This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/05/11/health/coronavirus-EMT-worker.html

The article has changed 29 times. There is an RSS feed of changes available.

Version 5 Version 6
Three Weeks in April: An E.M.T. Crew Faces Exhaustion, Isolation and Death Three Weeks in April: An E.M.T. Crew Faces Exhaustion, Isolation and Death
(3 days later)
After three years living in Nairobi, Kenya, working as a photojournalist throughout Africa and the Middle East, I decided I wanted to move home and pursue a career in public safety. I had always been interested in emergency medicine and was an emergency medical technician in college, so I got recertified and was hired by Empress Emergency Medical Service in a suburb of New York City last September.After three years living in Nairobi, Kenya, working as a photojournalist throughout Africa and the Middle East, I decided I wanted to move home and pursue a career in public safety. I had always been interested in emergency medicine and was an emergency medical technician in college, so I got recertified and was hired by Empress Emergency Medical Service in a suburb of New York City last September.
I remember reading briefly about the coronavirus earlier this year but not thinking much of it — until the second documented case in New York State was announced in early March, in Empress’s coverage area, New Rochelle.I remember reading briefly about the coronavirus earlier this year but not thinking much of it — until the second documented case in New York State was announced in early March, in Empress’s coverage area, New Rochelle.
As cases multiplied, and our work became riskier and more intense, I felt an obligation to document. Over the course of three weeks in April, I photographed my colleagues as we worked to do our part to combat the pandemic that has frozen our country.As cases multiplied, and our work became riskier and more intense, I felt an obligation to document. Over the course of three weeks in April, I photographed my colleagues as we worked to do our part to combat the pandemic that has frozen our country.
Empress’s E.M.T.s and paramedics work shifts that can range from eight to 24 hours. Last month Empress responded to about 350 cardiac arrest calls, many of them the result of complications stemming from Covid-19. The monthly average for cardiac arrest calls before the pandemic was 30 to 40.Empress’s E.M.T.s and paramedics work shifts that can range from eight to 24 hours. Last month Empress responded to about 350 cardiac arrest calls, many of them the result of complications stemming from Covid-19. The monthly average for cardiac arrest calls before the pandemic was 30 to 40.
AndrewJohn Briones is the operations captain at Empress Ambulance. He has been in emergency medical services for the past 12 years and said he’d never seen anything like this.AndrewJohn Briones is the operations captain at Empress Ambulance. He has been in emergency medical services for the past 12 years and said he’d never seen anything like this.
“Not many people alive today have ever seen anything like this, nor could imagine that something could cripple the world like this,” he said.“Not many people alive today have ever seen anything like this, nor could imagine that something could cripple the world like this,” he said.
I watched Captain Briones have difficult conversations with people who were likely sick with the virus, the same kind of conversations I was having with my patients.I watched Captain Briones have difficult conversations with people who were likely sick with the virus, the same kind of conversations I was having with my patients.
Often there is a tough decision to be made on whether they should go to the hospital. You can stay home and risk getting sicker or go to the hospital and possibly die alone.Often there is a tough decision to be made on whether they should go to the hospital. You can stay home and risk getting sicker or go to the hospital and possibly die alone.
“I always worry if the family truly understands that this might be the last time they see their family member,” Captain Briones said, “if this would be what they would want.”“I always worry if the family truly understands that this might be the last time they see their family member,” Captain Briones said, “if this would be what they would want.”
Most of the time we don’t know what happens to the patients we treat. I’ve found this to be one of the most difficult parts of the job, especially right now.Most of the time we don’t know what happens to the patients we treat. I’ve found this to be one of the most difficult parts of the job, especially right now.
We treat people in the field, transport them to the hospital, then don’t ever hear from them again. Often, I don’t know if the patients I brought to the hospital lived or died.We treat people in the field, transport them to the hospital, then don’t ever hear from them again. Often, I don’t know if the patients I brought to the hospital lived or died.
Many of us are also struggling with isolation from friends and family. My colleague, Austin Magnuson, 25, a paramedic from Dallas, has been sleeping in the basement of his home for the past month because he is worried that he might infect his partner and roommates.Many of us are also struggling with isolation from friends and family. My colleague, Austin Magnuson, 25, a paramedic from Dallas, has been sleeping in the basement of his home for the past month because he is worried that he might infect his partner and roommates.
I haven’t seen my partner, Maya, or my dog, Bear, since March 14. We decided it was best for Maya to stay upstate because her father suffers from a compromised respiratory system. We were scared that I could pass the virus to her, which in turn could infect her dad. I’ve found coming home to an empty apartment hard. I know I’m not alone in this experience.I haven’t seen my partner, Maya, or my dog, Bear, since March 14. We decided it was best for Maya to stay upstate because her father suffers from a compromised respiratory system. We were scared that I could pass the virus to her, which in turn could infect her dad. I’ve found coming home to an empty apartment hard. I know I’m not alone in this experience.
Updated June 5, 2020Updated June 5, 2020
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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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.
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.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.
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.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Lt. Rebekah Cosgrove became a supervisor at Empress a month before the coronavirus outbreak hit.Lt. Rebekah Cosgrove became a supervisor at Empress a month before the coronavirus outbreak hit.
“The hardest part is seeing the toll it will or already has taken on health care workers’ mental health, ” she said.“The hardest part is seeing the toll it will or already has taken on health care workers’ mental health, ” she said.
For most of us on the Empress crews, this is the most death we’ve have ever had to deal with.For most of us on the Empress crews, this is the most death we’ve have ever had to deal with.
“I don’t think I’ve ever come to work and prepared to be dealing with fatalities and loss on a scale like this,” Mr. Magnuson said. “It’s the first time I really thought about losing people I care about. I’ve never felt so powerless.”“I don’t think I’ve ever come to work and prepared to be dealing with fatalities and loss on a scale like this,” Mr. Magnuson said. “It’s the first time I really thought about losing people I care about. I’ve never felt so powerless.”
“I think for me the biggest thing for me is to take it one day at a time,” he added. “Some days are going to be worse than others. Some days will be more frustrating than the others. I tell myself every day, ‘One day at a time.’”“I think for me the biggest thing for me is to take it one day at a time,” he added. “Some days are going to be worse than others. Some days will be more frustrating than the others. I tell myself every day, ‘One day at a time.’”