“We were concerned about the rising risk of violence during the lockdown, and wanted to investigate how the pandemic was affecting access to emergency care for survivors of sexual and domestic violence” - Dr. Katherine MuldoonThe Ottawa Hospital saw a decrease in emergency department admissions for sexual assault and domestic violence in the early days of COVID-19, according to a study published in BMC Medicine.
“We were concerned about the rising risk of violence during the lockdown, and wanted to investigate how the pandemic was affecting access to emergency care for survivors of sexual and domestic violence,” said Dr. Katherine Muldoon, lead author of the study and senior research associate at The Ottawa Hospital and assistant professor a the University of Ottawa. “In the first two months of the COVID-19 pandemic there was a 50 percent reduction in sexual assault and domestic violence cases seen in the ED, compared to the same months in 2018.”
The research team compared ED admissions for sexual assault and domestic violence between March and May 2020 with the same time period in 2018. The Ottawa Hospital Sexual Assault and Partner Abuse Care Program typically sees 60-80 patients over a two-month period, but during the first two months of the pandemic it only saw 34. The weekly average of seven to nine patients dropped to four during that period.
Survivors had a median age of 25 years and 89 percent were female patients. Fifty-seven percent had experienced sexual assault and 49 percent had experienced physical assault. The most common locations for assault were in the assailant’s home or the survivor’s home, and in 52 percent of the cases the assailant was a current or former partner.
Compared to 2018, more cases in 2020 involved psychological abuse (29 percent compared to 12 percent) and more assaults occurred outdoors (23 percent compared to five percent). Importantly, the pandemic did not affect the care provided - patients in 2020 received the same high-quality clinical and forensic care as was provided before the pandemic.
“It’s an enormous effort for survivors of sexual assault and domestic violence to get help, and the pandemic makes it even harder, as sheltering at home may not be a safe place."- Dr. Kari Sampsel
“In March 2020, the United Nations issued a warning about the rising risk of domestic violence due to COVID-19 restrictions,” said Dr. Kari Sampsel, emergency physician and Medical Director of The Ottawa Hospital Sexual Assault and Partner Abuse Care Program and assistant professor at the University of Ottawa. “In previous pandemics and emergencies, financial insecurity, job loss, quarantine and social isolation were associated with increased risk of sexual and domestic violence.”
The researchers think there could be multiple factors behind the decrease in ED admissions. While it is possible that there was less domestic violence and sexual assault during this time period, the researchers don’t think this is likely.
A more likely explanation is that many people avoided hospitals entirely in the early days of the pandemic out of fear of contracting COVID-19. At The Ottawa Hospital, general ED admissions between March and May 2020 dropped by over 10,000 patients, a 33 percent reduction compared to the same period in 2018.
Other possible factors include being isolated at home with a controlling or violent partner and unable to leave to seek care, or fewer social interactions with people outside the home.
“We want to understand how survivors are accessing care during the pandemic, particularly as lockdowns continue in Ontario,” said Dr. Muldoon. “The full consequences of the COVID-19 restrictions on sexual assault and domestic violence may take months to appear, and we continue to monitor the situation.”
“It’s an enormous effort for survivors of sexual assault and domestic violence to get help, and the pandemic makes it even harder, as sheltering at home may not be a safe place for you. If you have been impacted, know that we are here for you, we believe you, and we support you,” said Dr. Sampsel. “Everyone can do their part by keeping their eyes open and checking in on friends, neighbours and loved ones who might be in a difficult situation.”
Resources for those affected by sexual violence
Reference: COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors. Katherine A. Muldoon, Kathryn M. Denize, Robert Talarico, Deshayne B. Fell, Agnes Sobiesiak, Melissa Heimerl, Kari Sampsel. BMJ Medicine. Feb 4, 2021. DOI:
Funding: This study was funded by The Ottawa Hospital Academic Medical Organization. Research at The Ottawa Hospital is also enabled by generous donations to The Ottawa Hospital Foundation.
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