Pa. agency seeing highest call rates ever as delta wave of COVID-19 continues
As Cumberland Goodwill EMS prepares for the omicron variant, Nathan Harig, assistant chief, says costs are up but reimbursements are not
CARLISLE, Pa. — With hospitalizations again rising and case counts remaining high, local ambulance crews remain crucial to the fight against COVID-19.
We talked to Nathan Harig, assistant chief of administration for Cumberland Goodwill EMS, about what crews are seeing in the pandemic's latest wave as well as the challenges those crews face.
Q. How does data for the current phase of the pandemic compare to what you've seen previously?
A. We have definitely seen an increase in the number of patients we are encountering for COVID-19 dispatches since the start of August.
That coincides with the start of the delta wave here in Pennsylvania. After a sharp rise in September and early October, we plateaued for a bit until recently when it seems to have returned to a higher rate of 911 calls for suspected cases. In general, October was our busiest month ever as an emergency medical service. We are responding to both COVID calls and the normal emergencies that take place this time of year. While we are still not where we were exactly one year ago, that exponential growth that took place at the end of 2020 is certainly something we do not want to repeat, especially with the wide availability of quality vaccines and boosters.
Q. What concerns do crews have as the omicron variant begins to spread?
A. Omicron continues to be researched. We've seen both promising news when it comes to how severe it may be but also concerning news when it comes to how easily it may be transmitted or reinfect those who only have a natural immunity. As is usually the case in EMS, we have to be ready for whatever hits our area, and right now that continues to be the delta wave. Luckily most of the precautions that work for delta appear to also work for omicron. We continue to respond to everything while wearing N95 masks and to highly suspicious cases wearing our full PPE. Every responder at our organization who goes out on a truck is fully vaccinated and we have begun working with staff to schedule their boosters. We want to make sure that responders are available and not having to quarantine if another wave comes. We've also had to invest in rapid testing for our staff that show any symptoms, and we reiterate to them frequently not to come to work even if feeling ill.
Q. From what crews see as they transport patients, how are emergency rooms and hospitals holding up?
A. Our hospital workers in the Carlisle area are amazing. They have done a great job recently at keeping the doors open for EMS. We are well aware that there are significant wait times, sometimes even close to a full day, before someone can be fully seen in a room in the emergency departments. That is even if they have arrived by an ambulance. Still, staff at UPMC Carlisle are finding ways to get them evaluated, maybe some initial care even in the waiting area, and to get the most seriously ill treated quickly to ensure everyone gets the best care possible during these difficult times.
Hospitals outside of Carlisle are struggling with high volume as well, with many in the Penn State system going on a total ER divert request for EMS almost daily. The UPMC hospitals tend to only go on psychiatric diverts, but will try to make sure that ambulances can offload their patients so they can then handle the higher volume in their communities. This has really been the challenge, and we're thankful that our hospitals are finally understanding that if we are unable to get out and respond to the needs of our community when they dial 911, it just creates more problems for the entire emergency medical system.
Q. Even before the pandemic, reimbursements from insurance companies have been problematic for EMS companies. How has this challenge been complicated by increased call volumes?
A. Reimbursements are a big problem in EMS. We have seen during this pandemic that EMS should be an essential service, but it is not funded appropriately or treated that way. What has helped us locally has been a tremendous response from the community to make donations and help us receive grants that bridge the gap from what Medicare, Medicaid and commercial insurances pay.
The problem is, our reimbursements have not changed dramatically but pricing has. We have to pay more for supplies, we are using more equipment to treat more sick patients, and all of this comes at a higher cost. The model of how we pay for emergency medical services is not working, and we have been very clear with our state and federal leaders that something needs to change. We are very concerned that other EMS agencies, even in our region, have had to close or merge and then see a reduced level of service in their community. What then happens is agencies like ours have to go and provide mutual aid services, sometimes into Perry, Adams or York counties. We don't receive any sort of financial support to serve those areas, but they are using resources more frequently that we had designated for our Carlisle community, resulting in other agencies having to come and backfill us.
What we need to move to is a funding solution very similar to how police departments are funded in Pennsylvania. Most EMS, especially in Cumberland County, are paid departments with significant regulatory and educational requirements. We need to stop treating this as if it's a free taxi ride. There's a lot more professional work that goes into a response that our government leaders need to be supporting.
Q. What can the public do to help EMS companies?
A. When you look at a map of vaccination rates, Cumberland County stood out. We had one of the most successful mass vaccination sites right here in our area. Our neighbors are to be applauded for doing what they can to make our job easier in EMS. Now, with delta still looming in our area, it is time to get a booster if you are eligible. This will help reduce severity of disease, especially in those who might see some waning immunity if it's been more than six months after their final vaccination. This means you have a lower chance of encountering EMS. One call reduced helps us to be available for someone else who is experiencing an emergency that might not be preventable by the free vaccine.
We continue to be concerned about how many people are entering the emergency medical service fields, and continue to work to host courses and connect people who are interested in serving their community as an EMT or paramedic with fully funded training if they qualify for a position with us. Finally we always except donations from the community. We are currently running our annual ambulance membership drive that is our major fundraiser for the year. Every little bit helps us to respond to the challenges that COVID-19 has created.
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