With growing concern, N.Y.’s first responders face outbreak
NEW YORK — The first of many calls that night involved a 24-year-old man who had a fever, body aches and a cough that sounded like a cement mixer.
While the Brooklyn paramedics took the man’s fever — 103 degrees — they noticed frightening vitals that hinted at the coronavirus: a critically low level of oxygen was flowing into his otherwise clear lungs, while his heart thumped with the intensity of a marathon runner’s. He was taken to the nearest hospital.
Then almost immediately came the next call: a 73-yearold man with symptoms similar to the young man’s. They took him to the hospital.
“It’s all a war zone,” one of the paramedics said.
Days later, another paramedic, Phil Suarez, was dispatched to two homes in Upper Manhattan’s Washington Heights neighborhood, where entire families, living in cramped apartments, appeared to be stricken with the virus.
“I’m terrified,” said Suarez, who has been a paramedic in New York City for 26 years and assisted in rescue efforts during the Sept. 11, 2001, terror attacks and later served in the Iraq War. “I honestly don’t know if I’m going to survive. I’m terrified of what I’ve already possibly brought home.”
Even as hospitals across New York become inundated with coronavirus cases, some patients are being left behind in their homes because the health care system cannot handle them all, according to dozens of interviews with paramedics, New York Fire Department officials and union representatives, as well as city data.
In a matter of days, the city’s 911 system has been overwhelmed by calls for medical distress apparently related to the virus. Typically, the system sees about 4,000 Emergency Medical Services calls a day. On Thursday, dispatchers took more than 7,000 calls — a volume not seen since the Sept. 11 attacks. The record for the number of calls in a day was broken three times last week.
Because of the volume, emergency medical workers are making life-or-death decisions about who is sick enough to take to crowded emergency rooms and who appears well enough to leave behind. They are assessing on the scene which patients should receive time-consuming measures like CPR and intubation, and which patients are too far gone to save.
“It does not matter where you are. It doesn’t matter how much money you have. This virus is treating everyone equally,” the Brooklyn paramedic said.
The amount of work has been record-setting for the city’s 911 system, said Frank Dwyer, a Fire Department spokesman.
“Our EMTs and paramedics are on the front line during an unprecedented time in the department’s history,” Dwyer said, adding: “They’re doing it professionally, and they’re doing it because they care about their patients. They care about this city.”
The department said it has started rationing protective gear in an attempt to stave off shortages. Earlier this month, the department told workers that they must turn in their used N95 masks — which filter out 95% of airborne particles when used correctly — in order to receive a new one.
“The department is carefully managing and monitoring usage of personal protective equipment and critical supplies to ensure we have what’s needed for this longterm operation,” Dwyer said.
Three weeks ago, the paramedics said, most coronavirus calls were for respiratory distress or fever. Now the same types of patients, after having been sent home from the hospital, are experiencing organ failure and cardiac arrest.
“We’re getting them at the point where they’re starting to decompensate,” said the Brooklyn paramedic, who is employed by the Fire Department. “The way that it wreaks havoc in the body is almost flying in the face of everything that we know.”
In the same way that the city’s hospitals are clawing for manpower and resources, the virus has flipped traditional EMS procedures at a dizzying speed. Paramedics who once transported people with even the most mild medical maladies to hospitals are now encouraging anyone who is not critically ill to stay home. When older adults call with a medical issue, paramedics fear taking them to the emergency room, where they could be exposed to the virus.
One paramedic told a 65-year-old patient in Brooklyn, whom she had previously transported to the hospital for recurring issues, to stay home this time and call a doctor.
In New York City, 911 calls are handled by both Fire Department ambulances and ambulance companies staffed by area hospitals. Their duties are effectively the same: They respond to the same medical calls, largely determined by what crew is closer and which is available sooner.
Neither the city, the state Department of Health nor the federal Centers for Disease Control and Prevention has issued strict rules as to how paramedics should respond to a coronavirus call. In recent days, Fire Department policy — which applies to all ambulance crews in the 911 system — has given more latitude to paramedics to make decisions on how to handle patients they believe have the virus.
Like doctors and nurses, many paramedics fear they are already infected and have taken the virus home to their families. On March 18, three members of the Fire Department tested positive for the virus. By Friday, 206 members had positive results.
Officials for the union that represents the city’s paramedics believe the actual number who have been infected is far higher. At a single station in Coney Island, Brooklyn, seven EMS workers were infected, one union official said.