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A Year of COVID-19: What We’ve Learned and What’s Next

By Keith Collinsalumni, Fire Science Management

In January of 2020, the first known case of SARS-COV-2 (COVID-19) reached the United States. By March, COVID-19 began to spread rapidly. The virus created a cascade of illness, fear, and stress, especially for first responders and healthcare professionals. We are still working to find our way out of the pandemic. It is human nature to find hope when faced with adversity.

How do we, in fire and emergency services, find the strength to continue battling this invisible foe and how much longer can we expect to confront this challenge?

Many first responder agencies and healthcare professionals across the nation have had their operations affected by COVID-19. What many of them have learned is how to manage risk, minimize health hazards, and just how resilient our personnel and agencies really are.

[Podcast: Helping Officers and Their Families Manage Stress]

One aspect that had to be identified early on was determining what is the safest way to work at a job that engages with the public daily in the midst of a pandemic? We have done our best using (and reusing) N95 or KN95 masks, surgical masks, eye protection, and (in some cases) disposable gowns.

Even with these protections, masks filter only a portion of the atmospheric environment in which they are worn. What we don’t know, due to numerous variables, is how much effectiveness was lost upon reuse of these masks. Whether due to personal habits outside of work, due to PPE failures, failure to wear PPE appropriately, or just due to aggregate exposure and risk, our industry has been impacted.

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According to Vince Davis via the National Fallen Firefighters Foundation (NFFF), as of February 2021, there were a total of 165 total reported deaths in the fire and emergency medical services industry due to complications from COVID-19. Seventy-nine of those deaths were fire personnel, with 33 line-of-duty deaths (LODD). EMS personnel had 51 LODD in 2020, and there are two to-date. The average age of fire personnel who died due to COVID-related complications is 52, the average age for EMS personnel is 53.

 What We Should Do Now

Presently, we still have to continue to work to protect our teammates – as much as possible – from this virus. The light is finally visible on the horizon but in the meantime the safest way for first responders and healthcare professionals to remain vigilant and prepared to serve the public is to train is outdoors, in small groups, as weather permits, or indoors in large bay areas with plenty of ventilation. Examples of outdoor training include, but are not limited to: NFPA 1410 drills, rapid resupply drills, ladder training, and so forth. Outdoors it is relatively safe to train without masks.

There is a much lower risk of transmission outdoors than indoors. Outside, when exposed to ultraviolet light, the virus is rapidly diluted in the natural atmosphere. The highest instance of outdoor exposure and risk that was around 6%. According to the article in Medical Express from Ivan Couronne, from an analysis of 25,000 cases approximately 6% were linked to an outdoor environment. This evaluation, however, has not been independently reviewed and the areas identified were documented as enclosed areas where social distancing was not observed, or where people congregated for longer periods. The author states “(t)here were virtually no cases that could be identified that took place in everyday life.” Given the limited evidence of risk, this is why I have stated outdoor training is an excellent option.

In bays, mask rules still apply, and crew members would still need to stay approximately six feet apart or work to limit the time of close contact. Examples of indoor training include, but are not limited to: ropes and knots, tools and equipment, Thermal Imaging Camera (TIC) use, and chainsaw maintenance, among others.

Personal Experience Getting the Vaccine

When presented with the opportunity to get vaccinated, I was hesitant at first. My age group is at low risk for serious or adverse effects from COVID-19. Even as a healthy and fit first responder taking the risk of added exposures, the decision weighed on me.

Then I read some of the science. Once I understood what I was agreeing to, I felt that I had a responsibility to get vaccinated. Lead from the front, as they say. By getting vaccinated – even with the possibility of being an asymptomatic spreader – we still contribute to the population with protections and we contribute to and build the chances for herd immunity.

My first shot caused some aches and pains, and a low-grade fever. I had soreness in the muscle at the site of injection. The worst of it lasted about 24 hours. The second shot was just a bit worse. Again, I had aches and pains, a low-grade fever, and soreness at the injection site. This time it lasted about 32 to 36 hours. But, in addition, I was lethargic and had some lymph node swelling for about a week after.

Those added reactions appear to be rare. Given my experience and knowing what I know now, I would be vaccinated again. I have had healthy friends who had exceptionally unfortunate outcomes from contracting COVID-19: Months of recovery, heart muscle issues, and memory problems to name a few. I know that the effects from this virus are widely varied, but when you think about your personal health, the health of your family, and the health of your community – the risks potential you face from natural infection versus immunization – to me, seem exceptionally more consequential.

Despite having recently reached the horrific number of half a million deaths in the U.S. from the coronavirus, we will show our faces in public again soon. We must. Our mental and physical health depends upon it. With President Biden’s current plan to ensure our nation reaches 100 million vaccinations within his first 100 days in office, believe it or not we are on track to return to life as “normal.”

If we reach that goal, my prediction is that between natural immunity and vaccinations our nation could reach herd immunity by late May to early or mid-June. While the reported natural infection population is around 28.9 million (as of March 5th, 2021 – and growing) cases, some health experts have hypothesized that our nation actually has an infected population between 44 million and 120 million.

If we take the median of these estimates, we can fairly approximate that there may have been around 82 million infections. Then through natural infections and reaching 100 million vaccinations by April, we could certainly attain herd immunity with that late May to mid-June projection. I could be wrong, of course. I wouldn’t be the first person with a Public Health education to make an inaccurate projection, but I am hopeful.

In order to achieve herd immunity, many public health officials consider between 60% and 70% immunity as the population standard for immunization or t-cell and b-cell immunity. To meet the threshold of herd immunity, we would need to reach approximately 198.6 million Americans with healthy immunity to begin to safely move away from this pandemic. Every day we are getting closer.

In the last several months, the United States and the world have demonstrated that when we are faced with difficult challenges we are up to the task. Let’s see this through.

Keith Collins graduated in 2014 with a bachelor’s of science in Fire Science Management from American Military University. In 2017, he earned a Master’s Degree in Public Health from Grand Canyon University. Keith has more than 15 years in the fire service, including military service, and is currently working as a Station Captain in Fort Huachuca, Arizona. Follow Keith on Twitter @keithgcollins.

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