incidence and nature of injuries within affected populations. We aimed to investigate these changes within metropolitan London and the impact lockdown had on London’s Air Ambulance’s (LAA) response to incidents. Methods: This retrospective cohort study compared data from all LAA missions in the two-month period following instigation of the first UK national lockdown in 2020 to the equivalent period in 2019. Patient demographics, nature and severity of injuries, incident details and LAA mission parameters were assessed. Results: LAA saw a significant reduction in the mean (standard deviation) of activations per week under lockdown (32.75 [4.95] vs. 54.25 [4.53], p < 0.001). The distribution of patients across different trauma aetiologies differed significantly under lockdown, with proportionately more injuries resulting from domestic violence (DV) (0.7% vs. 3.8%) and deliberate self-harm (DSH) (16.5% vs. 12.4%), although the absolute number of DSH fell. Significantly fewer incidents occurred in central areas of London, but injury severity was unaffected by lockdown. After adjustment for confounders, lockdown was associated with shorter drive times, but not overall response times. There was no association between lockdown and aetiology or severity of injuries. Conclusion: The COVID-19 pandemic and ensuing UK national lockdown had a substantial impact on major trauma patterns within London and the subsequent LAA response. The feared rise in suicide was not observed, but there was a notable increase in DV frequency.