• Cassanne Eccleston, Elizabeth Marsden, Alison Craswell, Amy Sweeny, Naomi Howell, Marianne Wallis, Julia Crilly, and COVERED-COVID Study Investigators.
• Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Sunshine Coast, Queensland, Australia.
• Emerg Med Australas. 2023 Oct 1; 35 (5): 799808799-808.

ObjectiveTo determine the impact of the COVID-19 state-wide lockdown on ED presentations for older adults in Queensland, Australia.MethodsA 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.ResultsThere 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.ConclusionThere 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.© 2023 Australasian College for Emergency Medicine.

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