'Volunteer Emergency Responders Face a Dilemma: Save Lives or Stay Safe' diff viewer (5/6)

This article is from the source 'nytimes' and was first published or seen on April 26, 2020 21:54 (UTC). It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/04/26/us/coronavirus-volunteer-emergency-responders.html

The article has changed 26 times. There is an RSS feed of changes available.

Previous version 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Next version

Previous version 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Next version

Version 5	Version 6
Volunteer Emergency Responders Face a Dilemma: Save Lives or Stay Safe	Volunteer Emergency Responders Face a Dilemma: Save Lives or Stay Safe
2020-06-08 21:22:52 UTC	2020-06-09 22:00:11 UTC (1 day later)
In Teaneck, N.J., half of the town’s volunteer ambulance corps is out sick, in quarantine or staying home to avoid potential exposure to the coronavirus. The remaining 25 are responding to double the usual number of daily calls, racing from one high fever or respiratory distress emergency to the next.	In Teaneck, N.J., half of the town’s volunteer ambulance corps is out sick, in quarantine or staying home to avoid potential exposure to the coronavirus. The remaining 25 are responding to double the usual number of daily calls, racing from one high fever or respiratory distress emergency to the next.
In Rockville, a Maryland suburb of Washington, D.C., hit hard by the virus, more than 10 percent of the 160-member volunteer ambulance force has stopped taking shifts, either because they tested positive for the virus or because underlying health conditions have forced them indoors.	In Rockville, a Maryland suburb of Washington, D.C., hit hard by the virus, more than 10 percent of the 160-member volunteer ambulance force has stopped taking shifts, either because they tested positive for the virus or because underlying health conditions have forced them indoors.
And in a rural Iowa county with one of that state’s highest infection rates, the Dysart Ambulance Service has just 22 volunteers who share two ambulances, cover 150 square miles and, in the first two weeks of April, responded to far more calls than in all of March.	And in a rural Iowa county with one of that state’s highest infection rates, the Dysart Ambulance Service has just 22 volunteers who share two ambulances, cover 150 square miles and, in the first two weeks of April, responded to far more calls than in all of March.
As the virus has continued its spread into suburbs and rural towns, overwhelming hospitals and emergency medical workers, it also has taken a toll on scores of volunteer emergency response units, many of which are the sole responders in critical and urgent situations.	As the virus has continued its spread into suburbs and rural towns, overwhelming hospitals and emergency medical workers, it also has taken a toll on scores of volunteer emergency response units, many of which are the sole responders in critical and urgent situations.
“Even if the worst-case scenarios from Covid-19 don’t play out, you’re going to have a lot of departments that are in a really difficult spot,” said David Finger, chief of legislative and regulatory affairs for the National Volunteer Fire Council, which represents firefighters, Emergency Medical Services personnel and emergency responders.	“Even if the worst-case scenarios from Covid-19 don’t play out, you’re going to have a lot of departments that are in a really difficult spot,” said David Finger, chief of legislative and regulatory affairs for the National Volunteer Fire Council, which represents firefighters, Emergency Medical Services personnel and emergency responders.
More than 80 percent of the nation’s 30,000 fire departments are all or mostly volunteer, responsible for providing emergency care to about one-third of the country’s population. And while more than 60 percent of the fire departments across the nation provide basic or advanced life support, those in smaller, rural communities — areas already dangerously short on health care and often dependent on part-time volunteers to transport patients to hospitals — are less likely to offer emergency medical services.	More than 80 percent of the nation’s 30,000 fire departments are all or mostly volunteer, responsible for providing emergency care to about one-third of the country’s population. And while more than 60 percent of the fire departments across the nation provide basic or advanced life support, those in smaller, rural communities — areas already dangerously short on health care and often dependent on part-time volunteers to transport patients to hospitals — are less likely to offer emergency medical services.
Many squads said in interviews this month that they were overwhelmed by the challenges. As they struggle to retain members, volunteer emergency response departments have also been hobbled by the cancellation of fund-raising drives that they rely on to keep the ambulances running and the station house lights on.	Many squads said in interviews this month that they were overwhelmed by the challenges. As they struggle to retain members, volunteer emergency response departments have also been hobbled by the cancellation of fund-raising drives that they rely on to keep the ambulances running and the station house lights on.
The financial shortfall is also complicating efforts to buy the gear needed to protect members from infection, they said. With training certification programs and recruitment drives also halted, volunteer corps are now worried about their ability to function long after the infection curve has flattened.	The financial shortfall is also complicating efforts to buy the gear needed to protect members from infection, they said. With training certification programs and recruitment drives also halted, volunteer corps are now worried about their ability to function long after the infection curve has flattened.
“I’ve never seen anything like this,” said Jules Scadden, the director of emergency medical services in Dysart, Iowa, a farming community in Tama County, where an outbreak at a nursing home led to more than 230 positive cases and seven deaths.	“I’ve never seen anything like this,” said Jules Scadden, the director of emergency medical services in Dysart, Iowa, a farming community in Tama County, where an outbreak at a nursing home led to more than 230 positive cases and seven deaths.
“My folks are scared,” she added. “Your risks are so high in the back of the ambulance, and we have a minimum 30-minute transport time so we know we’re back there with the virus.”	“My folks are scared,” she added. “Your risks are so high in the back of the ambulance, and we have a minimum 30-minute transport time so we know we’re back there with the virus.”
Some volunteers in Tama County have stopped taking calls because they are considered high risk or because they were told they would lose their day jobs if they continued riding in the ambulances, officials said.	Some volunteers in Tama County have stopped taking calls because they are considered high risk or because they were told they would lose their day jobs if they continued riding in the ambulances, officials said.
But Jackie Obrosk, a nursing home dietitian, said she has no plans to end her volunteer ambulance shifts with the Dysart Ambulance Service. “We’re our neighbors’ only line of defense between home and hospital,” she said.	But Jackie Obrosk, a nursing home dietitian, said she has no plans to end her volunteer ambulance shifts with the Dysart Ambulance Service. “We’re our neighbors’ only line of defense between home and hospital,” she said.
The volunteers are taking extra precautions — wearing masks and homemade face shields, and putting masks on patients, too. “You just pray that we’re doing enough,” she said.	The volunteers are taking extra precautions — wearing masks and homemade face shields, and putting masks on patients, too. “You just pray that we’re doing enough,” she said.
Ms. Scadden said she also now required members to take their temperature before entering an ambulance.	Ms. Scadden said she also now required members to take their temperature before entering an ambulance.
In Maryland, the pandemic is straining an already overtaxed volunteer emergency response system. Before the virus, the Wheaton Volunteer Rescue Squad in Montgomery County was among the nation’s busiest ambulances services, said Gamunu Wijetunge, the squad president.	In Maryland, the pandemic is straining an already overtaxed volunteer emergency response system. Before the virus, the Wheaton Volunteer Rescue Squad in Montgomery County was among the nation’s busiest ambulances services, said Gamunu Wijetunge, the squad president.
On nights and weekends, all-volunteer crews of nine handle emergency calls. They pull 12- to 18-hour shifts, and many of them are off-duty firefighters and medical professionals.	On nights and weekends, all-volunteer crews of nine handle emergency calls. They pull 12- to 18-hour shifts, and many of them are off-duty firefighters and medical professionals.
As cases continue to climb in Montgomery County — there were more than 3,480 cases and 152 deaths as of Saturday, the second-highest count in the state — the squad has tried increasing its dwindling ranks of 100 or so volunteers, Mr. Wijetunge said, while also barring dozens of recruits who have not completed E.M.T. training.	As cases continue to climb in Montgomery County — there were more than 3,480 cases and 152 deaths as of Saturday, the second-highest count in the state — the squad has tried increasing its dwindling ranks of 100 or so volunteers, Mr. Wijetunge said, while also barring dozens of recruits who have not completed E.M.T. training.
But he said the squad’s efforts to meet minimum staffing requirements have been hindered by local competition: a children’s hospital and a medical school that have told employees they cannot volunteer for shifts during the pandemic.	But he said the squad’s efforts to meet minimum staffing requirements have been hindered by local competition: a children’s hospital and a medical school that have told employees they cannot volunteer for shifts during the pandemic.
Maryland’s governor announced this month that people who had worked as E.M.T.s or paramedics in the past decade would be granted provisional licenses, a welcome relief for Eric Bernard, president of the Rockville Volunteer Fire Department.	Maryland’s governor announced this month that people who had worked as E.M.T.s or paramedics in the past decade would be granted provisional licenses, a welcome relief for Eric Bernard, president of the Rockville Volunteer Fire Department.
More than 10 percent of the 160 volunteers have stopped taking shifts, he said. Some have exhibited coronavirus symptoms, but others are worried their underlying medical conditions could put them at greater risk.	More than 10 percent of the 160 volunteers have stopped taking shifts, he said. Some have exhibited coronavirus symptoms, but others are worried their underlying medical conditions could put them at greater risk.
The ranks have also been diminished by the loss of firefighters too busy with their day jobs and medical professionals forbidden from volunteering by their employers. Mr. Bernard fears those numbers will grow. “We’re nowhere near toward the end of this,” he said.	The ranks have also been diminished by the loss of firefighters too busy with their day jobs and medical professionals forbidden from volunteering by their employers. Mr. Bernard fears those numbers will grow. “We’re nowhere near toward the end of this,” he said.
To reduce the risks of contamination, the department disinfects the station house and its vehicles every four days. But maintaining social distancing is near impossible. “When you have 19 people on a shift in the firehouse,” he said, “you can’t be six feet away from each other.”	To reduce the risks of contamination, the department disinfects the station house and its vehicles every four days. But maintaining social distancing is near impossible. “When you have 19 people on a shift in the firehouse,” he said, “you can’t be six feet away from each other.”
After weeks of searching, Mr. Bernard found nearby hotels to house members who needed to be quarantined or who wanted to avoid potentially exposing their families.	After weeks of searching, Mr. Bernard found nearby hotels to house members who needed to be quarantined or who wanted to avoid potentially exposing their families.
Updated June 5, 2020	Updated June 5, 2020
	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
With recruitment drives and training halted, Mr. Bernard said he was also anxious about the squad’s long-term viability. Like most volunteer departments, Rockville faces a high turnover and his recruits can no longer take classes or ride emergency vehicles required for certification. “When you have a temporary pause like this, how do you recover?” he asked.	With recruitment drives and training halted, Mr. Bernard said he was also anxious about the squad’s long-term viability. Like most volunteer departments, Rockville faces a high turnover and his recruits can no longer take classes or ride emergency vehicles required for certification. “When you have a temporary pause like this, how do you recover?” he asked.