You see an elderly man collapse on the sidewalk, having a heart attack.
Is it safe to perform CPR
(cardiopulmonary resuscitation) to try to save his life? Or are you risking being infected with the novel coronavirus or giving it to a dying man?
There's an answer: It's strongly encouraged that people perform CPR or chest compressions on others during the global pandemic, according to a report
published by a group of
Seattle emergency room physicians in the journal Circulation.
In fact, you may actually be hundreds of times more likely to save the dying man's life than you yourself are to die from Covid-19 by coming to his aid.
Rescue breaths in a pandemic
Here's how the math works.
From January 1 through April 15, emergency medical services in King County, Washington (which includes Seattle) responded to 1,067 cases of cardiac arrests occurring outside of a hospital setting. Once those patients made it to the hospital, less than 10% of them were diagnosed with Covid-19.
From there, the researchers also made their CPR safety calculation by cross-referencing a would-be rescuer's own risk of ultimately dying from their own act of compassion.
"Given a 1% mortality for Covid-19, approximately 1 rescuer might die in 10,000 bystander CPR events," the researchers wrote. "By comparison, bystander CPR saves more than 300 additional lives among 10,000 patients with (out-of-hospital cardiac arrest)."
Their advice: Don't let risk of infection scare you off from potentially handing someone else a second chance at life.
This study took place in Seattle, a city that saw 15 deaths from Covid-19 per 100,000 residents, less than half of the average US mortality, according to
Johns Hopkins University's Coronavirus Resource Center's Mortality Analyses.
The level of fear and risk for performing CPR could be greater in areas with higher Covid-19 prevalence, noted Dr. Michael Sayre, the study's lead author and a medical professor at the University of Washington's department of emergency medicine.
"We were worried that people were dying of fear rather than the disease," he said.
If you're not CPR certified, hands-only compressions can work
Every year 805,000 Americans have a heart attack
, according to the US
Centers for Disease Control and Prevention.
If you find yourself calling 911 to help one of them, the operator will ask you if the patient is awake and if they're breathing normally. If you answer no to both questions, the operator will begin giving instructions on how to provide chest compressions until paramedics arrive.
You don't need to do mouth-to-mouth during a pandemic.
Studies show that patients who received only chest compressions, rather than CPR with mouth-to-mouth breathing, have a similar likelihood
of surviving to hospital discharge.
The American Heart Association amended
its CPR recommendations in 2008, issuing guidance that bystanders could perform hands-only CPR
as the most effective means of trying to save someone's life until help arrived.
"Bystanders who witness the sudden collapse of an adult should activate the emergency medical services (EMS) system and provide high-quality chest compressions by pushing hard and fast in the middle of the victim's chest, with minimal interruptions," the guidance stated.
It's imperative to act as decisively and quickly as possible.
"The chance of survival goes down by 10% for every minute without CPR," said Dr. Comilla Sasson, vice president for science and innovation in emergency cardiovascular care at the American Heart Association, in March. "It's a 10-minute window to death in many cases."
"We know that if you can start putting your hands on the chest and do compressions right away, it extends that 10-minute time interval," she continued. "It pushes it back, and buys that person more time for help to arrive."
Bystanders are still providing CPR during the pandemic
And let's loop back to the original example of the stranger collapsing on the street. That hypothetical isn't all that common, pandemic or otherwise.
"The rescuer is likely to be a family member," Sayre said. "You will know if they're sick or not."
And there doesn't appear to be empirical data linking CPR and coronavirus infection so far.
In fact, during the course of this study in Seattle, the researchers didn't come across a single person who contracted Covid-19 from administering CPR on someone experiencing cardiac arrest. They also found that people's likelihood of performing CPR during real medical emergencies hadn't slipped in any meaningful way during the past few pandemic months.
Still though, Sayre argued it's important to keep researching the links between resuscitation and coronavirus transmission. Bystanders in other cities may be wary and passing up opportunities to save lies.
And this data could be particularly important in order to help first responders know how to protect themselves when