Ambulance driving through city

For the 12-month period ending October 31, 2020, trauma hospital admissions have increased 31% at an already high-volume Level I trauma center at Memorial Hermann-Texas Medical Center, says Michelle McNutt, MD, associate professor of surgery and chief of trauma in the division of acute care surgery at McGovern Medical School at UTHealth, and the Trauma Medical Director of the Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center.

“While a portion of that increase is the result of changes in trauma systems in the region,” says Dr. McNutt, “I can definitely trace some of the increase due to the impact of COVID-19.”

She says cases dropped in April, which she believes corresponded to the citywide shutdown from COVID-19. Then once those restrictions were lifted, trauma volumes “bounced back with a vengeance.” She says the higher volumes, particularly on weekends, are thankfully able to be accommodated by the addition of a second in-house trauma surgeon which, she says, is unprecedented.

‘A Really Concerning Trend’

“We saw not only an uptick in high-speed motor vehicle collisions but also, more concerning, a 53% increase in penetrating trauma cases—victims of stabbings and gunshot wounds,” says Dr. McNutt. “And these cases are spread out across all age groups. We’ve seen an 11% increase in the 0-15 age group and a 40% increase in the 0-21 age group. It’s a really concerning trend.”

Dr. McNutt speculates that two behaviors, each a possible byproduct of the pandemic, underpin the alarming increase. “First, there’s been more speeding with traffic volumes down. But I also suspect there has been an increase in drug and alcohol use which may be stress-related because of the pandemic. Because of COVID-19, everyone is stressed about their health and their families and their jobs. And some people just have better coping mechanisms than others.”

First Responders Seeing It Too

Houston Fire Department EMS Paramedic Supervisor Captain Christopher Ponzica, who covers the northeast part of Houston, says shootings and other traumatic injuries are definitely up. “Normally, in my area, we don’t see a lot of shootings, but lately we have seen a lot more domestic dispute shootings, gang shootings. It’s definitely on the rise. People are home, going stir crazy. They’re panicking about their jobs. Everyone really needs to be more vigilant of their surroundings.”

Harris County ESD 48 Fire Department EMS Assistant Chief Eric Bank says he’s seen a large increase in trauma cases over the past 90 days. “With motor vehicle accidents, there’s really no middle ground. It’s either really minor—bump and run—or it’s really, really bad. We’re also seeing a pretty significant rise in shootings and stabbings.”

Bank attributes the rise in trauma cases to a variety of factors. “When you have people who haven’t been out in a while and they’re all coming out, there’s going to be some reduction in patience. 2020 has been an eventful year, with the hurricane season, politics, COVID-19. I think people are just done.”

Turning the Corner

Hopefully, when COVID-19 vaccines become widely available, things will return to some level of normality. Dr. McNutt speaks for health care workers everywhere when she says, “Nobody is more ready for things to get back to normal than the health care industry.”

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