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| N.Y.C.’s 911 System Is Overwhelmed. ‘I’m Terrified,’ a Paramedic Says. | N.Y.C.’s 911 System Is Overwhelmed. ‘I’m Terrified,’ a Paramedic Says. |
| (8 days later) | |
| 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. | 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. | 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. | 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. | “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. | 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.” | “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. | 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. | 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. | 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. | 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. |
| And, they are doing it, in most cases they say, without appropriate equipment to protect themselves from infection. | 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 30,000 cases as of Saturday, and 672 deaths. | The paramedics described grim scenes as New York City has become the epicenter of the coronavirus pandemic in the United States, with more than 30,000 cases as of Saturday, and 672 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. | 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 drunk a liter of vodka after her cancer treatments had been delayed, in part because hospitals were clearing their beds for coronavirus patients. | One New York City paramedic described responding to a suicide attempt of a woman who had drunk 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. | 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. | “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. | 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.” | “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 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. | “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. | 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. | 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. | 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.” | “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. | 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. | 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. | 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. |
| Updated June 30, 2020 | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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.” | “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.” |