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Abstract
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It is well known that the 2019 coronavirus (COVID-19) pandemic has caused widespread morbidity and mortality across the United Kingdom (UK) and the world. The recent sobering milestone of 100, 000 COVID-19-related deaths in the UK1 generated fierce debate and discussion across myriad industries, from policy makers to scientists. So far, the battle against the virus has yielded novel pharmacological treatments, unique hospital COVID-19 pathways and brand-new vaccines, along with national lockdowns across the whole of the UK. However, behind the headlines and literally closed doors, there has been an insidious resurgence of domestic abuse and violence (DAV) cases as a consequence of the pandemic.
DAV is a broad term which describes any behaviour deemed to be controlling, coercive, threatening or violent from any family member or an intimate partner in adults aged 16 and over. The types of abuse are not limited to physical violence; they can include psychological, emotional, economic and sexual abuse.2 Mixed ethnicity, low income, disability, urban dwelling, poor mental health and low levels of education are just some of the independent risk factors for DAV.3 Since the onset of the COVID-19 pandemic and the consequential national lockdown, there has been a 7% rise in domestic abuse-related offences reported to the police. Of this increase, the period between April and May 2020 demonstrated the worst rise at 9%, with 30 homicides occurring as a direct result of DAV between just April and June 2020.4 In the UK, official government statistics demonstrate 88% of domestic homicides are committed by men towards women, demonstrating an evident female victim preponderance.5 More up-to-date estimates from the second national lockdown are not yet reported; however, the trend so far likely demonstrates a further increase in DAV.
These data suggest a stark problem, and it is a problem which firmly crosses the threshold of an orthopaedic department in the form of trauma secondary to interpersonal violence. According to the most recent prevalence estimates, 1 in 50 women who present to an orthopaedic clinic with an injury have suffered physical violence as a result of DAV.6 The reason for this is due to the nature of physical injury inflicted by perpetrators, which affects the musculoskeletal system. Such injuries comprise the most prevalent physical manifestation of DAV, second only to head and neck trauma, and can therefore be a powerful indicator of abuse...
Language: en |