When the coronavirus pandemic began, one U.S. children’s hospital saw an increase in trauma cases from recreational and outdoor activities, even as total ER visits dropped by 50%, researchers report.

What happened? Their new study suggests that being in lockdown, with schools closed, may have prompted more kids to go outside and play — and potentially get injured doing so. At the same time, parents may have feared taking their children to the hospital unless it was a dire injury.

Study author Dr. Zaid Haddadin, a postdoctoral research fellow at Vanderbilt University Medical Center in Nashville, and his colleagues looked at the number of emergency room visits for respiratory illnesses or trauma between March and May 2020.

Over that time, a total of nearly 6,400 pediatric emergency room visits occurred in 2020, compared with more than 12,000 in 2019.

Meanwhile, the number of respiratory care for kids visits dropped by 58% in 2020, the researchers found.

“Community efforts to control the spread of the SARS-CoV-2 might have played a role in decreasing the spread of other respiratory viruses in children,” Haddadin explained.

But at the same time, there was a significant increase in the number of trauma visits related to activities like all-terrain vehicles (ATVs) and motorcycles, which might have been related to school closings, Haddadin said.

“Most schools were closed starting mid-March in our area, and our data show an unusual increase of trauma due to recreational and outdoor activities, compared to previous years when kids were still at school during March to May,” he said. “These injuries are usually encountered during summer breaks.”

Also, trauma cases from abuse, suicide, assault and homicide dropped and animal-related injuries declined nearly twofold, the study found.

“Increased supervision with multiple caregivers at home likely resulted in a decrease in these intentional injuries,” Haddadin said.

Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City, agreed, adding, “The study’s findings related to increased traumatic injuries seen during the pandemic illustrate the importance of ongoing public health messaging to discourage the use of ATVs and motorcycle riding in the midst of lockdowns when resources for trauma care are diverted for care of patients with COVID-19.”

Parents also need to discuss with teens that engaging in such risky activities could result in serious injury due to delay in definitive care — the result of reduced access and capacity for trauma care during COVID-19, he said.

“Data from the study serves as a caution for families of teens who feel ‘cooped up’ or have ‘cabin fever’ and may want to pull out their ATVs and motorcycles and go riding during a raging pandemic,” said Glatter, who wasn’t part of the study.

While the message during the pandemic has been to “stay home,” it should also include a warning to avoid activities that place you at elevated risk for bodily injury and death, he said.

“Choosing lower-impact activities with a reduced risk for injury is advisable as we continue to face ongoing surges and reduced capacity at our nation’s hospitals,” Glatter said.

“Anecdotally, I continue to see teens with extremity fractures, head injuries and lacerations resulting from use of electric scooters and e-bikes during the pandemic,” he added. “The increase in injuries might be linked to a desire to avoid the risks of exposure to COVID-19 from public transportation.”

The report was published online Jan. 12 in the journal Hospital Pediatrics.

More information

For more on coping with COVID-19, see the U.S. Centers for Disease Control and Prevention.

SOURCES: Zaid Haddadin, MD, postdoctoral research fellow, Vanderbilt University Medical Center, Nashville, Tenn.; Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York City; Hospital Pediatrics, Jan. 12, 2021, online