‘Stay strong and stick together:’ FDNY EMS chief reflects on NYC’s COVID-19 peak

Through sheer force of will by first responders, healthcare workers and the city as a whole, the COVID-19 battle is winding down, but leaves scars


For weeks, as COVID-19 ravaged the city, the New York Fire Department’s EMS division fielded thousands of medical calls a day, shattering previous call records, while also dealing with a significant shortage in their workforce as the virus sickened hundreds of first responders and forced thousands more to self-quarantine.

I connected with FDNY EMS Chief Lillian Bonsignore, who reflected on the experience of managing the COVID-19 crisis as it was spreading to not only residents but through the department, as well.

EMS1: Is the department still relying on supplemental staff and ambulances, or has enough of the traditional force recovered to meet the required response in the city?

FDNY paramedic Elizabeth Bonilla strictly disinfects her ambulance prior to a double shift at EMS Station 3, Wednesday, April 15, 2020, in the Bronx borough of New York. (AP Photo/John Minchillo)
FDNY paramedic Elizabeth Bonilla strictly disinfects her ambulance prior to a double shift at EMS Station 3, Wednesday, April 15, 2020, in the Bronx borough of New York. (AP Photo/John Minchillo)

Chief Bonsignore: As you can imagine, a surge in call volume and a highly contagious virus is enough to stress any system. At one point, 25% of our EMS workforce was out sick related to this virus. When we started to see steadily increasing call volume, we requested supplemental resources from all of our EMS partners. Our hospital-based partners staffed additional enhancement units, NYC volunteers were activated and we requested FEMA resources, which brought 350 additional ambulances and crews into this fight. Currently, we are still operating with many of these resources on the front lines.

As chief, how has this period in your career changed you? Would you put it on par with going through the events of Sept. 11?

This is by far the most challenging time in my career. Over the last three decades, I have experienced many large-scale events; each one has changed me a bit. Sept. 11, 2001, was a particularly tragic and very personal day. In addition to all the civilian lives lost, we also lost so many of our own that terrible day. It was on purpose. It was an attack. I can still see it and smell it when I go to the site.

September 11 was very different. That attack was a static event. It happened and then it ended. We were left with the aftermath and we went to work. We worked around the clock; we knew what we had to do. We were not afraid to be there. We were able to go home to our families, hug our children, gather together, support each other and cry together when necessary.

COVID-19 was an MCI that escalated for three weeks before we plateaued. This virus brought personal isolation, immediate illness and fear, which made it much more difficult to handle. There is a palpable fear of getting the virus, fear of spreading the virus and fear of bringing it home to our families. Many of our members got very sick, some still fighting for their lives, some succumbed to the virus.

Our first responders are not able to gather and comfort each other. Many are not able to go home and hold their loved ones, kiss their kids or see their parents. Each rescuer is required to keep social distancing and have their face covered by a mask. COVID-19 brings a high death toll. The resuscitation efforts take place under the watchful, hopeful eyes of loving family members. Many patients cannot be saved, leaving our EMS providers to explain the situation to families over and over again during the same shift.

These are two major events that have changed me forever.

Looking back, what do you wish you had known before the effects of the pandemic began being felt in NYC? How would you have prepared differently?

Having never been through a global pandemic before, I wish I knew how fast this virus was going to move. In order to stay in front of what we were facing, we needed to change rules and policies very quickly. Communicating those rapidly changing orders to thousands of field members was a challenge, but our officers managed to make it work.

How has this pandemic shaped your decision-making for the future?

Now that we have been through this event, we have much more information and experience to fall back on in the future. I will certainly be able to adjust my future decisions and base it on what we know to be true.

What advice would you give EMS leaders to help them prepare for an outbreak in their area?

Plan for an extended operation, stockpile and conserve PPE, communicate expectations with the first responders as early as possible. First responders will get sick and will not want to go home; make arrangements for quarantine, if possible. Stay strong and stick together. You will get through it. EMS always does.

How has this shaped the career perceptions of young EMS providers?

A situation like this one is difficult for providers of all ages and levels of experience. In talking with them along the way, I found our EMS providers to be committed and courageous. They are pushing past their own fears and exhaustion because they have accepted their position in society. First responders don’t quit, they are soldiers during this medical war. They understand the mission and they are here to serve those patients that need them more than ever.

What words of encouragement have you offered to your force during the pandemic?

When a first responder shows up for work, they are guaranteed to cross paths with someone who is crying out for help. Their presence will change the world for a stranger. Their compassion, professionalism and empathy will live forever in someone else’s story. We do everything we can to help others and save lives, that’s not just what we do, that’s who we are.

The pandemic has clearly altered New York City, along with the world. What does “New York tough” mean to you in terms of EMS?

During this event, I put out a couple of video messages. In the last video, I say, “These may be tough times but not tougher than us, stay strong EMS!” “New York tough” means that no matter how difficult the challenge, we stand shoulder to shoulder and will absolutely overcome. This time, we are six feet apart, but we stand tough, we stand strong and, most importantly, we stand together.

I am so honored to be the FDNY Chief of EMS Operations especially through this time of crisis. What I witnessed was nothing short of amazing. I am so proud of all our courageous women and men that took this unprecedented challenge head on. A special thank you goes out to all frontline heroes. You make the world a better place!

Read next: FDNY hit hard by COVID-19: EMS Chief Bonsignore discusses historic call volume

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