Photo/Illutration A nurse teaches children how to perform CPR and use an automated external defibrillator (AED) in October 2019 in Nikko, Tochigi Prefecture. (Asahi Shimbun file photo)

A person collapses in the street, perhaps on a train, or wherever and requires cardiopulmonary resuscitation (CPR), but nobody rushes to help for fear of becoming infected with the new coronavirus.

Health experts are increasingly expressing concerns that such a scenario might play out as members of the public observe social distancing in the general atmosphere of fear generated by the COVID-19 pandemic.

Emergency life-saving procedures performed by strangers outside of a hospital environment often spell the difference between life and death.

As a result, new official guidelines were drawn up for performing chest compressions during the pandemic to assuage concerns that helping to save someone’s life could put a person at risk of contracting the virus--even though the risk is low.

Health organizations are trying to impress upon the public the importance of emergency rescue efforts even though people may prefer to shun close contact with someone clearly in distress.

The Japan foundation for emergency medicine developed new guidelines for performing CPR on patients in cardiac arrest to reduce the risk of infection during the procedure.

The guidelines suggest that "handkerchiefs or towels should be placed on the patient's nose and mouth, if they are available," when performing chest compressions.

The health ministry’s website also says the person performing CPR should wash their hands and face "thoroughly with soap and tap water, as soon as the patient is taken away by ambulance attendants."

The new measures follow reports from overseas that point to a growing unwillingness among people to perform CPR while the pandemic rages.

Across Europe, there has been a noticeable drop in attempts to save lives and a spike in the fatality rate outside of hospitals.

In northern Italy, only 31 percent of patients who suffered cardiopulmonary arrest outside medical centers received CPR over a 40-day period since Feb. 21.

The figure was 16 percentage points lower from the previous year.

The outside-hospital mortality rate rose 15 points year on year to 82 percent, partly due to the trend; although, other factors, such as delayed arrivals of ambulances, were also cited for the increase.

Similar results were reported in France.

Owariasahi city in Aichi Prefecture, which has been trying to raise awareness of life-saving measures among residents, suspended the operations of its AED Go app in April due to concerns about the spread of the virus. The app was introduced to help volunteers use automated external defibrillators (AED) more easily.

Chest compressions combined with the AED can make all the difference in helping an individual who suddenly suffers from cardiopulmonary arrest.

Since the chest must be pressed hard and fast in quick succession, some people believe it causes the person receiving help to eject tiny droplets out of their mouth, posing a risk for infection for the people involved.

But a team of scientists, mostly from the University of Washington, estimates the likelihood of becoming infected from such kinds of life-saving measures, without wearing face masks or other protection gear, is only about 10 percent.

In encouraging people to adopt the new CPR guidelines, organizations such as the Osaka Life Support Association and the AED Foundation of Japan established an online emergency help training session on Aug. 10.

"The most important thing is avoiding infection risks, but I want people at the same time to turn to the fact that there are lives at stake that they can save if they follow the proper steps," said Taku Iwami, a professor of medicine at Kyoto University, who also serves as managing director of the AED foundation.

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