Hospital visits by children injured by firearms rose by nearly 40 percent during 2020, according to a study published in the journal Pediatrics. The soaring numbers coincided with record increases in gun sales during the pandemic, the researchers said.

The firearm-related visits by children from birth to 18 rose significantly compared to the preceding three years, even as total hospital visits by children declined in 2020, the researchers said.

March 2020 — the month when the World Health Organization declared the coronavirus outbreak a pandemic — saw an increase in firearm-related hospital visits of nearly 15 percent. But by July-August 2020, visits were up by as much as 68 percent. Overall, nearly 800 firearm-related hospital visits occurred in the first six months of the pandemic, up from a median of 570 visits in the preceding three years.

Some communities were more affected than others. Consistent with previous studies, the authors found that the highest rate of firearm injuries was among non-Hispanic Black adolescent boys. Nearly half of them lived in a very low Child Opportunity Index neighborhood — areas with high levels of poverty, violence, and lower economic opportunity. Nearly 9 out of every 10 firearm-related hospital visits in 2020 were in urban areas, a geographic trend consistent with previous years.

While the study illustrates an alarming trend, it does not find the reasons for the rising numbers of injuries. Further research is needed to discover how the injuries might be related to the pandemic and gun purchases.

“In the meantime, it is absolutely imperative that we prioritize counseling parents and other guardians on safely storing firearms,” said Kelsey Gastineau, lead study author and a pediatric hospital medicine doctor at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“We also have to proactively promote crisis support and violence intervention resources to kids and adults alike,” she said. In the long term, advocating for continued firearm safety research and supporting responsible firearm legislation might make a significant difference, the authors said in the study.

In the United States, firearms are the second leading cause of death among children and adolescents. Compared to other high-income countries, firearm-related suicides and fatalities from unintentional firearm injuries among 5- to 14-year-olds are 8 to 10 times higher in the United States.

Researchers using data from a 2015 national survey estimated that anywhere between 3.9 million and 5.9 million children live in a household with a loaded and unlocked gun. But these estimates have probably shifted since the beginning of the pandemic because of an unprecedented rise in firearm purchases in the United States during a time of uncertainty about lockdowns and turbulence after the killing of George Floyd and racial justice protests. At the same time, some parents have made firearms more accessible at home, according to a paper published in the Journal of Behavioral Medicine, citing the need to protect their teens and others from escalating civil unrest and riots, threat of home invasion, crime and the fear of panic.

With the spread of the delta variant in the United States, the future of the pandemic remains uncertain. Given these study findings, the authors recommend prioritizing safe firearm storage and ease of access to crisis support interventions to help reduce firearm-related hospital visits among children.