Impact of COVID-19 on Emergency Medical Services Operations

Changes in Emergency Call Volumes During the Pandemic

Throughout the COVID-19 pandemic, many EMS systems reported fluctuating call volumes, which could be attributed to various factors, including lockdowns, public fear of infection, and changes in health-seeking behavior. A systematic review found that emergency call volumes experienced significant variance, with an overall mean change of 0.0% but a standard deviation of 31.3% (Richter et al., 2025). Some studies documented decreases in emergency calls, ranging from -50.0% to +121.0%, indicating a complex relationship between pandemic-related factors and EMS utilization.

For instance, in the context of cardiac emergencies, studies highlighted that while some regions experienced decreases in calls, others saw increases due to heightened awareness of symptoms. This variability reflects the non-linear impact of COVID-19 on different health crises, suggesting that while some patients deferred care, others sought emergency assistance more urgently.

Variations in Emergency Medical Service Operations and Responses

The pandemic has necessitated modifications in EMS operations, including triage protocols and resource allocation. Many countries experienced a decline in operational capacity due to staff shortages, as healthcare workers were reassigned to COVID-19 response efforts or were affected by illness themselves. A notable finding from a study was a mean decrease in EMS operations of -12.2%, with a standard deviation of 24.7% (Richter et al., 2025).

Variations in service delivery were also observed based on region and the nature of the emergencies being addressed. For instance, respiratory-related emergencies saw an increase in calls as COVID-19 symptoms prompted more individuals to seek urgent care. In contrast, trauma-related emergencies experienced a marked decrease, likely due to reduced mobility during lockdown measures.

Analysis of Specific Diagnoses: Cardiac Emergencies and Respiratory Issues

The pandemic has underscored the importance of understanding how specific diagnoses intersect with EMS operations. Cardiac emergencies and respiratory issues have been particularly affected. Studies indicated that EMS operations for cardiac emergencies varied, with some areas reporting increases as patients became more aware of acute symptoms (Richter et al., 2025).

Conversely, respiratory emergencies experienced a notable uptick in calls, reflecting public concern regarding COVID-19 symptoms. Increased call volumes for respiratory issues were attributed to heightened awareness of symptoms like shortness of breath and cough, prompting individuals to seek emergency assistance more frequently.

Influence of Socio-Demographic Factors on EMS Utilization

Socio-demographic factors have played a critical role in shaping EMS utilization patterns during the pandemic. Vulnerable populations, including low-income and minority groups, faced unique barriers to accessing emergency services. Research suggests that these groups were disproportionately affected by the pandemic, leading to increased rates of unmet medical needs and higher mortality (Richter et al., 2025).

Language barriers, economic instability, and limited access to healthcare resources contributed to reduced EMS utilization among these populations. For instance, language differences often hindered effective communication between EMS personnel and patients, complicating assessment and treatment efforts.

Strategies for Improving Emergency Medical Services in Future Crises

To enhance the resilience of EMS systems in the face of future crises, several strategies can be implemented:

1. Integration of Technology: Utilize telemedicine and mobile health applications to facilitate triage and care delivery, reducing the burden on EMS during peak periods.
2. Training and Resources: Invest in ongoing training for EMS personnel that addresses pandemic response protocols and improves cultural competency to better serve diverse communities.
3. Data-Driven Decision Making: Establish a standardized minimum emergency data set to facilitate better collection, analysis, and sharing of data among EMS and hospital systems, ultimately improving patient care.
4. Community Engagement: Foster partnerships with community organizations to ensure that vulnerable populations receive timely information and resources, improving their access to emergency care.

Conclusion

The COVID-19 pandemic has significantly influenced EMS operations globally, highlighting the need for adaptive strategies to ensure that emergency medical services can respond effectively in crises. By understanding the changes in emergency call volumes, variations in operations, influences of socio-demographic factors, and the importance of specific diagnoses, EMS can better prepare for future public health challenges.

FAQ

How did the COVID-19 pandemic affect the volume of emergency calls?
The volume of emergency calls during the COVID-19 pandemic showed significant variability, with some regions experiencing declines and others reporting increases, particularly for respiratory emergencies.

What were the main challenges faced by EMS during the pandemic?
EMS faced challenges such as staff shortages, changes in operational protocols, and increased call volumes for specific emergencies, notably respiratory conditions.

How can EMS improve its response for future crises?
EMS can enhance response by integrating technology, investing in training, utilizing data-driven approaches, and engaging with communities to bridge healthcare access gaps.

References

1. Richter, H., Schneider, M., Eisenberger, J., Jafari, N., Haumann, H., & Häske, D. (2025). Impact of the COVID-19 pandemic on prehospital emergency medical service: a scoping review. Front Public Health. https://doi.org/10.3389/fpubh.2025.1543150

2. Al-Wathinani, A., Hertelendy, A. J., Alhurishi, S., Mobrad, A., Alhazmi, R., & Altuwaijri, M. (2020). Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: a National Retrospective Study. Healthcare. https://doi.org/10.3390/healthcare9010014

3. Andrew, E., Nehme, Z., Stephenson, M., Walker, T., & Smith, K. (2021). The Impact of the COVID-19 Pandemic on Demand for Emergency Ambulances in Victoria, Australia. Prehosp Emerg Care

4. D’Ascenzi, F., Cameli, M., Forni, S., Gemmi, F., Szasz, C., & Di Fabrizio, V. (2021). Reduction of emergency calls and hospitalizations for cardiac causes: effects of COVID-19 pandemic and lockdown in Tuscany region. Front Cardiovasc Med. https://doi.org/10.3389/fcvm.2021.625569

5. Grunau, B., Helmer, J., Lee, S., Acker, J., Deakin, J., & Armour, R. (2021). Decrease in emergency medical services utilization during early stages of the COVID-19 pandemic in British Columbia. CJEM