COVID-19 pandemic-induced shifts in mountain rescue operations in Taiwan: a six-year retrospective study.

BACKGROUND: The COVID-19 pandemic caused a dramatic shift in outdoor recreational behavior, particularly an increase in domestic hiking due to international travel restrictions. While hiking offers physical and mental health benefits, the pandemic-induced shifts in recreational behavior may have led to changes in the profile of mountain incidents. However, few studies have systematically examined how the characteristics and causes of mountain rescue operations (MROs) have changed before and after the pandemic. We aimed to fill this research gap by analyzing pre-pandemic and pandemic mountain incident data in Taiwan to identify key changes in victim demographics, injury patterns, and rescue needs, providing insights for improving emergency response systems and public safety education. METHODS: We conducted a retrospective analysis of 783 documented MROs involving 965 victims in three major Taiwanese national parks. The study period was divided into two distinct phases: the pre-pandemic period from 1 January 2017 to 31 December 2019, and the pandemic period from 1 January 2020 to 31 December 2022. The data were obtained from standardized incident report forms completed by medical and rescue personnel. These forms included information on victim demographics, reasons for rescue, medical conditions, and rescue methods. Incidence rate ratios with 95% confidence intervals were calculated, and appropriate tests (Fisher's exact test, t-test) were used to compare categorical and continuous variables. RESULTS: A total of 965 mountain rescue incidents were recorded among 1,427,403 trekkers, with a significantly higher incidence during the pandemic period compared with the pre-pandemic period (76.3 vs. 56.1 per 100,000 trekkers; IRR = 1.36, 95% CI: 1.19-1.55, P < 0.001). Female trekkers accounted for a greater proportion of rescues during the pandemic (46.1% vs. 30.0%), with a 94% relative increase in incidence (IRR = 1.94, 95% CI: 1.55-2.43, P < 0.001). Injury-related incidents increased significantly (IRR = 1.50, 95% CI: 1.19-1.89, P < 0.001), particularly lacerations/contusions (IRR = 4.05, P < 0.001). Ground-based rescues became more common during the pandemic (54.7% vs. 37.3%; IRR = 1.47, 95% CI: 1.25-1.72, P < 0.001), while helicopter-based rescues remained stable (IRR = 1.15, P = 0.260). CONCLUSION: The COVID-19 pandemic was associated with a 36% increase in mountain rescue incidence, particularly among female trekkers and those involving minor injuries and weather-related events. The 47% rise in ground-based rescues and stable rate of severe cases reflects a likely influx of less-experienced hikers due to domestic travel restrictions. These findings highlight the need for targeted public education and preparedness strategies to mitigate risks in outdoor recreation during similar global events.