In a recently pre-released article in Pediatrics (10.1542/peds.2020-042697), Dr. Joanna Cohen and colleagues use publicly available data to compare the relationship between new gun ownership and childhood firearm injuries in the COVID-19 pandemic period (March-August 2020) versus a pre-pandemic time period (March –August 2016-2019). The authors examine the rates of fatal and non-fatal firearm injuries incurred by children 12 years of age and under, and those inflicted by children 12 years and under, and relate these data to the average number of new firearm acquisitions. By comparing these data for the pandemic and pre-pandemic time periods, the article gives us a window into a previously unexplored and dark corner that the pandemic appears to have impacted. The results are frightening and concerning, and well worth your time to read. The accompanying commentary by Drs. Bell, Robbins and Gosain thoughtfully explores possible causes and next steps (10.1542/peds.2020049746).
Overall, during the COVID-19 pandemic period, as compared to pre-pandemic periods, children ages 12 years and younger had a significantly higher risk of both incurring (RR=1.90; 95% CI 1.58, 2.29) and inflicting a firearm injury ((RR=1.43; 95% CI 1.14, 1.80). New firearm acquisition increased dramatically during the COVID-19 time period from a pre-pandemic mean of 21.28 (units of 100,000) to 33.12, for potential reasons suggested in the article and explored in the Commentary. The authors also examined and compared changes in firearm injury and purchase rates within each time period – another fascinating aspect of the analysis. While increases in both incurred and inflicted firearm injuries were significantly correlated with the increase in new firearm purchases, the authors are careful to caution us that the relationship they have identified does not necessarily indicate causality; however, given the magnitude of the associations they have uncovered, and prior suggestive studies, common sense leads me, and perhaps you, to conclude that a causal pathway is likely.
What is that pathway, though, and how can we map it and mitigate the saddening “chain reaction” from firearm purchase to child injury that we now see? Dr. Bell and colleagues walk us through these dilemmas in their commentary. This study used several publicly available data sources that were new to me, including the Gun Violence Archive and the National Instant Criminal Background Check System, as well as Census data; kudos to the authors for connecting and studying this information in a creative and timely way. This is research that stops you in your tracks and has the potential to lead us to game-changing legal, medical, and political interventions on behalf of children and families.