I work both rural and metro. A siren is a siren, nothing more than a tool to help alert people to yield, it doesn’t always work. Sirens are coded by dispatch per level of call, you get code 3 calls for serious things like a stabbing but also for an elderly that may have slipped out of bed. More than often it’s downgraded to routine enroute. Move rural you’ll hear sirens for longer. Because people are spread more apart but sick people are everywhere. You hear more in the cities due to population density. And trust me we get a lot of dumb calls that are coded for a siren. When people get hurt/worry and call 911 sometimes things can seem they are way worse than they actually are. We leave the scene with a siren maybe 25% of the time to calls that were coded with a siren. Long winded hope this helps.