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Challenges grow for rescue squads

SoVaNow.com / July 29, 2020
The coronavirus pandemic has taken a toll on local rescue squads, driving up costs and reducing the number of volunteers available to serve.

COVID-19 also has forced emergency responders in Mecklenburg County to rethink how they should respond — and who should respond — to patients in respiratory distress.

Recently, a woman living in Brunswick County near Lake Gaston said she had to drive her neighbor who was having a medical emergency to the hospital because the local squads were either busy or did not have staff or volunteers available to respond to her 911 call for help. The woman asked to withhold her name out of privacy.

In deaths and dollars, the final toll of the coronavirus outbreak has yet to be tallied. But for EMS providers in Mecklenburg County, this pandemic is already a consequential event.

Floyd Edmonds, current treasurer of the Southside Rescue Squad in South Hill, has been a member for 42 of its 60 years of existence. During the initial stages of the pandemic, Edmonds said, many of the older members stepped back from volunteer service since they are considered most susceptible to the virus. The squad was forced to turn to paid part-time staff.

“Young people want to get paid as EMS workers and there are fewer volunteers,” Edmonds said.

Southside Rescue Squad averages 2,300 service calls per year with a mix of paid and volunteer staff. The number of calls has not diminished during the pandemic.

This extra cost depleted the financial reserves the squad built up over the years, according to Edmonds, who has served as the squad’s treasurer for the past six years. Even with a forgivable loan obtained through the federal government’s Paycheck Protection Program to cover payroll costs, the squad was hurt financially.

John Zubrod, who serves as an EMT with the Lake Gaston Fire Department in Bracey, said the pandemic has “increased the tempo of the calls and the level of preparedness.” The unprecedented protective measures required when responding to a 911 call in the COVID-19 era translate to additional costs.

“We need more PPE [personal protective equipment] since these are disposable,” Zubrod said. Every call also has “a higher level of complexity” — from the questions asked by 911 operators to people in distress, to the preparations EMT workers take before entering a home.

“We’re burning through equipment at a higher rate. If there is the potential for [COVID-19] exposure we must wear face shields, gowns and gloves and sometimes full-face breathing devices,” said Zubrod.

Earlier, the Lake Gaston Fire Department and the Mecklenburg County Lifesaving and Rescue Squad in Clarksville received some additional equipment in the form of masks and gloves from the national stockpile. The Clarksville unit also received 200 N-95 masks from Southside Rescue Squad, “because ours had expired and we were looking at 12 weeks before we could receive some,” said Debbie Osborne, executive director of the Mecklenburg County Life Saving and Rescue Squad.

The equipment from the stockpile and the shared supplies have helped both agencies sustain their operations. Otherwise, the agencies received no financial support from the state or local governments to cover operational costs.

All three rescue agencies expect to receive CARES Act funding through Mecklenburg County in the next month or so. The exact amount is still unknown and squad leaders realize they are limited in how the money can be used, but EMS agencies are allowed to spend the money to cover the added expenses associated with their enhanced cleaning and sanitation protocols and the additional PPE – masks, gowns, face shields.

Just as pressing as the added costs these squads face is the impact the virus has had on their staffing. Both Zubrod and Edmonds said the shortage of volunteers that local rescue squads have grappled with for some time has been exacerbated by the virus.

Local squads used to share volunteers, but now some are restricting their members from working at multiple squads out of fear of spreading the virus, according to Zubrod. “Every exposure or potential exposure leads to a 14-day quarantine,” he explained.

While no one involved with the Lake Gaston squad has tested positive for the virus, Zubrod said there have been “a couple of cases among workers in the county.” He declined to say who or which agency has been affected out of privacy concerns.

Osborne said her squad has not been impacted much by the loss of volunteers. “We only have four volunteers.” The other 13 members of the staff are paid.

While the Clarksville unit did not lose staff and no one has had to go into quarantine due to exposure to the virus, the squad’s income took a hit early in the pandemic. Their call volume dropped “because people were afraid to go to the ER, afraid they would catch the coronavirus. Fewer calls means less income,” Osborne said. For that reason, Mecklenburg County Life Saving and Rescue Squad also needed a Paycheck Protection Program loan to cover payroll expenses.

HIPAA (Health Insurance Portability and Accountability Act) rules are proving to be a further impediment for the rescue squads. The rules, which were originally designed to protect individuals’ private medical information, are now used to block EMS agencies from learning if their personnel have been or could be exposed to the COVID-19 virus.

Now, all squad runs require extra precautions. “We treat every call as if involves a coronavirus patient,” Osborne said.

Squads must rely on information gleaned by the 911 dispatchers when assessing their risk. Occasionally, Osborne said the 911 dispatcher may say that the caller’s address is “under a healthcare alert or advisory.” But that information is sporadic, at best, and does not clearly convey if the person in need of transport or someone else in the home or at the location may have the virus.

She does not blame the 911 dispatchers for the information void. They don’t always receive updated health status reports from local hospitals or health departments.

In the age of the coronavirus, a dispatcher’s questions — as well as shared information among healthcare officials and first responders — could mean the difference between identifying a COVID-19 case in advance or seeing a first responder or EMT become infected.

Even when a dispatcher asks all the right questions, language barriers and misinformation can still create confusion, according to Osborne. Squads, already working with skeleton crews, may have to send people who are themselves vulnerable to the virus on an ambulance run or ask the 911 dispatcher to find another rescue agency to handle the call, which is not always possible.

Osborne said most transporting agencies in Mecklenburg County can only staff one ambulance per day.

Edmonds adds that fewer young people are willing to volunteer for EMS service or if they do, they will often stay with an agency long enough to complete their training before moving on to a paid position. He admits the squads have seen this problem coming for some time, but hoped it would be another couple of years before the situation became critical.

“We thought it was going to be two or three years in coming, but it’s here now,” said Edmonds.

Another burden cited by Edmonds, though not one tied to the coronavirus, is the rising cost of training and the increase in state requirements for qualification. An EMT must complete 200 hours of training, at a minimum. For a paramedic, training time is closer to a year.

Even amid the pandemic, Edmunds said he is optimistic about the future of the Southside Rescue Squad. “We have 10 junior members who can take the [EMT] test once they turn 18.” He hopes they will continue serving.

For now, to help mitigate some of the stress that rescue agencies are experiencing, Edmonds is also asking the public for help. His first request is for the public to “be forthcoming with answers to questions being asked by the 911 dispatchers because your answers could protect the person coming to your aid from getting infected.”

That’s one more EMT or paramedic that will be available to provide needed medical support the next time a call is made.



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