Out-of-Hospital Cardiac Arrests in Denver Increased, Ambulance Activations Decreased During COVID-19 Shelter-in-Place Order

Researchers encourage patients to go to the ER if they are having a heart attack

Contact: Sam Roth, sroth@acc.org, 202-375-6582

WASHINGTON (Aug 17, 2020) -

Denver saw a significantly higher number of out-of-hospital cardiac arrests during the COVID-19 pandemic “shelter-in-place” mandate and fewer numbers of people calling ambulances, according to research correspondence published today in JACC: Cardiovascular Interventions.

Researchers used the Denver Health Paramedic Division database before and after the emergence of COVID-19 to evaluate the ambulance activity and the number of out-of-hospital cardiac arrests (OHCA) per week across three timeframes: Pre-Mandate (January 1 – March 7, 2020); Peri-Mandate, when Colorado declared a state-wide emergency and “shelter-in-place” order (March 8 – 28); and Post-Mandate, the two weeks following the “shelter-in-place” order (March 29 – April 11).

Weekly OHCA in the Post-Mandate period significantly increased to 46 per week, compared with the Pre-Mandate period rate of 26 per week. When compared against data from similar time periods in 2011 through 2019, OHCA in 2020 were two times higher. In addition, the researchers found that OHCA during the Post-Mandate time period were greater than the number of individuals who died from COVID-19. The weekly average of all ambulance activations across all time periods were also lower than prior years, suggesting fewer people were calling 9-1-1 during a heart attack while under the stay-at-home order.

“Across-the-board restrictions on non-emergent procedures enacted by states, hospitals and cardiovascular society guidelines may have led to delays in diagnoses and treatments,” said Brian L. Stauffer, MD, chief of the division of cardiology at Denver Health Medical Center and senior author of the study. “Additionally, we worry that patients who have a heart attack are avoiding seeking care due to fears of contracting COVID-19 in the hospital.”

Heart attack prevention is especially timely during the COVID-19 pandemic, as its been reported in other studies that heart attack patients are avoiding the ER due to fear of being exposed to the virus. The ACC, through its CardioSmart initiative, began an educational campaign in April to encourage patients to call 911 if they thought they were having a heart attack and to reassure them that proper protocols are in place to keep them safe in the emergency room.

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

The Journal of the American College of Cardiology ranks among the top cardiovascular journals in the world for its scientific impact. JACC is the flagship for a family of journals—JACC: Cardiovascular Interventions, JACC: Cardiovascular Imaging, JACC: Heart Failure, JACC: Clinical Electrophysiology, JACC: Basic to Translational Science, JACC: Case Reports and JACC: CardioOncology—that prides themselves in publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC.org.


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