The Epidemiology of Facial Injury on the Far Side of the COVID-19 Pandemic Curve: What Happened After the Repeal of Social Distancing Laws?

Abstract

Background: In response to the COVID-19 outbreak, the widespread imposition of social distancing and lockdown orders had an unintended secondary effect on reducing and changing the characteristics of facial injury presentations to tertiary referral hospitals. As the pandemic curve plateaued and indeed fell, these restrictions were periodically repealed, engendering an anticipated rise in the frequency facial injuries. Objective: The purpose of this study was to determine whether the frequency and characteristics of facial injury presentations to our tertiary referral hospital returned to pre-COVID levels following the repeal of COVID-19 social distancing and lockdown laws on the far side of the pandemic curve. Methods: The authors designed and implemented a retrospective study of patients who sustained a facial injury over 3 comparable 8-week periods in 2019 (pre-COVID), 2020 (COVID lockdown) and 2023 (post-repeal of COVID lockdown laws). The study was conducted in the Department of Maxillofacial Surgery at a level 1 tertiary referral regional trauma hospital in Newcastle, Australia. Results: The principal finding was an increase in facial injury frequency in the post-COVID cohort (n = 149), compared to the COVID lockdown (n = 37) and pre-COVID groups (n = 103). Across all 3 periods, males consistently outnumbered females, with a common peak in the 20 to 30 age group. Bony injuries predominated in all cohorts, with no difference in management approach. The leading cause of injury pre-COVID was interpersonal violence, which shifted to falls during lockdown and post-COVID. There was also an increase in workplace and animal-related injuries post-COVID. Conclusion: The frequency and characteristics of facial injury presentation finally stabilized and returned to pre-COVID levels following the repeal of social distancing laws. This was most notable as communities entered the far side of the pandemic curve. The findings are in keeping with a very small number of comparable studies sourced from literature.