COVID-19 Resilience for Survival: Occurrence of Domestic Violence During Lockdown at a Rural American College of Surgeons Verified Level One Trauma Center.

Background As the early peak phase in the coronavirus outbreak has intensified, stay-at-home mandates requiring identified individuals as nonessential were advised to remain home to prevent community transmission of the disease. Further mandates escalated isolated environments such as school closures, social distancing, travel restrictions, closure of public gathering spaces, and business closures. As citizens were forced to stay home during the pandemic, the crisis created intensifying stressors and isolation, which fostered an environment for increased domestic violence.  Methods A retrospective review of all emergency department (ED) patients that presented to an American College of Surgeons (ACS) verified rural level one trauma center with associated diagnostic coding for assault was conducted during the 2019 (COVID-19) lockdown, integral dates March 16, 2020 to April 30, 2020. In particular the identification of proportional assaults that presented to the ED after school closures (March 16, 2020) was compared to the previous year (March 16, 2019 to April 30, 2019). The data collected included patient characteristics, grouping by mechanism, grouping by a specific mechanism, and domestic violence perpetrators.  Results A statistically significant (p = 0.01) increase in assaults was found during the COVID-19 lockdown, particularly during the period after school closures.  Conclusions Although overall trauma volume was reduced during the COVID-19 stay-at-home mandates, a significant increase in domestic violence assaults was observed. Largely the assaults were perpetrated against white men by partners and unspecified nonfamily members, which were predominantly penetrating injuries.