A First Responder Treating Coronavirus Patients: How It Feels

Editor’s Note: As Cleveland deals with the outbreak of the new coronavirus, or COVID-19, everyday life is being disrupted. In our new series “How It Feels,” we’re talking to students, teachers, nurses and those on the frontline of the pandemic to see what it feels like to live life in isolation and transition to new ways of working, thinking and living. For more, read Monday's installment, where we spoke to a local teacher of a low-income elementary school about the challenges her students face in distance learning.

This May, David Knecht celebrates his 25th anniversary as a first responder. A firefighter and paramedic, he’s served the Parma Fire Department since 1999, and worked for Cleveland EMS before that.

He has seen it all over his career: fires, opioid overdoses, anthrax scares, strokes, heart attacks, parking lot births. But the coronavirus is something different.

While most of us are practicing social distancing, Knecht’s job puts him in close quarters with people who have the virus. That’s made an already-risky job even more perilous. Already, four Cleveland EMS workers and one firefighter have tested positive for COVID-19. And in Parma, where a cluster of cases have emerged at a nursing home, two paramedics had to self-isolate after being exposed to a coronavirus patient. (They showed no symptoms and were medically cleared to return to work, Parma Fire Chief Mike Lasky told Cleveland Magazine. All Parma paramedics now wear full gowns, gloves, masks and face shields on nursing home calls.)

“The problem with this is there’s no end,” says Lasky. “We’re dealing with this every single day.”

We talked with Knecht about social distancing, helping coronavirus patients and missing the everyday interactions with his community.

Just entering the station, before you’re even allowed to enter, you have to have your temperature checked. We do that for the individual protection, the crew protection and most importantly the protection of the citizens.

When we’re in common areas, including the kitchen, we’re now wearing face mask. The only time we take them off is basically to shower and sleep. We’re doing our best at social distancing around the station. That’s different. The high fives and hugs have stopped.

We do annual respiratory testing for our masks. We’ve also had training seminars where we do donning and doffing of gowns, gloves, facemasks and shields. We try to make it as realistic as possible.

We’re fortunate enough to have emergency medical dispatchers. They’re asking the pertinent questions, like if [a patient] has shortness of breath, exposure to anybody or recent travels. They’ve been doing that for quite some time. They alert us on the radio to any potential exposure.

If the patient is able to, we’re instructing them to meet us outside. But if they can’t, we send in, for lack of a better term, a scout. He’ll go in and make contact, put a mask on them and bring them out to the ambulance, or he’ll instruct his partner if they can’t make it out on their own.

We’re also very cautious about using aerosolized treatments for people who are short of breath. We do those if we need to, but outside, in an open area, to prevent contamination. We have exhaust fans on nonstop [in the ambulance], to help expel the droplets if they do get in the air.

Initially it was a little more scary. But we’ve done this. This is almost like muscle memory now. We’re in constant contact with the health department, which works through the (Center for Disease Control and Prevention). You can see, whether it’s what we’re doing or what the community’s doing, globally, wherever, the numbers are decreasing. We don’t let our guard down.

We’ve seen a decrease in calls. But I’d say about 75% of our calls, even though they’re decreased, are COVID signs and symptoms or COVID potential exposures. I worked yesterday, and my guys had four or five calls. Four of them were suspected COVID, or COVID exposures.

If we get a call where the patient is suspected or they’ve said they have it, we’ll shut that [ambulance] out of service, they’ll decontaminate the truck at the hospital, the personnel will remain out of service and we’ll switch out members while they do a personal decontamination, which is removing their clothes and showering.

It’s almost like you’re a soldier, when you’re constantly in war, and you’ve got to deal with the potential for PTSD. We laugh through our masks. We lean on each other a lot.

We’ve noticed, the community, they’ve really stepped up. They’ve done their part. They’ve maintained social distancing. We get donations, from eyeglasses to N95 masks to people delivering food.

We [normally] enjoy visitors. We enjoy the little kid that wants to come up and see the fireman. We enjoy the grandma who makes us cookies and wants to drop it off. We enjoy the people that come in, the other firefighters who drop off patches to exchange. It’s sad because that’s an interaction that they want, but we also want. And we can’t do it right now.

People understand what we’re going through globally and locally. They know why we’re dressed the way we are. I had a gas leak yesterday in someone’s house. We had our masks on. She didn’t look at us any different. The only thing is, she couldn’t see us smile.

This is something we signed up for. First responders, nurses, we’ve always found a way to adapt. It’s a little uncomfortable at first wearing a mask. It was a little uncomfortable putting on gear, wearing it all the time, versus a training session. But we’ve adapted. We know that another 15 or 20 seconds can prevent us from being contaminated or contaminating other people. — as told to Sheehan Hannan