Question
How did interpersonal firearm violence change temporally and spatially in the first year of the COVID-19 pandemic period in the US?
Findings
In this nationwide cross-sectional study of the US, the pandemic period was associated with a 15.0% increase in firearm-related incidents, a 34.3% increase in firearm-related nonfatal injuries, and a 28.4% increase in firearm-related deaths. The excess burden was more pronounced from June to October 2020 and in Minnesota and New York State.
Meaning
These findings suggest that the COVID-19 pandemic was associated with an excess burden of firearm violence, with substantial temporal and spatial variations.
Importance
In the US, the COVID-19 pandemic intensified some conditions that may contribute to firearm violence, and a recent surge in firearm sales during the pandemic has been reported. However, patterns of change in firearm violence in the first year of the COVID-19 pandemic in the US remain unclear.
Objective
To quantify the changes in interpersonal firearm violence associated with the pandemic across all 50 US states and the District of Columbia.
Design, Setting, and Participants
This population-based cross-sectional study examined 50 US states and the District of Columbia from January 1, 2016, to February 28, 2021. The COVID-19 pandemic period was defined as between March 1, 2020, and February 28, 2021. Statistical analysis was performed from April to December 2021.
Main Outcomes and Measures
A 2-stage interrupted time-series design was used to examine the excess burden of firearm-related incidents, nonfatal injuries, and deaths associated with the pandemic while accounting for long-term trends and seasonality. In the first stage, separate quasi-Poisson regression models were fit to the daily number of firearm events in each state. In the second stage, estimates were pooled using a multivariate meta-analysis.
Results
In the US (all 50 states and the District of Columbia) during the pandemic period of March 1, 2020, to February 28, 2021, there were 62 485 identified firearm-related incidents, 40 021 firearm-related nonfatal injuries, and 19 818 firearm-related deaths. The pandemic period was associated with 8138 (95% empirical confidence interval [eCI], 2769-12 948) excess incidents (increase of 15.0% [95% eCI, 4.6%-26.1%]), 10 222 (95% eCI, 8284-11 650) excess nonfatal injuries (increase of 34.3% [95% eCI, 26.1%-41.1%]), and 4381 (95% eCI, 2262-6264) excess deaths (increase of 28.4% [95% eCI, 12.9%-46.2%]). The increase in firearm-related violence was more pronounced from June to October 2020 and in Minnesota and New York State.
Conclusions and Relevance
In the US, the first year of the COVID-19 pandemic was associated with an excess burden of firearm-related incidents, nonfatal injuries, and deaths, with substantial temporal and spatial variations.