If you’re a current subscriber, log in below. If you would like to subscribe, please click the subscribe tab above.
Username and Password Help
Responders in a pandemic: Behind the scenes with the Fire Rescue & EMS
AMANDA BROWN SNOWDEN
It is often assumed that first responders in a small town spend their days living in an Andy Griffith episode. Maybe they teach a lesson to a young boy or save a cat from a tree, but nothing ever truly happens in a small town, they’ll say.
However, every shift as an emergency services provider has the potential to be intense. Some days are quiet, some days are chaotic.
Even in a small community like La Salle County, a day’s events can put professionals to the test. Whether their career spans 30 days or 30 years, the experiences of the job from day to day can change everything. Where there are people and space, there are emergencies to be dealt with.
COVID-19 changed the world, from the big metropolitan areas to the small rural community. A new sickness, with no history to have learned from, and inconsistent details from early infections left everyone scratching their heads, but the La Salle County Fire Rescue team was ready to press on. An essential part of the service’s work is safety and prevention.
COVID-19 came in like a raging wildfire.
Cindy Williams, the EMS coordinator, points out that anyone who had immune problems of any kind, or pregnant, was first just asked not to come to work. Immune problems include her.
“If you’re at a higher risk like that, it can be so much worse, so right now I monitor calls and there’s some I just can’t go on,” Williams says. “I know they’re out there, and I can’t go out there and be with them and be front line.”
Williams says there are three on the team at that rank, so they do well managing it. As the EMS coordinator, she is responsible for knowing the information and working out protocols and protections.
It’s Saturday at the fire station in Cotulla. There’s a loudspeaker, so when the emergency dispatch comes over the radio, you can hear it from just about anywhere. The scene through the windows is interesting: a cup sits half-filled with soda from the can sitting next to it. The smell of a half-chopped onion on a cutting board actually wafts to the outside. It seems the makings of a good burger or taco night were ready to go, as evident from a large package of ground beef tucked away. The TV is on, still playing a football game, but nobody is home. You’d expect that someone would walk out at any time, until you realize that the ambulance and fire trucks are coming around the corner, returning from their recent dispatch. The resident cat waiting outside seems completely unfazed by the loud engines and commotion of unloading. He is much more interested in the food that’s been brought for the crew on shift tonight.
As it turns out, the timing is convenient. The ambulance that just responded to an accident in Cotulla came from Encinal because the ambulance from the Cotulla station was already on a call elsewhere. La Salle County Fire Rescue is available 24/7 in both the Cotulla (Station #1) and Encinal (Station #2) locations. Everyone responds accordingly but also backs each other up on calls. Jacob Galindo explains that even when there aren’t serious injuries requiring medical transport, or all the fuss of an emergency itself is over, firefighters tend to stay on a scene where fluids from vehicles are present. There is always the potential for a fire after the fact.
Galindo talks while everyone adjusts gear and masks.
“Oh yeah. Used to, a box of masks would last you probably a month, or even more,” Galindo says. “Now, in a shift, which is two days, a whole box is gone, easy.”
The responders show that their pockets are stuffed with all kinds of masks. Andy Flores takes out an assortment containing his decorated mask with firefighter graphics, as well as a collection of N95 masks, wrapped and unwrapped, from untold cargo pockets. Preston Hutchings says he always keeps one in his pocket in addition to the one he is wearing, as well as several in the front seat of the ambulance, in addition to the boxes in their supplies.
“One day, I broke my mask four times at just one location,” Hutchings says.
In another time, masks were necessary if there was an active case of tuberculosis but otherwise weren’t extremely common. Now, every call requires new masks, and each of those calls is usually handled the same.
“Put a mask on everyone and pray for the best, because you go into every situation assuming everyone has it,” Hutchings says.
It doesn’t stop at masks, though. Upon returning to the station, vehicles are cleaned and sprayed down with disinfectants. Everyone speaks at once as they explain how they often wash and rewash their hands on arrival, and they make lighthearted comments about soaking each other with disinfectant.
“Everything in the ambulance is probably sticky from the disinfectant, but it’s really clean,” Hutchings says.
All employees at LSCFR also have to be COVID tested regularly.
“At the least, every time there’s free testing here, we all get tested,” says Kea Neve. After a joke about being able permanently to feel the test swab in her nose, she adds, “I mean, we know more now than we did before. You just really have to be more mindful when you’re making your decisions.”
First responders often go to calls without a lot of upfront information and are regularly exposed to people of all kinds, from many places. There are more protocols now than what their work used to require. Often, the responders will try to send only one person into a house to assess a situation or do their best to bring a patient outside. If possible, they will try not to go into the homes at all.
These protocols don’t always work, of course. Hutchings tells of a recent medical alert call from an automated system, and there are no details before they arrive.
“Well there was a fall,” he says. “We knocked, tried to get someone to answer, but they can’t get to us. So one of us has to go in. I wound up making it in through a window, but I rolled through and onto the couch, so then you’re sitting in the room and in close contact just evaluating this person. And it was a fall, but then the patient is coughing, so it’s possible they have COVID. There’s no fever, but that doesn’t mean it’s not COVID, and I just had to roll around in their living room before I could even get to them.”
A story follows of a car accident where the call came 30 minutes later that the person treated was, in fact, COVID-19 positive.
“But now in an accident, you wear more personal protective equipment,” says Albert Maciel, “because there’s more potential for a situation like that.”
When asked about their personal feelings, the answers come quickly.
“Before COVID, we had one patient, a flu patient, that we had to lift assist,” Galindo says. “At that point, we’re probably all gonna get the flu. It was a concern previously, but it’s like… reality now,”
“Yeah, you can potentially, physically, take something home,” he adds.
“You bring home bad stuff now,” Hutchings says. “You’re taking more steps to stay safer, but you are exposing your loved ones.”
“Well, COVID, it’s more contagious,” Neve says, “but you also have the patients who just have no signs or symptoms, so you don’t know.”
The firefighters and medics tell stories of their shifts in the early days of the pandemic, about arriving home and changing clothes in the garage and running straight to the shower before they even speak to anyone. Each of them has a family at home. There are children, elderly parents, or even the immune-compromised when the emergency responders return to their families.
By all appearances, though, they’re faring better now. They simply know more now than they did before, and the answers don’t change as often. At the beginning, the stress was extreme, they say, because there were no answers. There were times that the job included being at locations taking temperatures, but there were no mask mandates. Then came masks, but medics don’t wait at the doors to take temperatures anymore.
“It’s a whole other level of being dynamic,” Hutchings says, “because everyone is stressed, and information would change so fast it was hard to keep up.”
For some time, as each shift began, there were new protocols. Twenty-four hours into a shift, there were changes again. At times, they said, from one call to the next, information would change and therefore protocols changed for the next call.
The responders recall a day that their protocols were different in the morning from protocols at noon, which were then different again in the evening. In some cases, the difference between La Salle County and Frio County were highlighted during a call, as La Salle County transports medical patients to Frio, but Frio County has different medical directors, and therefore different orders and procedures.
Finally, nine months into the pandemic, there was enough information that responders have an easier time keeping everyone safe and working together. Early in the pandemic, if a shift had an exposure, five people on that shift might be sent home.
“Of course, over twenty calls happened that shift after they all had to leave and we were shorthanded,” Neve says.
In the early stages of the pandemic, when there was a known exposure, responders who were sent home couldn’t quarantine there. As they had limited information about the illness, they stayed away from home for a week, in isolation, simply in holding.
Neve says that at least now when she goes home after a shift, she isn’t afraid to do simple things like taking her jacket into the house with her.
“We never panicked,” Neve says. “But nobody is worried about themselves, just taking it home. If I get it, statistically I’ll be fine.”
“Thing is, statistically, well, you know – I have a friend took it home to his wife, he’s a nurse,” Maciel says. “They both got it, and they got over it, but the wife has never smelled anything the same again. There’s still long-term effects.”
Many of them know other people who also work in emergency services, or as hospital staff, and they’ve heard numerous stories that contradict those statistics. These include instances of people continuing to test positive for months afterward, or who continue to suffer long term effects of the coronavirus.
“No matter what, it’s still in the back of your head,” Flores says. “Now we know what’s going on, at least, more than before, and now we’re used to it. At least as used to it as you can be.”
“Desensitized,” Hutchings says. “You’re front line, a first responder, you’re in on it.”
“And it’s about knowing and use of resources,” Maciel says. “When it all started, it was respiratory. But then you had patients, you know, presenting to the hospital with abdominal pain, and those turn out to be COVID patients, too. But at least we know that now.”
The emergency responders are somber-faced when they admit that many people simply look at them differently now because obviously they’ve been exposed. The stories overlap each other as each talks of personal and medical appointments that have been cancelled, or the sudden wide eyes, the step back, and the fear in response to their answers to COVID screenings. Each shift has had exposures, some lucky not to contract the virus, some not so lucky. They also tell of seeing patients who have been the picture of perfect conduct, who left home only one time in months and caught the virus anyway.
“That’s why I think it’s interesting,” Hutchings says. “We’re all working around it constantly. But we have PPE, we treat it like a real disease, and we’re prepared, and that’s maybe the difference.”
Do they still love their job?
After a pause, the reaction is unanimous, and it’s positive.
“Despite the problems,” Flores smiles.
Sometimes, at the end of their shift, emergency responders swear they aren’t coming back. Yet, four days later, here they are. The passion they have for their work is palpable. None would trade this job for another.
At the end of the day, La Salle County’s firefighters and medics have the same advice: You don’t know who has the virus but doesn’t have symptoms, or who has touched a surface before you. You should be cleaning everything a thousand times more than you would before. Take precautions. Disinfect. Clean. You’re only as safe as you make yourself. Just go into it prepared, and it helps.
Much the same as they handle their calls, you must assume in life that everyone has the virus, pray for the best, and go from there.