Bystanders are less willing to resuscitate out-of-hospital cardiac arrest victims during the COVID-19 pandemic

Aim: The COVID-19 pandemic may influence the willingness of bystanders to engage in resuscitation for out-of-hospital cardiac arrest. We sought to determine if and how the pandemic has changed willingness to intervene, and the impact of personal protective equipment (PPE). Methods: We distributed a 12-item survey to the general public through social media channels from June 4 to 23, 2020. We used 100-point scales to inquire about participants' willingness to perform interventions on "strangers or unfamiliar persons" and "family members or familiar persons", and compared mean willingness during time periods prior to and during the COVID-19 pandemic using paired t-tests. Results: Survey participants (n=1360) were from 26 countries; the median age was 38 years (IQR 24-50) and 45% were female. Compared to prior to the pandemic, there were significant decreases in willingness to check for breathing or a pulse (mean difference -10.7% [95%CI -11.8, -9.6] for stranger/unfamiliar persons, -1.2% [95%CI - 1.6, -0.8] for family/familiar persons), perform chest compressions (-14.3% [95%CI -15.6, -13.0], -1.6% [95%CI -2.1, -1.1]), provide rescue breaths (-19.5% [95%CI -20.9, -18.1], -5.5% [95%CI -6.4, -4.6]), and apply an automated external defibrillator (-4.8% [95%CI -5.7, -4.0], -0.9% [95%CI -1.3, -0.5]) during the COVID-19 pandemic. Willingness to intervene increased significantly if PPE was available (+8.3% [95%CI 7.2, 9.5] for stranger/unfamiliar, and +1.4% [95%CI 0.8, 1.9] for family/familiar persons). Conclusion: Willingness to perform bystander resuscitation during the pandemic decreased, however this was ameliorated if simple PPE were available.