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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


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.


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.


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.


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.