It helps you when you need to call 911 quickly but maybe can't talk freely or something dangerous will happen to you (E.g. domestic violence, Assault, etc).
The Pixel will transmit your location and also inform 5 emergency contacts, start a camera stream etc (depending on what you configured).
It's also not enabled by default so you must have enabled it
It's not covert in any way. The phone emits a siren sound at full volume for a few seconds before calling and the call comes up in handsfree/speaker mode.
I had no idea it had dialed anything until I happened to hear the operator. It wasn't even on speakerpbone but normal phone mode, so it was quiet, but luckily I was in a quiet room at thd time.
The speaker was functional. Other normal sounds were happening. It did vibrate, but it does that for several ordinary events, including reboot which I was half expecting, and so was not alarming.
Perhaps the audibility is configurable, placing this right back into "tool under the users control", and covert if the user wants it to be.
I just checked the settings again. Indeed there is a "Play alarm sound" setting if you scroll down. I guess it was enabled by default in my case (good, since otherwise I might not know that my phone made the call from my backpack).
Slightly off topic, but I did not even notice before the Emergency SOS settings screen has anything below the break. This UI design is just terrible. There is absolutely nothing hinting that you can scroll down:
(Looking at the screenshot now, you can just about see that alarm sound setting below the slightly transparent bottom row. That's just about impossible to see on the real phone, plus the row has the usual Android set of buttons on top, obscuring the text even further).
I don't remember where but I've seen examples of that "no clues to scroll down" or "no clues this word is clickable" etc a few different places. It's like we're forgetting everything we've spent hundreds of years learning. (interfaces in general, from way before computers)