Association between COVID-19 public health interventions and major trauma presentation in the Northern region of New Zealand

19th May 2021

Matthew J McGuinness, Chris Harmston, on behalf of the Northern Region Trauma Network.

New Zealand (NZ) joined the global fight against COVID-19 on 28 February 2020, following the first verified case. Confirmed community transmission and a rapidly escalating epidemic curve led the NZ Government to swiftly respond with restrictive public health interventions and a strategy aimed at COVID-19 eradication. Early reports suggested one downstream ramification was a change in trauma presentations. The aim of this study was to evaluate the effect these public health measures had on major trauma presentations in the Northern Region, New Zealand.  

The number of major trauma presentations from 16 March to 8June 2020was compared to the same time period in 2019. This period in 2020 included level four lockdown during which the population was instructed to isolate at home and limit interaction only to essential service.

Key findings:

  • There was a 25% reduction in major trauma presentations. 
  • There was a significant difference in place of injury with 20% of injuries happening at home in 2019 compared with 35% in 2020.
  • There was variation in effect amongst different institutions within the region with all Northern Region District Health Boards seeing a decrease in presentations apart from Northland District Health Board which saw a 29% increase in presentations in 2020 compared to 2019.
  • There was no significant difference in mechanism of injury, type of injury or intent of injury between 2019 and 2020.

This study has shown that public health interventions to prevent the spread of COVID-19 reduced major trauma admissions in the Northern Region of New Zealand. It demonstrates the responses in major trauma admissions at different levels of public health restriction allowing hospitals with future planning as further restrictive periods. This will facilitate prioritisation of resources in a time when they may already be stretched while maintaining adequate acute trauma services. This study also reinforces the notion that trauma is a societal disease. The significant reduction in the number of major trauma admissions highlights the preventable burden of disease trauma places on the healthcare system.

Figure 1. Comparison of 2019 and 2020 major trauma admissions by level of public health intervention and incidence of new COVID-19 cases per day.

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