Prism Schneider (Cumming School of Medicine, University of Calgary, Calgary, Canada) and others write in a commentary in the Canadian Medical Association Journal—because of an increase in domestic violence during the pandemic—healthcare providers should be aware of the signs of intimate partner violence and learn strategies to safely ask about injuries.
According to the press release announcing the commentary, China, Italy and Spain have reported increases in calls to emergency support lines. Also some areas of the UK and France have had police reports of violence increase by 20% and 30%, respectively; and crisis lines in Canada have seen large jumps in the number of calls. The press release notes that the frequency of domestic violence increased markedly during the economic downturn after Hurricane Katrina, suggesting that those affected will continue to be at risk long after the current phase of the pandemic ends.
In the commentary, the authors write: “Healthcare providers, although facing the need to learn many new skills related to COVID-19, must also maintain awareness of intimate partner violence, seek opportunities for self-education, develop strategies for discussing intimate partner violence and become familiar with currently available local resources for patient referral.”
They add that evidence supports direct questioning by a healthcare provider in a private environment if they suspect injuries from violence, as many women will not offer this information without prompting. Schneider et al note: “The onus is on health practitioners to begin the conversation with patients who may have experienced intimate partner violence.”
Lead author Schneider says: “Measures to minimise the spread of severe acute respiratory syndrome coronavirus 2 reinforce environments that facilitate behaviours that an intimate partner may use to exert power over another to inflict psychological, physical or sexual harm. The stress of confinement, financial uncertainty, attitudes about gender roles and a desire for control during disasters all contribute to an increased risk of intimate partner violence.”
As many physicians have moved to telemedicine consults to maintain physical distancing, Canada has launched a “Safe Word” campaign and a “Signal for Help” campaign for patients to send a silent request for help.