The Influence of 2020 Coronavirus Lockdown on Presentation of Oral and Maxillofacial Trauma to a central London hospital

Yeung, Elizabeth; Bradsma, Dirk Stephanus; Karst, Felix Wilhelm; Smith, Caroline; Fan, Kathleen F.M.

The novel coronavirus COVID-19, was first identified in China in December 2019. Its spread resulted in a pandemic, with the United Kingdom entering a period of national lockdown on 23rd March 2020 to reduce disease burden on the National Health Service (NHS). King’s College Hospital is a Major Trauma Centre serving an inner-city population of 700,000with 120,000 patients attending the ED annually. We aim to determine the effect of lockdown on OMFS trauma presentations and lessons learned from emergency service provision during a pandemic. METHOD: All referrals to the OMFS team from ED during the first 6 weeks of the lockdown period – 23rd March 2020-3rd May 2020 – were compared with the same 6 week time period for 2019. RESULTS: 111 referrals were made to OMFS during the first 6 weeks of the lockdown period in 2020 compared with 380 referrals in 2019. Of these 50.5%, (n = 192) were related to facial trauma in 2019 vs. (63.1%, n = 70) in 2020. Fewer patients were admitted under OMFS: 17.4% (n = 35) in 2019 vs 2.9%( n = 2) in 2020, and a greater number of patients discharged from OMFS care directly from ED: 63.2% (n = 127) in 2019 vs. 82.9% (n = 58) in 2020. DISCUSSION: There was profound effect of the lockdown on referrals to OMFS from the ED, in number and diagnosis type. This is potentially reflective of the increased availability of acute/emergency dental services in South-East London during the lockdown period. This gives us valuable insight for service planning in the event of further restrictions.