A Comparison of EMS Patients Diagnosed With COVID-19 Before and After Reopening in the United States of America 

Introduction: Demographic shifts in COVID-19-diagnosed patients following the easing of stay-at-home orders and the opening of economies in late spring of 2020 have been reported. Characteristics of patients with COVID-19 encountered by EMS have not been thoroughly explored.  

Objective: Compare EMS encounter and demographic characteristics of patients diagnosed with COVID-19 before and after the first reopening. 

Methods: This retrospective analysis evaluated prehospital records for all 9-1-1 patients from the national ESO data collaborative who had a hospital ICD-10 diagnosis of COVID-19. Patient demographics were compared during two time periods. For the analysis, March 15–April 30, 2020, represented “before reopening”; May 1–June 15, 2020, represented “after reopening.” Patient demographics including age, race, and sex were examined. Age was examined as both a continuous variable and dichotomized (less than 40/40 or older). Incident location type was also examined. Chi-square and Wilcoxon rank-sum tests were performed.  

Results: There were 1,844 COVID-19-diagnosed 9-1-1 patients before reopening and 1,765 after reopening. The median age before reopening (69; interquartile range [IQR] 55–81) was significantly (p < 0.01) higher than after reopening (64.5; IRQ 50–78). More patients were less than 40 years old after reopening (18%, 326 vs. 24%, 421, p < 0.001). The percentages of patients recorded as African-American/Black (29%, 439 vs. 28%, 426) or white (53%, 806 vs. 46%, 706) were lower after reopening, while those recorded as Hispanic/Latino (16%, 244 vs. 22% 339) or other (3%, 43 vs. 4%, 60) were higher after reopening (p < 0.001). There was no significant difference noted in patient sex (p = 0.73). Slightly more patients were transported from healthcare facilities (5%, 78 vs. 7%, 100) and homes/residences (53%, 814 vs. 55%, 839) after reopening, while slightly fewer were transported from nursing homes/assisted living facilities (33%, 515 vs. 32%, 479), police/jail (2%, 24 vs. 1%, 15), or other (2%, 30 vs. 1%, 15). Patient transports were similar from public places (5%, 81 vs. 5%, 74; p = 0.04). 

Conclusions: EMS patients diagnosed with COVID-19 were younger after the easing of stay-at-home orders. Also after reopening, more patients were reported to be Hispanic/Latino or other race, and slightly more patients were transported from homes/residences and healthcare facilities.