Ski patrolling was the perfect career choice for 34-year-old Leah Lombardi.

“It combined two things I really loved: skiing and helping people,” said Lombardi, who’s worked at Vail Mountain since 2013. She’s married to a Beaver Creek patroller, and they’ve found a mountain-town balance over the last eight winters.

That balance changed as Vail and other resorts stopped their ski lifts last month. Suddenly, both parents were out of work. Just as bad, Lombardi was stuck at home as Eagle County wrestled with an early outbreak of COVID-19.

“I’m sitting here with my background as a paramedic and a firefighter. It’s just really hard to sit on a couch and watch your friends and other people you know go out and help,” said Lombardi. “My coworkers on ski patrol, that’s what we want to do.”

Now, they’ve found a new way to help. More than 20 of Vail’s patrollers are in training to join Eagle County Paramedic Services. It’s part of a statewide response as emergency responders scramble for supplies, adopt new technology and prepare their crews for long, dangerous days.

“With that surge staffing, we could double our ambulance capacity if necessary today,” said Chris Montera, chief executive for ECPS. The ski patrollers will drive and ride in ambulances, potentially allowing the service to activate six reserve ambulances.

For now, his ambulances are actually running fewer calls than usual — less than half the usual number. No skiing means far fewer injuries. It’s the same situation for ambulances in metro Denver, where paramedics report far fewer calls to car crashes. But this may only be the quiet before the surge.

In Vail, the local hospitals have “seen a huge influx in respiratory patients over the past couple of weeks,” Montera said. His service is transporting three to five suspected COVID-19 patients per day, runs that require masks or even hoods with powered respirators for the crew. They’re even having some patients download a “telehealth” app, allowing them to connect via video to the paramedics who are waiting in their driveway.

All of this — including the ski patrolers — is part of a contingency plan that could keep Montera’s service running even if 40% of his staff is sick. ECPS has already had to test nine of its 86 staff members. None turned out to have COVID-19, but slow test results kept some off the job for weeks.

Paramedics in New York City have had to take drastic measures to keep pace with the outbreak. A new directive told them to stop transporting cardiac patients if their pulse can’t be restarted on the scene, The New York Post reported. In Italy, ambulance sirens have become a symbol of constant death.

Colorado’s emergency services aren’t anywhere near that level of desperation, and they’re striking a positive tone for now.

On the Front Range, Denver Health’s leaders are working with the city’s police and fire departments on contingency plans to keep EMS running, according to Julie Arellano, operations captain for the hospital’s paramedics.

“Denver Health has been really supportive of the needs of the paramedic, knowing that we are out in the frontline and, you know, not always in the best condition,” she said.

Like others, the service has seen a drop in trauma calls. But with respiratory calls increasing, its 240 front-line employees and 44 regular ambulances are just as busy as usual.

“I feel like almost every call you're going on, we're being told that the patient is exhibiting some sort of complaints that would be a relative to COVID,” said Denver Health paramedic Justin Loera.

It’s increased “pretty drastically” in the last two weeks he said. The shift has been eerie and frightening. While many people are staying home or minimizing their travel, medical responders are traveling empty streets to the homes of potentially infected people, seeing the crisis play out in a way that few others can. Instead of the short, hectic burst of a typical trauma call, they meet an endless stream of slowly suffering people.

When Loera slips a mask onto a suspected COVID-19 patient, he said, he can see “in their eyes and their facial expression, the fear that they have now.” They’re dealing with claustrophobia and anxiety. Loera tries to comfort them from behind his own mask, but he fears for his own health too.

“It's battling inside — the battle that you have inside your mind, with ‘Is this COVID, or is this maybe something else that's causing somebody to have trouble breathing?’” he said. When he arrives home — even after showering and washing his uniform at work — he wonders with “a sense of guilt” whether he’s exposed his girlfriend and her son. Denver Health officials declined to say whether any EMS staff had tested positive for the novel coronavirus.

The same questions are playing out across the nation. A Facebook page for EMS workers during COVID-19 has gained about 1,500 members since it launched last week. Often, they’re improvising as they confront an unknown threat with supplies that may be inadequate.

“They’re asking about PM2.5 masks and their effectiveness. Asking about different types of plastic you can use on thermometers … because they’re having trouble finding things like that,” said Carol Brown, deputy director for the Center for Health, Work & Environment at The University of Colorado Denver.

The problems can be more prevalent for smaller outfits. In metro Denver, Mile High Ambulance got its last shipment of masks a month ago. Chief paramedic Rob Moore calls his suppliers every day, hoping to secure even the smallest batch.

“I try and order a case, which is what we would usually order. But I'm hoping that maybe I'll get a box of 50 masks — and that's not going to last very long,” he said. Much of the existing supply has gone to the hospitals because “they needed it most,” he said.

The company’s current supplies will run out within a few weeks. Gov. Jared Polis said he is negotiating deals in China for millions of masks, and a new shipment from the strategic national supply arrived Friday. Larger services — like Eagle County and Denver Health — say they’ve secured more supplies.

“We've gotten what we've needed so far, which has been really, really good because I know that there are places that are probably not in that same position,” Arellano said.

Despite his worries about supplies, Moore said he was confident that the health system is prepared. In fact, he’s already taken patients to a newly converted wing of a local hospital.

But even for a 38-year-veteran, the outbreak already has brought haunting sights. This week, Moore’s crew arrived at a Denver-area home to find a couple in their 80s. They were “very ill, and they were really apprehensive,” he recalled

“I think they knew what the problem was likely to be, which was perhaps COVID-19. They'd both been trying to take care of each other, and they couldn't do that any longer,” said Moore, the chief paramedic for the private Mile High Ambulance company.

The couple was in severe respiratory distress and they knew the outbreak is especially dangerous to older people. As Moore’s crew carted husband and wife to the ambulance, he looked around and asked himself a question:

“Will they ever come back to that house?”