# The impact of the COVID-19 pandemic on forensic pathology services in Limpopo province, South Africa

## TL;DR

The study shows how the COVID-19 pandemic disrupted forensic pathology services in rural South Africa, leading to fewer cases and changes in procedures.

## Contribution

This study provides the first detailed analysis of how the pandemic affected forensic pathology services in a rural South African province.

## Key findings

- There was an 8.1% decrease in post-mortem cases during the pandemic compared to the pre-pandemic period.
- Natural deaths increased while unnatural deaths and forensic referrals decreased significantly.
- Most facilities reported fewer autopsies, except for one facility.

## Abstract

To evaluate the effects of coronavirus disease 2019 (COVID-19) and the preventative measures taken, especially how they affect forensic pathology services in rural South Africa.

This retrospective analysis includes referred post-mortem cases from all forensic pathology services in Limpopo province, comparing the period before the COVID-19 pandemic (01 January 2019 to 31 December 2019) with the pandemic period (01 January 2020 to 31 December 2020). Data analysis was performed using STATA 16.0 software (StataCorp; College Station, TX). Chi-square test was employed for comparison, with a p-value < 0.05 deemed statistically significant.

Approximately 9319 cases were submitted for post-mortem examinations, with 4857 occurring before the pandemic and 4462 during it, marking an 8.1% decrease. There was a decrease in the number of unnatural death cases, while the instances of natural deaths rose. Cases under investigation saw a notable increase. There was a marked decrease in referrals for forensic examinations across all districts. In addition, except for one facility, there was a decline in the number of cases sent for autopsies at all facilities.

In conclusion, forensic pathology services in this province had been severely disrupted by the COVID-19 outbreak and the lockdown that followed, especially in the tertiary hospital. It has led to new challenges for case management and necessitated changes to operating procedures.

It has required modifications to operational procedures and has introduced various challenges in case management.