Trauma can be divided into four categories: stab, cut, sprain, and contusion. The main clinical manifestations are swelling, pain in the injured area, tenderness, and other symptoms. If not treated in time, a patient may have shock, massive hemorrhage, shock, disturbance of consciousness, asphyxia, and other serious complications, thus having a certain impact on the patient's health and daily life [9]. The incidence of severe trauma continues to increase every year with rapid urbanization, including construction industry, high-speed public transportation, and so forth. Most of the severe trauma is caused by traffic, construction sites, and other accidents, which seriously damage the body function of patients and may also affect and damage multiple organs and tissues. The lives of patients are seriously threatened if the injury progresses quickly, the treatment is not given in time, or the rescue effect is not ideal. The golden hour of trauma first aid is within 1 h after the injury, which is of great significance to improve the rescue efficiency[10].
The numbers of first-aid workers and emergency workers were significantly lower in 2020 than during the same period in 2019. This was probably due to the following reasons. First, the media reported that the hospital lacked protective equipment and effective means of protection, leading to the spread of infection among hospitalized patients and medical staff. Hence, patients were worried about being infected with COVID-19 in the hospital or on the way to treatment. Consequently, they avoided going to the hospital. During the novel COVID-19 epidemic, ordinary patients who did not need emergency treatment were avoided and encouraged to wait until the epidemic situation was under control. Therefore, they delayed the appointment. Many people took drugs to relieve symptoms. Some patients delayed the treatment, leading to wound infection, fracture malunion, and other diseases. Elderly patients, or patients with underlying diseases, often had a secondary injury or even irreversible outcomes[11]. Second, Chinese governments, including Hangzhou, took measures to stop the transmission of the virus by restricting residents' travel and stopping public transportation during the COVID-19 epidemic [12], leading to a decrease in population flow. According to news media reports, traffic on the viaduct in Hangzhou decreased significantly. With the decrease in traffic flow, the road was unobstructed, the probability of accidents reduced, and the number of rescue personnel first-aid calls significantly reduced. Third, Hangzhou underwent significant urban development in recent years. Consequently, a large number of patients were injured due to falling or being hit by heavy objects. The production and construction were stopped at the construction sites during the COVID-19 epidemic. Consequently, the number of patients with traumatic injury decreased significantly, leading to a decrease in the numbers of rescue personnel first-aid calls and trauma emergency calls. Fourth, Hangzhou is an economically developed region in China, with an urban population of about 10 million. However, it has a large number of immigrants; the local population accounts for only 10%–15%. The outbreak of the novel COVID-19 epidemic happened during the Spring Festival, a traditional Chinese festival. Many migrant workers went home for the Spring Festival. The total population of Hangzhou decreased significantly during this period as a result of the epidemic, traffic control, and inability to return to work in Hangzhou, which also led to the reduction in trauma emergency calls.
The decline in these trauma data emergency calls was a good sign. The in-depth analysis revealed that travel restrictions and discontinued construction led to a serious decline in the city's economy. The decrease in social productivity and residents' income and the hindered urban development formed a vicious circle[13]. With an improvement in the COVID-19 epidemic, the Chinese government has lifted travel restrictions and is encouraging enterprises to resume work and production.
Considering the aforementioned observations, some countermeasures were proposed. First, community health services should be improved. In the case of less trauma, patients should call their family doctor, visit a clinic, or go to a community hospital for timely treatment. The state should strengthen the investment in appropriate medical equipment in community hospitals, especially for trauma-related x-ray examination, color Doppler ultrasound, computed tomography, and so forth, to detect the degree of injury and reduce the risk of patients going to a larger hospital. Second, the novel coronavirus may exist in humans for a long time, and hence nucleic acid detection should be popularized, especially for high-risk groups, such as medical staff, public transport drivers, window attendants, teachers, and so on. Hangzhou is the first city in China to implement the health code through establishing public health networks using big data of patients. The health records of injured patients should be checked, and doctors should familiarize themselves with the patient's medical history and previous health status. The recent nucleic acid detection report and the health code are convenient for on-site treatment and quick judgment of the risk of COVID-19 infection. These help in deciding whether to go to the designated new coronavirus hospital to prevent the virus from spreading. Third, traffic control and community closure are essential. The epidemic has led to economic recession worldwide, and hence people are encouraged to resume work and production. However, hand hygiene, using masks while moving out, and so on, should be ensured. At the same time, the health and safety education of the whole society should be strengthened. Safe production on the construction site, use of measures of road traffic safety, and reduction in risk factors of trauma are essential while returning to work[14].