Recent studies from communities severely affected by the novel coronavirus 2019 (COVID-19) pandemic have reported lower rates of successful resuscitation for out-of-hospital cardiac arrest (OHCA). Unadjusted rates of sustained return of spontaneous circulation (ROSC) decreased by 14.6% (from 25.2% in 2019 to 10.6% in 2020) in New York, New York.

Policy changes that were instituted among EMS agencies during the pandemic may have been implemented broadly, even in areas with low to moderate COVID-19 incidence. These changes may affect rates of sustained return of spontaneous circulation, including slower response because of a need to don personal protective equipment, shorter treatment duration on EMS arrival, or higher rates of termination of resuscitation in the field on patients without return of spontaneous circulation.

The pandemic continues to challenge even the most trained first responders. As we soldier on, keep in mind that advance care planning, advance directives and POLST are great tools to use to be prepared. Residents have the right to make informed choices on life sustaining interventions even during challenging times. Be sure you continue to provide information to your residents and families on this important topic.

Stay the course, stay strong, mask up, get vaccinated, and stay tuned!