An analysis by Magen David Adom of its ambulance response times shows that despite the onslaught of calls it received during the current coronavirus pandemic, the organization was able to maintain an eight-minute average response time throughout Israel, roughly equal to its response prior to the pandemic.
The average response time is considered extraordinarily fast for an EMS organization that responds to emergencies throughout the country and can’t arbitrarily decline a call due to it being outside its jurisdiction.
“As the national EMS service, we don’t have the option of saying that a medical emergency is too far away and leave it for some other organization to respond,” said Uri Shacham, a medevac paramedic and chief of staff for Magen David Adom. “If a medical emergency is in Israel, it’s our responsibility. We don’t get to cherry-pick which calls we respond to.”
Calls in cities and those near MDA’s 169 emergency medical stations can sometimes be responded to in less than two minutes. Calls in rural and remote areas of the country, however, have longer response times that raise the overall average. The organization also relies on two medevac helicopters to reach remote areas and uses 650 Medicycles to cut through traffic in urban areas.
So far, during the coronavirus crisis, MDA has been able to maintain its ambulance response time, despite the number of calls growing from an average of 6,000 a day to more than 82,000 one day in mid-March. MDA cited several factors in its ability to keep ambulance response times low during the crux of the crisis. Many calls were inquiries about coronavirus testing and didn’t require an ambulance response.
In fact, according to Ido Rosenblat, a medevac paramedic and MDA’s chief information officer, ambulance dispatches in March were only slightly higher than what was needed that same month in 2019 — 71,527 versus 70,342.
“Most of the calls we received were questions about coronavirus or by people wanting to make appointments for testing,” Rosenblat said, “not necessarily for urgent medical emergencies.”
Handling the slight increase in ambulance calls was not an issue since, with a full fleet of about 1,200 ambulances — more vehicles than all of Israel’s private ambulance services combined — the organization had a sufficient supply of vehicles it could employ. In normal times, the organization typically keeps some vehicles in reserve to have at the ready for large-scale incidents, such as a natural disaster or the outbreak of war or rocket attacks. During the current pandemic, the organization at times put additional ambulances into operation to be at the ready or to transport patients needing to get to testing sites.
The larger need for MDA was for people to staff drive-through testing sites and conduct at-home tests for people unable to drive. And here, MDA says, it was able to rely on its volunteer EMTs and paramedics, more than 23,500 of them, the largest volunteer force in Israel. With businesses shuttered during the pandemic, volunteer EMTs, who typically do ambulance shifts several times a month, were able to devote significantly more time to Magen David Adom, providing the organization with significant human resources to respond to needs.
As a result, MDA’s volunteers played key roles, including testing Israelis for infection at drive-through coronavirus testing centers, testing patients at home, answering calls at the organization’s National Operations Center, or treating patients in the field — whether for coronavirus or other medical needs.
The organization also noted that emergencies not related to the coronavirus pandemic have been greatly reduced during the country’s lockdown. That additionally helped Magen David Adom maintain its ambulance-response times, but it’s nevertheless a statistic that has MDA officials and other healthcare professionals concerned.
“When everyone was ordered into self-isolation, you’d expect injuries from car accidents to drop significantly since virtually no one was driving,” said Rosenblat. “However, we saw significant drops as well in the number of strokes and heart attacks, which doesn’t necessarily follow from a medical standpoint.
“You can conclude one of two things,” he said. “Either staying isolated at home has a beneficial effect of preventing strokes and heart attacks, which is highly unlikely. Or, the more likely scenario, people have been ignoring chest pains, motor issues, and other early signs of strokes and heart attacks out of fear of going to hospitals during the coronavirus pandemic, despite that ignoring the symptoms can lead to worse outcomes later on.”
“Our paramedics and EMTs are trained to transport patients during this challenging time without exposing them to coronavirus,” said Shacham. “And Israel’s hospitals are also trained to keep non-Covid patients from exposure. If people have signs of a serious cardiac or cerebral event, they shouldn’t let fear of the virus stop them from getting the treatment they need.”