I write this from the cab of an ambulance that I have been placed in for the day. Waiting on bated breath for the next 911 call to come in. It’s only Tuesday but I have already worked 30 hours this week. Despite primarily being a professional whitewater kayaker, I am also a Paramedic at an EMS county agency in the Upstate of South Carolina. I love being able to have a split life and keep my brain moving while working EMS. So far, we have been “lucky” during this Covid-19 outbreak. I never imagined being able to say that I worked on an ambulance through a worldwide pandemic, now we are all living through it. I have friends throughout the country who work in the medical field and we have all been touched and changed by this pandemic, in some way.

How infectious is it?

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But, some people who aren’t in healthcare are still skeptical if this is worth it. If crashing the economy and putting millions of people out of jobs is really worth it. This isn’t just the flu. If you don’t understand how infectious this virus is, here is an example. Not too long ago, we (EMS) were called to a household in reference to a breathing problem. Upon arrival, a family member met us at the door noting “We are in quarantine, I went to a party a week ago and three people from that party have tested positive. My family member is having a hard time breathing now but he hasn’t left the house, he can’t have Covid.” The man was able to walk out of the house but he was sick. He was struggling to breathe and had a fever. We donned our proper protective equipment and used the necessary precautions. We treated him as a possible covid positive patient and went from there. Despite the man never leaving the house, he was a positive covid test, his family member had brought it home and transmitted it to him.

That is how infectious it is. If someone has it and touches a box of cereal in the store and puts it back, the next person brings that box of cereal home with them and transfers it to anyone in the house. Breaking the chain is as easy as constant hand washing and distance from other humans. If I get supplies from the store, I bring them home and immediately wipe them off with disinfecting wipes. I am just doing my part to break the chain. I want the World to get back to normal just like the rest of us.

The EMS crews that are transferring the covid positive patients from the hospital to rehab facilities are dressed like they are transporting hazardous material. Technically speaking, they are. The Paramedics are uncomfortable, hot, and can barely breathe. Then, they are taking care of patients who are legit sick. If these patients end up on a ventilator, 60-80% of them will never breathe on their own again.

Is this the patient?

For all of you desk warriors, (thank you for the work you do, computers are hard) imagine every computer you touch could make you sick. Imagine if you downloaded an app and it physically gave you a really crappy virus. Now, imagine that with humans. Every patient we see in our ambulance needs us for a reason. They could have simple symptoms, a cough associated with fever for 5 days but say they haven’t been in contact with anyone for over two weeks. Is this the patient that is going to make me sick? Is this the one that’s going to put me on administrative leave for two weeks? We wear surgical masks at all times now. Think about being that patient, in their worst time, having two Paramedics stare down at them, unable to read their facial expressions. That patient thinking, “Do I have the virus? Am I going to die?”. All of us scared for different reasons while still taking the best care of our patients we can.

Building rapport with my patients is one of my favorite things to do. Surgical masks create a complete barrier to my most positive attribute, my smile. Now, we all have to find different ways to non-verbally communicate with our patients. It is a trying process and I am sure some of us are better at it than others, but it is a communication barrier that many of us have not had to encounter before this time. How do I keep a distance from an elderly woman who wants to pray for the EMS crew or needs her hand to be held to give her courage while she is ill? Even more changes to the job I thought I knew, after being in it for over ten years.

Family members like to accompany their loved ones to the hospital. This can’t happen. Imagine your loved one being whisked away in an ambulance while they are having a heart attack, knowing that family member will be alone in the hospital after they go to the cath lab. They will be alone for the whole time they are in the hospital during recovery, other than the doctors and nurses who take care of them. Covid positive patients die with only a nurse holding their hand if they even get that while closed off in their negative pressure room. Family members Facetime in to watch them take their last breaths. Then, there won’t even be a funeral and the nurse has more patients to care for.

Constant operational changes.

For reference, because this is a “novel” virus (meaning it hasn’t been documented in a human prior to now), we don’t know much about it. The CDC communicated little guidance and administration in healthcare has been making decisions without strong national assistance. Everyone is rapidly learning about this virus and trying to do the best for the greater good.

Close your eyes and think about going to work every day only to have one or two integral parts connected to your work, completely changed. That is how it is every day in healthcare during this pandemic. One day we are told to wear our PPE (personal protective equipment) only with certain patients. Few days go by and we are advised to wear our masks always despite being with a patient or not, no matter what their symptoms are. These changes are to protect us, the crews walking into these patient’s houses. Protecting us from the unknown, as much as we can. Our protocols (what we are allowed to do in the back of our ambulance) are ever-changing. We need to add a HEPA filter when we do certain airway procedures, we can’t do some invasive procedures without first calling a doctor since this pandemic started. We have new medications that have been rolled out to reduce our exposure. None of these facts are going against our administration. Our administration is making these changes to keep the crews as safe as they can and keep ambulances on the road. They are doing everything they can in a rapidly changing environment. The best for the greater good and for that, we are thankful. It is, however, additional stress on healthcare that most people don’t think about.

Personal hygiene.

I work 12-hour shifts. I drive what has come to be called our “covid car”, a 2004 Subaru that was gifted to us. It only drives from my house to work and back. I come home, after being put through the wringer, to strip down to my nudies, outside of my house. I put my effects and boots straight into a box, spray disinfectant in the box and put the lid on. I pick up my clothes and throw them immediately into the washing machine. I run, in my birthday suit, straight to the bathroom for a scalding hot shower. I don’t say hi to my husband, I don’t get a drink, I don’t pass go, I don’t get a welcome home kiss. Not until I have washed off what I may have brought home with me, in my hair or on my clothes. I shower at least 6 times a week, sometimes twice in a day. My scalp feels like a dry snakeskin and my hair doesn’t seem to be growing. After showering, I finally get to say hi to my husband and give him a kiss after the crazy day I have had.

Family time.

Without my husband, I wouldn’t eat, I wouldn’t sleep, I would probably just end up drinking myself into a stupor and sleeping on the bean bag day after day. I am so thankful we don’t have children to take care of or parents who rely on us. These worries are daily for anyone that works in healthcare and is consumed with possibly bringing this home to their family. I have friends who have moved out of their houses. They who won’t see their children or spouses for months, until this is over. People may think that is overkill. But none of us would be able to live with ourselves if we knew we brought this home and made a loved one sick.

Let’s all work together so we can get back to this. Flatten the curve, wash your hands, social distance, and stop touching your face.

Give thanks.

None of us get into this job to hear we did a “good job”, we do this job because we are passionate humans and want to help people. Anyone in healthcare is under additional stress with this Covid-19 outbreak. Please, I urge you, respect the people who have different views than you but remember we are all going through this. Most of us weren’t alive during the Spanish flu pandemic of 1918. We are all doing our best. If you see an ambulance sitting somewhere, say thank you. If you see a nurse or doctor in scrubs, tell them “good job”. To all of my healthcare patriots, thank you so much for all of the hard work you are putting in during these times. They truly are unprecedented. Just remember, this too shall pass and we will come out stronger and better on the other side.

If you have any questions, please feel free to ask in the comments and I will get back to you. Thank you for reading and stay healthy.