![]() ![]() 12 However, trauma admission volumes have declined during the pandemic, and the types of injuries have shifted, for example, the rates of motor vehicle collisions have decreased because of stay-at-home orders. Using 3.5 years of prepandemic data from four of the level 1 trauma centers included in this study, we previously found that the most commonly used insurance types among a subgroup of trauma patients were Medicare (35%), commercial/private insurance (35%), and Medicaid (10%), and this group had an uninsured rate of 13%. Finally, Texas (containing one center) unemployment rates remained steady between January 2018 and February 2020 (3.5% to 4.0%), after which they rose to 5.1% (March 2020), 13.5% (April 2020), 13.0% (May 2020), and 8.4% (June 2020). Kansas (containing one center) unemployment rates were steady between January 2018 and March 2020 (2.8% to 3.4%), after which they rose to 11.9% (April 2020), 10.0% (May 2020), and 7.5% (June 2020). ![]() Missouri (containing one center) unemployment rates were steady between January 2018 and February 2020 (3.0% to 3.5%), after which they rose to 3.9% (March 2020), 10.2% (April 2020), 10.1% (May 2020), and 7.8% (June 2020). 11 Colorado (containing three of the six centers) unemployment rates remained steady between January 2018 and February 2020 (2.5% to 3.3%), after which they rose to 5.2% (March 2020), 12.2% (April 2020), 10.2% (May 2020), and 10.6% (June 2020). Specific states have also reported similar trends to those seen in the USA overall, including the four states housing the six level 1 trauma centers included in this study. 5–7 US Census Bureau reports published in January 2019 and September 2020 estimated that during 20, 55.2% and 55.4% of the US population, respectively, was covered by employer-provided health insurance, 8–10 making it likely that increases in unemployment have resulted in large numbers of Americans losing their health insurance. In April 2020, 20.5 million Americans lost their jobs, and in this single month, the unemployment rate increased by 10.3% to a final rate of 14.7%, the largest single-month increase since the Bureau of Labor Statistics began tracking unemployment trends in 1948. 4 These measures have resulted in drastic increases in unemployment. In response to evidence of community transmission, on March 16, 2020, the White House announced a nationwide “social distancing” order, 2 3 and individual states issued stay-at-home orders according to their infection rates. 1 The rapid spread of the virus has had widespread impacts on almost all aspects of daily life in the USA. COVID-19 was declared a global pandemic by the WHO on March 11, 2020. ![]()
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