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Limitations                                        Authorship Statement
              There are several limitations to this study. This survey was on-  GKR performed the data analysis, and all authors contributed
              line and completely voluntary, making it potentially susceptible   to the study design and manuscript.
              to bias. The deployment of this survey was limited to a single
              state and utilized a convenience sample, which may affect the   Reprints
              generalizability of the findings. Only those EMS professionals   Reprints are not available from the authors.
              actively identified on the roster of an EMS agency were surveyed,
              excluding educators, students, military medical and non-medical   References
              support personnel, and non-EMS practicing personnel who may   1.  Centers for Disease Control and Prevention. COVID Data Tracker.
              have also been tangentially affected by the pandemic. As such,   https://covid.cdc.gov/covid-data-tracker/#datatracker-home.
              the findings from this study should be interpreted contextually.  Accessed 11 November 2021.
                                                                 2.  Centers for Disease Control and Prevention.  COVID Data
                                                                    Tracker: Cases & Deaths among Healthcare Personnel.  https://
              The PMBS identifies the potential severity of maladaptive cogni-  covid.cdc.gov/covid-data-tracker/#health-care-personnel.
              tions only. However accurate the PMBS may be, it is still consid-  Accessed 11 November 2021.
              ered non-diagnostic, particularly when utilized asynchronously   3.  World Health Organization.  WHO Coronavirus (COVID-19)
              in the online environment. In addition, while maladaptive cog-  Dashboard. https://covid19.who.int/. Accessed 11 November 2021.
              nitions are linked to both moral injury and PTSI, scores on the   4.  Strynkowski D. Distrust or Diligence: How Public Health
              PMBS alone should not be evaluated through that lens.  Communication Strategies  Affected COVID-19 Response and
                                                                    Effectiveness in Multiple Countries. University of Pittsburgh.
                                                                    http://d-scholarship.pitt.edu/40879/1/Strynkowski_Master%
              Due to the cross-sectional nature of the study, causation can-  27sEssay_2021.pdf. Essay. Accessed 18 August 2021.
              not be determined, and statements about causal inference   5.  Hubble MW, Renkiewicz GK, Hunter S, Kearns RD. Predictors
              cannot be made. Additionally, data were collected prior to the   of COVID-19 vaccination among EMS personnel. West J Emerg
              proliferation of the delta and omicron variants. Given the ex-  Med. 2022;23(4):570–578.
              plosion in cases and deaths in already stressed EMS systems,   6.  Shreffler J, Petrey J, Huecker M. The impact of COVID-19 on
                                                                    healthcare worker wellness: a scoping review. West J Emerg Med.
              scores on the PMBS may have actually been higher during   2020;21(5):1059–1066.
              these additional surges than are represented in this study in   7.  Firew  T, Sano ED, Lee JW, et al. Protecting the front line: a
              the population of EMS professionals.                  cross-sectional survey analysis of the occupational factors con-
                                                                    tributing to healthcare workers’ infection and psychological dis-
                                                                    tress  during the COVID-19  pandemic  in the USA.  BMJ Open.
              Conclusions                                           2020;10(10):e042752.
                                                                 8.  Knudson MM, Jacobs LM Jr, Elster EA. How to partner with
              Our findings suggest that maladaptive cognitions related to   the military in responding to pandemics—a blueprint for success.
              the COVID-19 pandemic are occurring among EMS profes-  JAMA Surg. 2020;155(7):548–549.
              sionals, which may predispose them to psychobiological and   9.  Hines SE, Chin KH, Glick DR, Wickwire EM. Trends in moral
              psychotraumatological effects post-pandemic, some of which   injury, distress, and resilience factors among healthcare workers
              may persist for years. Active coping behaviors must be intro-  at the beginning of the COVID-19 pandemic. Int J Environ Res
              duced in this population to avoid PTSI, substance abuse, other   Public Health. 2021;18(2):488.
              trauma- or stress-related disorders, and suicidality. Additional   10.  Levin CL, Zaritsky R, Maier P, Bucher J. Patient transport in
                                                                    times of crisis. JEMS. https://www.jems.com/coronavirus/patient-
              research should delve into the specific issues faced by EMS and   transport-in-times-of-crisis/. Accessed 11 November 2021.
              military frontline medical professionals in the treatment of pa-  11.  Daigle A. La. EMS reports more people refusing transport. The
              tients during the pandemic. Given the number of civilian, mili-  Advocate. May 22, 2020.
              tary, and tactical operators in austere environments, this work   12.  https://www.ems1.com/coronavirus-covid-19/articles/la-ems-
              may provide an important glimpse into the psychosomatic   reports-more-people-refusing-transport-zRWmNUUMrO33
                                                                    JV1W/. Article. Accessed 11 November 2021.
              stages of trauma response during the setting of a disaster.  13.  National Association  of  EMTs.  How  COVID-19  has  impacted
                                                                    our  nation’s EMS  agencies.  https://www.naemt.org/docs/default
              Working to reduce racial disparities in healthcare access and   -source/covid-19/covid-impact-survey-06-03-2021.pdf?sfvrsn=
              treatment may help to diminish maladaptive cognitions in   c62fea93_4. Article. Accessed 11 November 2021.
              minority populations of EMS personnel. Ensuring healthcare   14.  McCausland P. EMS services warn of ‚crippling labor shortage’
              worker vaccination and disseminating information about the   undermining 911 system. NBC News. 8 October 2021. https://
              COVID-19 illness and the vaccine, particularly from the em-  www.nbcnews.com/news/us-news/ems-services-warn-crippling-
              ployer and primary care physician, may ameliorate some of   labor-shortage-undermining-911-system-rcna2677. Accessed  11
                                                                    November 2021.
              the stress in the EMS professional. It is critical to address mal-  15.  Mukhtar S. Mental health and emotional impact of COVID-19:
              adaptive cognitions with interventions designed to implement   applying Health Belief Model for medical staff to general public
              active coping strategies in the workplace and beyond.  of Pakistan. Brain Behav Immun. 2020;87:28–29.
                                                                 16.  Pilch I, Wardawy P, Probierz E. The predictors of adaptive and
              Acknowledgements                                      maladaptive coping behavior during the COVID-19 pandemic:
              The  authors  would like  to acknowledge  participating  EMS   the Protection Motivation Theory and the Big Five personality
                                                                    traits. PLoS One. 2021;16(10):e0258606.
              professionals for their contribution to this project.  17.  Holland M.  The dangers of detrimental coping in emergency
                                                                    medical services. Prehosp Emerg Care. 2011;15(3):331–337.
              Funding                                            18.  Kerai SM, Khan UR, Islam M,  Asad N, Razzak J, Pasha O.
              This project received no external funding.            Post-traumatic stress disorder and its predictors in emergency
                                                                    medical service personnel: a cross-sectional study from Karachi,
                                                                    Pakistan. BMC Emerg Med. 2017;17(1):26.
              Conflict of Interest                               19.  Clohessy  S,  Ehlers  A.  PTSD  symptoms,  response  to  intrusive
              The authors report no conflicts of interest, and the authors   memories and coping in ambulance service workers.  Br J Clin
              alone are responsible for the content and writing of the paper.  Psychol. 1999;38(3):251–265.

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