Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak . Accordingly, hospitals have had to implement strategies to profoundly reorganize activities, which have affected procedures such as primary percutaneous coronary interventions (PCIs). This study aimed to describe changes in PCI practices during the health emergency at the national level . The Japanese Association of Cardiovascular Intervention and Therapeutics performed provided serial surveys of institutions throughout Japan during the pandemic . The data obtained on December , 2020 and February 2021 (during the 2nd wave of pandemic) were compared with the data obtained on August 2020 (1st wave). Primary PCI for STEMI was performed as usual in 99.1% , 98.7%, and 97.5% of institutions in mid-August, mid-December , 2020 and mid-February , 2021, respectively . The COVID-19 screening tests rates in patients were significantly higher during the third wave than during the second wave (54.0% in mid-August , 2020 and 64.6% in mid-February , 2021, P = 0.002). In addition, hospitals reported that personal protective equipment was more available over time (66.4% in mid-August , 2020 and 83.8% in mid-February , 2021, P <0.001). In conclusion, most institutions surveyed in Japan continued to perform primary PCI as usual for STEMI patients during the second and third waves of the COVID-19 pandemic . In addition, the COVID-19 screening tests were more frequently performed over time.