Philadelphia Medicine Fall 2021 - 6

FEATURE
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CORONA-VIOLENT
Exacerbated by raging pandemic, gun violence
takes toll on city's health care workers
By David A. Kostival, Contributing Writer
W
hen we first heard about the novel coronavirus in early
2020, no one could have guessed the extraordinary number
of lives it would claim.
But the pandemic wasn't the only tragic loss of life in Philadelphia,
as an epidemic of gun violence became the fallout from the stresses
of COVID-19 on a stressed population.
The medical community was forced to deal with a daily count
of gunshot victims, as well as those afflicted with the coronavirus.
In 2020, there were 1,836 non-fatal victims of gun violence in
the city, while 417 victims succumbed to gun shots. Compare that to
2019, when there were 1,170 nonfatal and 303 fatal shooting victims.
As of Sept. 1, 2021, Philadelphia's Office of the Controller reported
1,231 nonfatal and 306 fatal victims of gun violence.
To put the crisis into perspective, if we look back to the most
recent non-pandemic year, there was a 56.9% increase in the nonfatal
victims of gun violence from 2019 to 2020 and a 37.6% increase
in fatal victims.
During the mandatory lockdown
phase of the pandemic,
Dr. Natalia Ortiz-Torrent
recalls that most people
had to postpone medical
appointments and elective
procedures, and did not
have access to clinics, many
of which were closed.
Dr. Natalia Ortiz-Torrent
Gun violence problem
Dr. Natalia Ortiz-Torrent believes the pandemic has exacerbated
the city's gun violence problem.
Ortiz-Torrent, immediate past president of PCMS, is medical
director of consultation and liaison psychiatry at Temple University
Hospital, as well as a professor of clinical psychiatry and behavioral
science at Temple University's Lewis Katz School of Medicine.
" In my experience, I would have to say that during this pandemic,
the number of people with behavioral health issues has increased way
more than I have seen in the last 15 years, " Ortiz-Torrent said. " The
number of suicide attempts and violence in general has increased. I
saw people getting severely ill, both physically and mentally. "
During the mandatory lockdown phase of the pandemic,
Ortiz-Torrent recalled that most people had to postpone medical
appointments and elective procedures, and did not have access to
clinics, many of which were closed.
In addition, she says that many people had a tough time staying
connected with others because not everyone owns a smartphone or
computer, leading to social isolation.
" People perhaps did not have a psychiatric illness, but they were
affected by sickness, " Ortiz-Torrent said. " New social determinants of
health, like the loss of jobs, the inability to pay rent and now, more
recently, (some) are faced with getting evicted. "
Substance use disorders
Ortiz-Torrent has observed several reasons for agitation, including
substance use disorders, such as intoxication and withdrawal.
" I think all of these factors potentially contributed to violence, "
she said. " People with short fuses were getting into arguments and
had easy access to guns, whether legally or illegally. I understand
people wanting to protect themselves, but at the same time, if those
people are struggling with depression, anxiety, impulsivity or anger,
it can be problematic. In the heat of the moment, things escalate
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Philadelphia Medicine Fall 2021

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