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Objective: Diverting lower urgency ED presentations to more suitable healthcare is a key goal of several healthcare systems. During the early stages of the COVID‐19 pandemic in 2020, there was a substantial drop in ED presentations in New South Wales (NSW), potentially because of lower risk of illness and injury through social restrictions, or ED avoidance for lower urgent care. The present study aimed to better understand the impact of social restrictions during the pandemic on ED presentations, to inform potential shifts to alternative modes of care in emergency medicine. Methods: We conducted a quasi‐experimental study of public ED presentations in NSW. We compared changes in weekly ED presentation counts by urgency, during and after the period of tightest social restrictions in contrast to the baseline period. Expected weekly counts were estimated using segmented quasi‐Poisson regression, accounting for age and seasonality. Results: Lower urgency presentations fell more than mid‐high urgency presentations, both during and after the period of tightest social restrictions. Lower urgency presentations reduced 30.9% compared to the baseline period during tightest restrictions, in contrast to 20.9% reduction for mid‐high urgency presentations. Lower urgency presentations remained 14.4% lower after the tightest restrictions compared to the baseline period, whereas mid‐high urgency presentations returned to usual levels. Conclusions: This finding suggests that reducing lower urgency ED presentation beyond the COVID‐19 pandemic maybe feasible, by supporting alternative, more appropriate sources of care. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 has left no healthcare system untouched. In New South Wales (NSW), the most populous state in Australia, COVID-19 case numbers have to date been relatively low. However, that does not mean the state's healthcare system has been unaffected. Preparations to create sufficient capacity to accommodate a COVID-19 surge resulted in widespread deferment of scheduled medical procedures and appointments. Patterns of healthcare-seeking behaviour changed, with a reluctance to visit healthcare settings. The aim of this study was to quantify the changes in activity seen in the NSW health system in the first half of 2020., Methods: Healthcare data were drawn from multiple sources, including primary care, ambulance, emergency departments and inpatient settings. Volumes of healthcare activity in 2020, overall, by urgency of cases and by reasons for care were compared with the figures for the same period in 2019. Changes in the modality of care provision were also examined., Results: In March to June 2020, compared with the same period in 2019, primary care face-to-face consultations decreased by 22.1%, breast screening activity by 51.5%, ambulance incidents by 7.2%, emergency department visits by 13.9%, public hospital inpatient episodes by 14.3%, and public hospital planned surgical activity by 32.6%., Conclusion: There were substantial declines in a wide range of healthcare activities across the NSW health system between March and June 2020 due to the impact of the COVID-19 pandemic. Although activity levels were recovering by September 2020, they had not yet returned to 'normal'. The implications of these changes - and the indirect impact of COVID-19 - require further study., Competing Interests: None declared