Changes in alcohol intoxication-related ambulance attendances during COVID-19: How have government announcements and policies affected ambulance call outs?

Rowan P Ogeil; Debbie Scott; Agatha Faulkner; James Wilson; Naomi Beard; Karen Smith; Victoria Manning; Dan I Lubman

doi:10.1016/j.lanwpc.2021.100222

Changes in alcohol intoxication-related ambulance attendances during COVID-19: How have government announcements and policies affected ambulance call outs?

Lancet Reg Health West Pac. 2021 Sep:14:100222. doi: 10.1016/j.lanwpc.2021.100222. Epub 2021 Jul 23.

Authors

Rowan P Ogeil^{1

2}, Debbie Scott^{1

2}, Agatha Faulkner², James Wilson², Naomi Beard², Karen Smith^{3

4

5}, Victoria Manning^{1

2}, Dan I Lubman^{1

2}

Affiliations

¹ Eastern Health Clinical School and Monash Addiction Research Centre, Monash University, Box Hill, Australia.
² Turning Point, Eastern Health, Richmond, Australia.
³ Department of Community Emergency Health and Paramedic Practice, Monash University, Clayton, Australia.
⁴ Research and Evaluation, Ambulance Victoria, Blackburn North, Australia.
⁵ Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia.

Abstract

Background: In response to COVID-19, government-mandated health directives including widespread lockdowns were implemented. Changes in alcohol purchasing were reported, with growing concern that alcohol may be consumed as a way to cope with pandemic-associated stressors. Hitherto, there have been limited studies examining alcohol-related harms, including acute harms requiring an ambulance, and their relationship to government announcements or policies related to COVID-19.

Methods: Analyses were conducted between January and September 2020, with matched months in 2019, using Victorian data from the National Ambulance Surveillance System in Australia. Interrupted time series (ITS) models with odds ratios (OR) were used to map alcohol-related harms as a function of government policies for both metropolitan and regional areas.

Findings: A total of 43,003 alcohol intoxication-related ambulance attendances occurred between January 2019 and September 2020. Attendances in the home increased in 2020 by 9% compared to matched 2019 months. The most socioeconomically advantaged cases showed the highest percentage change. ITS models showed decreased odds of alcohol-related attendances at the beginning of each COVID-19 wave in metropolitan (OR:0•77; 95%CI: 0•71-0•83; p<0•001) and regional Victoria (OR: 0•72; 95%CI: 0•67-0•79, p<0•001) separately, and increased odds following the introduction of harsher restrictions in metropolitan Melbourne (OR:1•07; 95%CI:1•01-1•11, p=0•005). A 19% increase in odds of alcohol-related harms was observed at the end of the second wave lockdown period in regional Victoria (OR:1•19; 95%CI: 1•01-1•41, p=0•004).

Interpretation: Alcohol-related attendances during COVID-19 restrictions showed a displacement to home settings. Changes in patterns of harms were evident in specific sociodemographic groups, and geographic regions when mapped to government health directives. This study is one of the first to investigate alcohol-related harms at the population level in response to a global pandemic.

Funding: Commonwealth Department of Health and Victorian Department of Health.

Keywords: Alcohol; COVID-19; alcohol harms; ambulance; government policy; intoxication; paramedicine.