Calls of Despair: An EMS Perspective on Suicide and Overdose in Rhode Island during COVID-19.

ABSTRACT

In 2020, Americans suffered marked increases in overdose deaths and self-reported suicidal ideation, widely attributed to COVID-19. However, the recent pandemic's full effect on suicide and drug overdose, two of the "deaths of despair", remains poorly understood. This study aims to illustrate the impact of COVID-19 on suicide and overdose calls to emergency medical services (EMS) in Rhode Island using syndromic analysis as a novel public health surveillance tool. Utilizing computer algorithms, suicide and overdose EMS calls were identified during the pre-pandemic (March 2019-February 2020) and pandemic (March 2020-February 2021) years. Versus the prior year, pandemic year mean monthly call volume declined significantly for opioid (-16.2%), overdose (-15.5%), and suicide ideation (-6.2%) syndromes. Given elevated national overdose deaths and suicidality, our results suggest that hesitancy to call 911 amid COVID-19 hampered EMS intervention on suicide and overdose patients, potentially compounding their despair and the acuity of their eventual presentation.