Introduction: Emergency Medical Services (EMS) are expected to be affected by a pandemic outbreak. However, the available data about trends and extents of these effects is limited. Methods: We analyzed numbers of ambulance calls for all 136 diagnosis codes used by Magen David Adom (MDA), Israel's national EMS during 121 days between January 01 and April 30, 2020. Results: There was an increase in calls for COVID-19 symptoms (cough, fever, throat pain). This trend followed the same shape as the curve for confirmed COVID-19 patients. Trends were found to increase for calls not followed by transport to the hospital as well as in calls for mental or psychiatric causes. Simultaneously, there was a decrease in calls for cardiovascular issues, pneumonia, and all injuries. Conclusion: Understanding these correlations may allow better preparedness of the EMS and a better response towards the public needs in the period of an epidemic or a pandemic.

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Objective: The scientific literature on COVID-19 is extensive, but little is written about the role of emergency medical services (EMS). The objective of this study is to describe the role of Magen David Adom (MDA), Israel’s National Emergency Pre-hospital Medical Organization, in the pre-exposure period, before widespread governmental action. These efforts were based on (1) phone diagnosis, dispatch, and transport, and (2) border management checkpoints. Methods: This is a descriptive study of MDA’s role in pandemic response during the pre-exposure period. Medical emergency telephone calls from either individuals or medical sources were identified by a dispatcher as “suspected COVID-19” based on symptoms and travel exposure. Data were also collected for travelers approaching the MDA border checkpoint at Ben-Gurion International Airport. Results: The total number of protected transports during this time was 121. Of these, 44 (36.3%) were referred by medical sources, and 77 were identified as “suspected COVID-19” by dispatchers (63.7%). The checkpoint was accessed by 156 travelers: 87 were sent to home-quarantine; 12 were transported to the hospital; 18 were refused entry; 39 required no further action. Conclusion: EMS can work effectively in the pre-exposure period through instructing home quarantine, providing protected transport, and staffing border control checkpoints.

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