The SARS-CoV-2 pandemic has severely affected the entire world population.
Health systems around the world have been severely tested, but Coronavirus was not just a hospital affair.
The pandemic has had and will continue to have serious repercussions on world economies which have probably experienced one of the most serious setbacks of the contemporary history [1].
Moreover, the consequences on mental health of the world population will be equally serious, with increase of isolation, depression and anxiety disorders [2].
Even if they are rarely mentioned, we should not forget that our pets are also included in this anomalous situation.
The main public health measure to limit the virus spread imposed by almost all the states most severely affected by Coronavirus was the "Lockdown": the order to stay at home except for fundamental needs [3].
This meant that entire families remained at home increasing the sharing of spaces with their pets and their greater exposure to children that interact with the animals not always supervised by adults.
Bowen J. et al studied how the confinement affected the human-animal bond during Spanish lockdown: their results showed that the owners of pets declared that during the confinement the closeness to their animal helped them overcoming isolation and sadness [4].
On the contrary, the confinement seemed to affect negatively the quality of life of dogs: the commonest behavior problems that quickly got worse during lockdown were annoying or excessive vocalization and fear of loud or unexpected noises.
Moreover, the pets’ owners reported also higher incidence of the subsequent behavioral problems: attention-seeking, irritability and more excitable tendency, frustration and stress.
The main explanation of the behavioural worsening of dogs during Lockdown are surely the reduction on number and duration of walk per day, forcing them to stay the most of time in a close environment like home where they are also overexposed to children which may or may not be supervised by adults.
An aspect that should not be underestimated is that during confinement Caregivers have the additional stress of children staying at home 24 hours a day, 7 days a week, for months without the possibility of out-of-home activities (school, playdates, parks, …) and dog may experience “emotional contagion”, a state in which companion dogs mirror the emotions and stress levels of their human caregivers [5].
Dixon et al. are the first and only ones in literature that described an increase of dog bites from March to May 2020 during the confinement in the USA, but they analysed just the first wave of Coronavirus outbreak [6].
With our data we show the entire 2020 fashion of dog bites in Bologna, an Italian city, one of the countries with the most severe confinement regulation.
Considering the average number of dog bites in the period between 2014 and 2019 and the number of bites that occurred in 2020 (41 vs 22), it would seem that the number of these events has decreased (Fig. 2).
Actually, these data must be read with extreme attention: the number of dog bites in 2020 would seem lower only because the number of strangers dog’s bites has been drastically reduced by 40%. Stranger dog bites are typical to occur on the street or at the parks and playgrounds, places children have been less exposed to due to confinement; this explains the decline previously exposed in the total number per year.
The worrying aspect, however, is the notable increase in bites by family dogs, which increased by 40% compared to the 2014-2019 average (p .002).
Perhaps, even more alarming is the significant (p .003) increase in the number of wounds that needed to be sutured, an expression of greater violence exerted by the dog during the act of biting, not to mention the higher incidence of bites that injured the face (72% in 2020 vs 43% between 2014-2019) of the patients resulting in unesthetic scars.
Analysing the number of bites per month, as shown in Fig. 3A, it is possible to see how two of the highest peaks of incidence of bites from family dogs are located during the two lockdowns Italy underwent in 2020; equally remarkable is that, even if decreasing, the relative number of bites per month from dogs to their paediatric owner maintains always higher compared to the ones of 2014-2019.
Furthermore, even the third peak located in between the two lockdown periods could be easily explained as follow.
Holland KE et al demonstrated in their paper that spending extra time with our dog(s) may negatively impact on the animal’s future ability to cope when left alone [7]. In fact, dropped the restriction and returned to routinary life, the dogs may have experienced the stress and frustration derived by their reduced autonomy becoming, therefore, more aggressive.
In figure 3B is shown the lower relative number of bites per month from stranger dogs that had a peak during summer 2020, when the restrictions were abolished (except for face masks and social distancing).
What the data of the present study is telling us is that now more than ever we need paediatricians and healthcare providers in general as public health professionals too to increase efforts for preventions in order to reduce the number of dog bites.
Therefore, we have the duty to educate parents of children, especially ones from 5 to 9 years old that have higher risk of dog bites (confirmed by our data too), reminding them that the most important prevention of dog bites is to always supervise infants and children when they are near a dog [8,9].
For this purpose, we present here a list of tips to avoid dog bites diffused by the American Academy of Pediatrics (Table 1) and already reminded by Dixon et al; we suggest sharing extensively this table with parents of children and owners of dogs [6].