By Angelo Gefeke

We tend to think of our first responders as a reliable, indispensable, and almost invincible service that is always there when we need them. However, while COVID-19 has hit the city of New Orleans hard, our frontline personnel are among those that bear the highest risk of infection. This includes New Orleans Emergency Medical Services (NOEMS), which was severely impacted by the pandemic both in their personnel numbers and standard procedures. When cases began to spike in the early Spring, NOEMS were among the first on the scene when availability to testing and information was limited. By the end of March 2020, 67% of NOEMS were in self-isolation due to direct positive exposures to the virus. While dealing with an unprecedented shortage of staff, NOEMS was also faced with the task of implementing their new precautions and changing their standard procedures to protect themselves and their patients from COVID-19 as much as possible. 

When the pandemic first began to spike in New Orleans, NOEMS was severely underprepared for the amount of staff they would soon lose to quarantine. When speaking to Persan Balarmen, a NOEMS responder since 2018, he described how tough it was on the staff to keep up with the increasing demand for emergency medical services. Balarmen stated “I had coworkers who were working every single day from mid-March through the end of April. Just to give you an idea of how crazy that is, at NOLA EMS our full time work schedule is 3-3-2-2 which means you’re on for three days then off for three days, then on for two days and off again for two days, but we had so few staff and resources available that pretty much everyone was asked to pull overtime and work extra days with no days off.”  NOEMS first responders were working 12 hour shifts 7 days a week, which was undoubtedly taking a huge toll on their physical and mental health during an already extremely stressful time. While the majority of Americans were out of school and work, forced to self-isolate in their homes, our first responders were working tirelessly on the front lines to make sure New Orleanians received the help they needed. Unfortunately, even with the tireless efforts of the unexposed EMS staff, they still faced immense difficulty responding to all the calls they were receiving. As described by Balarmen, “there was a point where every single ambulance was on a call and there were still about 35-40 code 3 calls holding; Code 3’s are serious calls. Calls were also backlogged, and every ambulance was either on the street or at the hospital, so they were unable to respond to those holding calls. We were completely overwhelmed the first time around.” NOEMS was so backed up in the Spring that they could barely keep up with the demand for their services with their extremely low supply of staff. In June and July, New Orleans decided to activate mutual aid resources that allowed ambulances from all over the state to come to New Orleans and help respond to those in need. Balarmen explained that this was one of the sole reasons that NOEMS was able to get the department under control and relieve some of the stress placed on the staff. 

Within a month, the NOEMS staff had to completely change their operations and standard procedures, instituting a number of precautions to help protect EMS workers and their patients. Staff were requested to not use specific aerosol methods such as the CPAP, also known as continuous positive airway pressure. EMS worker Jonathan Gan said, “we have this thing called a nebulizer and that’s how we can administer certain medications in an aerosolized form. We were told to try and resist doing that as much as we can because of the risk of aerosolizing any pathogen like COVID and the same goes with some of our more invasive airway techniques” While measures like this may seem simple, they were imperative to mitigating the spread of the virus. Other measures that were instituted were more time consuming, like sanitizing the entire truck between calls. While this was extremely necessary, it also contributed to longer response times to patients. Gan stated, “After every patient who is presumed positive or confirmed positive, we were scrubbing down the ambulance fully. We had our detergent sprays and all of our sanitizing cloth and Clorox to wipe down every single surface. It would take 15-20 minutes to scrub down. This was something new because before the pandemic we would usually save the scrubbing for the end of the shift unless it was a messy call. Every call was cleaned during COVID-19 and was extremely time intensive. We had biohazard waste where we would need to put gloves and masks in. We definitely took sanitation and hygiene to a whole new level to prevent spreading the disease.” While it may not seem like a long time, even the 15-20 minutes EMS workers took to completely sanitize their trucks contributed to the massive backup of the department. Since the Spring, the NOEMS has managed to recover from the massive surge in calls and lack of staff. Balarmen noted that “a lot of people who were already really sick have passed, and most of the new cases are not hospital cases but rather mild symptoms so the number of calls we get have gone down a little even though the case number has stayed consistent.” 

Nonetheless, all first responders were hit hard and are still recovering, including other city departments like the New Orleans Police Department (NOPD). When asked about how COVID-19 has affected NOPD, New Orleans police technician Stanley Nguyen said “NOPD and other first responders lacked adequate equipment to face a nationwide pandemic long term. Many of our personnel were equipped in the beginning with high end 3M respirators with filters for organic matter but as time has passed, we have all resorted to use cloth/disposable face masks instead due to lack of funding and support. NOPD has put its best effort in equipping its staff with the budget it has.” The lack of funding and adequate amounts of resources is a harsh reality for first responders in New Orleans right now, making it harder for NOPD and other city departments to do their jobs effectively. Regardless of the general lack of resources and funding, our New Orleans first responders are trying their best to protect both themselves and their constituents from the virus by implementing precautions such as a social distancing protocol that limited the number of officers on duty. The NOPD “set strict guidelines to utilize this equipment while having any interaction with the public,” Nguyen noted, “and in our district stations we are socially distanced, have capacity restrictions, and many non-essential units such as police records/recruitment/data entry worked from home.” 

Similar to the NOEMS, NOPD has also faced the challenge of severe staff shortages throughout the spread of the virus. Out of their 1200-person department, they have had close to 450 employees out sick with COVID-related illnesses or possible contact with infected individuals.Unfortunately, the city lost 9 officers/first responders due to COVID-19 since it began to surge in the Spring. Interestingly, when asked about staff shortages, Nguyen stated that this problem is not a new one for their department. “NOPD has been known to be severely understaffed even before COVID-19. The city has been trying to increase staffing to be back where the pre-Katrina department used to be. It is difficult to work short staffed especially during the pandemic, but the department is used to it and we make do the best we can with the resources we are given” Given that the NOPD was severely understaffed and underfunded pre-COVID, the surge of COVID-19 cases in the Spring made it a lot more challenging to deal with the spike in crime. “Naturally crime in New Orleans spikes around the time that COVID lockdowns took place (around Mardi Gras/ festival season).” The surge in COVID-19 cases and crime, paired with the shortage of employees in an already understaffed department, was a huge challenge faced by NOPD when the virus first hit New Orleans. Nguyen did not personally believe COVID-19 lockdowns were causal of the spike in crime, since crime habitually spikes in late winter/early spring. However, we will know more about that relationship when complete crime statistics and analysis for 2020 are finished in March of next year.

Since the Spring, city departments like NOPD and NOEMS have now gotten used to the new safety protocols and are operating with a relatively short-staff. Regardless, the need for adequate funding and resources in these departments persists, and it is essential that our frontline workers are sufficiently supported by city officials, especially as we start to see the distribution of a vaccine in coming months. Even though cases have seemingly plateaued in New Orleans, it is important to recognize and pay homage to all of the first responders on the front lines who risk exposure every day to help New Orleanians.