The effect of the COVID-19 Lockdown levels on trauma cases in a South African district hospital emergency department

Background: In response to the Coronavirus disease (COVID-19) outbreak, the South African government implemented lockdown alert levels based on the prevailing status of the pandemic. This study aimed to assess the effect of these measures on the number and profile of trauma presentations to a district hospital in Gauteng, South Africa. Methods : A retrospective analysis of trauma admissions was performed at the emergency department of a public district hospital in Gauteng from April 1, 2020, to September 30, 2021. Data collected from the trauma registers were segmented into intervals according to the adjusted alert levels 1 to 5 (5 being the strictest alert level) and compared to changes in trauma incidence across the different lockdown levels. Data were further stratified according to the mechanism of trauma. Results: The study included 3359 patients. Alert level 5 resulted in the fewest trauma presentations, and alert level 1 the most. Assault, followed by road accidents, accounted for the majority of presentations, the fewest being trauma-related falls from height. Conclusion: During the COVID-19 pandemic, this study showed that strict lockdown measures implemented during alert level 5 resulted in the fewest trauma admissions to a Gauteng district hospital. This resulted in freeing healthcare resources to address other health issues related to the pandemic. However, trauma injury patterns remained the same as prior to COVID-19. emphasizing the need for a national plan to reduce assault related trauma burden in South Africa.