A Comparison of Emergency Medical Service (EMS) Utilization, Dispatches for Respiratory Complaints, and Non-transports Before, During, and After the COVID-19 Pandemic.
Cureus · 2026-07-01 · Registry study
Abstract
Introduction COVID-19 caused massive healthcare system disruptions. The pandemic's impact on Emergency Medical Service (EMS) utilization varied regionally and is still not fully characterized. Some data show decreased overall EMS utilization, changes in utilization for respiratory complaints, and increases in non-transports during the pandemic. Limited data are available on the changes in EMS utilization post-pandemic. This study analyzes changes in EMS utilization by comparing the pre-pandemic, pandemic, and post-pandemic periods. Materials and methods This is a retrospective analysis of the Delaware EMS database from January 2019 to July 2022. Time periods included "pre-pandemic" (January 1, 2019, to March 24, 2020), "pandemic" (March 24, 2020, to May 30, 2020), and "post-pandemic" (May 31, 2020, to July 1, 2022). The pandemic period corresponds to the statewide "stay-at-home" order, representing the period with the greatest restrictions. Call volume was based on basic life support responses. Daily call volume, percentage of respiratory dispatches, and percentage of non-transports from pre-pandemic, pandemic, and post-pandemic periods were compared while controlling for seasonality. Results There were 155,781 pre-pandemic calls, 19,584 pandemic calls, and 272,048 post-pandemic calls analyzed. Average daily pandemic EMS utilization decreased by 64.66 dispatches compared to pre-pandemic (95% CI: 55.72, 73.44; p < 0.001). Utilization pre-pandemic was 1.23 times higher than the pandemic period. Pre- and post-pandemic utilization did not differ significantly, although post-pandemic call volume showed a numerical increase in daily post-pandemic call volume by 7.32 (95% CI: 3.51-11.06; p = 0.09). The average pandemic daily activations for respiratory complaints as a percentage of total activations significantly increased by 1.41 (95% CI: 0.91, 1.90) compared to pre-pandemic (p < 0.001). Compared to pre-pandemic, the rates of non-transports increased significantly by 4.29 (95% CI: 3.62, 4.96; p < 0.001) during the pandemic and 1.99 (95% CI: 1.71, 2.28; p < 0.001) post-pandemic. Conclusions Analysis of overall EMS utilization in Delaware during the COVID-19 pandemic showed a statistically significant drop in EMS utilization during the pandemic and a nonsignificant increase in call volume post-pandemic when compared to pre-pandemic. The proportion of calls for respiratory complaints increased during the pandemic. Rates of patient non-transports increased during the pandemic and remained elevated in the post-pandemic period. Lifestyle changes, perceptions of danger, and/or the impact of governmental lockdowns may have contributed to these effects.