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Firefighters from the Menlo Park Fire Protection District knew that they needed to adapt to the new normal about two weeks ago, when the district received a call from a local hospital letting them know that a man they had just treated for cardiac arrest had tested positive for COVID-19.
Paramedics from the district, which serves Menlo Park, East Palo Alto and Atherton, had asked the patient to step outside and treated him with a nebulizer. Responders were wearing the typical personal protective equipment, including N95 masks and gowns, Fire Chief Harold Schapelhouman said. But because their eyes weren’t protected, there was a chance that they might have come into contact with droplets from the man.
While none of the responders contracted the coronavirus, Schapelhouman treated the incident as a wake-up call.
“We said, ‘That’s it. We’ve got to change what we’re doing,'” Schapelhouman said.
The district’s evolution has been swift. It now has a dedicated “pandemic rig” that responds only to COVID-19 incidents. Its paramedics have the highest level of personal protective equipment and they regularly decontaminate their apparatus, equipment and clothing, Schapelhouman said. The district also dipped to the cache of equipment it has accumulated because of its status as a National Response Team — including powered, air-purifying respirators and mask voice modulators.
Other emergency-response organizations, including hospitals and health care providers, have also had to adjust, both to the enhanced need for personal protective equipment and to the dwindling global supplies of such equipment.
In the past, Schapelhouman said, firefighters would only wear gowns, masks, face shields and glasses on rare occasions, such as when responding to someone with spinal meningitis or tuberculosis. These days, the district gets between one and seven COVID-19 calls, requiring greater use of the protective gear.
“Arguably, for almost every medical call we should be heading out like for a worst-case scenario.” Schapelhouman said. “We tried to up our game — that may mean we use less of the paper products and more of what we use in a typical decontamination process, which we have the power to do.”
The shortage of personal protective equipment for emergency responders has become a major problem in other parts of the nation, where the recent surge of patients has overwhelmed health care systems. In New York City, which has been ravaged by COVID-19 over the past two weeks, more than 1,000 police officers and more than 250 firefighters had reportedly tested positive as of last week.
In the Bay Area, the number of COVID-19 cases has risen only gradually, and departments have not exhausted their caches of equipment. Even so, the issue of personal protective equipment is becoming a topic of growing concern.
“On an ongoing basis, we are able to meet our day-to-day needs,” Palo Alto City Manager Ed Shikada told the City Council Monday, when asked about protective equipment. “But it is short. And I think it’s accurate to say we had to be pretty strategic in terms of how that equipment is distributed, as well as to seek additional sources for equipment.”
The Palo Alto Fire Department remains well-stocked with most types of the basic protective equipment, including masks and gloves, according to Fire Chief Geoffrey Blackshire.
“As long as we can provide them with appropriate protective gear, which we’re doing now, and funding solutions and contingencies when stock is low, that keeps them confident and keeps them prepared,” Blackshire told the council Monday night.
One area where the department has seen a shortage has been in gowns. But the department, Blackshire said, is finding additional ways to protect responders: coveralls. And if the city runs out of both gowns and coveralls, staff has identified a specific type of raincoat that can be disinfected and reused.
The department has also received some help from the community in the form of donations. This includes a donation of 100 masks from Palo Alto’s Chinese-American community last month. More recently, the department received 2,000 surgical masks from Palo Alto’s sister city, Yangpu District, China, and 3,000 gloves from the Palo Alto Unified School District. While the donated masks weren’t N95 masks and donated gloves that it also received weren’t medical gloves, the department was able to use both and conserve its use of the higher-level protective gear.
“We were able to get creative. We were able to use those masks on patients to protect the responders. And we were able to use those gloves to clean and decontaminate the fire stations and apparatus instead of using medical gloves,” Blackshire said. “The donations have been very beneficial, and we’ve been able to adapt to the equipment we’ve received.”
(The department is now accepting donations of gowns, safety goggles, disposable coveralls, aseptic wipes, heavy-duty paper towels, hand sanitizer and disinfectant spray, according to the city’s donation page.)
Police also switch gears
Police departments have also had to adapt their operations, in many cases by reducing face-to-face interactions and switching to phone and video calls for routine matters. The Menlo Park Police Department has urged residents to only call 911 for “life threatening emergencies (life or death) only” and informed them that for non-emergency incidents, callers may be asked to use an online form or file a report over the phone.
Atherton Police Chief Steven McCulley said that, just like in Menlo Park, if police receive a call about something minor — a stolen bike, for example — they will take the report over the phone or using a video call instead.
McCulley said he has instituted new measures to protect his officers during the outbreak. At the police station, officers and the department’s eight support staff members wear surgical masks as a precaution and officers clean their boots at a washing station so they don’t bring the virus inside. And once the department acquires a forehead thermometer, staff will soon have their temperatures taken when they enter or exit the station, McCulley said.
Before the outbreak, the police department had supplies on hand for officers entering contaminated sites. McCulley and his 20 police officers have access to Tyvek protective suits and a limited supply of N95 masks if they need to enter an area that will potentially expose them to COVID-19. Officers also have chemical-agent masks with special filters and eye protection. The department has enough personal protective equipment for the next month or two and that can easily be resupplied, he said.
Additionally, supplies are coming in from Atherton residents, who have been donating hand sanitizer, disinfectant wipes, surgical masks and catered meals, he said.
Officers wear a surgical mask anytime they interact with the public. If it’s necessary for police to respond to a call in person, police dispatchers are trained to ask callers about their symptoms, McCulley said. The dispatcher briefs the callers about precautions police will take when they arrive on the scene.
San Mateo County now has two hotels where officers can go to rest and another hotel set up for officers who are showing symptoms of the virus and don’t want to go home to their families, McCulley said. Personally, McCulley leaves his boots at the front door of his home and washes his hands right away to protect his wife from any possible exposure to the virus.
Although the outbreak puts an added layer of stress on officers, “This is this is the time we (police officers) all choose to rise to the occasion,” he said.
“Our residents are looking to us for leadership and confidence, and we know now this is the time we have to come to work,” he said.
Find comprehensive coverage on the Midpeninsula’s response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.
