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Effects of COVID-19 on Ambulance Call-out for Heart Attack / Stroke

Leads: Prof Richard Lilford, Dr Samuel Watson (Meths), Dr Gavin Perkins (Acute Care Interfaces)

This was rapid response research.

Dates: April 2020 - May 2020

Background:

Attendance at Emergency Departments in English decreased sharply following the imposition of a national lockdown as a result of COVID-19. Anecdotal reports in the media suggested that there had been a significant reduction in heart attacks and strokes presenting to Emergency Department, leading to fears that acutely unwell patients were delaying seeking help.

Policy and Practice Partners:

West Midlands Ambulance Service NHS Foundation Trust.

Co-Funding Partners:

West Midlands Ambulance Service NHS Foundation Trust.

Aims and Objectives:

The aim of the study was to ascertain whether this perceived reduction in patients seeking help was correct.

Methods:

Working with West Midlands Ambulance Service (WMAS) which is the second largest ambulance trust in England, we analysed data on the number of callouts for ambulances for ST-segment Elevation Myocardial Infarction (STEMI) and stroke between 2018 and 2020 for the presence of a structural break.

Main Results:

The data on these two conditions could not confirm any reduction in ambulance call outs. Whilst an effect cannot be excluded, any effect must be of small magnitude.

Conclusions:

We find no evidence that people are reluctant to call an ambulance when experience the symptoms of heart attack or stroke.

Implications for Implementation:

The public can be reassured that patients with stroke and heart attack have not been neglected, contrary to numerous media reports.

Publication:

Lumley-Holmes J, Brake S, Docherty M, Lilford R, Watson S. Emergency ambulance services for heart attack and stroke during UK's COVID-19 lockdown. Lancet. 2020. doi: 10.1016/S0140-6736(20)31031-X.