Houston’s trauma centers see uptick in cases
After being cooped up for so long, it may be that people are being less cautious
It started with a Frisbee. Jaijo Vannatt, 24, is a medical student studying radiology at Baylor College of Medicine. When the spring semester was cut short in late March, he and his friends decided to get together one more time before they went home to quarantine.
Frisbee is a relatively distanced sport, they thought. They can play without getting right next to each other. “Kind of like tennis,” Vannatt said.
Then he leaped to catch the Frisbee.
Though he doesn’t know exactly what happened, Vannatt thinks he landed wrong on his leg, fell to his knee and rolled until he was lying on his back. He didn’t lose consciousness, but he couldn’t stand up or move his leg.
“Everything was a haze, but it was excruciating pain every time I tried to move my right leg,” he remembered. “At some point, one of my legs seemed shorter than the other, but my roommate said I was being dramatic and that everything would be fine.”
Vannatt’s hip injury doesn’t usually happen to Frisbee players, said Dr. Milton “Chip” Routt, professor of orthopedic surgery at UTHealth. His fractured, overextended and separated femoral head (highest part of the thigh bone) usually happens to people who are in high-speed car wrecks, Routt said.
Since March, Routt has noticed an uptick in traumatic injuries, such as Vannatt’s. May and June were two of the busiest months for trauma at Memorial Hermann-Texas Medical Center, he said.
When the pandemic started, school was canceled, and many adults transitioned to working from home. Everything that wasn’t considered essential was closed during the lockdown, which led to people “getting after things,” Routt said.
“They were crashing cars, ATVs, shooting each other,” he said. “Everybody was getting frisky, and we were very busy. It continued in May, June and July.”
The volume of traumatic injuries dramatically increased, he said, because people may have been less cautious after being cooped for up weeks.
Vannatt’s injury happened at the start of the pandemic, before hospitals were shut down to visitors and nonessential surgeries were postponed. There is so much hospitals know now compared to then, Routt said.
“When he came in, everything was really unknown. We were still struggling to see if you had enough N-95s to get through the week,” Routt said. “It seems like a long time ago, but it wasn’t very long at all.”
Dr. Michelle McNutt, chief of trauma at the Red Duke Trauma Institute at Memorial Hermann, agrees with Routt’s assessment about the uptick in trauma cases, although there is not enough data available to confirm the increase is related to the pandemic.
Texas Medical Center doctors have noticed an uptick in trauma volume, McNutt said. There has been a 20 percent increase in cases between March and July 2020 compared to the same time period in 2019, which she called a “significant increase.” The hospital is the busiest in the state for these types of injuries.
“We are doing more operations on traumatically injured patients,” said McNutt, who is also the associate professor of surgery at McGovern Medical School at UTHealth. “Some patients who do get injured don’t end up needing surgery, but we are seeing more patients that are so critically injured that more operations are required.”
The trauma timeline isn’t the same at every Houston hospital, however.
At HCA Houston Healthcare, doctors saw a slight reduction in the number of patients requiring orthopedic surgery referred from the emergency and trauma units at their facilities in the early weeks of the pandemic.
“Over the last several months, we have seen a marked increase in the number of referrals from emergency physicians,” according to a statement issued by HCA. “We believe the dip in referrals from the emergency and trauma departments was due to fewer automobile and other accidents while people were quarantined due to the COVID-19 pandemic.”
Traumatic injury patterns have changed significantly across the country, according to Trauma System News. While most trauma centers saw an overall reduction in cases as a result of work closures and stay-at-home orders, other hospitals saw reported increases in “domestic, recreational and pediatric trauma and specific mechanisms of injury.”
At JPS Health Network in Fort Worth, there was a general decline (down by one-third) in trauma injuries, such as vehicle crashes, between March and mid-April. In that period, the hospital reported that burn and electric shock injuries had quadrupled; assaults without a weapon decreased about 25 percent; stab wounds increased; and machinery and equipment injuries were basically eliminated.
While they do not make a direct correlation between the trauma injuries and COVID-19, the timeline is consistent, McNutt said.
“You can’t really speculate, but people were stuck at home for three weeks. When bars and restaurants opened up, people were excited to see friends and socialize again, which led to increases in car accidents and traumatic injuries. It’s a natural reaction to being stuck at home for a period of time and being released.”