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Westlake Legal Group > Posts tagged "Fire Department (NYC)"

‘Possible Covid’: Why the Lulls Never Last for Weary E.M.S. Crews

For seven and a half hours, the two New York City paramedics had worked a surprisingly normal shift: a few people with difficulty breathing, one trip to the hospital — and, miraculously it seemed, no clear cases of coronavirus.

They were about to head back to their station when an urgent call flashed over their dispatch screen: cardiac arrest, with a patient who had been feeling sick for a week.

“Heads up,” a radio barked. “Possible Covid.”

The paramedics, Sean Mahoney and Kenny Cheng, rushed to the apartment building, donned gowns, goggles and face masks and restarted the patient’s heart. But then the person crashed. The ambulance doors closed as Mr. Cheng frantically began chest compressions. Moments later, the patient was dead.

Such is the disturbing new normal for the city’s paramedics, whose days can be mundane until — suddenly — they are not.

The peak of the coronavirus epidemic in New York City — when paramedics were declaring scores of people dead a day — has passed, at least for now. Yet the virus still casts a shadow over everything they do. And when it resurfaces, it does so swiftly and with a vengeance.

ImageWestlake Legal Group 00ambula3-articleLarge ‘Possible Covid’: Why the Lulls Never Last for Weary E.M.S. Crews New York City Fort Totten (Queens, NY) Fire Department (NYC) Coronavirus (2019-nCoV) Bronx (NYC) Ambulances

Like the rest of the city, paramedics are facing an unnerving uncertainty: When can they see their loved ones again? When, if ever, can they return to normal? And what if the virus comes back when they do?

“It’s a little bit overwhelming,” said Mr. Mahoney, 40. “But that’s what we signed up to do, right?”

Nearly two months into the coronavirus crisis, the strain has taken a heavy emotional and physical toll on paramedics. The city employs around 4,500 paramedics and emergency medical technicians, who are buttressed by privately employed ambulance crews paid by hospitals. Though the city’s medics work for the Fire Department, they are paid significantly less than firefighters and do not receive the same benefits.

For weeks, they have worked exhausting days trying to save people, facing the threat of exposure each time they responded to a call. And after their shifts, they have had to isolate themselves at home to protect their relatives, spouses and children from infection.

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Mr. Mahoney moved into a separate bedroom in his upstate home, and for weeks has not interacted with his wife and three young children. Mr. Cheng, 36, swapped residences with his parents, who have an apartment in Manhattan. They have moved to Queens to stay with Mr. Cheng’s wife and daughter.

Mr. Cheng and Mr. Mahoney were reactivated for duty out of the Fire Department’s E.M.S. training academy in Fort Totten, Queens, a storied supplementary fleet known as “Station 60.” Its instructors have periodically gone back on the job during the city’s crises — like the Sept. 11 attacks and Hurricane Sandy — and they are staffing 10 ambulances now.

Each day, Mr. Mahoney and Mr. Cheng gather with their colleagues for a moment of silence and updates on friends and co-workers who have contracted Covid-19, the disease caused by the virus. One ill colleague named during the meeting on Monday morning, an emergency medical technician named Idris Bey, had died by Friday.

Mr. Cheng and Mr. Mahoney find out each morning whether they will be on an ambulance duty, at high risk of exposure, or working in an office on the training academy’s campus.

The nature of the job requires a certain detachment from pain. Neither Mr. Mahoney nor Mr. Cheng is easily rattled by death or suffering. Still, the virus has shocked them in unexpected ways, chilling them with its rapid spread, the havoc it wreaks on bodies and its bizarre symptoms.

Many patients have vital signs — like low blood-oxygen levels — that indicate that they should be unconscious or dead, Mr. Cheng said. He recalled one patient whose oxygen levels were so low he was surprised the person was still coherent.

“They were still awake and talking, which scientifically, should not be possible,” he said.

Beyond the day-to-day horror of dealing with coronavirus victims, Mr. Mahoney and Mr. Cheng are also wrestling with the loss of normal comforts, like most New Yorkers. Mr. Cheng said he missed ordering Chinese food and had found many of the restaurants around him have closed indefinitely. Mr. Mahoney, a lifelong Boston Red Sox fan, feared baseball season was slipping away.

Neither will seriously entertain visiting family members. Mr. Mahoney said he hoped to get a coronavirus test so he could see his wife, twin daughters and their baby brother this month. But that window, he said, would be brief — by the next shift, he would again be at risk of exposure and would have to isolate himself again.

Mr. Cheng video chats daily with his young daughter, but said he had no idea when he might return home. Even when the city begins reopening, paramedics would still be at high risk of exposure, he said. He was recently reminded why he had taken pains to protect his family, when his father-in-law, who was not quarantining with them, died of the virus.

As they wait in the ambulance in between calls, the men wear surgical masks, and they put them on whenever they are off-duty and go out in public. Mr. Cheng fashioned a headband that held the straps away from his ears, which he said got “shredded” by the elastic.

Even when he is at home, Mr. Mahoney said, the feeling haunts him.

“At the end of the day, I still feel like I’m wearing the mask,” he said.

At the peak of the virus’s rampage through the city, paramedics were pronouncing hundreds of people dead in their homes every day. The 911 calls were constant, and many of the patients were too ill to save.

Some days, the calls were relentless. Mr. Mahoney recalled one shift this month when he and his partner had been assigned to Brooklyn, but they were diverted almost immediately after leaving Fort Totten.

“We got hit from the academy and just bounced from one call, as soon as you hit the button,” he said. “We never made it out of Queens.”

That pace has abated in recent days, indicating that the virus’s first wave might be ending; fewer New Yorkers were making emergency calls.

“They’re either recovered, or, most of them are dead,” Mr. Cheng said.

Call levels soared to record highs in early April, rising to around 7,000 a day compared with the normal 4,000.

Now, they have dropped to levels even lower than that — so many people are staying inside that injuries related to car accidents and crime, for example, have plummeted. And many people have decided against calling ambulances for maladies unrelated to the coronavirus because they are fearful they could be exposed to the illness if they go to a hospital.

On one call last Monday, for example, Mr. Cheng and Mr. Mahoney responded to a patient who had difficulty breathing. It was unclear if the person had coronavirus, but the medics donned their protective gear anyway.

The patient had mostly normal vital signs and was unlikely to be admitted at a hospital, the medics said. In the end, the patient opted to stay home.

Such calls were growing more and more common. People were scared, the paramedics said, and often they just wanted a medical professional to come and make sure they were not dying of the virus. Many of them were equally afraid of going to a hospital.

Rarely do Mr. Cheng or Mr. Mahoney know for sure if a patient has the virus, so they treat every call as a potential exposure. Each time they were called to an apartment last week, they lined up next to their ambulance, putting on gowns, gloves, goggles and N-95 respirator masks. Curious residents, huddled in windows, looked on as the men were transformed.

Throughout the day, as Mr. Cheng and Mr. Mahoney wove their way through the Bronx, dozens of residents could be seen lining up at grocery stores and banks. People were walking through parks, or standing talking to neighbors on street corners.

“Seems like a lot more cars are on the road today,” Mr. Mahoney said. “I think people are starting to slowly filter back into society. ”

The implication of his statement needed no explanation: As people begin to relax their social distancing efforts, it could mean the start of the virus’s next wave.

The juxtaposition of the dangers they face and the returning normalcy on the street can be disorienting.

As the paramedics lifted the limp body of their last cardiac arrest patient into the ambulance that afternoon, four other medics, suited up with personal protective equipment, raced frantically around the gurney. They moved silently, with urgency — like faceless extras from a biohazard movie.

Next to them on the sidewalk, a couple out for an afternoon stroll stepped aside for the stretcher, looking on with passing interest as they continued on their walk. Neither was wearing a mask.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid

Westlake Legal Group coronavirus-in-n-y-toll-soars-to-nearly-3000-as-state-pleads-for-aid Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid Quarantines Police Department (NYC) New York City Milley, Mark A Manhattan (NYC) hospitals Fire Department (NYC) Epidemics Emergency Medical Treatment Defense Department Deaths (Fatalities) de Blasio, Bill Cuomo, Andrew M Coronavirus (2019-nCoV) Brooklyn (NYC) Birx, Deborah L Bellevue Hospital Center
Westlake Legal Group 04nyvirus-ledeall1-facebookJumbo Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid Quarantines Police Department (NYC) New York City Milley, Mark A Manhattan (NYC) hospitals Fire Department (NYC) Epidemics Emergency Medical Treatment Defense Department Deaths (Fatalities) de Blasio, Bill Cuomo, Andrew M Coronavirus (2019-nCoV) Brooklyn (NYC) Birx, Deborah L Bellevue Hospital Center

New York, the increasingly battered epicenter of the nation’s coronavirus outbreak, on Friday reported its highest number of deaths in a single day, prompting state officials to beg the rest of the United States for assistance and to enact an emergency order designed to stave off medical catastrophe.

In the 24 hours through 12 a.m. on Friday, 562 people — or one almost every two-and-a-half minutes — died from the virus in New York State, bringing the total death toll to nearly 3,000, double what it was only three days before. In the same period, 1,427 newly sickened patients poured into the hospitals — another one-day high — although the rate of increase in hospitalizations seemed to stabilize, suggesting that the extreme social-distancing measures put in place last month may have started working.

Despite the glimmer of hope, the new statistics were a stark reminder of the gale-force strength of the crisis that is threatening New York, where more than 102,000 people — nearly as many as in Italy and Spain, the hardest-hit European countries — have now tested positive for the virus. The situation, as it has been for weeks, was particularly dire in New York City, where some hospitals have reported running out of body bags and others have begun to plan for the unthinkable prospect of rationing care.

“It is hard to put fully into words what we are all grappling with as we navigate our way through this pandemic,” Vicki L. LoPachin, the chief medical officer of the Mount Sinai Health System, wrote in an email to the staff on Friday. “We are healing so many and comforting those we can’t save — one precious life at a time.”

Around the country, the total number of coronavirus cases spiked sharply as of Friday afternoon, exceeding a quarter million, with more than 6,660 total deaths. After New York, New Jersey was the state with the highest rate of infection. Globally, more than one million people had been infected and nearly 60,000 had died.

Hot spots continued to emerge.

“We continue to watch, in addition, the Chicago area, the Detroit area, and have developing concerns around Colorado, the District of Columbia,” Dr. Deborah Birx, the White House coronavirus response coordinator, said at a daily news briefing on Friday. She added that the government would “move supplies creatively around the country to meet the needs of both the front line health care providers but also every American who needs our support right now.”

As the inexorable march of contagion in New York continued, Gov. Andrew M. Cuomo issued an impassioned plea to the nation to hurry medical staff and equipment to the state before an expected shortfall of both overwhelmed its already groaning health care system, perhaps as early as next week.

Mr. Cuomo, vowing to return the favor, said he would redirect hundreds of lifesaving ventilators and teams of local doctors to other states as soon as the crisis in New York passed its peak.

But unable to count on reinforcements arriving fast enough, Mr. Cuomo also issued an extraordinary executive order on Friday giving him the power to commandeer ventilators from hospitals in less-affected counties in the state and to redeploy them to hard hit areas in Brooklyn, Queens and Long Island.


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“I’m not going to let people die because we didn’t redistribute ventilators,” Mr. Cuomo said, adding, “We don’t have enough — period.”

But Representative Elise Stefanik, a Republican congresswoman who represents a rural district of northern New York, said in a statement that she was “very concerned” about the order.

“I represent demographically the largest number of seniors of any district in New York,” she wrote. “This is the most vulnerable age group facing Covid-19 and needs to be considered.”

She and 11 other state and federal Republican officials later issued a joint statement opposing Mr. Cuomo’s action.

As the outbreak entered its second month, New York City in particular hunkered down for what promised to be a long and grueling siege.

Earlier in the week, city officials rushed 45 refrigerated trailers to overburdened hospitals where in-house morgues were filling up with bodies. Crematories, under eased restrictions, are now allowed to run around the clock. A special team of 42 military mortuary affairs officers was starting to arrive from Virginia to help the city’s medical examiner.

One out of every six police officers in the city had called out sick or was in quarantine, straining the department at the very moment when its 36,000 officers have been asked to enforce new rules intended to slow the spread of infection.

To cut back on crowding in emergency rooms, the city’s Fire Department issued new guidelines to thousands of paramedics, telling them not to bring cardiac patients to hospitals unless they were able to find a pulse.

Mayor Bill de Blasio has been warning that the city was only days away from what he called a “D-Day,” when the outbreak would overwhelm the health care system, putting hundreds, if not thousands, of additional people at risk. In an early morning television appearance on Friday, he made his own appeal to the country, asking for what amounted to a draft for medical personnel.

“Unless there is a national effort to enlist doctors, nurses, hospital workers of all kinds and get them where they are needed most in the country in time, I don’t see, honestly, how we’re going to have the professionals we need to get through this crisis,” Mr. de Blasio said.

As the weekend neared, the possibility emerged that the city could finally get relief from the U.S.N.S. Comfort, the Navy hospital ship that arrived in New York to great fanfare on Monday.

Pentagon officials had initially said the ship would treat only non-coronavirus patients in an effort to keep the vessel free from infection. But on Friday, Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, said the military was “reassessing” its policy and might allow coronavirus patients aboard the ship.

General Milley’s comments came after New York hospital executives complained on Thursday that the Comfort was sitting at its berth in New York largely empty while hospitals in the city were overrun.

In one sign of the strain on hospitals, Lenox Hill Medical Center in Manhattan temporarily experienced a drop in pressure in its oxygen supply on Friday, according to a memo that hospital executives sent to staff members. The cause was apparently the heavy demand.

To bolster the local health care system, Mr. Cuomo this week enacted an unprecedented plan for all of New York’s hospitals — public and private, upstate and downstate — to work together in a kind of single network. By the end of the week, there were early signs that the effort was working.

On Thursday, Woodhull Medical Center, a public hospital in Brooklyn, reached its capacity for treating virus patients and transferred 15 to the Bellevue Medical Center, a public hospital in Manhattan, said Dr. Robert Chin, Woodhull’s emergency department director.

“So far, we’ve been holding it together,” Dr. Chin said. “Are we ready for what’s coming? I can’t really say — because I don’t know what’s coming.”

Jesse McKinley, William K. Rashbaum, Matt Richtel, Brian Rosenthal, Michael Rothfeld and Ali Watkins contributed reporting.

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‘War Zone’: Ambulances in N.Y.C. Are Now as Busy as on Sept. 11

Westlake Legal Group 00nyvirus-ems001-facebookJumbo ‘War Zone’: Ambulances in N.Y.C. Are Now as Busy as on Sept. 11 Protective Clothing and Gear New York City Fire Department (NYC) Emergency Medical Treatment Emergency Medical Service Coronavirus (2019-nCoV) Ambulances

The first of many calls that night involved a 24-year-old man who had a fever, body aches and a cough that sounded like a cement mixer.

While the Brooklyn paramedics took the man’s fever — 103 degrees — they noticed frightening vitals that hinted at coronavirus: a critically low level of oxygen was flowing into his otherwise clear lungs, while his heart thumped with the intensity of a marathon runner’s. He was taken to the nearest hospital.

Then almost immediately came the next call: a 73-year-old man with symptoms similar to the young man’s. They took him to the hospital, too.

“It’s all a war zone,” one of the paramedics said.

Days later, another paramedic, Phil Suarez, was dispatched to two homes in Manhattan’s Washington Heights neighborhood, where entire families, living in cramped apartments, appeared to be stricken with the virus.

“I’m terrified,” said Mr. Suarez, who has been a paramedic in New York City for 26 years and had assisted in rescue efforts during the Sept. 11, 2001, terror attacks and later served in the Iraq war. “I honestly don’t know if I’m going to survive. I’m terrified of what I’ve already possibly brought home.”

Even as hospitals across New York become inundated with coronavirus cases, some patients are being left behind in their homes because the health care system cannot handle them all, according to dozens of interviews with paramedics, New York Fire Department officials and union representatives, as well as city data.

In a matter of days, the city’s 911 system has been overwhelmed by calls for medical distress apparently related to the virus. Typically, the system sees about 4,000 Emergency Medical Services calls a day.

On Thursday, dispatchers took more than 7,000 calls — a volume not seen since the Sept. 11 attacks. The record for amount of calls in a day was broken three times in the last week.

Because of the volume, emergency medical workers are making life-or-death decisions about who is sick enough to take to crowded emergency rooms and who appears well enough to leave behind. They are assessing on scene which patients should receive time-consuming measures like CPR and intubation, and which patients are too far gone to save.


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And, they are doing it, in most cases they say, without appropriate equipment to protect themselves from infection.

The paramedics described grim scenes as New York City has become the epicenter of the coronavirus pandemic in the United States, with more than 29,000 cases as of Saturday, and 517 deaths.

If the rate of growth in cases in the New York area continues, it will suffer a more severe outbreak than those experienced in Wuhan, China, or the Lombardy region of Italy.

One New York City paramedic described responding to a suicide attempt of a woman who had drank a liter of vodka after her cancer treatments had been delayed, in part because hospitals were clearing their beds for coronavirus patients.

Another paramedic said she responded to so many cardiac arrests in one shift that the battery on her defibrillator died.

“It does not matter where you are. It doesn’t matter how much money you have. This virus is treating everyone equally,” the Brooklyn paramedic said.

The amount of work has been record-setting for the city’s 911 system, said Frank Dwyer, a Fire Department spokesman.

“Our E.M.T.s and paramedics are on the front line during an unprecedented time in the department’s history,” Mr. Dwyer said, adding: “They’re doing it professionally, and they’re doing it because they care about their patients. They care about this city.”

The department said it has started rationing protective gear in an attempt to stave off potential shortages. Earlier this month, the department told workers that they must turn in their used N95 masks — which filter out 95 percent of airborne particles when used correctly — in order to receive a new one.

“The department is carefully managing and monitoring usage of personal protective equipment and critical supplies to ensure we have what’s needed for this long-term operation,” Mr. Dwyer said.

Inside ambulances, on rudimentary digital screens, the dispatches are listed — call No. 2,488, sick; call No. 2,555, sick; call No. 2,894, sick with a fever. The screen goes on for rows, a catalog of the city’s ill and dying. Peppered among them are the usual every day calls still demanding attention: injuries, accidents, heart attacks.

New York City’s soundtrack has always included the sound of ambulance sirens. But now, with many of the city’s businesses closed and its neighborhoods quiet, endless wailing seems to echo through the deserted streets.

Three weeks ago, the paramedics said, most coronavirus calls were for respiratory distress or fever. Now the same types of patients, after having been sent home from the hospital, are experiencing organ failure and cardiac arrest.

“We’re getting them at the point where they’re starting to decompensate,” said the Brooklyn paramedic, who is employed by the Fire Department. “The way that it wreaks havoc in the body is almost flying in the face of everything that we know.”

In the same way that the city’s hospitals are clawing for manpower and resources, the virus has flipped traditional Emergency Medical Services procedures at a dizzying speed. Paramedics who once transported people with even the most mild medical maladies to hospitals are now encouraging anyone who is not critically ill to stay home. When older adults call with a medical issue, paramedics fear taking them to the emergency room, where they could be exposed to the virus.

One paramedic told a 65-year-old patient in Brooklyn, whom she had previously transported to the hospital for recurring issues, to stay home this time and call a doctor.

In New York City, 911 calls are handled by both Fire Department ambulances and ambulance companies staffed by area hospitals. Their duties are effectively the same: They respond to the same medical calls, largely determined by what crew is closer and which is available fastest.

Neither the city, the State Department of Health or the federal Centers for Disease Control and Prevention have issued strict rules as to how paramedics should respond to a coronavirus call. In recent days, Fire Department policy — which applies to all ambulance crews in the 911 system — has given more latitude to paramedics to make decisions on how to handle patients they believe have the virus.

Recent guidance has also directed paramedics to wear surgical masks, gloves, gowns and eye protection for suspected coronavirus patients. N95 masks, in short supply, are only worn for certain procedures.

Since many hospitals are in dire need of personal protective equipment like N95 masks, paramedic crews employed by the hospitals also face shortages.

The Brooklyn paramedic said she had started sewing her homemade masks with bandannas and coffee filters.

Another paramedic in Brooklyn said she had been using the same N95 mask for days. Last week, as she and her partner exited an apartment building after tending to a patient, the building’s supervisor — noticing the pair’s worn equipment — met them downstairs and shoved new N95 masks and a can of Lysol into their arms.

Like doctors and nurses, many paramedics fear they are already infected and have brought the virus home to their families. On March 18, three members of the Fire Department tested positive for the virus. By Friday, 206 members had positive results.

Officials for the union that represents the city’s paramedics believe the actual number who have been infected is far higher. At a single station in Coney Island, Brooklyn, seven Emergency Medical Services workers were infected, one union official said.

At least one E.M.S. worker with the virus was in an intensive care unit last week and on a ventilator.

The growing pandemic has tested paramedics physically and mentally, said Anthony Almojera, an E.M.S. lieutenant for the Fire Department who said he cried on the job for the first time in his 17-year career.

He and his team had responded to a cardiac arrest dispatch for a middle-age woman, a health care worker, who had been infected. When paramedics arrived at her home, the woman’s husband, who was also a health care worker, said she had been sick for five days.

The husband frantically explained that he had tried to stay home and tend to his ill wife, but his employer had asked him to work because their facility was overrun with coronavirus patients.

Grudgingly, the man told the medics, he went to work. When he returned home after his shift that day, he found her unconscious in their bed. For 35 minutes, Mr. Almojera’s team tried to revive the woman, but she could not be saved.

Usually, Mr. Almojera said, he tries to console family members who have lost a loved one by putting his arm around them or giving them a hug.

But because the husband was also thought to be infected with the coronavirus, Mr. Almojera delivered the bad news from six feet away. He watched the man pound on his car with his fist and then crumble to the ground.

“I’m sitting there, beside myself, and I can’t do anything except be at this distance with him,” Mr. Almojera said. “So, we left him.”

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