'Alarming' Drop in 911 Calls May Imply Fear of Coronavirus Infection

Emergency calls to the medical services dropped by over a quarter in the U.S. amid the COVID-19 pandemic, according to a study. Calls related to suspected deaths, meanwhile, doubled.

The findings may partly come down to a reluctance to visit hospitals, perhaps due to a fear of catching the coronavirus, the authors wrote in their paper published in the journal Academic Emergency Medicine.

After COVID-19 emerged from China in late 2019, the first case in the U.S. was reported on January 20. In mid-March, the White House issued guidelines on how to avoid catching and preventing the spread of the coronavirus, including following state and local guidelines such as stay-at-home orders.

To find out how the COVID-19 pandemic may have changed how people access emergency medical services (EMS), the researchers looked at data from the National EMS Information System across 47 states from the past three years. They studied the 40th week of 2017 in early October to the 21st week of 2018 in late May, and the corresponding chunks of time in 2018, 2019, and 2020. The team noted the total number of medical 911 calls per week, and the type of emergency.

The number of medical 911 calls was found to have dropped by 26 percent, or by 140,292, in the 10th week of 2020 in early March and the 16th week in April when compared with previous years.

In addition, the number of medical 911 calls involving a person thought to be dead almost doubled between the 11th and 15th weeks of 2020, from 1.49 to 2.77 percent. And between weeks 10 and 13, emergency calls involving a possible injury fell from 18 percent to 15 percent.

Since COVID-19 cases were first identified in the U.S. and social distancing measures were introduced, EMS calls "declined rapidly," the team wrote. The findings suggest that people are not accessing the emergency medical system as often, partly because stay at home orders means that people are engaging in less risky activities.

However, it is also possible that changes in perceptions, for instance fear of catching the coronavirus, may have played a part, the authors said. This shift may be positive if those who don't really need the emergency services are turning elsewhere for treatment.

But the doubling in the rate of people suspected dead may mean that people in medical emergencies are not accessing care in a timely manner.

The study was limited in a number of ways, the team acknowledged. For instance, it only takes into account the states who submit to the database and in the given timeframes. In addition, the study is based on calls not individual patients, and multiple records may have been completed for one patient.

Co-author E. Brooke Lerner, a professor in the Department of Emergency Medicine in the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, said in a statement: "The public health implications of these findings are alarming."

"When people are making fewer 911 calls but those calls are about far more severe emergencies, it means that people with urgent conditions are likely not getting the emergency care they need in a timely way," Lerner said.

Other studies cited by the authors similarly showed that measures such as stay-at-home orders to attempt to ease the pressure on healthcare systems have been tied to "dramatically" lower visits to emergency departments.

Lerner said the trend persisted even when the COVID-19 outbreak eased in some areas.

In future outbreaks, officials and policymakers should balance asking people to consider their burden on health services while ensuring they seek treatment when they need it, the researchers wrote.