The impact of COVID-19 on heat-related ambulance calls and the challenges for emergency medical transport in the Kansai region, Japan: a mixed methods approach

The COVID-19 pandemic, coupled with more frequent and stronger heatwaves, has introduced a novel confluence of challenges. for example, it has become very difficult for emergency transport staffs to differentiate between COVID-19 and heat stroke at the scene because they share some similar symptoms. This paper studied the impacts of the COVID-19 pandemic on heat-related ambulance calls and identifies the challenges faced by local fire departments in the Kansai region of Japan 2020-2022 by using historical data analysis and an online questionnaire survey. We utilized a heat-related ambulance calls prediction model developed in our previous research based on the historical data (2008 ~ 2019) and projected the expected number of heat-related ambulance calls from 2020 to 2022. Then, a comparison was done between the expected number and the actual number of daily heat-related ambulance calls to examine the changes of heat-related ambulance calls in six prefectures of the Kansai region. We found a statistically significant decrease, ranging from 77.1% to 96.8%, of heat-related ambulance calls during the COVID-19 pandemic in all Kansai prefectures. The decline in heat-related ambulance calls can be attributed by changes in people’s daily lifestyles such as the increase of remote work and decrease of outdoor exercise. However, it may also be influenced by the strain on the emergency medical resource. Another research finding highlighted significant pressures on local fire departments and emergency medical transport systems during the pandemic. The predominant challenge for local fire departments was finding available medical facilities for their patients. Improving the efficiency of emergency medical transport system and enhancing the coordination between emergency medical services and healthcare facilities may offer a more resilient response in future crises.