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Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand.
BMJ Open. 2020 12 23; 10(12):e044726.BO

Abstract

OBJECTIVE

To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand.

DESIGN

A descriptive cross-sectional, observational study.

SETTING

High-quality data from ambulance electronic clinical records, New Zealand.

PARTICIPANTS

Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020).

MAIN OUTCOME MEASURES

Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period.

RESULTS

During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005).

CONCLUSIONS

Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population's mental well-being will need to be seriously considered against the benefits of elimination of virus transmission.

Authors+Show Affiliations

Paramedicine Department, Auckland University of Technology, Auckland, New Zealand bridget.dicker@stjohn.org.nz. Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand. Wellington Free Ambulance, Wellington, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand. Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand. Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand.Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.Paramedicine Department, Auckland University of Technology, Auckland, New Zealand. Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

33361171

Citation

Dicker, Bridget, et al. "Changes in Demand for Emergency Ambulances During a Nationwide Lockdown That Resulted in Elimination of COVID-19: an Observational Study From New Zealand." BMJ Open, vol. 10, no. 12, 2020, pp. e044726.
Dicker B, Swain A, Todd VF, et al. Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand. BMJ Open. 2020;10(12):e044726.
Dicker, B., Swain, A., Todd, V. F., Tunnage, B., McConachy, E., Drake, H., Brett, M., Spearing, D., & Howie, G. J. (2020). Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand. BMJ Open, 10(12), e044726. https://doi.org/10.1136/bmjopen-2020-044726
Dicker B, et al. Changes in Demand for Emergency Ambulances During a Nationwide Lockdown That Resulted in Elimination of COVID-19: an Observational Study From New Zealand. BMJ Open. 2020 12 23;10(12):e044726. PubMed PMID: 33361171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand. AU - Dicker,Bridget, AU - Swain,Andrew, AU - Todd,Verity Frances, AU - Tunnage,Bronwyn, AU - McConachy,Emma, AU - Drake,Haydn, AU - Brett,Michelle, AU - Spearing,Dan, AU - Howie,Graham John, Y1 - 2020/12/23/ PY - 2020/12/28/entrez PY - 2020/12/29/pubmed PY - 2021/1/7/medline KW - COVID-19 KW - accident & emergency medicine KW - health policy KW - mental health KW - primary care KW - public health SP - e044726 EP - e044726 JF - BMJ open JO - BMJ Open VL - 10 IS - 12 N2 - OBJECTIVE: To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand. DESIGN: A descriptive cross-sectional, observational study. SETTING: High-quality data from ambulance electronic clinical records, New Zealand. PARTICIPANTS: Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020). MAIN OUTCOME MEASURES: Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period. RESULTS: During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005). CONCLUSIONS: Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population's mental well-being will need to be seriously considered against the benefits of elimination of virus transmission. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/33361171/Changes_in_demand_for_emergency_ambulances_during_a_nationwide_lockdown_that_resulted_in_elimination_of_COVID_19:_an_observational_study_from_New_Zealand_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&amp;pmid=33361171 DB - PRIME DP - Unbound Medicine ER -