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

Background: 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. Methods: 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. Results: 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. Conclusion: 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. Coronavirus disease 2019 (COVID-19) was first identified in Wuhan City, Hubei province, China, on 12 December 2019, and was declared a global pandemic by the World Health Organization on 11 March 2020. In response to the escalating pandemic, many countries, including South Africa, implemented public health interventions such as social distancing, mask-wearing, self-isolation, closure of businesses and schools, travel restrictions, bans on public events, and regulated movement of people. These measures have led to a variety of outcomes in South Africa, notably a reduction in non-natural deaths, but an increase in mortality because of natural causes. A similar trend has been observed in research conducted by Gunawardena et al. in Colombo, Sri Lanka. Contribution: It has required modifications to operational procedures and has introduced various challenges in case management.