The outbreak of COVID-19 has caused global concerns. Currently, the therapeutics for COVID-19 including supporting treatment, drugs, vaccines, while control and prevention are other strategies to reduce the transmission within China and elsewhere [6, 7]. The local government in Wuhan announced the suspension of public transportation, including the closure of railway stations, highways and airports on January 23, 2020, to prevent further disease spread [8]. Consequently, Hubei province was placed under lockdown approximately 3 weeks after the start of COVID-19 outbreak [9]. The Chinese government made great efforts to control the flow of people. Shopping malls and other entertainment activities were closed, in-person classes were replaced by online ones, public transport was restricted, public gatherings were banned and routine health checks were carried out in order to prevent the spread of SAR-CoV2 right after Wuhan shutdown [10].
Due to the impact of COVID-19 and relevant control measures, the way people travel has also undergone subtle changes. Indeed, some new trends have emerged in the epidemiology of RTIs in Suzhou. Compared to the same period in 2019, the number of cases involved in road traffic accidents from January to May 2020 decreased significantly, but both the absolute number and proportion of electric bicycle related RTIs increased significantly. In terms of the characteristics of injury, the proportion of patients with consciousness disorder also increased.
To reduce the risk of infection and prevent the spread of disease, the government introduced corresponding control and prevention measures, including encouraging people to stay at home. As a result, fewer people went out and the roads were empty, which directly leaded to a reduction in the number of RTIs, especially in late January and February, when the epidemic situation was the most severe and the control measures were the most stringent. As the epidemic abated and more people traveled, the number of RTIs began to rise, and the incidence of RTIs in May was basically the same as that in May 2019.
In the subgroup analysis, we found that the incidence of electric bicycle related RTIs increased significantly, as did the proportion of patients with consciousness disorder.
Those may be related to the following factors. The COVID-19 epidemic has a subtle impact on all aspects of social life, including how people choose to travel. To reduce the direct contact between human, people try to avoid using public transportations such as taxis, buses and subways, and prefer to travel with electric bicycles that are convenient and having lower risk of infection, which directly leads to a growing number of electric bicycle related RTIs.
However, in the event of electric bicycle traffic accidents, the injured without helmet are easy to be combined with craniocerebral trauma. During the study period, electric bicycle riders in Suzhou generally did not wear helmets, which resulted in a significant increase in the proportion of patients with consciousness disorder in RTIs. Therefore, Suzhou traffic police department has carried out the "helmet-belt" safety protection activity to further help electric bicycle riders establish the safety awareness of consciously wearing helmets, which is very necessary to reduce the electric bicycle related RTIs and prevent craniocerebral trauma.
Although this study obtained new epidemiological characteristics of RTIs in Suzhou under the influence of COVID-19 epidemic and control measures through detailed historical data, there are still some limitations. First, only the data of the five months from January to May were analyzed, but the medium - and long-term impacts of COVID-19 epidemic on RTIs were not clear. Second, there are many factors affecting RTIs in reality, the influence of other confounding factors cannot be completely excluded from the historical data only.