WORCESTER — Less than two months ago, when Ron Gigliotti, a paramedic, would respond to a 911 call, he would go running into a home to help a screaming child who may have broken a leg, or an elderly person having a heart attack, or to a serious car crash.

Now, he and other paramedics and emergency medical technicians rely on dispatchers for UMass Memorial Emergency Medical Services to ask more questions of callers regarding symptoms of COVID-19 to make sure they have all their personal protective equipment on appropriately before rushing to the scene.

“It’s a complete 180 from what we’ve done before. Every single call you go on now, you have to dress for the occasion. You have to wear full PPE. Regardless of their complaint or injury, you have to treat them as though they’re infected and they can infect you, if you drop your guard. It’s affecting every patient interaction. It’s exhausting and taxing," Gigliotti, 46, a 28-year veteran paramedic and shift lieutenant, said during an interview while in his command SUV parked outside the DCU Center. The convention center has been converted into a 250-bed field hospital to accommodate the surge of patients.

In some cases, he has gone back in the hospital a couple of hours after a transport and was told that the patient had tested positive. That’s when what he calls the “mental marathon” sets in. He begins to back track, asking himself about everything he may have touched and what particular equipment like a stethoscope he may have used with the patient and had he cleaned it; and who the people were that he had come in contact with during that time.

“It’s mentally exhausting,” he said of the repeated mental checks.

The emergency medical services' call center has always had one of the highest volumes in the area. On average, a 911 call comes in about every 45 minutes to an hour. Because people are staying at home and not uses the emergency room for minor maladies now, the volume is down, but the quantity and sickness of patients with COVID-19 is through the roof, Gigliotti said.

“We’re seeing a lot of these respiratory patients … short of breath … they’re very, very ill,” he said, describing his new work normal. “After every call you do like that you now have to decontaminate your truck from top to bottom … and every piece of equipment and anything that we wear that touches that patient. You don’t want to leave a truck that might be dirty and infectious for the oncoming crew."

Sanitation has always been important, but even more so now. Looking out for co-workers — making sure they put on and remove their PPE properly and their vehicles are disinfected — has strengthened the camaraderie among the crews.

“It builds that family bond. We’ve always had it, but it has just gotten stronger now,” Gigliotti said. “Our empathy has gotten stronger than it was before with each other and toward our patients. Everybody is working with the sole purpose of not infecting yourself, your partners and the other population that has to be put in the ambulance.”

Gigliotti rated his anxiety level a seven or eight, on a scale with 10 being the highest level. "Every day its seven or eight. You just live in this heightened state," he said.

The drastic changes and anxiety caused by the unprecedented pandemic does not stop after Gigliotti has responded to his last 911 call for the day.

“You go home, strip your clothes off, run and take a shower and put on clean clothes. That’s become every day. Before, on an average day, after work, you might stop and get some coffee, do some food shopping. I can’t do that now on the front line.”

After work, he and his wife, a nurse for more than 20 years who works in the emergency room at Metro West Hospital in Framingham, share stories of their experiences. In their wildest dreams, they never thought something like this would happen.

“They’ve made movies about stuff like this. As health care providers, we’re living in that reality,” he stressed.

The couple shares everything about their jobs with their children, absent the “gory stuff.” The teens had some anxiety until about two weeks ago, when the family stopped watching the news. Their 18-year-old daughter, a pre-med student at UMass-Amherst, who plans to become a doctor, has already seen 10 seasons of “The Office.” The son, 16, is a football player at Ashland High School, watches past Patriots games.

After a surge of cases of COVID-19 patients two week ago, he and his wife began talking about looking for a retirement home and stepping out of emergency medicine. That would be tough for Gigliotti.

“I love doing this job. I meet so many amazing patients. I make limoncello (an Italian liqueur) for Christmas parties and as presents. I got that recipe from a little old Italian lady that I had as a patient,” Gigliotti said.

But, he understands that nurses like his wife, have a very difficult job because they are caring for their patients for hours and days on end. He thinks there are a lot of nurses who question if they want to continue doing this.

“She is seriously questioning whether to go into another form of nursing where she is not on the front line. Not that we are not prepared. It’s the gravity of it,” Gigliotti noted. “You can run a marathon for so many years. Then you say, ‘Slow down. I’m going to try to walk.’"