Over the past month, the emergency department at Sharp Coronado Hospital has seen an uptick in the number of e-bike riders coming through its doors.
Though she did not have any formal statistics to perfectly pinpoint the trend, Dr. Megan DeMott, an emergency specialist at the region’s only island-based medical center, said the pattern has been pretty clear: Most are vacationers who decided to rent a bike and venture off the city’s bike path to reach popular destinations served only by regular roads, those often filled with cars.
“When I’m seeing them, they’ve had some sort of intersection with a car, usually,” she said. “They can be a little unexpected for the drivers, because they’re not necessarily expecting a bike to go as quickly as the e-bikes can go.”
Generally, she said, the result is predictable. While e-bikes are heavier and can accelerate more quickly than traditional cycles due to their built-in electric motors and onboard rechargeable battery packs, even relatively low-speed collisions with autos tend to go the way they do when traditional pedal pushers are involved.
“We certainly have seen extremity fractures and, very commonly, head injuries,” DeMott said. “It gets much busier here during the summer months, and I do anticipate that we will be seeing even more of these kinds of injuries.”
Coronado law enforcement has recently been forced to step up speed limit enforcement on its portion of San Diego’s Bayshore Bikeway due to some exceeding the 24-mile thoroughfare’s 15 m.p.h. speed limit while the City of Carlsbad recently passed a new ordinance for motorized mobility devices after documenting an increase in collisions, banning use on public sidewalks, drainage ditches, culverts, channels, athletic courts and gyms.
The upward trend clearly started with the 2020 coronavirus pandemic which provided an unheard of opportunity to bike on public streets abnormally devoid of automobiles. Bike sales of all kinds, and especially e-bikes, jumped and year-long waiting lists quickly formed. Fast forward to the spring of 2022 and there is a newfound interest in anything that can get a person around without burning gallon after gallon of very-expensive gas.
Though e-bikes share the same propulsive technology as electric scooters, the health care consequences they cause seem, so far at least, to be somewhat less severe.
The trauma unit at Scripps Mercy Hospital in Hillcrest has seen a clear resurgence of scooter-related mayhem as pandemic restrictions have ebbed and the smartphone-rentable two-wheeled rides can once again be seen everywhere in popular locations, especially downtown San Diego. Mercy documented 52 scooter-related trauma cases in 2021 after handling only 9 in 2020. That latest-year number is the largest recorded, with 43 in 2019 and 37 in 2018.
Dr. Vishal Bansal, Scripps’ director of trauma surgery, said that about half of scooter-related injuries severe enough to be classified traumatic involve intoxication of one sort or another, and the consequences can be quite long lasting, especially for those who sustain brain injuries. Recovery times for head injuries tend to be quite long.
“They’re generally never getting right back to normal, it make take months to years — sometimes never — to have full brain recovery,” he said.
Dr. Leslie Kobayashi, a trauma surgeon at UCSD Medical Center, also in Hillcrest, echoed her Scripps’ colleagues observations. Generally, there are about half a dozen scooter-related trauma cases per month, but that rate jumped to a dozen to 25 cases per month last summer.
“This summer is really going to be the test of what’s going to happen now that pandemic restrictions are off, the scooters are back, and the weather is warming up,” she said.
Neither physician said they could recall a recent increase in trauma cases among cyclists, and that may be, some have speculated, that e-bike riders may be more likely to wear helmets. DeMott, the Coronado emergency specialist, said that most of the e-bike injuries she has treated recently were wearing helmets when they arrived, and none had injuries severe enough to be transferred to the UCSD trauma center which is assigned to handle all such cases occurring in Coronado.
It’s also clear that the health care system is not yet set up to detect when an e-bike is involved in a traumatic injury. These vehicles are so new, that there is not electric-versus-analog distinction built into the codes that first responders use to document injuries.
“We capture the fact that it was a bicycle, but we don’t always get the granular information that it was an electric bike,” Bansal said. “I suspect there is some degree of injury from these things, but we just don’t have that data to be able to say one way or the other at this point.”
There is also building interest in e-bike safety.
The San Diego Bicycle Coalition has seen broad attendance in the e-bike classes that it puts on throughout the region, with 1,000 Encinitas high schoolers logging in for one recent Zoom-based symposium and a new collaboration with the American Automobile Association.
Kevin Baross, the coalition’s education programs manager and a League of American Bicyclists cycling instructor since he was 18, said that instruction includes cementing of how e-bikes are intended to be used and a reminder of the rules of the road which are the same for e-bikes as they are for traditional muscle-only varieties. State law, he noted, gives cyclists unequivocal rights to use the roadways, provided they stay to the right “as far as is practicable.” Parked cars can push bikes into the flow of automobile traffic with mixed results.
The issues, Baross said, tend to occur when four-wheeled vehicle drivers are distracted or speeding and when bike riders behave in ways that are unpredictable. Those unfamiliar with being so close to cars and trucks, he said, may seek to minimize their presence and may also not be clear that, when mixing with 3,000-pound cars, they should obey the same conventions, especially where stop signs are concerned.
“You wouldn’t be riding through stop signs, you wouldn’t be riding in the gutter, you would be in the travel lane in a way that makes you predictable and makes it so that people know what you’re going to do next,” Baross said. “A lot of times, when people are finding themselves in these trouble situations, it’s because they assume that they can act in a way that isn’t in the same way that they would act if they were in a vehicle.
“They assume that people will see them coming and will get out of the way or they assume that they can get around someone and not have them even notice that they were there in the first place. Those are the situations that are going to cause trouble. Acting in a way that makes you visible, acting in a way that makes you predictable, that’s pretty much always going to be the best idea.”