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Motor vehicle collision (MVC) emergency department (ED) visits and hospitalisations in Ontario during the COVID-19 pandemic
  1. Adrian Sammy1,
  2. Alexia Medeiros1,
  3. Brice Batomen2,
  4. Linda Rothman2,3,
  5. M Anne Harris2,3,
  6. Daniel W Harrington1,
  7. Colin Macarthur4,
  8. Sarah A Richmond1,2
  1. 1Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
  2. 2Dalla Lana School of Public Health, Division of Epidemiology, University of Toronto, Toronto, Ontario, Canada
  3. 3School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
  4. 4Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  1. Correspondence to Dr Sarah A Richmond, Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada; sarah.richmond{at}


Background The COVID-19 pandemic policy response dramatically changed local transportation patterns. This project investigated the impact of COVID-19 policies on motor vehicle collision (MVC)-related emergency department (ED) visits and hospitalisations in Ontario.

Methods Data were collected on MVC-related ED visits and hospitalisations in Ontario between March 2016 and December 2022. Using an interrupted time series design, negative binomial regression models were fitted to the pre-pandemic data, including monthly indicator variables for seasonality and accounting for autocorrelation. Extrapolations simulated expected outcome trajectories during the pandemic, which were compared with actual observed outcome counts using the overall per cent change and mean monthly difference. Data were modelled separately for vehicle occupants, pedestrians and cyclists (MVC and non-MVC injuries).

Results There was a 31.5% decrease in observed ED visits (95% CI –35.4 to –27.3) and a 6.0% decrease in hospitalisations (95% CI −13.2 to 1.6) among vehicle occupants, relative to expected counts during the pandemic. Results were similar for pedestrians. Among cyclist MVCs, there was an increase in ED visits (12.8%, 95% CI −8.2 to 39.4) and hospitalisations (46.0%, 95% CI 11.6 to 93.6). Among non-MVC cyclists, there was also an increase in ED visits (47.0%, 95% CI 12.5 to 86.8) and hospitalisations (50.1%, 95% CI 8.2 to 101.2).

Conclusions We observed fewer vehicle occupant and pedestrian collision injuries than expected during the pandemic. By contrast, we observed more cycling injuries than expected, especially in cycling injuries not involving motor vehicles. These observations may be attributable to changes in transportation patterns during the pandemic and increased uptake of recreational cycling.

  • Time series
  • Epidemiology
  • Pedestrian
  • Motor vehicle � Occupant
  • Bicycle
  • COVID-19

Data availability statement

Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data may be obtained from a third party and are not publicly available.

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  • X @S_A_Richmond

  • Contributors Concept and design: AS, BB, LR and SAR. Acquisition, analysis or interpretation of data: AS, AM, BB, LR, MAH, DWH, CM and SAR. Drafting of the manuscript: AS and SAR. Critical revision of the manuscript for important intellectual content: AM, BB, LR, MAH, DWH and CM. Supervision: BB, LR and SAR. Guarantor: SAR.

  • Funding This work was partially supported by an operating grant from the Canadian Institutes of Health Research (FRN: MM1-174905). The funding source was not involved in the collection, analysis and interpretation of data, the writing of the report or in the decision to submit the article for publication.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.