Quantitative analysis of the impact of COVID-19 on the emergency medical services system in Tokyo

Aim: The coronavirus disease 2019 (COVID-19) pandemic has imposed a heavy burden on emergency medical services (EMS) systems. Therefore, we quantitatively analyzed impacts of COVID-19 on the EMS system in Tokyo. Methods: In this retrospective observational study, we used publicly available data, including the daily number of newly diagnosed patients with COVID-19, the weekly number of transport difficulties, and the field activity time, from March 2, 2020, to January 25, 2021. Data for the same period in the previous year were used as controls. Results: The total number of EMS calls decreased by 12.7% in 2020 compared with that in 2019. The number of daily transport difficulties significantly increased in 2020 compared with that in 2019 (89 [72-120] vs 57 [49-63]; P < 0.001). Additionally, the field activity time significantly increased in 2020 compared with that in 2019 (22.7 [22.3-23.8] min vs 20.7 [20.6-21.2] min; P < 0.001). Furthermore, the daily number of new patients with COVID-19 was positively correlated with the number of transport difficulties (R = 0.76) and the field activity time on the scene (R = 0.74). With an increase in the number of people infected with COVID-19 by 1,000, the number of daily transport difficulties increased by 86.4. Per 1,000 infected patients per day, the field activity time increased by 3.48 min. Conclusion: This study revealed that the increase in the number of patients with COVID-19 indirectly affected the EMS system in Tokyo.