The coronavirus disease (COVID-19), caused by the virus SARS-CoV-2, has strained international healthcare systems, including ambulance availability. Ambulance officers and paramedics are at the frontline of this pandemic and are therefore particularly exposed. Under normal operational circumstances, ambulance delivery is challenging; the effects of COVID-19 have exacerbated both the delivery of services and the stress placed on paramedics. In this case report, we describe a 12-hour emergency ambulance dayshift in central London during the second wave city-wide lockdown. We also discuss the impact COVID-19 has on day-to-day operations and the strategies employed to reduce paramedic infection.