Increases in Ambulance Call Volume Are an Early Warning Sign of Major COVID-19 Surges in Children

• Published in: International journal of environmental research and public health Vol. 19; no. 23; p. 16152
• Main Authors: Kienbacher, Calvin Lukas, Tanzer, Joshua Ray, Wei, Guixing, Rhodes, Jason M, Roth, Dominik, Williams, Kenneth Alan
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.12.2022; MDPI
• Subjects: Adolescent; Ambulances; Child; Child poverty; Coronaviruses; COVID-19; COVID-19 - epidemiology; Ecological studies; Emergency medical care; Emergency Medical Services; Epidemics; Humans; Infectious diseases; Mass casualty incidents; Pandemics; Pediatrics; Public health; Residence Characteristics; Risk analysis; Risk factors; Surges; Time series; Trends; Variables; Rhode Island; United States > US; COVID-19; emergency medical service; public health
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph192316152

Background: Infectious diseases, including COVID-19, have a severe impact on child health globally. We investigated whether emergency medical service (EMS) calls are a bellwether for future COVID-19 caseloads. We elaborated on geographical hotspots and socioeconomic risk factors. Methods: All EMS calls for suspected infectious disease in the pediatric population (under 18 years of age) in Rhode Island between 1 March 2018 and 28 February 2022 were included in this quasi-experimental ecological study. The first of March 2020 was the beginning of the COVID-19 pandemic. We used the 2020 census tract and the most recent COVID-19 data. We investigated associations between pediatric EMS calls and positive COVID-19 tests with time series analysis and identified geographical clusters using local indicators of spatial association. Economic risk factors were examined using Poisson regression. Results: We included 980 pediatric ambulance calls. Calls during the omicron wave were significantly associated with increases in positive COVID-19 tests one week later (p < 0.001). Lower median household income (IRR 0.99, 95% CI [0.99, 0.99]; p < 0.001) and a higher child poverty rate (IRR 1.02, 95% CI [1.02, 1.02]; p < 0.001) were associated with increased EMS calls. Neighborhood hotspots changed over time. Conclusion: Ambulance calls might be a predictor for major surges of COVID-19 in children.