Medical professionals, as well as police officers, firefighters and paramedics, had to adjust the way they carry out everyday tasks with limited information about COVID-19, the disease caused by the new coronavirus.
Hospitals worked to designate coronavirus-specific units. Worcester’s police officers have eliminated roll call. Paramedics found themselves administering tests to the public. And firefighters increased sanitation in their stations, limiting the number of people who come in and out.
They needed personal protective equipment, or PPE, more than ever. As hospitals worked to find more PPE to protect health care workers, police officers, firefighters and paramedics began donning more gear on each call, never knowing where coronavirus lurked.
Any semblance of an “average day” is now gone. Here is a glimpse at what a day on the job looks like now for Worcester’s front line medical professionals and first responders in the age of coronavirus.
Worcester doctors, nurses and physician assistants
For modern-day health care workers, the pandemic is unprecedented. With the number of cases steadily increasing in Massachusetts, hospitals have had to put most of their focus on coronavirus.Intensive care units have been near capacity will gravely ill patients, as Massachusetts has seen 2,899 deaths from illness related to coronavirus and at least 54,938 cases of the virus as of Sunday.
The biggest change for health care workers, said Justin Precourt, the UMass Memorial Medical Center chief nursing officer and incident commander for the hospital’s coronavirus response, is adjusting to working in that environment. Instead of just one or two critically patients in the intensive care unit, today there can be 10 or 20 patients in grave condition, all with conditions that change rapidly.
“The level of illness that patients in critical care present with is really unprecedented,” he said. “They are incredibly sick and they get incredibly sick really quickly.”
One physician assistant said that hospitals were not prepared for how sick this tidal wave of patients would become, and did not expect the percentage of the population the virus would affect.
For Precourt and other UMass Memorial leaders, mornings and afternoons are dotted with meetings, identifying new issues with coronavirus response that need to be addressed and setting new goals.
Before the pandemic, doctors, nurses and physician assistants would keep families updated on a patient’s condition from within the hospital’s walls. But when the severity of the coronavirus crisis became clear earlier this year, hospitals started limiting the number of visitors who could come inside with loved ones.
“It’s changed the way that we interact with [families] and it’s really created quite a bit of moral distress, especially when you’re taking care of really sick patients, to not be able to update the family in person and talk things through,” Precourt said.
That has led health care workers to rely on technology and telehealth methods. It works, but it’s not the same as a face-to-face conversation. Meanwhile, hospitals have reported seeing fewer patients coming in to emergency rooms, waiting injured at home amid the pandemic.
The crisis has been taxing for health care workers. Precourt said he’s worried about the staff as they navigate this stressful, uncharted territory.
“Those of our staff that are really on the front lines and living this day in and day out, making sure that they have the support both now and after this to appropriately process, to understand what happened,” he said. “This is something that’s probably going to change them for the rest of their lives and I just want to make sure that we are giving them everything that they need in order to heal from this.”
Worcester police
Worcester police officers in the operations division used to start their day coming into work, changing into uniform, going to roll call and getting ready for the day before hopping into their cruiser to head out on patrol.But now, that routine is changed.
The police department is trying to keep as few people inside its building as possible. Limiting time in the building meant eliminating roll call, said Officer Dan Heavey.
“We miss it because obviously, it takes away from the social aspect, bonding with fellow officers. That’s definitely different but it’s just another challenge that we face and we’re adapting to and understand that it’s important," Heavey said.
Officers now get their temperature taken and head right out to their cruisers -- which are disinfected between shifts -- to go out and patrol Worcester’s streets, getting information on tasks for the day via email.
Worcester’s police department values community policing and officers try to be out-and-about, interacting with the public. Now, officers drive on streets that have fewer cars and check on empty properties, shuttered amid the pandemic.
In today’s world, responding to any call takes on the aspects of going to a medical incident.
“I guess now the only difference is we need to take those precautions on every call we go to because we have to treat everyone we interact with possibly, potentially having the virus," Heavey said. “That’s just your average routine calls, making sure you have gloves on, we have our N95 masks on, or gowns, face shield, if needed.”
Police officers go through rigorous training. But dealing with a dangerous, highly infectious virus was unexpected.
“This is definitely something I never expected to this degree,” Heavey said. “Obviously our job is inherently dangerous. This is a different kind of danger we haven’t necessarily always been trained to deal with so it’s definitely new and we have to adapt pretty quickly.”
Heavey said he sees the restrictions in place as just another challenge to overcome in a mission to keep the city safe.
Worcester firefighters
Firefighters have had to react to viruses before. But this time, it’s more serious.“This one seems to have overtaken everything,” said Worcester Fire Lt. David Anger. “It’s slowing down us being able to get in because we have to do certain things now with PPE.”
When going to calls around Worcester, firefighters now don downs for added protection. On some calls, only one firefighter will go into a residence and determine if more than one person is needed inside, an effort to expose the fewest amount of people.
While coronavirus is at the forefront of everyday life right now, these firefighters try and do their jobs as normal as possible.
“It’s always in the back of your mind but we’re also well trained and as prepared as we can be to handle this,” said Lt. Michael Santella. “To allow worry to get in the way of work I think would be counterproductive. We still have to go about doing our job because it is our job.”
As lieutenants, the two are constantly thinking about making sure their crews stay safe amid the pandemic.
Inside the fire stations, things have changed in the wake of the pandemic. Firefighters are frequently wiping down surfaces and disinfecting the trucks. The public is not allowed inside currently, and firefighters have been asked to only be in the station when on duty and only go inside the stations to which they’re assigned. Firefighters are trying to keep their distance, which is tough during meals, which are usually a family-style, group affair.
With more people working at home because of coronavirus restrictions, there are far fewer cars on the road. Worcester fire trucks are able to navigate city streets with more ease and without the gridlock that comes with rush hour. That part of the job is faster now. Donning all the protective gear does add a few seconds to the response time, however.
“It might take a couple more seconds to gear up for the call, aside from that we’re still here when needed,” Santella said. “For us, we are still responding, were still there for the city.”
Worcester EMS
For paramedics in Worcester, coronavirus has changed just about every aspect of the job.Inside Worcester EMS ambulances, the area connecting the driver’s seat and the rear of the ambulance is now closed off. Responding to calls now involves even more PPE than before: gowns, masks, goggles, gloves and in some situations, powered air purified respirators.
“It seems like at this point three-quarters of what we go to is a fever, a cough or trouble breathing,” said Bryan Urato, the president of IAEP Local 95 in Worcester and a lieutenant with Worcester EMS.
When paramedics get to calls now, just one person will go into a residence to try and limit exposure.
Telehealth has become a regular part of the routine for paramedics. With hospitals inundated by coronavirus patients, paramedics are utilizing telehealth to connect doctors with patients at home, helping to determine if the person needs to come in to the hospital.
Paramedics have been testing people across Worcester for the respiratory illness, and have taken specific steps to help care for the city’s homeless population.
Using a 12-person van that’s frequently sanitized and outfitted with plastic barriers, Worcester EMS has been picking up members of the homeless population who test positive to bring them to a designated shelter, limiting the spread of the virus.
Worcester City Manager
Before coronavirus, City Manager Edward Augustus Jr. already had a schedule replete with meetings.His schedule is still packed. But now, just about all the meetings are about one thing: coronavirus.
Augustus gets to City Hall early and starts organizing his day, often doing a morning call to talk about the Worcester Together Fund, which as of Friday has raised more than $5 million for the city’s short- and long-term needs amid the pandemic. Then there’s a call with the Emergency Operations Center command staff to discuss what’s coming up for the day. There are more calls around 4 p.m. and 7 p.m.
Keeping the hospitals from becoming overwhelmed is a priority. Part of that mission has been in helping the homeless population in Worcester, which has seen dozens of cases of coronavirus. City nursing homes and health care centers, like the rest of the state, have been hit hard by coronavirus outbreaks. The Jewish Healthcare Center has seen at least 13 deaths related to the virus.
“That’s stressful,” Augustus said. “That’s peoples’ lives. You know the impact it has on families. You know how when you announce something like that, how nervous people are going to be. People have loved ones there. People who have loved ones who work there.”
Usually this time of year, Augustus is consumed with the city’s budget. Now, the budget needs to be completely revisioned: COVID-19 response and equipment, and over time, have changed everything.
“I’ve been really focused on trying to make sure my workforce is protected,” Augustus said. “That’s a big important obligation I have, not only because as an employer, that’s our responsibility, but also in terms of the services we provide, they’re critical to everything else working. If you didn’t have enough police or fire or dispatchers or public health nurses, the rest of the system wouldn’t work.”
For weeks, Augustus has held a press conference just about every day, updating the public and the press on increases in cases and new initiatives.
Augustus said his staff has been the biggest resource in this time, working long hours to help the city steer its way through the pandemic.
MassLive reporter Michael Bonner contributed to this story.
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