The effect of COVID‐19 lockdown periods and societal restrictions on blood product usage in adult trauma patients: A retrospective observational study

Main Article Content

A M Levey
R Wise
D G Bishop

Abstract




Background. Blood products, though potentially lifesaving, are a scarce and costly resource. Trauma injuries, which contribute to the demand for these resources, increase in proportion to alcohol consumption. South Africa’s COVID-19 lockdown measures included a ban on alcohol sales and curfews.
Objective. To investigate the effect of these societal measures on blood product usage.


Methods. We retrospectively compared medical patient data from the South African National Blood Service database of red cell concentrate (RCC) usage in four disciplines during the COVID-19 period with data from the 3 years preceding the pandemic. We also examined trauma case patterns using an institutional database from the Harry Gwala Regional Hospital (HGRH) Emergency Department during the same periods.


Results. In total, 16 922 RCCs at HGRH and 528 734 RCCs in KwaZulu-Natal were issued across the four disciplines, from March 2017 - March 2021. RCC usage significantly decreased among trauma patients at institutional and provincial levels during the COVID-19 period (provincial pre-lockdown mean 10.99 units per day; SD 6.89, 95% CI 10.63 - 11.35 v. lockdown 7.46 units per day; SD 5.42, 95% CI 6.14 - 8.79; p<0.01). Further, RCC usage significantly increased during the weekend immediately following the lifting of the first alcohol ban, along with a significant decrease in the number of trauma patients seen during hard lockdown periods.


Conclusions. Societal restrictions, including curfews and banning alcohol consumption, decreased the use of RCCs in trauma patients. Government policies aimed at reducing alcohol-related traumatic injuries would likely have a significant impact on RCC usage.





 

Article Details

How to Cite
The effect of COVID‐19 lockdown periods and societal restrictions on blood product usage in adult trauma patients: A retrospective observational study. (2024). Southern African Journal of Public Health, 7(2), e1654. https://doi.org/10.7196/SAJPH.2024.v7i2.1654
Section
Original Articles
Author Biographies

A M Levey, Anaesthetic registrar, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa

Registrar in Anaesthesia

UKZN

R Wise, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, South Africa

Clinical Fellow (Anaesthesiology and Critical Care)   John Radcliffe Hospital: Oxford, Oxfordshire, Great Britain

D G Bishop, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, South Africa, Adult Intensive Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, United Kingdom, Faculty Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium

Professor 

Anaesthesiology

UKZN

How to Cite

The effect of COVID‐19 lockdown periods and societal restrictions on blood product usage in adult trauma patients: A retrospective observational study. (2024). Southern African Journal of Public Health, 7(2), e1654. https://doi.org/10.7196/SAJPH.2024.v7i2.1654

References

Moustakis J, Piperidis AA, Ogunrombi AB. The effect of COVID-19 on essential surgical admissions in South Africa: A retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex. S Afr Med J 2020;110(9):910-915. https:// doi.org/10.7196/SAMJ.2020.v110i9.15025

Chinazzi M, Davis JT, Ajelli M, et al. The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science 2020;368(6489):395-400. https://doi. org/10.1126/science.aba9757

Matzopoulos R, Walls H, Cook S, London L. South Africa’s COVID-19 alcohol sales ban: The potential for better policy-making. Int J Heal Policy Manag 2020;9(11):486-487. https://doi. org/10.34172/ijhpm.2020.93

Atalan A. Is the lockdown important to prevent the COVID-19 pandemic? Effects on psychology, environment and economy-perspective. Ann Med Surg 2020;56:38-42. https:// doi.org/10.1016/j.amsu.2020.06.010

Siedner MJ, Kraemer JD, Meyer MJ, et al. Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: A longitudinal cohort study. medRxiv (preprint server) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273272/

Adiamah A, Thompson A, Lewis-Lloyd C, et al. The ICON Trauma Study: The impact of the COVID-19 lockdown on major trauma workload in the UK. Eur J Trauma Emerg Surg 2021;47(3):637-645. https://doi.org/10.1007/s00068-020-01593-w

Thornton J. COVID-19: A&E visits in England fall by 25% in week after lockdown. BMJ 2020;369:m1401. https://doi.org/10.1136/bmj.m1401

Reuter H, Jenkins LS, De Jong M, Reid S, Vonk M. Prohibiting alcohol sales during the Coronavirus disease 2019 pandemic has positive effects on health services in South Africa. African J Prim Heal Care Fam Med 2018;10(1). https://doi.org/10.4102/phcfm.v12i1.2528

Morris D, Rogers M, Kissmer N, Du Preez A, Dufourq N. Impact of lockdown measures implemented during the COVID-19 pandemic on the burden of trauma presentations to a regional emergency department in Kwa-Zulu Natal, South Africa. African J Emerg Med 2020;10(4):193-196. https://doi.org/10.1016/j.afjem.2020.06.005

Manyoni MJ, Abader MI. The effects of the COVID-19 lockdown and alcohol restriction on trauma-related emergency department cases in a South African regional hospital. African J Emerg Med 2021;11(2):227-230. https://doi.org/10.1016/j.afjem.2020.12.001

Navsaria PH, Nicol AJ, Parry CDH, Matzopoulos R, Maqungo S, Gaudin R. The effect of lockdown on intentional and nonintentional injury during the COVID-19 pandemic in Cape Town, South Africa: A preliminary report. S Afr Med J 2020;13183. https://doi.org/10.7196/ samj.2021.v111i2.15318

Chu KM, Marco JL, Owolabi EO, et al. Trauma trends during COVID-19 alcohol prohibition at a South African regional hospital. Drug Alcohol Rev 2022;41(1):13-19. https://doi.org/10.1111/ dar.13310

Hardcastle TC, Oosthuizen G, Clarke D, Lutge E. Trauma, a preventable burden of disease in South Africa: Review of the evidence, with a focus on KwaZulu-Natal. South African Heal Rev 2016;(1):179-189. https://hdl.handle.net/10520/EJC189309

Shead DC. Drop for drop: A descriptive analysis of blood product usage in a South African tertiary care setting during the COVID-19 pandemic. African J Emerg Med 2021;11(1):171- 174. https://doi.org/10.1016/j.afjem.2020.09.017

Stanworth SJ, New H V, Apelseth TO, et al. Effects of the COVID-19 pandemic on supply and use of blood for transfusion. Lancet Haematol 2020;7(10):e756-764. https://doi.org/10.1016/ S2352-3026(20)30186-1

Wise RD, Gibbs MW, Louw VJ. Lockdown and our national supply of blood products. S Afr Med J 2020;110(5):337. https://doi.org/10.7196/SAMJ.2020.v110i5.14749

Government SA. COVID-19 About Alert System. South African Government (www.gov.za). www.gov.za/COVID-19/about/about-alert-system (accessed 7 August 2020).

Chikritzhs T, Livingston M. Alcohol and the risk of injury. Nutrients 2021;13(8). https://doi. org/10.3390/nu13082777.14749

Mkhize Z. The burden of alcohol on the health care system. SACoronavirus.co.za. 2020.

https://sacoronavirus.co.za/2020/08/21/the-burden-of-alcohol-on-the-health-care-system/

(accessed 20 August 2020).

WHO. SAFER - alcohol control initiative. World Health Organization. 2019. https://www.who.

int/initiatives/SAFER (accessed 20 August 2020).

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