Electric bikes saw an increase in popularity when the pandemic hit—but they're not your average bicycle.

By Claire Gillespie
August 10, 2020
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Sales of bikes have soared during the coronavirus outbreak, as people avoid public transportation and find new ways to exercise outdoors—taking advantage of the quieter roads to experience the joys of cycling.

For many people, it’s all about the electric bike, or "e-bike"—energy efficient, emission-free transportation that’s much faster than a regular bike. Google reported a spike in searches for “best electric bike” starting on March 22nd, less than two weeks after the World Health Organization (WHO) declared the new coronavirus a pandemic

But e-bikes also come with some safety concerns, which Simon Cowell can attest to. The America’s Got Talent judge broke his back in several places in an e-bike accident over the weekend. ABC News reported that Cowell was testing his new e-bike in front of his family at his Malibu home when the accident took place.

According to NBC News, Cowell underwent a six-hour surgery Sunday, during which doctors placed a metal rod in his back.

On Sunday night, Cowell tweeted “a massive thank you” to all the nurses and doctors that were taking care of him, and gave some advice to anyone who buys an electric trail bike: “read the manual before you ride it for the first time.” 

Despite the severe injury, doctors said they considered Cowell very lucky. He's currently recovering in the hospital, and he'll reportedly be there for a few more days, following his Sunday surgery.

How dangerous are e-bikes, really?

Because e-bikes have a motor they’re often more powerful than a regular bike, and that’s where the risk comes in. One recent study, published in the British Medical Journal in November 2019, analyzed hospital data from 2000 to 2017 by the United States Consumer Product Safety Commission’s National Electronic Injury Surveillance System and found that people injured using e-bikes were more likely to suffer internal injuries and require hospital admission than people injured on regular bikes. 

E-bikes are legal in all states, although New York only recently passed a bill to lift its ban on throttle-based e-bikes. According to BikeRadar, most e-bikes are classified as pedal-assist, meaning the power only kicks in when you pedal, but some models also have a throttle, which usually kicks in when you press a button. Throttle-based e-bikes often go a lot faster than pedal-assist e-bikes, but this means they’re not allowed on multi-use paths and come with a minimum age requirement in certain states, like California. 

Christina Seifert, MD, a trauma and fracture surgeon with Hoag Orthopedic Institute in Southern California, has seen a “slight increase” in e-bike and electric scooter accidents over the past few months. However, they’ve not been on the same scale as Cowell's. “These accidents have been mostly fractures of the tibia, the larger of the two lower leg bones,” Dr. Seifert tells Health. 

And she's not the only one who's seen an increase. Robert S. Bray, Jr., MD, founding director of Diagnostic and Interventional Spinal Care (DISC) in Newport Beach, California, tells Health he's also seen a "huge increase in e-bike accidents over the pandemic [or] lockdown period."

Speed is often the major concern with e-bike or other electronic-powered transportation devices. "There have been lots of hand and wrist, head and spine, neck and back injuries," Dr. Bray says. "These aren't toys." And, of course, the faster you're going, the more damage an accident can cause. "A fall at 4-5 mph is much different than falling off at 15-20 mph," he says. "Forces are multiplied going a lot faster—the bike adds velocity and power which you normally wouldn't have."

In a situation like Cowell's, when a person falls on their back, Dr. Bray says the dangers include compression fractures in the neck or back—injuries which often need to be treated surgically. Ian Wittman, MD, chief of emergency medicine at NYU Langone Hospital–Brooklyn, who hasn’t seen many e-bike accidents in his emergency room during lockdown, says other, less common injuries are intracranial hemorrhage from head trauma, and injuries to the spleen from abdominal trauma. 

Clearly, learning proper e-bike safety should be at the top of your list of things to do before you ever step foot (or sit down) on an e-bike—and these devices should be taken seriously. "Treat these devices more like a small motorcycle than a bicycle," Dr. Bray says.

After familiarizing yourself with the bike, Dr. Wittman says to always wear a helmet and obey traffic laws. Dr. Bray also advises further protective gear, like protective pants or even armored pads or jackets. "A helmet is not enough because they give riders enhanced capability over what they're normally used to."

Though they may be easier to ride, Dr. Seifert says, it's essential to respect their power. "As with anything new, it takes practice and learning—it's not just a bicycle," Dr. Bray adds. "Know the risks, ride with people in case you fall, practice, an be sure to start slow."

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