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Background: The COVID‐19 pandemic has been associated with detrimental effects on mental health and psychological well‐being. Although multiple studies have shown decreases in mental health‐related Emergency Department (ED) presentations early in the COVID‐19 pandemic, the medium‐term effects on mental health‐related ED presentations have remained less clear. This study aimed to evaluate the effect of the pandemic on mental health ED presentations by comparing observed presentation numbers to predictions from pre‐pandemic data. Methods: This retrospective cohort study tallied weekly ED presentations associated with mental health disorders from a state‐wide minimum dataset. Three time periods were identified: Pre‐Pandemic (January 1, 2018–March 8, 2020), Statewide Lockdown (March 9, 2020–June 28, 2020), and Restrictions Easing (June 29, 2020–June 27, 2021). Time series analysis was used to generate weekly presentation forecasts using pre‐pandemic data. Observed presentation numbers were compared to these forecasts. Results: Weekly presentation numbers were lower than predicted in 11 out of 16 weeks in the Statewide Lockdown period and 52 out of 52 weeks in the Restrictions Easing period. The largest decrease was seen for anxiety disorders (Statewide Lockdown: 76.8% of forecast; Restrictions Easing: 36.4% of forecast), while an increase was seen in presentations for eating disorders (Statewide Lockdown: 139.5% of forecast; Restrictions Easing: 194.4% of forecast). Conclusions: Overall weekly mental health‐related presentations across Queensland public EDs were lower than expected for the first 16 months of the COVID‐19 pandemic. These findings underline the limitations of emergency department provision of mental health care and the importance of alternate care modalities in the pandemic context. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the COVID‐19 state‐wide lockdown on ED presentations for older adults in Queensland, Australia. Methods: A retrospective cohort study pertaining to adults aged 70+ years who presented to Queensland public hospital EDs across three separate time periods; 11 March to 30 June 2018 and 2019 (pre‐pandemic average), 2020 (COVID‐19 state‐wide lockdown) and 2021 (post‐state‐wide lockdown). The primary outcome was change in presentation rates to ED. Secondary outcomes included change in triage category rates, length of stay (LOS), diagnosis and disposition. Results: There was 380 854 older adult presentations. During the COVID‐19 state‐wide lockdown, ED presentation rates decreased by 12.5% (incidence rate ratio 0.875 [95% confidence interval 0.867–0.883]). All triage category presentation rates decreased, as did ED LOS and reasons for presentation, except sepsis and disorders of the nervous system. In the post‐state‐wide lockdown period a 22% (incidence rate ratio 1.22 [95% confidence interval 1.21–1.23]) increase in the presentation rate was observed and presentations in all triage categories increased. ED LOS increased to longer than pre‐pandemic (P < 0.001). Respiratory presentations increased by 346%. Patients who 'did not wait' increased by 212% and ED mortality rose by 42% compared to during the lockdown. Conclusion: There was a significant decrease in presentation rates to EDs during the COVID‐19 state‐wide lockdown for the older population, followed by an increase in presentation rates, longer ED LOS, and an increased ED mortality rate, in the post‐state‐wide lockdown period. It is important to ensure older adults continue to seek appropriate, timely medical care, during a pandemic. [ABSTRACT FROM AUTHOR]

Objectives: To assess emergency department (ED) presentation numbers in Queensland during the coronavirus disease 2019 (COVID‐19) pandemic to mid‐2021, a period of relatively low COVID‐19 case numbers. Design: Interrupted time series analysis. Setting: All 105 Queensland public hospital EDs. Main outcome measures: Numbers of ED presentations during the COVID‐19 lockdown period (11 March 2020 – 30 June 2020) and the period of easing restrictions (1 July 2020 – 30 June 2021), compared with pre‐pandemic period (1 January 2018 – 10 March 2020), overall (daily numbers) and by Australasian Triage Scale (ATS; daily numbers) and selected diagnostic categories (cardiac, respiratory, mental health, injury‐related conditions) and conditions (stroke, sepsis) (weekly numbers). Results: During the lockdown period, the mean number of ED presentations was 19.4% lower (95% confidence interval, –20.9% to –17.9%) than during the pre‐pandemic period (predicted mean number: 5935; actual number: 4786 presentations). The magnitudes of the decline and the time to return to predicted levels varied by ATS category and diagnostic group; changes in presentation numbers were least marked for ATS 1 and 2 (most urgent) presentations, and for presentations with cardiac conditions or stroke. Numbers remained below predicted levels during the 12‐month post‐lockdown period for ATS 5 (least urgent) presentations and presentations with mental health problems, respiratory conditions, or sepsis. Conclusions: The COVID‐19 pandemic and related public restrictions were associated with profound changes in health care use. Pandemic plans should include advice about continuing to seek care for serious health conditions and health emergencies, and support alternative sources of care for less urgent health care needs. [ABSTRACT FROM AUTHOR]

The article discusses the need for the Royal Australasian College of Physicians (RACP) to include doctors with disabilities. It highlights employment disparities and discrimination, emphasizes workplace inclusion, legal protections, and calls on the RACP to prioritize the inclusion of doctors with disabilities for the sake of health equity.