In the trenches: Mobile area paramedics cope with COVID-19 outbreak
An APR News Feature
Mobile County was the first Alabama county to top 2,000 COVID-19 cases. As efforts to deal with the virus continue, first responders and medical personnel face risks they would not have imagined a few months ago. A report from Kaiser Health said close to 600 front line health care workers may have died from exposure to the virus. That includes paramedics who respond to emergency calls involving the coronavirus.
If the COVID-19 outbreak can be compared to a war, places like the Douglas Melton Fire Station are on the front lines. The station is on a quiet street in historic midtown Mobile. But this is one of the hottest spots for coronavirus calls in Mobile County, which has the most cases in Alabama. This has meant changes for paramedics and firefighters.
“The first couple of weeks we were dealing with it, we had multiple patients inside of one house,” paramedic Richard Miller said.
He’s spent most of his career in midtown.
“For us, that involves a lot of units. We have to dispatch a district chief. We had to dispatch a couple of fire trucks, a couple of ambulances, but our main goal there was to send one medic up evaluate the few patients and deal with the people as needed,” he said.
“One of our biggest goals, one of my biggest goals, is to get the minimal amount of people in contact with the patient as possible,” said fire department spokesman Steven Millhouse. "Our whole goal, again, was to protect our firefighters and medics and the public."
He said procedures have had to change as COVID-19 swept through Mobile.
“So reducing the amount of exposure or potential exposure was one of the biggest things, so early on, we may have gone into the house with most of the entire crew may have just rushed in, whereas weeks later, what we’re going to do is just have one paramedic, fully PPE’d up, go in the house and evaluate everyone there and then we’d bring them out and transport,” Millhouse said. “Over time, we decided to start asking the caller or the public or the patient, ‘Can you just meet us outside?’ versus us going into the house and again, we would still just have one paramedic or one firefighter approach that patient, assess that patient to reduce that exposure to everyone else.”
PPEs are the personal protective equipment like masks, gloves, and gowns. You might see that kind of gear on doctors and nurses, but fire fighters and paramedics use it too. Dealing with risks is part of a firefighter’s job. Neil Sherer is also a paramedic at the Melton station.
“It’s been a change and just one of those things that you’ve got to kind of keep in your head,” Sherer said. “We’re in a hazardous job and we knew we were in a hazardous job when we signed up for it and it’s just another level of precaution that you have to take.”
“We’re an all-hazards department and that includes pandemics, unfortunately,” Miller said.
We met him at the beginning of this story. Speaking for himself and Sherer, he said their biggest fear isn’t what happens to them.
“Honestly, yes, we both have young kids. We both have little girls. He’s got two. I’ve got one. I think our biggest fear is taking something home to them, so we’re wearing the PPE, we’re coming back,” Sherer said. “We’re de-conning ourselves. We’re de-conning our units, but before we leave here, before we get home, we have to change clothes. So I think that’s my biggest fear is just taking something home to my daughter.”
Dispatchers ask callers if they have symptoms of COVID-19. In a perfect world, first responders would always know what to expect when they roll on calls. Sherer said dispatchers do a good job, but the world isn’t always perfect.
“It also went from something that, you have a pretty good idea, if somebody’s hacking or coughing outside of this pandemic, you’re going to be cautious of particulates, airborne particulates,” he said. “You’re going to put a mask on. You’re looking for things already, like tuberculosis. If you see blood, obviously, you’re not going to touch it. You’re going to clean it up as soon as you can. But this is kind of… I feel like it takes so long to show signs sometimes, you don’t know, so, yes, it’s easy if they’re symptomatic, but if they’re not, that’s the real mystery here. You treat everybody like they have a disease that they could transmit to you and that’s a good mindset to be in. You never know if it could help you or don’t, because if it does help you then you never know about it.”
Miller said paramedics have to wear things like masks and gloves on all calls since anyone could be carrying the virus.
“Now, we’re able to wear an N95 on every call and we’re putting a surgical mask on a patient, so we’re constantly protecting ourselves now, whereas we weren’t quite doing that in the past,” Miller said. “We’ve got to be mindful of it now, whether they have something or not. It’s like he says, the patient could be sitting here talking to you and not have any signs, but could absolutely have the active COVID inside their system.”
Last fall, no one had heard of COVID-19. Now, in Mobile, the virus has its own dispatch designation. It called a Signal 99. Rescue 8. Sherer said his unit often answers more Signal 99s than almost any other unit in Mobile.
“Downtown, midtown, generally have a lot of medical calls like that,” he said. “You have a lot of calls down the Parkway, a lot of them downtown and that’s obviously breeds more COVID cases, not necessarily a COVID hotspot, but a busier area in general.”
Miller said the area has a lot of people and some do not have much access to medical care.
“The concentration of people is just, everybody’s right on top of each other. The homeless population down here,” Miller said. “They’re downtown, we’re basically downtown. We’re considered midtown, but we run downtown a lot with the downtown engine, so we end up down there with a lot of the homeless.”
First responders have learned a lot about dealing with COVID-19 calls, but Millhouse said much remains to be done.
“We think we’re in a pretty good position right now,” Millhouse said. “Right now, it’s just dealing with not letting ourselves get complacent, just consistently reminding firefighters and paramedics that this is still a very real situation. It’s a very real virus. Things will open back up and the public may have a different perception about it, but our perception is still to protect ourselves and protect the public as best we can.”