Under pressure: EMS units step up during crisis

Firefighter paramedics David Hernandez and John Hudson work the C Shift Friday morning responding to emergencies at Brownsville Fire Department Station 9. These EMS workers started their shifts at 8 a.m. and will work a 24-hour shift at the station. (Denise Cathey/The Brownsville Herald)

“Hero” is a word that gets tossed around a lot these days, but when it comes to the EMS teams risking their health and even their lives as the pandemic rages, it totally fits.

Like the doctors, nurses and other caregivers grappling with COVID-19, Emergency Medical Services personnel are under a great deal of stress as they do their jobs while also worrying about the safety of their loved ones.

Brownsville Fire Chief Jarrett V. Sheldon acknowledged the situation has been tough on his people, a fair number of whom have become infected with the virus, though thankfully most are recovered and back at work. Stress and anxiety among the ranks are a reality, though, while morale among care givers in general has taken a beating these past months, he said.

“They’re dealing directly with these COVID patients,” Sheldon said. “They’re worried about their families at home. … It does put stress on our system, but we have professional paramedics and they’re doing a great job. They’ve really stepped up to the plate here and they’re really providing a great service to the community.”

BFD has EMS units assigned to all but two of its nine fire stations and is currently running eight ambulances with about 170 EMS-certified personnel, he said. That number will increase soon to around 205 once training is complete for additional personnel, Sheldon said.

In a case of good timing, before anyone knew the pandemic was on the horizon the Brownsville Fire Department received a grant from the Federal Emergency Management that allowed the department to add 15 more firefighters to the street, and a total of 19 new personnel have been added over the past two or three years, Sheldon said.

While EMS has seen its call volume spike since the virus has tightened its grip on Cameron County, in late March and April when it first struck calls actually dropped off significantly — from 80 to 100 on a typical day to a mere 30 or 40, he said. Sheldon said he thinks it was because people were afraid of catching the virus at the hospital or doctor’s office.

With reopening, however, COVID-19 numbers increased and so did EMS calls. BFD had already created continuity plans, including ordering personal protective equipment, to be able to continue operating without overwhelming the system, he said.

“We were watching the national trend,” Sheldon said. “We were watching what was going on around the world, the shortages. So we kind of got ahead of that game and started warehousing and ordering plenty of PPE to ensure that we weren’t going to run low.”

The pandemic itself has resulted in “somewhat of a paradigm shift” for BFD in the sense that it presents an opportunity to look at operations and make changes that likely will benefit the community long term, he said. For instance, a paramedic has been added to the dispatch center, which helps calm anxious family members on the other end of the line and allows EMS to get answers to questions that determine whether an ambulance is needed and what type of care — doctor’s office versus hospital for example — is best for the patient, he said.

It’s already been a big help, Sheldon said.

“We were already working toward it but the pandemic caused us to pull the trigger a little faster,” he said.

BFD has also added a “paramedic in a pickup truck,” who assesses callers at home in cases where an ambulance and crew isn’t necessarily required, Sheldon said, comparing it to “triage on wheels.” The paramedics in pickups and the dispatch center will remain regular features of the department from here on out, he said.

Firefighter paramedics David Hernandez and John Hudson work the C Shift Friday morning responding to emergencies at Brownsville Fire Department Station 9. These EMS workers started their shifts at 8 a.m. and will work a 24-hour shift at the station. (Denise Cathey/The Brownsville Herald)

As far as the spike in virus-related call volume, Sheldon said BFD has a mutual-aid agreement with surrounding communities in case one department is overwhelmed, but that it can’t rely on that too much now because “everybody’s in the same boat here.” BFD requested and received EMS assistance from the county and the state, and for a couple of months had help from relief ambulances and crews from other parts of the state with lower call volumes, he said

“Once those units left FEMA was able to send us some ambulances, so right now we have ambulances from around the country that are assisting here, Cameron and Hidalgo County,” Sheldon said.

The peak in Brownsville EMS calls in Brownsville was early to mid-July, when the dispatch center was getting 110 to 120 calls a day, he said. While that might not sound like much more than normal, the need to disinfect the ambulance after every transport adds about 45 minutes to each call, which puts more stress on the system, Sheldon said.

For a time, with hospitals at or over capacity for COVID-19 patients, ambulances crews were having to wait up to six hours just to get their patients into the ER, though that situation has largely been alleviated as hospitals have found more capacity, he said. EMS has also seen a big increase in calls for people who have died at home, Sheldon said, noting that home deaths per day are pretty much in line with the county’s hospital deaths per day.

“We can only suspect that they’re COVID-related deaths but we can’t confirm it. … But we have seen an increase in deaths at home,” he said.

Before the pandemic, EMS might get 17 calls a month for death or cardiac arrest at home, though now that’s more than doubled, Sheldon said.

“With this virus they’re still learning about secondary illnesses that are caused by it,” he said. “I know there’s been a lot of talk about the virus causing strokes and long term effects, the respiratory issues. I think we’re still learning every day.”

Sheldon said it’s very important that people call 911 if they’re experiencing severe symptoms.

“If you’re having chest pains, if you’re having that shortness of breath, if you’re having stroke symptoms, don’t want to seek medical attention,” he said. “The longer you wait the more severe that it can become.”

Sheldon said he thinks the measures the city of Brownsville and Cameron County have put in place to stem the spread of the virus are beginning to have an effect, though that’s “not to say we’re in a better place right now.”

He appealed to residents to obey mandates and recommendations for facial coverings, frequent hand washing, social distancing, sheltering in place, avoiding crowds and even avoiding family gatherings at home.

“This is about taking care of each other in the community,” Sheldon said. “It’s out there everywhere. People may not even know they have it, so follow the recommendations. Follow the guidelines.

“I know it’s difficult, because a lot of people have this fatigue sometimes from sheltering in place, but the only way we’re going to get back to a little sense of normalcy is if we follow these guidelines. It is difficult, including myself. I haven’t seen a lot of my family in quite some time, because I’d rather have them safe and healthy and be able to celebrate later on.”