A look at COVID-19 from EMS

As COVID-19 numbers gradually soften across the Ozarks, CoxHealth EMS Regional Manager Ryan Verch looks back at a summer unlike any other in his career.

The season is always a busy time for EMS, he says, given the increase in people spending time outdoors. But the overlay of COVID-19 cases, which began to increase in May 2021, added a wild card factor that sent any normalcy out the window.

“In August, things exploded for us,” says Verch.

He shares that CoxHealth EMS was, for the year, more than 4,100 calls ahead of 2020 by mid-August. There were patients experiencing difficulty breathing due to the virus; not just older patients, as were seen in the previous surge, but individuals with young families.

There were others experiencing significant issues due to long COVID cases. There were people who had deferred care from months prior, as they willed themselves to stay out of the hospital for other issues because of concern over the virus.

“If we just went to Kansas City, you figured by the time we load the patient, drive time, stop and get fuel, it’s a minimum of a six-hour transport,” says Verch. “That was one patient taking up an entire shift.”

Thankfully, emergency strike teams from the Missouri State Emergency Management Agency (SEMA) arrived in July to help handle many of those long-haul transfers. But the toll on health care workers, including EMS, was not only due to the increased workload. It was also emotional.

“There is a lot more death than what we experienced before, and a majority of what we’re seeing is younger people,” he says. “And way sicker.

“It's definitely harder for majority of our people. It's been hard because you're seeing so many avoidable deaths every day.”

Things have shifted with time, too. In the pandemic’s early days, Verch says that EMS crews didn’t usually know if a patient was COVID-positive before crews arrived, but they took precautions all the same. Now, it’s normal for patients to know they have COVID before crews arrive. And there are other calls where it’s both.

“There's still some calls where it's being coded as a cardiac arrest and then we get there and the wife's like, ‘Well, we just you know, we both have been quarantined with COVID,’ and then we find out that ‘OK, this ... is probably COVID-related cardiac arrest,” says Verch.

He speaks of patients who have extreme difficulty breathing, but are still conscious when EMS arrives, and say they would like to receive the vaccine. “And it’s like, ‘The answer is, you know, the vaccine is not going to do anything for you now,’” regrets Verch.

“It’s disheartening to know that there’s so many people that would still be alive if they would have just made the choice to get vaccinated.”

In August, others in CoxHealth EMS shared their thoughts on the pandemic and what they have experienced. Even as this wave of the pandemic continues to decrease, please take their words to heart and do what you can to protect yourself, your families and your communities: vaccinate.

“We have gone on a lot of COVID calls, but it was definitely been better after all the strike teams got here. We still go and pick up a lot of patients that have serious COVID symptoms. We do our best. We really do our best. I think this one is worse than the first wave. It just seems like they’re sicker than they were in the first wave,” says Ashley Coonfield.

“We’ve been on quite a few emergent calls for COVID when people are super sick. It limits my access to family members and friends because my girlfriend has (health concerns) and I’ve got to be very careful interacting with her. It’s hard. It’s super hard. Get depressed, can’t see her, and try to talk on the phone and FaceTime. I’ve been in this job a long time – this literally scares me. Right now, with the surge, we pretty much have just kept our distance. I take all the precautions … but there’s only so much we can do,” says Randy Booker.

“I remember before the Delta variant, we were seeing maybe one COVID patient a week and (later) it would be 3, 4, 5 a day. I feel that’s just a struggle. It doesn’t seem to matter what anybody says about it. A lot of people out there; their minds are made up about COVID. The best thing we can do is just (explain) what it is – say, ‘Yeah, it affects everyone differently. Some people don’t get too sick, and other people end up on ventilators.’ It’s such a heated topic for people. Try to have a real, honest conversation with your doctor about (vaccination). Try to not get too distracted with things you hear and see on the internet. A lot of the stuff, you don’t know where it’s coming from or how accurate it is. Try to listen to the real, medical health professionals who are in your community. The best person that can be is your primary care physician. Talk to them. Someone you already trust to make good medical decisions," says Nick Sloan.

“I think everything is busier. Every call is extended by at least 20 minutes by putting PPE on and then there are things you have to do at the hospital which delays your availability to go somewhere else. And then you’ll go out and have another call which is identical to what you just ran. Because you’ve been there 30 minutes instead of 15 or 20 because you have to clean the ambulance, decontaminate it, restock it and everything takes longer. In my experience, the patients are very scared. I always ask them if they are vaccinated or if they are not vaccinated. The overwhelming majority say they are unvaccinated. A lot of them are just genuinely scared. Not being able to breathe – it's a very scary thing. I came in one day on my day off to move a patient and we were gone 16 total hours from when we left the station and moved them to another state – just for one room. That was the closest place that would take them,” says James King.

“I don’t really know the answer to all of this. We’re doing our best. Call volume; you can’t even find time to eat anymore. It’s back-to-back. You’re really rushing to even try to get to the restroom before you go to another call. You’ve got to try and find healthy realities outside of work. A work-life balance on top of all of this. After a shift, whether it’s 12 hours or 24 hours, it almost takes an entire day to reset. Find some normalcy. Do your part. Everyone’s trying. We’re doing the best we can,” says Zach Holstein.