On September 11, 2001, 343 FDNY firefighters (as well as several EMS workers and police officers) lost their lives when the World Trade Center towers collapsed in New York. One thing that came out of the tragedy was an increased admiration and appreciation for firefighters and the fire service nationwide.
Firefighters were hailed as heroes, and rightfully so, as the public saw first-hand the daily risks firefighters face. The FDNY became synonymous with bravery and fortitude in the public eye.
When people would talk about firefighters in the wake of Sept. 11, they would say with respect that “they are the ones running into the building when others are running out.” While a great deal of EMS is provided by the fire service in the United States, there are just as many municipal third-service, hospital-based, private company, or volunteer-based EMS providers. With all of these EMS units on the proverbial “front lines” of the COVID-19 virus, is this the time of a sea change when EMS will be regarded as highly as the fire service was after 9/11?
Paramedics and EMTs have been taught since their first EMT class that their first thoughts should be “scene safety and body substance isolation (BSI).” Certainly that is foremost in the mind of all providers now, as every scene is a potential COVID-19 patient, and every patient contact runs the risk of exposure. There is a shortage of personal protective equipment, including N-95 masks, face shields, and isolation gowns. There is a shortage of cleaning equipment, disinfectants, and hand sanitizer.
If all this wasn’t enough, departments face the risk of cross exposure of personnel, quarantine of exposed providers, and reduced manpower. Additionally, with schools across the country closed, many parents who have to work are left without child care options. On March 9, a FDNY EMT was the department’s first person to contract the virus. Subsequently, that department stopped sending first responder engines and trucks to many EMS calls.
Other states and departments have followed similar protocols. In Washington State, dozens of EMS providers were quarantined after being exposed to COVID-19 patients. This is coupled with typically low EMS pay (or in the cases of volunteers, no pay at all) and disregard by some politicians. New York City Mayor Deblasio, when asked about equal pay between firefighters and EMS, said that he would not consider equal pay because “...the work is different." The risks are many and the benefits are not as good as they should be.
So will this be the time that the public sees EMS providers as more than just “ambulance drivers” or lumps us all under the catch-all title of “first responders”? Hopefully that will happen organically, but there are several things departments can do to help seize the moment. Many departments are being proactive and reaching out to their communities to discuss what a COVID-19 EMS response would look like.
They are communicating the screening that will take place by 9-1-1 call takers as well as “doorway” screening by crews before they enter homes. They describe that all providers will be wearing masks for their protection and that patients will be asked to wear one for theirs. They describe the cleaning procedures crews are following for patient and crew protection. They urge community members to call their doctors or utilize telemedicine for a consult to reserve emergency departments and 9-1-1 responses for the truly sick.
They provide quotes, accurate information, and statistics to local news media and make sure they use correct titles and terminology to accurately describe what they do. They help the public see EMS for the risks that are taken and the professionalism they exhibit. Recently, University Hospital (NJ) EMS Director John Grembowiec and several of his EMTs and paramedics conducted an interview with CBS’s John Elliott. Grembowiec and his team made sure the media knew that their primary mission is a strong standard of patient care.
In a Twitter comment on March 17, 2020, former President Barack Obama stated, “We owe a profound debt of gratitude to all our health professionals and everybody who’ll be on the front lines of this pandemic for a long while. They’re giving everything. May we all model our own behavior on their selflessness and sacrifice as we help each other through this.” EMS workers certainly fall under that “health professional” umbrella, but they deserve their own moment in the sun.
EMS crews are facing risk of quarantine and illness during this time of COVID-19. While EMS has always faced that risk, the hopeful silver lining is an increased awareness and appreciation of emergency medical providers by the American public.
Barry A. Bachenheimer, EdD, FF/EMT, is a frequent contributor to EMS World. He is a career educator and university professor, as well as a firefighter and member of the technical-rescue team with the Roseland (N.J.) Fire Department and an EMT with the South Orange (N.J.) Rescue Squad.