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.
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.
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.
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