Abstract
Introduction: In light of the COVID-19 pandemic, various emergency medical services (EMS) and health agencies in New York City (NYC), and other hard-hit cities, issued new guidelines terminating resuscitation efforts in cases of out of hospital cardiac arrests (CA). This guidance was issued to protect the health and safety of EMS providers, to conserve hospital resources, and to ensure optimal use of equipment to save the greatest number of lives. However, the psychological impact of this public health messaging on existing CA survivors has not yet been studied. Methods: Between 5/15 - 5/18 of 2020, a month after the NYC COVID-19 pandemic peak, CA survivors from an ongoing, prospective study, were invited to participate 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; e.g., “I am stressed around other people because I worry I’ll catch the coronavirus;” range 1-42). Survivors’ self-reported 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 5-point Likert-scale (Not at all—extremely). Results: Of 100 approached, 75 CA survivors participated (53% male; age 61±15 years; 44% non-Hispanic White, 20% Black, and 31% Latinx). The majority, 63 of 75 (84%), had no COVID-19 symptoms or had not been tested. The median COVID-19 anxiety score was 28 (interquartile range [IQR]: 21-37). Participants who were “very to extremely” afraid that emergency care would not come if they had another CA made up 45% (34 of 75; 95% C.I: 34-57) and scored 1 SD higher (mean±SD 34±6 vs 23±9, p<0.001) on COVID-19 anxiety scores than those with little fear about the availability of emergency care. The association was significant after adjusting for age, race, sex, and COVID-19 testing status (Odds Ratio = 1.17; 95% CI: [1.079, 1.274]; p<0.001). Conclusion: A better understanding of the potential psychological impact of disaster-related public health messaging is needed to prevent campaigns from causing additional distress and contributing to poor mental health and quality of life.
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