The world in 2020 looks very different compared to the end of 2019. With the focus on doctors and nurses working in hospitals, first responders may not be the first people you think of when you consider the impact the coronavirus is making on the way people do their jobs.
Yet these individuals are the very people who are the most essential of workers. They’re also the ones hurting, with very little they can do about it.
From adapting to new procedures, to colleagues leaving for other work, to hazard pay, here’s an in-depth look at how the coronavirus is affecting first responders, their careers, and their lives.
Who Are First Responders?
To clarify, “the first responder” is not a job title but rather a blanket term that covers a wide variety of people. Law enforcement, firefighters, paramedics, EMTs, and more all qualify as first responders.
A first responder is a person with specialized medical training that is first on the scene of emergencies, including 911 calls, natural disasters, and other crises. They are usually responsible for assessing the situation and providing immediate care. First responders in ambulances, such as EMTs and paramedics, can also be referred to as EMS, which stands for Emergency Medical Services.
High Turnover Means Low 911 Responses
Part of what’s happened to first responders is actually leftover from the time before the virus. Staffing shortages, low pay, and ignored requests for both to be fixed means first responders weren’t retaining the talent they needed to adequately handle calls.
Even before COVID, New York EMS union leaders say the majority of their ambulance employees had less than 5 years of experience. This works in direct opposition to the fact that the likelihood of patients surviving severe injuries goes up when you have personnel treating them who possess at least six or seven years of experience.
Additionally, even though medical 911 calls outweighed fire-related incidents by a huge margin, firefighters in New York outnumber EMS two to one. Firefighters were being asked to step in to help close the gap, but they lack the proper training.
High turnover is a large problem in first responder departments, especially EMTs, and coronavirus has made it worse.
Now, factor in the virus. What this means is that you have understaffed unions made up of responders who—despite trying their best and giving their all every single day—just don’t have the necessary years of experience to improve the likelihood of positive outcomes for their patients.
Why are EMS employees leaving in such droves? Some may leave because of stress or personal health. For most, however, the answer is simple: a lack of adequate pay and proper benefits. With limited sick days and lower pay than sanitation workers, those who choose the EMS life—at least in New York—are facing an uphill battle to remain in their careers.
Being short-staffed results not only in struggles keeping up with calls, but also puts first responders’ own lives in danger. When they can’t get enough sleep and mental rest, their health suffers. With jobs as critical and demanding as EMS careers are, they need all the regeneration they can get. This puts remaining EMS workers under more pressure, which can also make them more likely to leave or make a mistake.
Plus, understaffing means first responders must now triage—or prioritize—the calls they get and the patients they treat. Depending on the nature of the call, this means in a worst-case scenario that they may not be able to respond to and treat every patient in time to prevent irreversible damage or even save their life. The virus has only exacerbated this problem.
Triage is the New Normal
While first responders don’t simply charge into houses to answer 911 calls, just a few short months ago, they were able to at least enter buildings and assist with disasters with average amounts of forethought.
Now, however, triage is the new normal, both in terms of evaluating which patients get care first and what precautions EMSs must take before entering a scene.
With the rate of 911 calls increasing exponentially, coupled with low numbers of people on the job, dispatchers and first responders are put in the unfortunate position of needing to prioritize which patients get seen first.
Calls that are seen as less of an emergency or not related to the virus may get pushed down in terms of how quickly ambulances arrive or even if—in a worst-case scenario—the patient is asked to find their own way to the hospital.
Additionally, some counties have set up specialized virus hotlines. 911 calls that may have to do with a coronavirus infection get routed to these special lines, rather than using normal resources. While this frees up dispatcher time and attention for non-virus emergencies, it does nothing to help first responders with their stress over assessing patient needs.
In addition to prioritizing certain cases over others to make the most of limited resources, EMS workers are relying on their dispatchers, and the scene as it presents when they arrive, to determine the level of personal protective equipment (PPE) they need to wear.
Dispatchers must ask callers for travel history, signs of respiratory distress, and other in-depth questions to determine if first responders need extra PPE. Because the equipment is in such high demand and therefore harder to obtain, departments can’t afford to waste a single mask or gown.
These extra precautions and added moments, both in terms of patients and gear, add stress and precious minutes to an already intense job—a job for which many are not getting hazard pay.
The Push for Better Benefits and Hazard Pay
Adding “Line-of-Duty” Deaths
In addition to low wages, first responders must struggle with concerns about their ability to take care of their families if they should fall ill or, worst case, die from the virus they’re exposed to on a daily basis.
For years, only police or firefighters who died on the job were able to pass their pensions on to their surviving family members. Now, with more departments stepping up and engaging with the virus firsthand, there’s a strong desire to expand this benefit to all EMSs.
In New York, the virus has claimed more than 50 first responders in the fire and police departments alone. A relief package from the Federal government currently being voted on in the Senate would help, but is mostly focused on hazard pay and is distributed across more than just first responders.
Hazard Pay for First Responders
Back in March, US Treasury Secretary Steven Mnuchin confirmed hazard pay needs to be a requirement in the stimulus packages the government is rolling out across the nation. However, the bill that passed a few months ago did not contain enough aid for EMS providers.
The bill currently under negotiation is a vital step forward in terms of hazard pay. It dictates that essential workers get a $13 per hour raise as well as retroactive payments of up to $10,000 beginning January 1, 2020, for hours already worked.
These measures will hopefully go a long way toward keeping essential EMS workers at their posts and ensuring their families stay protected and cared for if the worst were to happen.
Early Infections and Returning to Work
Changes to routine, pay, and benefits aren’t the only ways first responders’ careers are changing. Early and frequent infections rocked the system, and returns to the job are causing heightened anxiety amongst these essential workers.
There are plenty of stories about EMS workers getting infected with the virus. In March, a deputy in Houston came down with COVID and had to miss work for weeks. Weakened, she worried her colleagues wouldn’t want her back once she’d recovered. Fortunately, her worries were unfounded.
In New York, first responders who contract the virus feel guilt for not being able to recover more quickly and to get back out in the field and keep helping. This can lead to troubling situations like paramedics returning to work before they’re fully healed, even though it’s technically safe to do so.
EMS workers are strong, loyal, dedicated people, and getting set back by the virus can cause feelings of stress, shame, and anxiety. However, in very unique situations, it can also work in the department’s favor.
A chief of police in Aurora, Illinois, for example, was so determined to keep her team from getting sick, she stayed in a conference room with other officials for days to put plans in place to keep her officers safe. Not long after, she contracted the virus, probably during those meetings.
By keeping herself sequestered, in addition to other measures the department enacted, she, in effect, took the possibility of the virus spreading through her department off the table. This is essential as these front line workers fear not only for themselves but for their families.
Fears for Family Members on the Rise
First responders have families they come home to after their shifts, and if the virus weren’t frightening enough, sometimes their family members have conditions that put them even more at risk.
Whether it’s concerning for an infant or an elderly parent, or a family member with preexisting asthma or other respiratory issues, EMS workers worry they will bring the virus home and infect their loved ones. This is no small scare—in April, close to 14% of first responders in New York were out sick.
Of course, every state has its own levels of infection. However, the number in New York, if it’s indicative of the rest of the country, is troubling. Though it isn’t stopping first responders from showing up and doing their jobs.
Most report that, despite their fears about their families, they continue to feel that once they put on their uniform, they’re ready. They won’t back down, and they won’t stop serving their communities.
Concerns About PTSD
First responders have one of the most stressful career paths in existence. With grueling hours, long shifts, and the job itself providing high-stress levels, some experts are concerned about PTSD and its effects on these workers.
This concern is especially valid as our society begins to reopen. EMTs, law enforcement, and firefighters must return again and again to scenes or situations in which they potentially experienced significant trauma.
Whether it’s getting called to the same apartment building in which they were too late to save someone from the devastating respiratory effects of COVID or reliving the calls they had to make to families of the deceased, there’s no denying that EMS workers are in danger of developing PTSD.
The possibility of a “second pandemic” in terms of mental health problems rising after the initial virus calms is very real. Ensuring easy, consistent access to medical care, especially therapy, is key in helping those who have worked the front lines to cope with their experiences.
The Future of First Responders and Coronavirus
Of course, we do not know how long this pandemic will continue to be a threat. No one truly knows the long-term health impacts of the virus, where the future of the virus is taking our society, or even how it will continue to impact first responders.
EMS workers say they continue to struggle with lack of equipment, work stress, balancing multiple first responder roles, and more. Hazard pay will take some of the edges off their money worries, but it’s only the beginning.
These essential workers are quite literally working on the front lines every day. Their careers might include changes for years to come. They may experience new procedures that change how they respond to calls, have mandatory PPE, or receive extended hazard pay.
However their lives change, society needs to think about first responders and how we’re taking care of them, so they can continue to take care of us during the pandemic and beyond.