COVID-19 fear discrimination among first responders. Is this the new form of discrimination?

Firefighters tell EMS they must vacate their station immediately even though they have no symptoms of the virus.

As if EMS didn’t have enough to worry about already, EMS faces a new enemy in the fight against COVID-19, and its not what you think it would be. Its not a shortage of PPE (personal protective equipment) or lack of decontamination supplies.

photo credit Matthew Henry

I’m a paramedic working in the middle of the COVID-19 pandemic in central Texas. Although we are not getting hit as hard as other parts of the country we are in the fight just like everyone else. This week I was told to leave one of the fire stations that I have worked in over this past year by fire department staff simply because I’m an EMS provider. I have never tested positive for COVID-19. I don’t have any symptoms of it and neither does my partner. It might not seem like a big deal to you if you’re reading this, but to us being asked to leave our station is a huge deal. My truck/station has been reassigned three times in one week because nobody knows what to do with us. This is not okay. Why in this day and age have we let fear take over our ability to make rational decisions? Furthermore, why am I being treated like a refugee when I’m needed the most by those who are on my own team?

During times of crisis when EMS is needed the most by the community, we are being shown by other departments that we are needed the least. Incidents like these prove that we as EMS providers are at the bottom of the public safety food chain. Is this the new norm? We wouldn’t tolerate any form of discrimination in the workplace whether it be based on race, gender or sexual orientation. So why would we accept this new form of discrimination now?

one of the rooms we were offered at our new assignment

Here is a photo of a room in the new warehouse where we have been assigned. We were originally told it would be temporary by management but now it is sounding like it’s permanent. There are no beds, no showers, no internet, no computer, no recliners, no kitchen, no stove, no TV, and no people around except for those we can hear through a wall. Images of Milton in his downstairs basement cubicle in the movie Office Space become all too similar. Some staff members next door used to walk in to use the microwave in the room next to ours but they don’t do that anymore. This is most likely because they are afraid to get close to us. Some inmates who live in a jail cell actually have better conditions than this. This is our punishment for what we do 7 days a week. Should we accept this as our fate because we work EMS and we are not firefighters? We run the same calls they do.

I have been in EMS for 22 years. Ever since I started working EMS we have always been treated by other agencies as the service that gets shoved into an unwanted storage locker like the one you see pictured above but we are still held accountable to the same or higher standards when it comes to patient care no matter what type of emergency we respond to. In most parts of our county we are the only ALS (advanced life support) asset. We get the least amount of money when it comes time to budget adoption. Even though we are responsible for saving lives, we currently have the least favorable retirement of all 3 public safety organizations (police, fire, ems) but we still have the non-judgmental drive and passion for what we do regardless.

Taking a toll on first responder well being and mental health

Stressed. Worried. Anxious. We dealt with all these issues as EMS providers long before the virus came to town. These are even more prominent now that we have to worry about the virus and whether or not we will encounter it on our next call. Will my next COVID-19 patient require an aerosolized breathing treatment that will dramatically increase my exposure? Will I have to intubate a COVID-19 patient? Will I bring this home to my family? We are slowly starting to understand the science behind the virus as researchers disclose information on this evolving situation.

Embarrassment and shame. 3 other EMS providers and I were kicked out of a fire station simply for the work that we chose to do. What will other people think of us? When will we be allowed back? Will I be in this small room permanently? We used to be part of a team now we are not part of that team for something we had no control over based on fear. A lot of these feelings are going through the minds of first responders across the country and you are not alone. I don’t believe that this decision reflects the sentiment of the majority of people of the community, however. Most people in the community are very appreciative of the work we do. People wave more as you drive by in the ambulance. While shopping at the grocery stores people thank you for your service more than they normally would.

Unfounded Fears

“Medics who work in the county also work in the city and there are more cases in the city” Our medics who currently work our truck in the county only work in the county. We do not rotate into the city. There is no evidence that there are more cases per capita in the city versus in the county. There is community spread in our county and the local health authority has identified that there are 3 areas but has not disclosed where they are. We have been trying to find out where the clusters or outbreaks are but the information has not been disclosed.

“We can’t practice proper social distancing because there are too many people in the station.” There is plenty of room for social distancing in the station we were removed from.

“Medics are not full PPE on every call which means they are going to expose me to more stuff” Due to having 2 different PPE policies this has allowed for confusion. The fire department we respond with wears PPE on every call no matter the patient complaint or location to include traffic accidents and falls due to their policy. Some firefighters think that we are blatantly disregarding PPE policy when that is not the case. We know that we have a limited supply of PPE and we want to conserve PPE for calls where it is necessary which is why our department adopted a more rational PPE policy. We also understand that there is a national shortage of PPE and don’t want to have to purchase more if we don’t have to. Purchasing more PPE due to waste means other first responders across the country cannot get the supplies they need.

Here is why EMS getting removed from fire stations is a big deal….

Here in Travis county we have 7 other station configurations outside of the city of Austin with shared EMS/Fire quarters and 22 stations in the city with shared quarters. What would happen if every fire department across the county decided that they did not want ems in their stations due to fear? If the fear ran rampant city and county emergency officials would have to scramble to find almost 30 new stations for ems immediately. The cost of this would be astronomical. Eminent domain requests would have to be issued. This is happening in our county and is most likely trending across the country and administrative officials need to deal with it promptly.

First responders aren’t the only medical providers facing fear discrimination however. Right now, it doesn’t matter where you are in the country or even the world for that matter. Out in public, nurses report getting weird stares from people who probably wonder “Are they contaminated? Are they wearing the same clothes from their shift? I’m sure these medical workers have been around sick people. Maybe they will give me whatever it is their last patient had.”

You are hearing about nurses, doctors and first responders who are being discriminated against by their landlords also simply because they are fearful of healthcare providers spreading the virus to others. Some hotels have created first responder discount rates for first responders to stay in during the pandemic so that they don’t have to go back home and risk spreading the virus to others which is a great idea. Some departments are looking into adding temporary lodging to their budgets in the near future. This is something as a society we will have to cope with. Healthcare personnel and first responders right now are in the heart of this fight and the community must support them. Asking them to leave because of the profession they chose is ethically wrong. These medical providers are already under enough pressure as it is. Let’s not add to it by removing them from their workplaces or their homes simply because of the line of work they are in.

Here are some pertinent facts about our fight against COVID-19 to dispel some of the rumors

· According to Dr. Pickett a local health authority on the spread of COVID-19, “briefly being in contact with someone who might have COVID-19 does not carry significant risk, including shift change in a station. Being in the same classroom is low risk of transmission of COVID-19.”

· As of the time this article was published, patients who are symptomatic in our community who receive a COVID-19 test due to having symptoms such as cough or fever are 5% likely to test positive

· Our department has enacted universal temperature monitoring and is erring on the side of caution. We must take our own temperature at the start of shift and before the end of our shift. Any provider with more than a 99.5 fever regardless of symptoms must leave work immediately and not return for at least 2 weeks.

· Our ambulances are decontaminated after every suspected COVID-19 case in many cases beyond the CDC standards using foggers

· We wipe our ambulances down at the beginning and the end of every shift with disinfectant wipes

· There are no shortage of COVID-19 tests in our area. Every first responder who is symptomatic gets a test.

· In our community EMS Responds to the same calls that firefighters respond to no matter the patient complaint and are exposed to the same patients we are

· There is no evidence that there are proportionately more COVID-19 patients in the city versus in the county. There isactually an abundance of nursing homes in our district that do not exist in the city.

· There was plenty of room in our station to practice social distancing and we have plenty of room to do that now

What would the community think?

Most Fire department ESDs in Texas are managed by ESD board members who are appointed by county commissioners. Would they support removing EMS from these stations when they are needed the most? Would they be okay with increased response times from EMS in certain districts due to this division and fear? What about the city councilmembers who represent the cities that are within these districts? Many times changes like this are due to political pressure from labor unions themselves and not the fire chiefs which is most likely the situation in this case. Due to the power of some labor unions administrative officials give in to their requests.

Most fire stations are paid for by bonds funded by taxpayers for emergency medical services and fire service not just exclusively for firefighters of a specific department. Some interlocal agreements even spell out how living situations work and who pays for what. Bonds that are issued to pay for these stations are often passed by local ordinance and voted on by members of the community. These ordinances spell out the purpose of the construction of the station. This should also be taken into consideration prior to putting the bond out to a vote.

Recommendations for improvement (Strategies for public officials to mitigate this threat)

· Lobby for new countywide ordinances that make it against the law for any taxing authority to discriminate against EMS providers simply for the line of work they are in

· Adopt universal system policies for PPE and safety guidelines so that there is not a misunderstanding of different policies and who may be violating each policy

· Interlocal agreements set forth by city and county governments need to address station and living situations among their first responder organizations when the contracts are created. They also may need to be revised occasionally for improvement. Sometimes interlocal agreements can set forth the amount of money allocated for EMS Service stations.

· Educate first responders about how the virus spreads by experts not through panic and the shadow of fear but through science and data. Fear can be a good thing up until a certain point. Don’t let fear drive all of your decisions and don’t allow it to divide your team.

· Local county commissioners, city officials and even state reps may need to pass emergency ordinances to prevent labor organizations and administrative officials from segregating EMS from their response stations.

· Don’t deprive those who are there to do the same job that you are there to do. Instead come up with realistic strategies that do not segregate first responders from other departments

· Improved lines of communications that works from bottom up and the top back down not only between administrative staff on both the EMS and Fire dept organizations. Labor unions also need to be involved in the conversation from both EMS and fire to prevent things like these from happening.

· EMS departments should allocate funds in their budgets early and implement plans alongside the expansion of Fire Departments so that agencies aren’t scrambling at the last minute during times of crisis to find a place to house them.

This article was not written to downplay the severity of the virus but instead to raise awareness of the effects fear can have on the lives of first responders due to the virus and the trickle effects these policies create. EMS departments and EMS associations should not accept this form of discrimination for what it is and should fight for their employees to have the same working conditions they did before the virus infiltrated their communities. EMS does not deserve to get kicked out of the communities they are trying to serve. We deserve better.

Please sign this petition if you think EMS is a vital part of our community and should not be removed from fire stations.

Do you care about this topic? Sign the petition to demand change

About the author

Damon Fogley currently works in Travis County Texas as a paramedic in the Lake Travis Community. His opinions do not represent the opinions of the department he works for or the association he belongs to. He has served as an elected official in Hays county as a councilmember for the city of kyle, public safety commissioner, and hays county emergency communications executive board member and holds a masters degree in public administration from Texas State University.

Other related articles and links related to this topic..

The Alarm Has Sounded A Descriptive study of Performance Measures of Fire Department ESDs in Travis County