Feb. 11 2021

COVID-19 Containment Measures Linked to Increase in Firearm Violence

Researchers from Columbia University Mailman School of Public Health and Lewis Katz School of Medicine at Temple University studied the magnitude of an uptick in firearm violence in Philadelphia during the COVID-19 pandemic and if the increase could be explained by two major events of 2020: the enactment of public health policies designed to contain COVID-19 and a national reckoning with systemic racism, including widespread protests sparked by the police killing of George Floyd. The results are published in JAMA.

While the COVID-19 pandemic brought most of the country to a standstill in March 2020, Philadelphia trauma surgeons noticed an alarming trend in the incidence of firearm violence. Instead of decreasing with containment measures, firearm-injured patients were presenting at even higher rates to surgeons and trauma centers around the city.

“Gun violence has a very strong epidemiologic signature right across the U.S., particularly in relation to social inequity,” said Christopher N. Morrison, PhD, assistant professor in the Department of Epidemiology at Columbia Mailman School and senior author. “At the same time, the COVID-19 epidemic and the measures that we’ve had to take to contain its spread have compounded inequities. In Philadelphia, these powerful systemic drivers seem to have converged with disastrous human costs.”

Using the Philadelphia Police registry data of shooting victims from January 1, 2016, through November 26, 2020, the researchers were able to determine when the spike in firearm violence began by examining changes in the number of individuals shot per week following the enactment of Philadelphia’s first COVID-19 containment policy. They also assessed the closure of non-essential businesses on March 16, 2020, and following the killing of George Floyd on May 25, 2020.

There was a significant and sustained increase in firearm violence in Philadelphia following the enactment of COVID-19 containment policies. During the 256 weeks studied, there were 7,159 individuals shot in the city overall. Prior to Philadelphia’s first COVID-19 containment policy, there was an average of 25 individuals shot per week, and in the weeks after that policy was put in place on March 16, that average number spiked to 46 per week. The killing of George Floyd was not associated with any significant increase in the rate of gun violence in the study model.

“In the city of Philadelphia, shootings are often geographically concentrated in lower-income communities,” said Jessica H. Beard, MD, MPH, assistant professor of surgery and director of trauma research at Temple University Lewis Katz School of Medicine and first author. “These communities have not only been disproportionately affected by the coronavirus disease itself, but the pandemic and its associated policies have also exacerbated issues that were already present, including unemployment, poverty, structural racism, and place-based economic disinvestment, which are empirically tied to firearm violence in Philadelphia.”

The measures put in place to contain the pandemic for health and safety reasons had a significant and sustained association with increased firearm violence in the city, according to the researchers. They noted that in addition to mitigating the impact of COVID-19 in Philadelphia, the city must also come together to address what is now an epidemic of gun violence in the city.

Co-authors include Amy Goldberg and Zoë Maher in the Department of Surgery, Temple Lewis Katz School of Medicine, Temple University; Sara Jacoby, University of Pennsylvania School of Nursing; Beidi Dong, George Mason University; and Elinore Kaufman, Perelman School of Medicine at the University of Pennsylvania.