Intimate violence against partners spikes after COVID-19 lockdown

The toll of COVID-19 does not always show on the screen of a radiologist as injured lungs. These doctors who peer under the skin with the help of CT or MRI scans are seeing more and more evidence of physical abuse by these patients’ domestic partners as a result of the months of orders to stay home, job loss and escalating family stress that the pandemic has worked.

On the high-tech images they order, radiologists and their doctor colleagues in hospital emergency departments see fractured bones and injured and punctured organs. The questions that result often bring to the fore the secret of an abusive partner.

A new study finds that as the immediate restrictions on non-essential activities began to lift in Massachusetts, doctors at a large hospital in Boston saw an almost double the proportion of cases of domestic abuse that resulted in physical injury compared to previous years. The injuries were also dramatically more severe, raising concerns that victims had delayed seeking care, even as the violence against them escalated.

Experts on intimate partner violence feared that such abuse would escalate during the COVID-19 pandemic, despite the fact that fewer victims emerged from fear of becoming infected in a clinic, shelter or hospital emergency department.

In April, United Nations chief António Guterres called for action against what he called a “horrifying global surge in domestic violence” linked to the pandemic and targeting women and girls. And a May study of domestic abuse calls to police in 14 metropolitan areas around the US found the pandemic and associated public health response had led to a 10.2% increase in such calls.

The new study finds evidence that physical abuse has both increased and escalated – even as the number of casualties has declined.

Researchers at Brigham and Women’s Hospital in Boston identified 62 adults seeking help for physical and non-physical abuse by an intimate partner between March 11 and May 3. That was much less than the numbers that emerged in the same period for help and / or treatment in 2019 (104 people), 2018 (106) and 2017 (146).

But the proportion of men and women whose abuse was physical – instead of verbal as well as emotional – was 80% higher in 2020 than in all three previous years combined. And the physical abuse was much heavier.

The new study was published in the journal Radiology.

The researchers categorized the patients’ injuries by their severity, and distinguished superficial injuries such as bruises and black eyes from deep injuries that result from strangulation, burns, knives, guns and other objects that can damage internal organs.

In the past three years, Boston Hospital has seen a total of 16 “deep” injuries caused by intimate partner violence. In 2020, however, the number of deep injuries was 28.

The results suggest that “victims may be so afraid of COVID-19 that they will not reach us until the abuse is serious,” said Dr Bharti Khurana, a radiologist at Brigham and Women’s Hospital who teaches at Harvard Medical School.

“We know that high-risk physical abuse and serious bodily injuries are strongly linked to murder,” Khurana said. However, having been overwhelmed by the pandemic doctors, they should be on the lookout for evidence of domestic abuse, she added.

Study co-founder Dr Babina Gosangi, a radiologist who teaches at Yale, said the location of the serious injuries was less visible to the casual observer. The victims whose injuries were considered deep were often stabbed, kicked or hit in the abdomen and chest instead of in or around the face.

While all patients in the study acknowledged that their injuries were at the hands of another housekeeper, the damage was not as easily identifiable as domestic abuse, as opposed to broken wrists and arms (a typical defensive injury) or broken facial ligaments or bruises that occur more frequently in cases of intimate partner violence.

The study period included an intense period of COVID-19 related restrictions for the Boston area. Schools closed March 12, and on March 24, Gov. Massachusetts Gov. Charlie Baker issued an emergency call, excluding only essential activities. The peak of COVID-19 cases came in late April, and by the end of the study on May 3, a low level of activity in the region began to recover.

The researchers found that the ethnic burglary of victims of abuse was different during the pandemic than in previous years. Roughly two-thirds of those seeking treatment by 2020 were white. In previous years, white people made up 26% of such cases.

Khurana said that in ordinary times, intimacy of partner abuse is almost not experienced too much. In the midst of a pandemic, when victims are helped for long periods with their abusers and have a few other social contacts, that undercount is likely to be even more pronounced.

“This is the tip of the iceberg,” said Khurana, who has worked to help other radiologists identify victims of violence against partners. “We saw at least 26 victims of physical violence. That is very small compared to what is happening. ”

In children, the toll – and its undercount – could be even harder. Most cases of physical abuse are identified by teachers and school administrators, who have not seen most students in months. Thus, most cases of bodily injury at the hands of a caregiver are unlikely to be identified unless they are serious enough to require a visit to a physician.

“The long-term consequences of the COVID-19 pandemic for children will not be understood for years to come,” actress, filmmaker and activist Angelina Jolie wrote recently. “But we can already see the heavy costs of missing school time, lost opportunities, mental pain and an increased exposure to life-changing violence. It’s time to bring the needs of children forward in the discussion on how we can build a better society. ‘

The National Domestic Violence Hotline is available to help victims of intimate partner violence 24 hours a day, 7 days a week by calling or texting (800) 799-SAFE (7233).