Adverse emergency medical services related public health messaging during the COVID-19 pandemic was associated with increased psychological distress in cardiac arrest survivors

ABSTRACT

Objective: This study aimed to assess the contribution of adverse public health messaging related to emergency medical services during the peak of COVID-19 pandemic in New York City (NYC) on COVID-19-related anxiety. Background: New guidelines terminating resuscitation efforts in cases of out-of-hospital CA were issued by health agencies in cities hard-hit by the pandemic to protect the safety of EMS providers, to conserve hospital resources, and to ensure optimal use of equipment to save lives. However, the psychological impact of this public health messaging on existing CA survivors has not yet been studied. Design/Methods: Between 5/15/20-7/31/20, after the NYC pandemic peak, CA survivors from a prospective cohort participated in a telephone-based assessment of the pandemic's impact on psychological and behavioral dimensions. COVID-19 anxiety was assessed using the 7-item Perceived Coronavirus Threat Questionnaire (PCTQ;range 1-42). Fear and uncertainty in receiving immediate life-saving care in the event of a CA due to recent public health messaging was assessed on a self-reported 5-point Likert-scale (Not at all-extremely). Results: Of 130 approached, 105 CA survivors participated (57% male;mean±SD age 58.5±17 years;41% non-Hispanic White, 18% Black, 35% Latinx). The majority (75%) had no COVID-19 symptoms and had not been tested. The median PCTQ score was 28 (IQR 21-35). Responders who were "very" to "extremely" afraid that emergency care would not come if they had another CA (n=43;42%) scored 1 SD higher (mean±SD 33±6 vs 24±8, p<0.001) on PCTQ scores than those with low fear about the availability of emergency care. The association was significant after adjusting for age, race/ethnicity, sex, and COVID-19 testing status (β=8.8;95% CI 6, 12];p<0.001). Conclusions: A better understanding of the psychological impact of disaster-related public health messaging is needed to prevent additional psychological distress.