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Palm Coast Sunday, Apr. 5, 2020 1 month ago

COVID-19 and the Fire Department: A Q+A with Palm Coast Fire Chief Jerry Forte

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'If we don’t flatten the curve, it’s going to affect our population in a way that we can’t recover from well.'
by: Jonathan Simmons News Editor

How is COVID-19 affecting Palm Coast's Fire Department? How are firefighter-paramedics preparing for coronavirus calls? And how is the pandemic affecting responses to other emergencies? Palm Coast Fire Chief Jerry Forte shared his insights.

Could you give an overview of how the Fire Department is responding to COVID-19 — how it’s changed things?

For a firefighter, change is very hard, especially when you don’t see it coming. What the deputy chief and I had been used to doing is making social meetings with the crews in the afternoons and the evenings, where we’d go out every Thursday and meet with one of the crews at one of the stations, and just see how they’re doing. And part of what we’re doing now is virtual meetings on the Zoom app, which is really not quite the same. ... And we miss doing that; we want to go out and see the crews. But we know it’s beneficial that we maintain our distance from the responding crews.

Sometimes during a pandemic or a hurricane or a wildfire, the nonessential calls seem to wane away, and the essential calls come in heightened. So we’re seeing a whole lot more respiratory calls that are life-threatening, and our call volume in the last four weeks has gone very high.

So when you add the new response procedures — we wait for the dispatch center to tell us if they’ve been screened for COVID questions or not — they’re pretty apprehensive when we’re going up to any patient, justifiably so. ... We’re all taking extra steps to make sure we’re staying safe.

What are some of those steps?

Well, first is the PPE [personal protective equipment]. ... The PPE shortage is challenging everywhere you go. So we were able to take our self-contained breathing apparatus masks, our Scott masks, and we’ve got conversion kits that now we’re able to use our masks as a full facepiece when we talk to a patient, instead of an N95 mask. ... As this disease progresses into the community more, people are going to start seeing firefighters roll up in a full face mask, which covers the eyes, nose and mouth, when dealing with a patient. 

So when they’re wearing their SCBA masks, they’re not actually on air, right? It’s an insert or a filter that’s added?

Correct. It’s an adaptor, and on the adaptor we were able to put a P100 filter which filters 99.997% of particulates at 0.3 microns. This face mask will actually cover their eyes, nose, mouth all at one time, and they’re used to wearing the mask a lot anyway.

What’s it like trying to get proper equipment? Is the use of the SCBA masks because it’s been impossible to get the N95 masks? Or more because it’s a more secure option?

Our job in the fire service is, go with Plan A, but you’d better have a Plan B, C and D in your pocket. When the ebola crisis came out four years ago, we went to these masks and the adaptors and the filters. So, putting a bunch of smart people in a room, we figured we can put the ebola kits together and instead of using it for the ebola scare, now we’re able to utilize it on a daily basis. The cartridges that we use for the filter last at least 30 days. ... We went online and ordered a whole bunch of filters. So, imagine all the calls that we would be going on using an N95; now those get to stay in circulation in the county system, and the crews that can use the N95s will have access to additional masks while we’re using the airpack masks.

So if you were able to get the N95s, there was no shortage, do you think you’d switch to that, or is this just a better thing all around?

I would feel more comfortable leaving the masks from the airpacks on the crew, because it covers more area. ... Yes, we would still stay with the masks.

There have also been some other changes, right? Aren’t you reducing the size of the crew that goes out on these possible COVID, or flu-like symptom calls?

Right. In the past we would go with an ambulance, so there’d be two on an ambulance, three on an engine and we would go to a typical medical call. So you’d have five people showing up on a call. 

Now, if we’re on an engine, we only send one person in to assess the inside of the house with the patient. We ask them if they could come outside, which typically is a far cry from what we would normally do — you don’t ask the patient to get up and move. ... If we do go inside, with that one firefighter, they assess it and they see if we need to send more people in, or bring the patient out.

We want to make sure that there’s at least one person that’s not affected by the contact, and they’re able to drive the engine back to the station while we take a small utility vehicle to pick up the firefighters to de-con them. As you know, if you’ve got a contaminated firefighter and you put him in a clean truck, you’ve now got a contaminated truck, and now that truck’s out of service for an indefinite period of time until we can clean it up and wipe it down. 

What steps do you take to prevent things like uniforms from being contaminated, for the person that goes in and maybe has to be handling the patient really closely?

We ordered booties and smocks and things, but the reality on using those out in the field is they become another contaminant, whereas the uniform, the shirts and the T-shirts that we wear, if they’re going to have anything on them, they take those off, wash them in soap and water, and just change their clothes and that's part of what our response is.

One thing that I’ve conveyed to the crews this past week is: Throughout our whole careers we’re told when the bell goes off, get in the truck, go to the call, they need you at that as quick as possible. But now we’re saying, when you get to the door, you’ve got to slow down, you’ve got to stop and assess the situation even moreso than ever before, because as much as the patient on the other side of the door needs our assistance, we have to make sure we’re protecting our crews as much as possible before they go in the house. And for them, it’s a change of pace.

I’d imagine there are also scenarios where you might get called out to something when it’s not clear if people on the scene might have symptoms — for instance, if you’re called out to a car crash. So how does that work?

We’re going in with the presumption that everybody’s got it, until deemed otherwise.

What is frustrating is, the dispatchers ask the appropriate questions — and they’re doing a great job — but the patients refuse to answer the questions sometimes. So that just heightens our concern about that patient. It’s distressing to the crews that people are withholding information. 

How often does that happen, that people don’t answer the questions? Is it a couple times a week, or?

No, it’s daily. We’ll hear the dispatchers say the patient refused to answer COVID questions.

And then that means you have to do the whole COVID routine that you would do if they answered positive, right?

Right.

So, if you have somebody go through this whole process of decontamination, that must take somebody out of circulation for a while every time you go on one of these calls, right?

Before we had the COVID virus, we would respond in less than 7 minutes ... and get back in service/available within 25 to 30 minutes from the original call-out.

Now, after COVID, we have to go there and we have to take take the time to talk to the patient, additional PPE, gear up, handling them specially, then if one of us does have some sort of contact with the patient, now we’ve got to go for an additional 15 minute de-con. So that unit is out out of service probably an additional 20 to 30 minutes. So that one 30-minute call for a fire engine has now turned into an hour.

So if a second call comes in in the same zone, now we’re taking a unit from across town and sending them to that call, which is going to extend the response time. 

Do you have a sense of how the crews are feeling, what morale is like with this virus?

They’re doing good. They know these are strange times. And we’ve got a lot of seasoned officers who’ve been through a lot of these things, whether it’s a hurricane, or wildfires or just a really bad month of wrecks. ... And they certainly know that there’s absolutely nothing they can surprise us with, that they can tell us anything and we’ll work with them on things. But also ... we’re including them in the decision-making process, and keeping them informed. 

What else would you like the community to know?

That we understand that it’s very stressful at this time for them to be home. Our folks are going out under the understanding that whatever they contact out in the field, they might get and take to their house. So it’s stressful on us.

And if they can be as honest with us before we get on the scene as possible, it works out best for everybody. We appreciate them staying at home, as much as they want to get out in this beautiful Florida weather. But if we don’t flatten the curve, it’s going to affect our population in a way that we can’t recover from well. 

I spoke with our family priest a couple of weeks ago about the new normal, and how you can actually take a look at life.

In ’98, we were dealing with a lot of fires. It was very stressful, there was a lot of smoke in the air, and it would obscure the sun. And as you’re working in this environment, you don’t see the sun, you experience some of those moments where you’re looking at yourself and saying, “What am I doing?” 

And then at some point, when the fire starts to bank down or lessens and the smoke clears, and you can start to see the stars or the sun comes out, you get that sense of rebalance again. He reminded me of that.

And if the community just looks at it as — we’re given an opportunity to stay at home and be more connected with our families and what we do, and it would be a great opportunity for us to take advantage of that, and reconnect with our families and our kids and get used to the idea of what our family life could be if we didn’t have all these outside distractions technology presents, as good as it is.

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