In Florida’s 30 census-designated rural counties, COVID-19 is putting emergency medical services personnel to the test.
For instance, there’s not much margin for error in Suwannee County, with a population of about 44,000 people where the health department on Tuesday announced its 33rd coronavirus case.
“I can’t do without many of my guys, especially if they’re under quarantine,” Suwannee County Fire Chief Eddie Hand said.
COVID-19 has changed the way his department and others in Florida’s northern and central rural counties approach, evaluate and transport patients, Hand said. EMS and hospital patient intake procedures sometimes change multiple times a day.
Due to its small size and funding, Suwannee County can only accommodate 20 first responders to serve those residents, Hand said. But despite limited resources, the county has implemented precautionary measures to help reduce the spread of the coronavirus.
Hand said Suwannee County now operates a central station in the middle of the county for coronavirus cases. One-fourth of the county’s total ambulance fleet is dedicated to COVID-19 calls in the absence of an active emergency, Hand said.
To reduce virus spread while at work, emergency service personnel are taking precautions, Hand said. Shift personnel are kept separate from administration and all stations are closed to the public. He expects these preventative measures to continue for the ‘foreseeable future.’
In Highlands County, social distancing measures have caused a short-term drop in emergency calls, public safety director Marc Bashoor said.
“The change allows us to focus more on normal EMS calls, instead of chasing accidents up and down the road,” Bashoor said.
Call volume has decreased 20% compared to the previous year, he said. But Bashoor expects this trend will reverse within three weeks as Florida approaches the peak of the virus infection curve.
One-third of Highlands County’s 102,000 population is above the age of 65, the highest risk group for COVID-19 infection, Bashoor said. He fears many of the county’s residents will be among those infected.
“It’s going to get a lot worse,” he said.
Highlands County officials have considered reducing the number of personnel in service to lower the chance of infection among staff. His team is currently down three first responders due to a quarantine put in place after exposure to the coronavirus, and he believes they can only handle one more loss.
Taylor County’s Doctors’ Memorial Hospital is the only hospital serving Taylor, Dixie, Lafayette and Jefferson counties.
For Zach Hale, its emergency medical director, fears of being down a staff member keep him awake at night. The hospital has only 20 total EMTs and paramedics on staff, making any self-imposed quarantine a significant strain on resources.
“There is literally no one else in these rural communities to replace our responders if we become sick,” he said. “Who's going to show up when you call 911?”
Although Taylor County has not yet recorded a positive case of COVID-19, Hale said his team has begun updating protocol to prepare for an operations change.
Once approved, first responders will be able to directly evaluate potential COVID-19 patients using a questionnaire to determine if they require transport to the hospital, Hale said. EMS personnel will notify local health department officials of the patient and provide their information if follow-up testing is needed.
If a patient’s condition requires hospital transport, EMS crews will provide advanced notice to the receiving hospital to prepare sanitary measures for ambulance arrival, he said.
All of the hospital’s ambulances are stocked with personal protective equipment like masks, face shields and gowns. These supplies are very limited, Hale said.
“My biggest current concern is the limited amount of personal protective equipment for rural first responders,” Hale said. “If there is a large influx of patients, we very well may run out.”
Hale said Doctors’ Memorial Hospital is currently reaching out to federal and state resources for more of these supplies.
In the Panhandle, Gulf County has only one reported case of COVID-19. The case is travel-related, and the woman infected is not hospitalized and is in self-quarantine. However, with a population of just over 13,000, EMS director Jody Daniels worries whether the county will be able to handle a large outbreak.
According to Daniels, Gulf County has about 35 full-time EMTs, and it does not have a large quantity of personal protective equipment. His region is still recovering from the aftermath of Hurricane Michael, which ravaged the coastal county in 2018.
Officials in the county are taking necessary precautions however possible, Daniels said. Beaches and other public places are closed and people are working from home if they can. But the uncertainty is still on everyone’s minds.
“It’s really hard to deal with because we just don’t have the manpower if this gets bad,” he said.
Gulf County would likely have to reach out to neighboring counties for assistance if the number of COVID-19 cases rise significantly, Daniels said.
It is unclear exactly how the coronavirus will continue to affect rural Florida areas, but in Georgia, as The New Yorker noted this weekend, counties just north of the Florida border have started experiencing strains on their systems. Those with a lack of medical professionals and equipment have had to send patients to bigger hospitals.
The Phoebe Putney Health System in Albany has become a hub for southern counties looking for some relief. Now there are concerns about how many more days’ worth of personal protective equipment are left as the hospital's 91 beds fill up.
Emergency personnel in suburban counties are also implementing precautions due to the coronavirus.
In Osceola County, just outside of Orlando, almost 200 cases have been confirmed as of Friday. Despite this, there is not a high volume of hospitalizations, said county fire rescue spokesman Andrew Sullivan.
Osceola County’s sheriff's office operates call centers for COVID-19, making the jobs of medical professionals slightly easier, Sullivan said. The office screens calls from residents who report symptoms and relay that information to responders so they know the scope of what they are dealing with. St. Cloud and Kissimmee have their own call centers.
“We’re having success in being able to work with the folks that are in need,” Sullivan said.
As of April 3, no first responders in Osceola have reported symptoms related to the coronavirus.
Across the state, medical personnel are on the frontlines in the fight against COVID-19, but the best advice in slowing the spread is the same advice that has been broadcast for weeks: social distancing.
“Help us by staying at home and remaining socially distant,” Hale said. “It will be uncomfortable for a while, but it will benefit us all in the end.”