Supplementary Material for: Geospatial and temporal analysis of emergency medical services during the COVID-19 pandemic: a case study of Astana, Kazakhstan

Introduction: Few local-level studies examining population needs for emergency medical service (EMS) within specific districts during pandemics. This study used geographic information systems (GIS) to analyze 312,707 EMS calls in Astana, Kazakhstan, examining changes before, during, and at the peak of the COVID-19 pandemic. Methods: This study retrospectively evaluated Emergency Medical Services (EMS) data in Astana, Kazakhstan to assess the impact of the COVID-19 pandemic. Data was extracted from two automated systems used by the Astana ambulance station: "Komek 103" (introduced in late 2019) and the ADIS information system. These systems collect comprehensive call data including caller demographics, address, time, seasonality, and emergency outcome. Moreover, we detected the geographical distribution of EMS calls during COVID-19. Results: The results show a substantial increase in EMS calls during the COVID-19 pandemic in Astana, Kazakhstan. Before the pandemic (Jan 1- Mar 13, 2020), there were 50,488 calls, compared to 126,308 calls at the onset and 135,911 calls at the peak. The peak period saw the highest call volume on Mondays (21,329 calls), a 35.7% increase in calls from individuals aged 65+, and a significant rise (51%) in complaints of fever. Within the 65+ age group, men accounted for a 26.6% larger proportion of EMS users compared to women. Moreover, the number of requests for emergency medical care varied by district in Astana. Conclusions: The main trends in emergency medical services calls showed that during the peak of the pandemic, the number of calls significantly increased. GIS technologies made it possible to determine the main flow and need of emergency medical service calls.