• V Bachan, I Molefe, and B Davies.
• Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa. varushka.bachan@uct.ac.za.
• S. Afr. Med. J. 2023 Jun 5; 113 (6): 505650-56.

BackgroundAlcohol is a significant contributor to injury-related morbidity and mortality in South Africa (SA). During the COVID-19global pandemic, restrictions to movement and to legal access to alcohol (i.e. ethanol) were introduced in SA.ObjectivesTo investigate the effect of alcohol bans during the COVID-19 lockdown periods on injury-related mortality and blood alcoholconcentrations (BACs) in these deaths.MethodsA retrospective, cross-sectional analysis of injury-related deaths in Western Cape Province (WC), SA, between 1 January 2019 and31 December 2020 was conducted. Cases where BAC testing was performed were further examined according to the periods of lockdownand alcohol restrictions.ResultsA total of 16 027 injury-related cases were admitted to Forensic Pathology Service mortuaries in the WC over the 2-year period. Anaverage decrease of 15.7% injury-related deaths in 2020 compared with 2019 was noted, as well as a 47.7% decrease in injury-related deathsduring hard lockdown (April - May 2020) compared with the same period in 2019. In the injury-related deaths, 12 077 (75.4%) had bloodspecimens collected for BAC testing. In 5 078 (42.0%) of submitted cases, a positive BAC (≥0.01 g/100 mL) was reported. No significantdifference was observed in the mean positive BAC between 2019 and 2020. However, in April and May 2020, the mean BAC observed(0.13 g/100 mL) was less than that in 2019 (0.18 g/100 mL). A high number of positive BACs in the 12- 17-year age group (23.4%) was observed.ConclusionThere was a clear decrease in injury-related deaths in the WC during the COVID-19-related lockdown periods, whichcoincided with the alcohol ban and restriction of movement, and an increase following relaxation of restrictions on alcohol sales andmovement. The data illustrate that mean BACs were similar between all periods of alcohol restriction compared with 2019, apart from hardlockdown in April - May 2020. This coincided with a smaller mortuary intake during the level 5 and 4 lockdown periods.

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