P0101 - Impact of the COVID-19 Pandemic on Pediatric Firearm-Related Injuries in the USA

Introduction: Firearms are the second leading cause of death for those under age 19 in the United States. The majority of unintentional gun-related deaths occur in the home while parents/guardians are absent, and over 1 in 3 children in America live in a household with a gun. Previous research has demonstrated that firearm-related injuries and fatalities are more prevalent for children who live in homes with guns, as well as in states with higher rates of gun ownership. The COVID-19 pandemic has caused unprecedented change in American society, including closures of over 124,000 schools, affecting over 55 million students across all 50 states. We sought to analyze the impact of pandemic-related public health measures implemented since March 2020 -- including school shutdowns and “Stay at Home” orders -- on pediatric firearm-related injuries and fatalities. We also investigated if findings were modulated by state-level differences in legislation around Safe Storage (SS) of firearms.

Methods: Firearm-related injury and fatality data for victims aged 0-17 years from January 1, 2019 to April 26, 2020 was obtained from the Gun Violence Archive. Information about state adoption of SS laws was obtained from the Giffords Law Center. Difference-in-differences estimates were calculated in Stata using ordinary least squares with heteroskedasticity robust standard errors.

Results: Preliminary results demonstrate several changes in pediatric firearm-related injuries and fatalities in the United States since March 2020. Daily pediatric firearm-related injuries and fatalities appear largely unchanged on weekdays (Monday through Friday) in 2020 relative to 2019. However, daily pediatric firearm-related injuries and fatalities appear to have decreased by 9.27 (p = 0.005) on weekends (Saturday and Sunday) in 2020 compared to 2019. This decrease in weekend pediatric firearm-related injuries and fatalities appears to be larger in states without Safe Storage laws.

Conclusions: These preliminary results suggest that public health measures adopted in response to COVID-19 are associated with a decrease in pediatric firearm-related injuries and fatalities on weekends. This pattern may be consistent with the likely increased presence of parents/guardians in the home on weekends when compared with the pre-pandemic era, potentially limiting minors’ access to firearms. Firearm-related violence may be stable during the pandemic on weekdays because youth are under similar levels of supervision whether in school prior to the pandemic or at home with a parent/guardian during the pandemic. Further investigation is needed to expand upon these results, delineate potential sub-group differences between various types of firearm-related injuries and fatalities (unintentional injuries, homicides, mass/school shootings, or suicides), and follow these trends while pandemic-related policies remain in place. Our findings may help inform physician counseling strategies for injury prevention and suggest future directions for advocacy and research.