Over the years I have spent many hours at planning meetings for many different areas of healthcare. These meetings involve planning for mass casualty incidents, active shooters, moving patients during a national emergency and yes even pandemics. We have received funding and supplies over the years in preparation for such events, but never really had the need to use them until this year.
During the Ebola outbreak, our department became one of several in the State of Iowa to develop specialized ambulance transport teams to move highly infectious disease patients from hospital to hospital if necessary. Our team received funding for specialized equipment to use for these transports and team members received specialized training. Because of this, we started monitoring the COVID-19 outbreak early on. By the end of January our planning was already taking place.
Our first step was to inventory our protective supplies. At first, we did not include our specialized response team supplies, anticipating the need to keep those separate and available for specialized transports. Eventually we needed to utilize some of these supplies also. Luckily, we had over 2000 expired N95 masks and hundreds of patient gowns. These had all been provided by the Iowa Department of Public Health during previous outbreaks such as the H1N1 flu outbreak and had been kept in the corner of a supply room. We also received several UV light disinfection systems through similar means as the masks. All these items would come into use as the virus soon became a pandemic.
West Des Moines Emergency Medical Services is a municipal EMS agency that partners with a local healthcare system to provide for their transportation needs. Because of this, our crews have been transporting suspected or positive COVID-19 patients in both the hospital and pre-hospital setting for many months. We average 3 to 4 COVID-19 positive or suspected positive patient transports each day. These include longer distance transports of very sick COVID-19 patients from smaller to larger hospitals.
Early on, our crews were notified by either the hospitals or public health if we had transported a positive patient. The first few notifications that came to us were on patients that did not have COVID symptoms, but we transported them for other reasons. Because of this, we decided to treat every patient as if they had COVID-19 and use enhanced precautions. Because we had the large supply of expired N95 masks it was decided to use N95, gloves and eye protection with every patient. We added a disposable gown if we were entering a nursing home or the symptoms indicated COVID-19. In addition, we added policies on vehicle decontamination that included electrostatic sprayers and UV light decontamination. These were in addition to the CDC recommendations. Last, we closed our stations to the public and required cloth/surgical masks for all our staff in the stations and while in our vehicles.
We feel these early measures have helped us to provide a safe work environment for employees and a safe transport and treatment environment for our patients. We have transported hundreds of COVID-19 positive patients this year and out of 70 of our staff members, only 5 have tested positive. Of those five, only 2 were symptomatic. The State of Iowa offered the ability for first responders to test for the COVID-19 antigen through a blood test. We decided to take advantage of this opportunity and felt it would be a good test to see if our protective measures were effective. The antigen test would indicate anyone who may have been positive but showed no symptoms. Nearly all our staff was tested and only 2 had the antigens. Both were in the group of 5 that tested positive.
As we continue to navigate the COVID-19 Pandemic, it is important to not become complacent in the recommended protective measures. The CDC website has protection and exposure recommendations for almost every type of occupation. While there is much we don’t know yet about COVID-19, we do know that some basic precautions provide protection against the virus.