The Impact of the COVID-19 Shelter-in-Place Order on Traumatic Brain Injuries in San Francisco, California

BackgroundIn response to the COVID-19 pandemic, San Francisco, California issued a shelter-in-place (SIP) order in March 2020, during which emergency medicine physicians noted drop trauma cases, as well change traditional mechanisms of trauma.ObjectivesOur objective was determine epidemiology traumatic brain injury (TBI) pre- and post-COVID-19 SIP.MethodsWe reviewed electronic medical record only center city number characteristics patients with diagnosis head presenting department between December 16, 2019 June 2020. Using Chi-squared Fisher's exact tests when appropriate, we compared post- lockdown epidemiology.ResultsThere were 1246 TBI-related visits six-month study period. Bi-weekly TBI cases decreased by 36.64% two weeks following SIP then increased near baseline levels older (mean age: 53.3 pre-SIP vs. 58.2 post-SIP, p<0.001), more likely be male (OR: 1.43, 95% CI: 1.14-1.81), less 17 or younger (8.9% 0.5%, post-SIP respectively, p=0.003). Patients Hispanic (27.2% 21.7% p=0.029). The proportion attributable cycling accidents (14.1% 52.7%, p<0.001) while those pedestrians involved road traffic (37.2% 12.7%, p=0.003).ConclusionsUnderstanding changing pandemic can aid immediate future disaster resource planning.