For the past several years, the long-term sustainability of rural EMS systems has been of great concern. This blog post written by Melissa Brook, Mark Deavers, and Ann Smith and published by the New York State Association for Rural Health (NYSARH) discusses how the COVID-19 pandemic has made the entire rural EMS infrastructure at risk for further widespread deterioration. The financial and staffing uncertainties in the wake of these trying times have caused an additional strain that will continue to negatively impact the EMS system for years to come.