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Abstract
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Interpersonal violence has plagued our large cities for decades. As our region and medical system prepared to manage the anticipated influx of critically ill Coronavirus Disease 2019 (COVID-19) patients, we sincerely hoped social distancing measures would interrupt this cycle of interpersonal violence.
However, in many large metropolitan centers across the country--including Chicago, Dallas, Houston, and Philadelphia--this epidemic of violence, fueled by irresponsible and often criminal use of handguns, has intensified in recent weeks. Our center's experience has mirrored this trend. Although blunt injuries have decreased with less vehicular and pedestrian traffic, in the 6 weeks since the World Health Organization declared a global pandemic, our highest-level activations and penetrating injuries have risen sharply in comparison with the same period in 2019.
This observation prompts two questions.
First, how do we balance the simultaneous demand for additional high-acuity trauma care while meeting the unprecedented pandemic-fueled demand for those same critical resources? Like most others across the country, our center has cancelled all elective procedures and rapidly re-configured and expanded our inpatient space to meet the pandemic surge. Even with such aggressive measures, at least one metropolitan area with a high concentration of COVID-19 activity significantly curtailed trauma services due to lack of bed availability, creating limited regional access to trauma care, thereby potentially increasing preventable deaths. To avoid such a quandary and remain fully open to trauma, we diligently attend to patient throughput in our trauma bay, designate a minimum of two open "crash" trauma critical care beds at all times, and actively arbitrate critical care beds assignments with multidisciplinary input.
Second, how can we remedy this epidemic of violence? In the short term, community interventions and social services focused on acute urban societal stresses must be deployed into violence hot spots. Longer term, funding for gun violence...
Language: en |