{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:59:56Z","timestamp":1774540796763,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,29]],"date-time":"2020-08-29T00:00:00Z","timestamp":1598659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if COVID\u201019 State of Emergency (SOE) restrictions were associated with a reduction in presentations to two urban EDs in Melbourne, Victoria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational study included adult patients presenting to The Alfred and Sandringham Hospital EDs during the first month of stage 2 and 3 SOE restrictions (26 March\u201325 April 2020). Patients transferred from other hospitals or diagnosed with COVID\u201019 were excluded. The primary outcome was the average number of presentations per day. Secondary outcomes included the average daily number of presentations for pre\u2010specified subgroups defined by triage category and diagnosis. The independent impact of SOE restrictions, adjusted for underlying trends in attendance, was determined using negative binomial regression and reported as an incident rate ratio (IRR) with a 95% confidence interval (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average daily attendance during the exposure period was 174.7. In the absence of SOE restrictions, 278.8 presentations per day were predicted, a reduction of 37.3% (IRR 0.63, 95% CI 0.59\u20130.67). Attendance was lower than anticipated for all triage categories (especially category 5 [IRR 0.51, 95% CI 0.44\u20130.59]) and diagnostic groups (including circulatory problems [IRR 0.62, 95% CI 0.50\u20130.76] and injury [IRR 0.58, 95% CI 0.53\u20130.63]). There were fewer than predicted presentations for several sentinel diagnoses, including gastroenteritis (IRR 0.27, 95% CI 0.17\u20130.42) and renal colic (IRR 0.55, 95% CI 0.33\u20130.92).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SOE restrictions were associated with a significant reduction in ED presentations across a range of triage categories and diagnoses. Public health messaging should emphasise the importance of timely ED attendance for acute illness and injury.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13606","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T07:05:03Z","timestamp":1596524703000},"page":"1027-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Impact of <scp>COVID<\/scp>\u201019 State of Emergency restrictions on presentations to two Victorian emergency departments"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-3348","authenticated-orcid":false,"given":"Rob D","family":"Mitchell","sequence":"first","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-917X","authenticated-orcid":false,"given":"Gerard M","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-2450","authenticated-orcid":false,"given":"Biswadev","family":"Mitra","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De Villiers","family":"Smit","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Philippe","family":"Miller","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-557X","authenticated-orcid":false,"given":"Peter A","family":"Cameron","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,29]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.WHO Director\u2010General's Opening Remarks at the Media Briefing on COVID\u201019 \u2013 11 March 2020. [Cited 20 Mar 2020.] Available from URL:https:\/\/www.who.int\/dg\/speeches\/detail\/who\u2010director\u2010general\u2010s\u2010opening\u2010remarks\u2010at\u2010the\u2010media\u2010briefing\u2010on\u2010covid\u201019\u2010\u2010\u201011\u2010march\u20102020"},{"key":"e_1_2_8_3_1","unstructured":"Johns Hopkins University.COVID\u201019 Dashboard. [Cited 24 Jul 2020.] Available from URL:https:\/\/coronavirus.jhu.edu\/map.html"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30073-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30162-6"},{"key":"e_1_2_8_6_1","article-title":"A strategic framework to ease community\u2010wide COVID\u201019 suppression measures","author":"Coghlan B","year":"2020","journal-title":"Med. J. Aust."},{"key":"e_1_2_8_7_1","article-title":"The effectiveness of social distancing in mitigating COVID\u201019 spread: a modelling analysis","author":"Milne GJ","year":"2020","journal-title":"medRxiv"},{"key":"e_1_2_8_8_1","unstructured":"Department of Health and Human Services.Victoria's Coronavirus (COVID\u201019) Modelling Confirms Staying at Home Saves Lives. [Cited 26 Apr 2020.] Available from URL:https:\/\/www.dhhs.vic.gov.au\/victorias\u2010coronavirus\u2010covid\u201019\u2010modelling\u2010confirms\u2010staying\u2010home\u2010saves\u2010lives"},{"key":"e_1_2_8_9_1","unstructured":"Department of Health and Human Services.Directions issued by the Chief Health Officer. [Cited 25 Apr 2020.] Available from URL:https:\/\/www.dhhs.vic.gov.au\/state\u2010emergency"},{"key":"e_1_2_8_10_1","unstructured":"CunninghamM NoyesJ.Locked\u2010down lives drive emergency department numbers to record lows.2020. [Cited 12 Aug 2020.] Available from URL:https:\/\/www.smh.com.au\/national\/locked\u2010down\u2010lives\u2010drive\u2010emergency\u2010department\u2010numbers\u2010to\u2010record\u2010lows\u201020200420\u2010p54lcc.html"},{"key":"e_1_2_8_11_1","article-title":"Where are all the patients? Addressing Covid\u201019 fear to encourage sick patients to seek emergency care","author":"Wong L","year":"2020","journal-title":"NEJM Catal."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2020.101"},{"key":"e_1_2_8_13_1","first-page":"418","article-title":"Impact of SARS on an emergency department in Hong Kong","volume":"15","author":"Man CY","year":"2003","journal-title":"Emerg. Med. Australas."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13540"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1401"},{"key":"e_1_2_8_16_1","article-title":"Do not stay at home: we are ready for you","author":"Deerberg\u2010Wittram J","year":"2020","journal-title":"NEJM Catal."},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-319385"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000507666"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.011"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(09)70146-7"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1557"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30895-3"},{"key":"e_1_2_8_23_1","first-page":"m1607","article-title":"What is happening to non\u2010covid deaths?","volume":"2020","author":"Appleby J","year":"1607","journal-title":"BMJ"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31067-9"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.13606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.13606","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.13606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T03:07:28Z","timestamp":1693883248000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.13606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,29]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/1742-6723.13606"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.13606","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,29]]},"assertion":[{"value":"2020-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}