OH Fire Departments Seeing Decrease in EMS Calls

Editor's note: Find Firehouse.com's complete coverage of the COVID-19 pandemic here.

Firefighters and paramedics respond to high-risk calls every day, but not knowing if their next call could expose them to COVID-19 is causing even greater stress during the pandemic.

"It's the unknown of who we're going to get, who has it, and who's going to get it," said Chief Scott Ervin of the Clinton Township Fire Department. "We are very nervous."

First responders and their dispatch counterparts have instituted a number of new procedures to protect themselves and the public from contracting COVID-19. Dispatchers are asking additional questions to assess if callers may have the virus and first responders are wearing additional layers of personal protective equipment on every call.

"It's been an unbelievably quick change in policies for our first responders," said Rhodes Walter, director of the Wooster-Ashland Regional Council of Governments, which dispatches for Wooster, Orrville, Ashland and Kidron fire departments.

EMS calls decrease

WARCOG, the Wayne County Dispatch, and the Holmes County Dispatch have all seen dips in EMS calls over the first three months of the year compared to 2019.

In Wooster, WARCOG saw an 8.1% slide from last year between Jan. 1 to April 13. Calls in Orrville dropped 18.8% and Kidron Fire saw a 32.5% decline.

The Wayne County Dispatch, which serves all other fire departments in the county, including the City of Rittman, reported a drop in emergency service calls of 2.2% from 2019 to 2020 for the months of January through March. EMS calls to the Holmes County Dispatch have decreased by 16% over the same time period.

Walter attributed the downturn to the community not calling 911 for non-life threatening needs and awareness about reducing visits to hospitals during the pandemic. Instead, people are calling a primary care physician or a telehealth provider for non-emergencies.

"People are aware of that," Walter said. "They recognize if they don't need to go to the hospital and the issue can be addressed through a phone call or telemedicine, it's better than risking the safety of others or yourself."

More questions

Under the guidance of the Centers for Disease Control and Prevention, dispatchers started asking three additional questions in January to determine if the caller could be positive for COVID-19. These questions are asked of anyone calling 911, no matter if the request is for fire, EMS or police.

"WARCOG Dispatch has been doing an outstanding job of screening all 911 calls and relaying the information to us," said Chief Chris Bishop of the Orrville Fire Department.

The dispatcher will ask if the patient has recently been in contact with an individual who has a confirmed case of COVID-19; if the patient is experiencing mild to severe respiratory illness or issues; and if the patient has a fever, cough, shortness of breath, or gastrointestinal (GI) issues.

If the caller answers "no" to all of the questions, EMS will respond wearing a surgical mask, goggles and gloves. A "yes" answer means EMS will respond in a full protective suit, gloves and an N-95 mask. The dispatcher will also ask the caller to put on a mask and meet the squad outside.

"There is greater dilution outside then inside the building, all the better for both EMS and the patient," Walter said. "If you need a squad, don't freak out if you see them coming like this."

The Holmes Fire District No. 1 will send in one EMT who will give the patient a mask. The EMT will then ask the patient to walk outside to the cot. If the patient can't make it outside, a second EMT will enter the home to put the patient on the cot and carry them out.

In an effort to reduce trips to the hospital, paramedics in Wayne County can call the emergency department at Wooster Community Hospital and initiate a virtual visit with a board-certified emergency medicine physician. After the physician evaluates the patient, he or she will provide direction to EMS to either transport the patient to a hospital or instruct the patient to follow up with a primary care physician.

"This is a relief for patients who are nervous about going to the hospital," said Ervin, who hopes to continue using virtual visits after the pandemic. "It's an extension of the ER into their homes. I think it's going to help."

Procedural changes

Before Ohio had a confirmed case of COVID-19, the Wooster Fire Department instituted a "layered defense" to protect its first responders from exposure to the virus and influenza. This includes infection control, workplace protection, and community mitigation.

"The goal is to create multiple layers of protective measures against exposure to the influenza and COVID-19 virus for first responders. The more layers of protection, the better protected a person will be," said Chief Barry Saley of the Wooster Fire Department.

Infection control includes the basics — hand washing, not touching the face, social distancing, and taking appropriate sick leave. Workplace protections include cleaning and disinfecting surfaces and equipment, increasing ventilation to the emergency vehicles and the fire station, and limiting public access to the station.

"For first responders, the goal is to protect the emergency service or function that is performed by the emergency service responder. The responders, in turn, protect their families, their workplace, and the community at large. Better protected first responders are thereby better able to protect their communities," Saley said.

Some of the fire departments have designated one of their squad trucks to make all runs for possible COVID-19 calls. Wooster also designated one team of paramedics per shift to respond to all probable COVID-19 cases and has a separate Flu Response Vehicle, a designated squad used for all other flu-type calls.

Kidron Volunteer firefighters, the East Wayne Fire District and the Paint Township Fire Department are sharing a squad designated for COVID-19 calls in the areas of Sugar Creek Township, Paint Township and the villages of Dalton and Marshallville.

Coordinated response

The fire chiefs of Wayne County have met weekly through Zoom to address the constant changes being made in services. The availability of PPE is checked daily so anyone needing a specific item can get it. Together, they are working with the Ohio Fire Chiefs Association and the Wayne County Emergency Management Agency to secure the much-needed equipment.

"PPE right now is very hard to come by and everyone from the Chiefs Association to EMA are doing the best they can to get us the equipment we need," Bishop said.

The Wooster Community Hospital is allowing departments to take advantage of the Battelle N-95 mask sterilization process, which Wooster's Saley called a "game changer."

The coordination efforts in Holmes County are going through the Holmes County Emergency Operations Center, a collaboration between the Holmes County Emergency Management Agency, the Holmes County General Health District, Pomerene Hospital, the Holmes County Sheriff's Department, and all of the county fire departments.

"I think Holmes County is prepared for what we had to deal with. We're prepared to deal with more if needed," said Chief Scott Balder of Fire District No. 1.

Thorough cleaning

All squad trucks that handle a possible COVID-19 return to the station to undergo a decontamination process that takes about 30 minutes. Squads that handle potential or probable cases also are decontaminated at the hospital.

"There's a feeling of urgency that you have to do everything right, donning and doffing PPE. You come back, you want to make sure everything is put back together and well decontaminated," Balder said.

Wooster purchased a battery-powered machine that decreases the disinfection time and increases the effectiveness of the cleaning process. All of the department's medic units have the drive compartment isolated from the patient compartment to reduce the potential spread of airborne particles. The designated squads also have the patient compartments covered with plastic sheeting to minimize the spread of the virus and increase the effectiveness of cleaning.

While EMS calls have dropped, Ervin has seen his department's total runs stay about the same due to people burning outdoors.

"We have more open burns and fire calls this year," he said.

The Ohio Department of Natural Resources Forestry prohibits outdoor open burning and prescribed fires in the months of March, April, May, October and November between 6 a.m. and 6 p.m. The ban includes the burning of yard waste, trash, and debris, even in a proper burn barrel.

Outside the time and date restrictions, any person conducting a burn must obtain landowner permission, remain with the fire while it is burning, and take all reasonable precautions to prevent the fire from escaping.

— Reporter Emily Morgan can be reached at 330-287-1632 or [email protected].

Emergency Medical Service calls

Wayne County Dispatch: 1,234 first quarter 2019, 1,207 first quarter 2020

Holmes County Dispatch: 928 first quarter 2019, 779 first quarter 2020

EMS Calls to WARCOG Jan. 1 - April 13, 2019 and 2020

Wooster: 1,135 in 2019, 1,043 in 2020

Orrville: 234 in 2019, 190 in 2020

Kidron VFD: 43 in 2019, 29 in 2020

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