COVID Efforts Prove EMS Is a Force Multiplier

For more than a decade, I have served as the NAEMT representative to the Forum on Medical and Public Health Preparedness for Disasters and Emergencies, convened by the National Academies of Sciences, Engineering, and Medicine. Long before COVID-19 arrived, pandemic planning conversations revolved around how to get vaccines out to the “last mile,” the most-difficult-to-reach residents. Last-mile individuals include the frail elderly or people with mobility problems who have difficulty getting out of the house and people in outlying areas who don’t have transportation or a means to readily get to vaccine sites. 

When the preparedness forum met in early 2020, it was clear our pandemic planning discussions were no longer theoretical—the pandemic we had pondered was happening. Along with stocking up on PPE, training my staff on how to properly use it, and implementing robust infection-control processes and quarantine procedures, I began to think about how we were going to help the patients in our last mile. 

As EMS practitioners, we know the diabetics in our area who can’t leave their house, the people without cars who call cabs to get to their doctors’ offices, and those who have just enough to fill up their gas tanks to come into town once a month to get groceries. As the fire chief of a super-rural agency serving a population of 12,000 people spread over 272 square miles, I knew reaching those patients would be challenging. I also believed it was our duty to try. 

In September 2020 we started offering COVID testing in our community. In keeping with our We Solve Problems motto, we also began putting a vaccination program in place—rehabbing a vaccine fridge we’d acquired at no charge from the public health department and training EMTs to administer vaccines under the guidance of our state and local medical directors.

As soon as vaccines became available, our EMTs and paramedics shadowed staff at a local hospital as they administered the first vaccines to healthcare workers. As a paramedic and fire chief, I was there with my staff, putting shots in arms. On New Year’s Eve 2020, we had extra doses, so we offered them to first responders. We stayed late into the evening, waiting for the last people to show up to receive their vaccines so none were wasted. 

We officially began vaccinating our community on January 10, 2021. Since then our staff of 30 has administered more than 3,200 vaccines. Our EMTs and paramedics also stepped up to serve with the national ambulance strike team, assisting in FEMA clinics around the country. Our personnel were sent to New Jersey and Memphis on 30-day assignments, administering vaccines 12 hours a day. 

Halting the Pandemic 

Why did we do this? First we recognized the pandemic was a national emergency, and our local health district, like other public health agencies around the country, had the expertise but not the horsepower to do all that was needed to respond. 

Second, we knew we had the expertise and personnel to help ensure members of our community not only had access to emergency medical care when they were sick with COVID but could access COVID-19 testing and vaccines. In doing so, we could help prevent the spread of COVID throughout our community and ultimately do our part to end this devastating pandemic.

Because our agency got on board with vaccinations early, the state of Colorado contracted with us to assist other public health bodies in reaching underserved communities. We developed processes to deliver vaccines wherever they were needed. We visited an Indian reservation, stood up a walk-in clinic at a pancake breakfast in a small rural town, and showed up at businesses and vaccinated their entire staffs. 

We were fortunate that at the time vaccines became available, our agency’s seasonal call volume was down, allowing on-duty staff to conduct these operations. It was an all-hands-on-deck effort, with everyone from our administrative staff to our clinicians participating in learning new computer systems, monitoring the vaccine fridge, and greeting people arriving for vaccines. 

Take-Home Points

We learned a lot. We learned our community has a large population of people over 70 who are shut-ins or nearly so. As we get into wildfire season, we are working on ways to make sure we can evacuate these folks quickly if needed. 

We learned the value as an EMS agency of participating in our local healthcare coalition. The relationships built with our health department and trust developed between our organizations were invaluable in facilitating our efforts.

We also learned the public’s trust in our agency was key in overcoming vaccine hesitancy. We had a lot of long conversations with residents about the value of vaccines, how they work, and what their risks are. I was encouraged when those conversations convinced some skeptics to get vaccinated. 

Vaccinating our community also helped the mental health of our providers, who for months have been in protective clothing and providing care to those with COVID-19. It was a morale booster to administer vaccines to people who were grateful and left our clinics with senses of relief and occasional tears of joy. People in our community brought us cookies, lunch, and other expressions of gratitude. It helped our providers refuel their tanks, knowing they were potentially saving lives. 

It’s been seven months since our agency started administering vaccines. As we start to shift our efforts toward the seasonal increases in EMS calls and the wildfire season, our vaccine efforts are winding down. The state has vaccine buses circulating, and there are plenty of vaccines available. We see a light at the end of the tunnel. 

When I look back at the efforts of my staff, along with those of so many EMS practitioners around the nation who stepped up to care for the sick, administer vaccines, and provide medical standby at vaccine clinics, I feel proud we were part of helping our country overcome the pandemic. We succeeded in keeping our community as safe as we could. For years we have said EMS is a force multiplier with a role in public health and injury and illness prevention. The pandemic gave us a chance to demonstrate this and show we are ready and able to help protect the health of the community, however we are needed.

Bruce Evans, CFO, SPO, NRP, MPA, is president of the National Association of Emergency Medical Technicians and chief of the Upper Pine River Fire Protection District in Bayfield, Colo. He is adjunct EMS faculty at the National Fire Academy and has received both the NAEMT Presidential Leadership Award and James O. Page EMS Achievement Award.