How local EMS is responding to the COVID-19 pandemic

HENRY COUNTY - Working on the front lines of the COVID-19 pandemic comes with a unique set of fears and stresses.

'This is completely unprecedented for us … EMS as a whole has never experienced something like this,” Jacob Dodds, emergency medical services director from Henry County Health Center, responded in an email about dealing with the current global pandemic.

As the number of active cases grows, so does the potential for exposure among health care professionals, who are working with those patients. Dodds explained his team and the hospital staff at HCHC are taking the necessary precautions to avoid further spread of the virus.

'EMS staff have been provided with all CDC recommended personal protective equipment,” Dodds explained. The PPE includes gowns, eye protection and N-95 masks.

In addition to protective equipment, the EMS staff are also using a power air purifying respirator (PAPR) for transfers of confirmed and potential coronavirus patients and 'encapsulated protective suits to limit their risk of exposure,” during those transfers, Dodds noted.

'We have also designated one ambulance in the fleet to transport COVID patients,” the EMS director further explained. That particular ambulance 'has been outfitted with plastic covering in the patient area to reduce contamination of supplies and equipment.” The team also follows 'a defined process” in cleaning their vehicles and equipment before heading back out to receive more calls.

As crews respond to calls, Dodds said his staff are wearing masks, eye protection and gloves, 'at minimum.” In Henry County, 9/11 dispatch pre-screens patients for symptoms, who inform EMS workers of the situation ahead of time.

'If the patient is showing symptoms of COVID-19, then the crew will dress in full PPE before making patient contact, and one EMS provider will enter the scene to conduct an assessment of the patient's condition,” Dodds said.

The EMS director added that crews may 'avoid certain procedures that could aerosolize the virus” and will notify hospitals of the possible coronavirus case.

Dodds explained past illnesses and outbreaks like Ebola and the swine flu lead to the implementation of certain screening procedures and 'specific treatment protocols,” but the COVID-19 pandemic has been a different experience entirely.

'Our biggest challenge is being seen with the limited sourcing of PPE nationally, and given the high-transmissibility of this virus, keeping staff healthy. Fortunately, so far, we here in Henry County have a reasonably adequate supply of PPE, and I have not had any staff fall ill,” Dodds wrote.

But seeing how the virus has affected the EMS systems in other areas of the country is a major concern for Dodds.

'There are areas in the U.S., such as NYC and New Orleans, where the EMS system's ability to respond has been decimated due to staff illnesses,” he explained. If members of the staff should fall ill, it would mean mandatory overtime for other crew members to continue to meet the needs of the community.

For his staff, Dodds said 'there is legitimate fear of getting the virus, and an even greater fear of bringing the virus home.”

'We are still responding to all calls as we normally do, but there is a greater degree of cautiousness being exercised, which may clash with the expectations people may have when they call an ambulance. It may be unnerving to see the crews walk in wearing masks, or frustrating to see them putting on PPE at the curb instead of dashing into your home, but crew safety is paramount right now,” Dodds noted.

Another challenge Dodds and his team faces is the ever-changing guidelines in response to the pandemic.

'I am constantly monitoring the information coming from federal, state and local public health authorities and adjusting our practice as necessary,” he explained. Dodds also meets with his employees everyday 'to go over the current conditions and assess for our department's operational and PPE needs.”

'My goal from the beginning has been to keep my staff safe and healthy by giving them the tools and operational flexibility they need to do that, and also to be as transparent as possible with all information that I have. I also prioritize the importance of following up with crews that have transported patients who have ended up testing positive,” Dodds said.

In addition to the heightened potential for his crew to contract the illness, Dodds said many of the stresses come from 'the unknown” and a prolonged and delayed sense of when the worst will hit.

'I have often likened this pandemic to having a bomb strapped to your chest and having no idea when it is going to go off … If an EF-5 tornado tore through the heart of Mt. Pleasant, there is no doubt that would be stressful and strain our resources, but it would be sudden, and the EMS response side of it would be over within hours or days. With COVID-19, we know this is coming … we just don't know when … or how bad it's going to be … or for how long we are going to be affected,” he said.

These concerns only add to the regular concerns his staff have such as worrying for high-risk family members or dealing with child care.

'Unfortunately, the true physical and psychological toll won't be known until long after this pandemic is over,” Dodds added. The EMS director also noted the extent of the peak of cases in the state, which is expected to come in late-April, also will determine the affect the virus has on local resources and his team.

Though it has been a scary time for his staff, Dodds said they have also 'seen a wonderful outpouring of support from the local community since this started, and it has been much appreciated.”

Dodds urges people to continue to follow recommendations from local and state public health to 'maintain social distancing and stay at home as much as possible to contain the spread of this virus.”

'I have seen firsthand there are still a number of people in this community who are still not taking this seriously. Only call 911 for true emergencies; This will help conserve our resources and also protect both the patients and the EMS providers from possible exposure,” Dodds added.

The EMS director also hopes this experience and his team's work during the pandemic will highlight the necessity of EMS.

'I hope this brings the issue of EMS as an essential service to the forefront of people's minds, and that we are not forgotten and taken for granted. Gov. Reynolds has referred to EMS providers as essential employees in several of her news conferences, but despite that, there still is no guarantee for Iowans that they have timely access to ambulance service,” Dodds added.