Strategies to Handle Increased Demand in the COVID-19 Crisis: A Coronavirus EMS Support Track and a Web-Based Self-Triage System

Prehosp Emerg Care. 2021 Jan-Feb;25(1):28-38. doi: 10.1080/10903127.2020.1817212. Epub 2020 Oct 9.


Background: In emergencies, such as the COVID-19 pandemic, there is an increased need for contact with emergency medical services (EMS), and call volume might surpass capacity. The Copenhagen EMS operates two telephone line the 1-1-2 emergency number and the 1813 medical helpline. A separate coronavirus support track was implemented on the 1813 medical helpline and a web-based self-triage (web triage) system was created to reduce non-emergency call volume. The aim of this paper is to present call volume and the two measures implemented to handle the increased call volume to the Copenhagen EMS.

Methods: This is a cross sectional observational study. Call volume and queue time is presented in the first month of the COVID-19 pandemic (27th of February 2020 to 27th of march) and compared to the equivalent month from the year before (2019). Descriptive statistics are conducted on call volumes and queue times and spearman's rank correlation test are performed to test correlation between web triage and call volume.

Results: Total EMS call volume increase by 23.3% between 2019 and 2020 (92.670 vs. 114,250). The 1-1-2 emergency line total call volume increase by 4.4% (8,4942 vs. 8,870) and the 1813 medical helpline increased by 25.1% (84.176 vs. 105.380). The coronavirus support track handled 21,063 calls. The 1813 medical helpline queue time was a mean of 02 minutes and 23 seconds (CI: 2.22-2.25) in 2019 and 12 minutes and 2 seconds (CI 11:55-12:09) in 2020 (P < 0.001). The web triage was used 10,894 times. No correlation between call volume and web triage usage was seen.

Conclusions: In the first month of the ongoing COVID-19 pandemic a significant increase in call volume was observed in the 1813 medical helpline compared to 2019. A large number of calls were handled by the additional coronavirus track and diverted away from the regular tracks of the 1813 medical helpline. This likely contributed to mitigating increased call volumes and queue times. The web triage was widely used but no significant correlation was seen with 1813 medical helpline call volume. Other EMS organizations can learn from this to enhance capacity in a future epidemics.

Keywords: call volume; dispatch; emergency medical services; health care capacity; pandemic management.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Emergency Medical Services* / statistics & numerical data
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Pandemics
  • SARS-CoV-2
  • Telephone
  • Triage* / statistics & numerical data