Impact of the COVID-19 pandemic on South Australia's emergency departments: evidence from two lockdowns

Objective. This study assessed the impact of the COVID-19 pandemic on emergency departments (EDs) in South Australia, measured by changes in the number and casemix of patients in the system over time. Methods. Data from the South Australia Emergency Department Dashboard, updated every 30 min, were analysed for the period 4 October-21 December 2020. The Dashboard reports live counts of the number and type of patients in each of the six adult metropolitan public EDs in Adelaide, South Australia. Results. There was a significant difference in the mean daily average occupied ED capacity before and during two distinct increases in COVID-19 cases in South Australia. An increase in COVID-19 cases coincided with a decrease in patients in EDs (Pearson's r = -0.93 and -0.67; P < 0.001 for both). Presentations in Australasian Triage Scale (ATS) Categories 2-5 decreased during these periods, whereas ATS Category 1 stayed constant. Mental health patients continued to present to the ED, despite the overall drop in ED presentations. Conclusions. During the two periods of COVID-19 case growth in South Australia, there was a significant drop in the number of patients presenting to the major public EDs and a change in the casemix of patients over time.