COVID-19 Street Fighters
The EMTs and Paramedics Who Tackle Coronavirus Before it Gets to the Hospital
by Kristen Miller
To use a clichéd analogy, if doctors and nurses are soldiers in the fight against coronavirus, emergency medical technicians (EMTs) and paramedics are the infantry on the front lines. Each day, they quite literally meet the virus where it lives—in the homes of patients who call 911 and on the streets of the communities they serve.
I spent almost a decade serving as chief of staff for a large municipal EMS service and I can tell you without hesitation, EMS is the canary in the coal mine. Want to know if the flu has hit your city? Want to know what types of public safety directions to give citizens after a natural disaster? Want to get an understanding of whether there are enough medical providers in your community? Talk to your local EMS agency.
It’s not hyperbolic to say the work EMTs and paramedics do often determines whether a patient will be able to walk out of the hospital after treatment, yet they’re often overlooked in discussions about how our public health systems are fighting coronavirus. Here are a few important things to know about the role these emergency responders play in keeping us healthy and safe:
(1) Their already dangerous jobs just got more dangerous
On a regular day, EMTs and paramedics know little about what to expect when they make an emergency run. Patients or others in the household may be disoriented or combative (frequently enough that many states have laws protecting the physical safety of emergency medical responders). They have no control over their surrounding environment, where everything from cleanliness hazards to an aggressive pet can make their jobs more difficult. And exposure to communicable illnesses is a daily hazard, either from direct patient contact or an errant needle stick in the back of an ambulance racing to the hospital.
Now, throw in the added danger of a highly contagious virus that’s sweeping across the globe. While the rest of us are practicing social distancing and trying to learn what it really looks like to stand six feet apart, EMS personnel have been thrust into close proximity of sick patients or groups of potential carriers.
Agencies are implementing new policies and procedures in order to protect their personnel, but they are not immune to the personal protective equipment (PPE) shortages even well-funded hospital systems are experiencing during the COVID-19 outbreak. Many larger EMS systems are municipally funded, and I’ve yet to hear of a city government complaining it is too flush with resources. Complicating finances, municipal government budgets are often supported by occupational taxes levied against the community’s workers. When unemployment is high—the way it is now with so many Americans being furloughed or laid off—the coffers get depleted quickly and stay that way until the economy improves. That means EMS personnel may be struggling to find funding for necessary PPE for months to come.
And as more and more patients start calling 911 afraid they may have the coronavirus, the time it takes to respond to emergency medical calls will likely get longer. Those EMTs and paramedics who fall ill with the virus will have to self-quarantine, leaving fewer personnel on duty to handle a growing number of calls. Putting on PPE appropriately and sanitizing ambulances between runs takes additional time. And emergency medical calls for non-virus-related issues don’t just stop coming in during a pandemic—car crashes, broken limbs, and heart attacks will still happen, further depleting emergency medical resources.
If you aren’t one of the millions of Americans already doing your part by staying home, please hear this: If you won’t do it for your grandma, if you won’t do it for your friend who’s a doctor or nurse, then do it for the EMT who does not have time to come get you because you got sideswiped by another car while on a coffee run.
(2) They’re not just “ambulance drivers”
There is work going on in the back of that ambulance, and these personnel are trained to know what to do and how to do it. While regulations vary from state to state, the typical EMT receives around 150 hours of emergency medical training. EMTs must also pass the National Registry Emergency Medical Technicians cognitive and psychomotor examinations in order to receive their certification. Becoming a paramedic takes about 1,800 hours of training above and beyond an EMT certification, which can often be obtained in conjunction with an associate degree at a local college or university. Then a paramedic student must take a state licensing examination to gain their certification.
On top of these requirements, EMTs and paramedics must be trained on the medical protocols used by their particular agency, and they receive regular, ongoing continuing education on new treatments and technologies. These folks aren’t just Baby Driver in a uniform—if they’re in the back of that ambulance, they’re actively starting IVs, helping patients breathe, and administering life-saving medications.
(3) They’re making progress in reflecting the communities they serve
One (valid) criticism of many public safety agencies is that they bear little resemblance to their communities—that is to say, they’re overwhelmingly male and white. (Which is true.) But there has been progress.
A recent study showed that only 8 percent of U.S. firefighters were female in 2018, and among career (full-time) firefighters, that figure drops to 4 percent. Less than 8 percent of firefighters in 2018 were black, and the figure is about the same for Hispanics. Approximately 15 percent of police officers were female in 2018, and just more than 13 percent were black.
In contrast, almost 35 percent of EMTs and paramedics were female in 2017, and there have been some recent improvements seen in the number of Hispanics becoming certified as EMTs and paramedics. However, the rate of Black EMTs and paramedics remains just as low, at 8 percent.
Diversity in public safety is critical, and particularly so in public health. When an EMT or paramedic is trying to treat a patient, calm and detailed communication is imperative. The conversation between EMS personnel and the patient or any bystanders will determine what medical protocols are followed; what kind of information is transmitted to staff at the hospital emergency department, maybe even which hospital can appropriately receive the patient. But communication efforts can be stymied by language or cultural barriers and implicit biases. Plus, when there are sirens blaring and radios squawking all around, there’s an inherent comfort factor that comes with knowing your care is entrusted to someone who looks like you and may possibly understand more about you. Seeking a more diverse workforce in emergency medical services isn’t just a feel-good goal, it’s a way to ensure all patients get the emergency medical treatment they need.
The next time you’re giving a well-deserved shout-out to the healthcare workers fighting the coronavirus, whether that means applauding from your window or sharing a supportive post online, don’t forget to include a thanks to the courageous, highly-trained EMTs and paramedics who serve your community. They often get overlooked, even with the flashing lights and blaring sirens—but it can’t be overstated how vital they are to keeping us safe and healthy.
Kristen is a management, legal, communications and public relations consultant for Well-Red Consulting and Creative, her new main hustle after several unfulfilling years as an attorney. A native of Louisville, KY, she owns way too many Kentucky Derby hats for someone who is super-allergic to horses. She is an anxious traveler, a bourbon lover, a college sports fan and a music snob. Check out her random musings on Instagram at @kmillerwku.
