Thursday, June 11, 2020

Preparing for the Next Wave

 I read a great article about how to improve our response to COVID-19 when the second wave arrives (as most people believe it will) in the fall or sooner if social distancing and state reopenings fail.

How the world can avoid screwing up the response to Covid-19 again

I would like to add how EMS can improve its response during a second go-around.

  1. Test the EMS workforce for COVID-19, and then maintain testing on a regular basis. Quarantine those employees who test positive even if they are asymptomatic.
  2. Provide comprehensive and updated education to the EMS workforce on COVID-19, not just so EMS can understand the signs and symptoms of the disease and how it is most easily transmitted.
  3. Provide education to the EMS workforce on COVID-19 so EMS can then teach patients who we encounter on the safest practices to reduce risk.
  4. Induct EMS into the public health army. Consider training EMS workers to administer COVID tests to those with limited access to health care.
  5. Put non-transport protocols with strict medically approved criteria into place to be activated should hospitals start to be overwhelmed.
  6. Accumulate sufficient stores of N95 masks so EMS workers do not have to wear substandard surgical masks.
  7. Have hospitals equip their ambulance bays with “foggers” that can be used on ambulances to decontaminate the rigs in between trips. Many hospital EDs defog the ED rooms in between suspected COVID patients.  Ambulances, which have much more confined spaces and see more patients over the course of a day, could also benefit from “fogging.”
  8. Provide early warning to EMS of upticks in cases. I know already many in EMS are slacking as our case load as significantly dwindled. We have seen more failure to wear PPE in recent weeks for patients who turned out to be COVID positive than we did when everything was going crazy and everyone was assumed to have COVID.  When cases start to rise again, put out alerts.
  9. Tell us the truth. Don’t bend the laws of science to protect the the availability of the workforce (or service) by putting individuals at risk.  Don’t tell us surgical masks are safe enough.  Don’t tell us that being in a confined space with someone with COVID while not wearing a mask is not an “exposure” if we were only there for 15 minutes.  Respect us.
  10. Work to see that testing positive for COVID-19 is covered by worker’s compensation and that EMS doesn’t have to prove they received COVID-19 on the job versus off-the-job.

Note:  These recommendations are not targeted at a specific service, but meant as a general response to all services and hospitals involved in EMS, as well as public health experts and state and federal officials.