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EMS in the News

New York’s Paramedics, on the Front Lines and Forgotten

BY Mara Gay  NEW YORK TIMES   APRIL 8, 2020

Christell Cadet waiting for a call during her evening shift in Queens last year.Credit...Damon Winter/The New York Times

Christell Cadet, a New York Fire Department paramedic, loves her job.  I know because she told me. When I asked her what it was like to be on the ambulance last year, she spoke of the thrill of saving a life, of racing toward danger to help when others were running away.  Christell has been on a ventilator for the better part of a month, sick with the coronavirus and fighting for her life. She is 34 years old.  "I just want people to know that she's a very beautiful person. She has a good heart," her mother, Jessy Cadet, told me by phone this week. "She's always ready to help anybody, everybody, everywhere."

Much attention in this terrible pandemic is being focused on the country's hospitals, and rightly so. But the battle is also being fought by the nation's front-line emergency medical workers, paramedics and E.M.T.s. These skilled professionals are responding to a deluge of calls, risking their lives to aid millions of sick Americans.

In New York City, where the roughly 4,400 emergency medical workers who work for the Fire Department are already underpaid and overworked, the pandemic is taking an enormous toll.  The city's E.M.S. workers are responding to between 6,000 and 7,000 calls a day; the previous average was about 4,000 a day.

Nearly a quarter of the city's E.M.S. workers are on sick leave, according to Fire Department officials. At least three are in critical condition.  One question amid the shortage is how many face masks in the city's stockpile are actually making it to the E.M.T.s, paramedics and other city workers who are most at risk. De Blasio administration officials declined to respond to repeated inquiries about how the masks and other critical medical supplies were being distributed across city agencies.

Mayor Bill de Blasio said at a news conference Tuesday that the F.D.N.Y. commissioner, Daniel Nigro, had assured him the department had the supplies it needed. The mayor said the department was meeting a "crisis standard" of personal protective equipment held as acceptable by the Centers for Disease Control and Prevention. "Anything more they need, they will get," Mr. de Blasio said.

  E.M.S. workers tell a different story.

In interviews, they said some stations started running out of N95 masks weeks ago. They said they have been forced to reuse masks, gowns and other protective gear. To request additional N95 masks, they said they must explain in writing how they used their previous supply. And they said there is little or no coronavirus testing available to them or their colleagues.

"It's scary, because you take a patient to the hospital and the nurses and the doctors are fully covered from their head to their toes," said Elizabeth Bonilla, an F.D.N.Y. paramedic. "They have booties, they have hairnets. A gown, two masks. We're exposed."  It's not just a New York problem. Bruce Evans, president-elect of the National Association of Emergency Medical Technicians, said some workers in the United States were using raincoats as protective gear.

Bree Brown-Rosa, a paramedic with an F.D.N.Y. HazTac unit, which is trained to handle terrorist attacks and hazardous materials, said her unit doesn't consistently have enough N95 masks to safely perform its job, even as she and her colleagues do their best to conserve them.  The other day, Ms. Brown-Rosa walked into her E.M.S. station to find a pile of P-100 respirator masks, donated by The Home Depot.

"Here I am, a HazTac paramedic in the best Fire Department in the world, and we have to take donations from local businesses to protect ourselves," she said. "People need to be held accountable. Heads need to roll."  How did this happen in New York, a city with a world-class Fire Department justly celebrated for its heroic service during the Sept. 11 attacks?

Emergency medical services have been an afterthought in New York for years. In much of the country, firefighters also serve as paramedics or E.M.T.s. But in New York, E.M.S. is a separate division within the Fire Department. Firefighters receive a base pay of about $85,000 after five years on the job, compared to about $65,000 for paramedics and $50,000 for E.M.T.s. The firefighting force is three-quarters white and about 99 percent male; more than half of the department's E.M.S. workers are minorities, and more than a quarter are women, according to city data.

Christell Cadet on the job last year. She now has the coronavirus and is fighting for her life.Credit...Damon Winter/The New York Times

 Mr. de Blasio, now staring down a yawning budget hole, says it's not the time for pay raises. "We want to take care of these workers and support them, of course have their backs, but this is a bigger issue in the labor dynamics of this city," he told WNYC on April 3. "It's not the time to, you know, make something up on the fly in the middle of a crisis. We'll figure this out when we get through this crisis."

Remember that the next time you hear a siren. Tell that to Christell Cadet's mother.

The pay gap was wrong before the pandemic. It was bad public policy, making it difficult to attract and retain talent in New York's E.M.S. force. More than 1,500 E.M.T.s and paramedics became firefighters since 2013, according to city officials, leaving E.M.S. units understaffed and working regular mandatory overtime shifts.

Mr. de Blasio failed to strengthen the city's E.M.S. service in recent years even as medical calls, rather than fires, came to make up more than 80 percent of the Fire Department's work. Despite this, firefighters managed to rack up more than $340 million in overtime in fiscal year 2019, which ended last June. When it comes to political power, New York's firefighters just have more juice.

Paramedics and E.M.T.s, like firefighters and police officers, doctors and nurses, are asked to do a skilled and dangerous job. They should be treated with respect, and paid fairly in return.

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