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Personal protective equipment, procedures key for first responders facing COVID-19

by Jeff Haldiman | April 3, 2020 at 4:26 a.m. | Updated April 3, 2020 at 12:31 p.m.
Cole County EMS paramedic Nicholas Barton, right, assists fellow paramedic Cpt. Kelly Holman on Thursday as she demonstrates personal protective equipment at the Southridge Drive station house. This particular gear is from when emergency personnel were gearing up for the Ebola virus and has enclosed foot protection.
For more news about the COVID-19 coronavirus, access the News Tribune Health section.

Local first responders stand ready to answer calls with necessary procedures and personal protective equipment to keep staff and members of the public safe during the COVID-19 pandemic.

The department most involved in coronavirus response is the Cole County EMS.

EMS Chief Matt Lindewirth believes his department's plan to handle response to possible COVID-19 cases works to ensure the safety of first responders and the public.

"They will not do any type of testing on an individual," Lindewirth said. "They will assess signs and symptoms."

If a COVID-19 report comes through dispatch, the dispatcher does a screening. If it appears the caller is indeed a COVID-19 patient, ambulance crews are alerted. When the two-person crew arrives, one responder will go to the patient's door while the other begins putting on personal protective equipment. The responder at the door - keeping at least 6 feet between himself or herself and the patient - will conduct another assessment. If they agree it is a case of COVID-19, the other responder, now in protective gear, will begin treatment and preparing for transportation. The responder who first went to the door will then begin putting on protective gear.

Cole County Sheriff John Wheeler said his department has also taken precautions in the face of COVID-19, especially in operations at the Cole County Jail.

"All inmates as they come through the booking process must use hand sanitizer and are asked a series of questions that our health provider has given us," Wheeler said. "We don't wear masks, but we are using gloves at all times. During their time in our facility, we take their temperatures to see if they may be running a fever."

Wheeler said the jail is equipped with a medical pod where an inmate can be isolated from the rest of the population.

The jail population was at 116 as of Thursday, and Wheeler said there had been no problems with day-to-day operation since the COVID-19 emergency began locally.

"Our judges have been good to work with to make sure our jail population includes only those that should be kept in custody due to the severity of their crimes," Wheeler said. "That's done with the pre-trial program, which is designed to help judges determine which defendants should be bonded and supervised rather than jailed before a trial."

Jefferson City Police Department Lt. Pat McCutchen said officers continue responding to all calls for service, but they have made some changes because of COVID-19.

"We have officers doing their reports in their patrol cars, which our on-board computer systems are capable of," McCutchen said. "We have them park in safe areas, such as the police station parking lot, to complete them. It's a way to limit the person-to-person contact as much as possible."

McCutchen said officers are trying to respond to as many calls as possible by phone but will do face-to-face calls when needed.

"We'll meet the callers outside of their residence if we can," McCutchen said.

If an EMS provider treats a patient who tests positive for COVID-19 - and took all the protective steps necessary - the EMS worker will not be placed in quarantine because they would not be considered "exposed," Lindewirth said.

"With that said, they would only take the necessary precautions because either the patient had symptoms that indicated it was possible they were positive or if the crew had any suspicion that caused them to don personal protective equipment," Lindewirth said.

If a patient tested positive for COVID-19 and the crews were not in the necessary protective PPE, then the EMS workers would be placed into quarantine, Lindewirth said.

"Should someone be suspected either by a hospital or health department of having COVID-19 and the crew did not wear the necessary protective PPE, then they would be quarantined until the test results were received on the patient, and that result would dictate if the crew remained in quarantine or not," Lindewirth said. "To be clear, though, not all patients that may test positive with COVID-19 would have initiated the donning of PPE by EMS. We hope that we have a system in place to catch them all, but there is a chance they don't."

Wheeler said his department has gotten PPE, including gloves and masks, through the state Department of Public Safety.

"As far as what PPE we use, it's on a case-by-case basis," Wheeler said. "If they are able to determine that masks are needed, then they currently have a supply to handle the situation."

Wheeler hopes while hand sanitizer is not considered PPE, the DPS might include some in upcoming deliveries.

Jefferson City Fire Department Public Information Officer Jason Turner said they are working with the state to make sure their stock of PPE is maintained.

"Each of our apparatus is equipped with protective equipment such as masks and gloves," Turner said. "Right now, we have not had any issues with our personnel and the need for PPE."

There is a broad array of situations in which firefighters would use PPE "because there are so many indicators we use," Turner said. "It all starts with the Q&A the 911 operators do with callers to determine the potential for a possible COVID-19 response, and it goes from there.

"We do an inventory count every morning, and we watch our burn-through rate every day," Turner added. "We'll adjust accordingly, but right now, we're not taking drastic measures to meet our PPE needs."

Cole County EMS had no personnel in quarantine as of Thursday, "unlike several agencies in St. Louis that have as many as 26 paramedics in quarantine in one EMS alone," Lindewirth said. "While we may not be able to make that claim next week, we hope we can, and we think we are placing our team members' health and well-being at the very top of our list."

Lindewirth admitted it would put a strain on the EMS staff if any members of the service have to be taken out of action.

"That is why we are taking the necessary steps on a lot of cases that are likely the flu or other illness, but the risk of not doing it is far greater than if we do," Lindewirth said. "We need to keep as many of our providers as safe and healthy as we can for themselves, their families and for our community."

Lindewirth would not say if Cole County EMS had responded to any positive COVID-19 calls, citing patient privacy.

"Our PPE includes the N-95 masks, surgical masks, suits, goggles, face shields and gloves," Lindewirth said. "I'd say for now we're doing OK on supplies, but we're always looking to get more."


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