System impacts of the COVID‐19 pandemic on New York City's emergency medical services

OBJECTIVES: To describe the impact of the COVID‐19 pandemic on New York City's (NYC) 9‐1‐1 emergency medical services (EMS) system and assess the efficacy of pandemic planning to meet increased demands. METHODS: Longitudinal analysis of NYC 9‐1‐1 EMS system call volumes, call‐types, and response times during the COVID‐19 peak‐period (March 16–April 15, 2020) and post‐surge period (April 16–May 31, 2020) compared with the same 2019 periods. RESULTS: EMS system received 30,469 more calls from March 16–April 15, 2020 compared with March 16–April 15, 2019 (161,815 vs 127,962; P < 0.001). On March 30, 2020, call volume increased 60% compared with the same 2019 date. The majority were for respiratory (relative risk [RR] = 2.50; 95% confidence interval [CI] = 2.44–2.56) and cardiovascular (RR = 1.85; 95% CI = 1.82–1.89) call‐types. The proportion of high‐acuity, life‐threatening call‐types increased compared with 2019 (42.3% vs 36.4%). Planned interventions to prioritize high‐acuity calls resulted in the average response time increasing by 3 minutes compared with an 11‐minute increase for low low‐acuity calls. Post‐surge, EMS system received fewer calls compared with 2019 (154,310 vs 193,786; P < 0.001). CONCLUSIONS: COVID‐19‐associated NYC 9‐1‐1 EMS volume surge was primarily due to respiratory and cardiovascular call‐types. As the pandemic stabilized, call volume declined to below pre‐pandemic levels. Our results highlight the importance of EMS system‐wide pandemic crisis planning.