EMS In The Fires of the PandemicJuly 14, 2020
Strain was unprecedented for the busiest system in nation.
Even before New York City became the epicenter of the coronavirus pandemic, its Emergency Medical Services (EMS) system was the busiest in the nation. But as the virus took hold on New York City, the system was quickly overwhelmed. What was an ember in early March raged into a wildfire just two weeks later. The number of emergency calls rose from about 4,000 a day to 7,000. The usual monthly toll of cardiac arrests was being reached in less than a week.
The pandemic also took a severe toll on the city’s first responders. At one point in April, more than onequarter of the city’s EMT workers were out sick. Others stayed away from home out of fear of infecting family members. By the end of April, eight of the workers had passed away.
“To keep my seven-year-old son safe, I left him behind with my mother,” said Amanda Dasaro, an EMT for the last eight years at NYU Langone Medical Center in Manhattan. “I stayed at an NYU dorm until the Union helped me find an Airbnb.”
Dasaro said that words were inadequate to describe the intensity of her experience. “It was unbelievably mentally and physically challenging,” she said. “At times, I couldn’t catch my breath. I felt as if I was drowning in a sea of worry, and I had a constant knot in my stomach.”
Also especially painful, Dasaro said, was the sight of patients’ family members who tearfully watched her take their loved ones away. “The helplessness I saw in the eyes of both patients and family members was heartbreaking,” she said. “As my partner and I carried patients away, I literally begged them to hold on.”
Dasaro and other EMS workers said they long for the days when the usual sounds of the city replace the endless screeching of sirens, and when springtime heralds the blossoming of flowers and children frolicking in parks and playgrounds.
Added to the stifling volume of work during the pandemic is a far more demanding protocol. The need to protect themselves and others from the virus necessitates a much greater level of caution and care for patients and themselves.
“Unlike before, you can’t just pick up and drop off a patient,” said Jack Chapman, a paramedic at Staten Island University Hospital (SIUH).
“Everything has to be sanitized before and after each call. All the protective personal equipment (PPE)—the masks, gloves, face shields—have to be taken off, cleaned and put on.”
He said that he was also physically and mentally exhausted by the volume of calls. He noted that his toughest challenge was seeing patients of all ages who were previously healthy lying in the ICU, being intubated and sometimes sadly passing away.
To make it through the day, he tried to reduce personal involvement with patients and not take his work home.
“I’m fortunate that my fiancée, who has a master’s degree in nursing, is there for me if I need to discuss my work.”
“My family didn’t sign up for this,” says another SIUH paramedic, Antonio Jimenez. Having a family—a wife and two children in Jimenez’s case—added another layer of anxiety for him. After he contracted the virus in March, Jimenez isolated himself at home for close to two weeks in order to protect family members.
After his return to work, he undressed after each shift at the door and headed straight to the shower, before greeting family members. He puts his clothing in a plastic bag before it’s washed or he sometimes leaves it in his work locker. “For me, the most difficult part of the workday is seeing families crazy with worry and concern for their loved ones,” Jimenez says.
Although EMS workers have been given more latitude to determine whether patients should be hospitalized, the new protocol limits the amount of time workers can spend attempting to resuscitate a patient from about 35 or 40 minutes to 20.
Jimenez and the others talked about “the fragility” of life and how death seems to lurk everywhere. “I have flashbacks,” Jimenez said. “This is going to take a long time to get over.”
EMS and other healthcare workers have questioned the timing of states that decided to relax public health restrictions and scale back stay-athome orders although the number of infected people in their states continued to increase. In the absence of mass testing and adequate contact tracing, infectious disease experts also believe that easing the lockdowns is premature. They add that even with changes in behavior, the reopenings could spark a resurgence of the pandemic.
Dasaro, although she’s going through one of her life’s toughest tests, remains positive. “I do this work because I put everyone before me,” she said. “I’m fortunate that I’ve been able to escape infection, and I still have my family and my job. So many others have lost lives and livelihoods.”
Chapman said his hope is that the pandemic will make us wiser and more prepared if a resurgence of COVID-19 or another crisis comes. “My fear is complacency,” he warned.
“I’m also frustrated by those who don’t take this pandemic seriously. They should talk to people like those of us who work in health care.”