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Background: Previous studies have shown reductions in the volume of emergency department visits early in the COVID-19 pandemic, but few have evaluated the pandemic’s impact over time or stratified analyses by reason for visits. We aimed to quantify such changes in British Columbia, Canada, cumulatively and during prominent nadirs, and by reason for visit, age and acuity. Methods: We included data from the National Ambulatory Care Reporting System for 30 emergency departments across BC from January 2016 to December 2022. We fitted generalized additive models, accounting for seasonal and annual trends, to the monthly number of visits to estimate changes throughout the pandemic, compared with the expected number of visits in the absence of the pandemic. We determined absolute and relative differences at various times during the study period, and cumulatively since the start of the pandemic until the overall volume of emergency department visits returned to expected levels. Results: Ov

United kingdomVancouver islandBritish columbiaUnited statesNatalie prystajeckyAlexis crabtreeMoe zandyAman dheriKate smolinaJiayun yaoBraeden klaverMichael irvineNational ambulatory care reporting systemEmergency departmentMinistry of healthRegional health authorities