Impact of COVID-19 pandemic: Social distancing and the vulnerability to domestic violence.

The COVID‐19 pandemic has serious destructive consequential effects worldwide, particularly in deaths and economic burdens. Travel restrictions, social isolation, stay‐at‐home orders, and quarantines were adopted to curb the spread of the virus and minimize harm. Due to its proximity and the number of flights arriving from China, Taiwan was expected to have the second highest number of cases after the index outbreak location. Experience from the previous SARS epidemic in 2003 enabled Taiwan to respond quickly in recognizing the crisis and activating emergency management structures. Managing the crisis through implementation of border control, case identification by new technology, efficient quarantine of suspicious cases, proactive case finding, and equitable resource allocation system, have saved Taiwan, a country with a population of 23.58 million, from the risk of the second‐highest importation to 451 cases of COVID‐19, presenting with a low case fatality rate at approximately 1.55%, as of July 10 2020.

However, lockdown, social distancing, and stay‐at‐home policies are leading to increased vulnerabilities regarding mental health. Serious psychological repercussions such as fear, frustration, and boredom are associated with post‐traumatic symptoms, anxiety, and depression during these social isolation periods. The aforementioned mental health issues are closely associated with domestic violence, and adds to the catastrophic milieu. The rise of alcohol consumption and alcohol sales during the COVID‐19 pandemic has also been cause for alarming given its relationsip to domestic violence. More than half of domestic violence perpetrators are reported to have been affected by alcohol at the time of the incident.

Domestic violence refers to a range of violations emanating from the household and within relationships defined by familial or emotional (former or present) attachment. A global surge in domestic violence cases since the COVID‐19 pandemic outbreak has been noticed, particularly in countries with high numbers of COVID‐19 reported cases, such as United States, Argentina, France, Cyprus, and Singapore. Although Taiwan has been declared relatively safe from a formidable outbreak of COVID‐19, cases of domestic violence have also spiked. A 5% increase of domestic violence cases, from 30 470 to 32 000 cases compared with the same period last year, was observed in Taiwan in the first quarter of 2020, as reported by the Ministry of Health and Welfare's Department of Protective Services. The number of domestic violence incidents reported to police increased 13% in the first quarter of 2020, from 18 408 cases to 20 924 cases, compared with the same period last year. Various counties/cities have experienced greater impacts of domestic violence, for instance, an increase of incidences of almost 30% arose in March in New Taipei City. Although stay‐at‐home orders were not implemented in Taiwan, people were encouraged to self‐isolate at home to reduce social contact, and the pandemic made it difficult for people to reach out to their social networks. Heightened stress from families spending more time at home in cramped conditions, the disruption of protective networks, and the inaccessible of public services, may further exacerbate domestic violence.

The economic crisis associated with the COVID‐19 pandemic is raising huge challenges worldwide. Amid the pandemic crisis, Taiwan's adjusted unemployment rate increased to 4.1% in April 2020 and this was the highest jobless rate since 2013. To avoid laying off employees directly, employers have been allowed to negotiate with employees to reduce working hours, so‐called “volunteer for unpaid leave”. The number of employees who passively volunteered for unpaid leave increased to 18 840 in April 2020 and was the highest number since 2009 when the legislation was enacted in Taiwan.

We preliminarily examined the impact of COVID‐19 confirmed cases and number of employees with unpaid leave on the number of domestic violence in all 22 counties and cities in Taiwan. Undoubtedly, higher numbers of COVID‐19 confirmed cases corresponded with higher numbers of employees passively volunteered for unpaid leave in that county/city (r(14) = 0.915, P < 0.001). Results of the Pearson correlation indicated that there were significant positive associations between domestic violence detected by police and number of COVID‐19 confirmed cases (r(14) = 0.649, P = 0.006), as well as the number of employees with unpaid leave (r(20) = 0.497, P = 0.019). The higher number of COVID‐19 confirmed cases and employees with unpaid leave in the county/city saw a higher prevalence of reported domestic violence.

The rise in domestic violence during the COVID‐19 pandemic was not only seen in the countries with higher numbers of cases, but also in countries experiencing social distancing like Taiwan. Of note, it is not only economic crisis that contributes to domestic violence with forced proximity itself also being a risk factor. Stressful life events during the COVID‐19 pandemic, accompanied by economic pressure, injury, and illness, may exacerbate preexisting familial conflicts. The reported number of domestic violence is always underestimated and the impact of COVID‐19 on domestic violence noticed currently is just the tip of the iceberg. While we are still grappling with the novel coronavirus, it is crucial to address the issue of the rise in domestic violence and take an actionable step forward, for instance, increasing accessibility to public resources through new technology and mental health resource allocation. At least, as the UK Government suggests, guidance on social isolation does not apply if you need to leave your home to escape domestic violence. Besides providing reimbursements for economic loss, early screening and identification of those vulnerable to domestic violence, particularly those infected with COVID‐19, experiencing unpaid leave or disruption of social networks, are warranted in this pandemic period. Appropriate screening tools should be more readily available and first responders, physicians and other healthcare personal need to be made aware of the potential for increased domestic violence. Social media outlets should be used to raise awareness of the psychological repercussions of social isolation. Telehealth‐related service should be expanded during this pandemic, including the accessibility to 24/7 public health service through teleconference, initial screening and psychiatric evaluation by videoconference, and telemedicine services for those in home isolation and quarantine.

Disclosure statement

The authors declared no conflicts of interest.