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On the very front lines of COVID-19 in Squamish

The pandemic has taken its toll on paramedics, who are likely the first responders you will see first if you need help.

A story that sticks out for Troy Clifford, provincial president of Ambulance Paramedics and Dispatchers of BC, involves an older man with COVID-19 who was heading into an ambulance and wondering out loud if he would ever see his wife again.

“She gave him a hug, the paramedic told me. It was sad,” Clifford recalled.

“She said, ‘Yes you will.’”

Due to the pandemic, the wife had to stay behind as her husband drove away.

It is stories like this that paramedics across B.C. relay to him that demonstrate the impact of this virus on those on the very front lines.

Clifford, who is also a working paramedic, spoke to The Chief on behalf of his members in the Sea to Sky.

Looking back almost a year after the pandemic was declared, Clifford said no paramedic could have predicted what was to come.

“None of us could have envisioned this. Not only in our profession but the world,” he said.

And it is taking a toll on his members.

“I think everybody is really fatigued.”

Being a paramedic has always been stressful, and that is compounded during the pandemic.

One of the biggest challenges for paramedics is all the extra protocols due to COVID-19.

“Every call is full personal protective equipment (PPE),” he said. “Every call, all the time. That is not something that we ever experienced.”

Paramedics previously would use full PPE for certain calls where there was a risk of flu or other viruses, but not all the time.

Take a heart attack in a home; during the pandemic, the paramedic has to don a mask, shield, gloves and potentially gowns. More assessments are done before treating the patient — over the phone or at the front door —  to determine the risk of COVID-19.

“We are treating every call like a potential exposure,” Clifford said.

Communication is harder with patients, family, and each other due to the mask and shields, he added.

“It is exhausting,” he said.

“One of the fundamentals is reassurance and trying to communicate with [patients] and the families and when you are wearing a mask or asking from 10-feet away, ‘Do you have any symptoms,’ and stuff like that... that changes our assessments.”

He said people often think areas like Squamish are quieter than the city, but he said paramedics don’t experience it that way.

“Those are growing areas,” he said, adding mental health calls are up and the opioid crisis has taken a toll on communities like Squamish.

“We call it the triple threat. We have got three really big issues that we are dealing with on top of our regular business — the regular calls, the strokes, the heart attacks, and the falls,” he said, referring to COVID-19, the opioid crisis, and a lack of resources.

“The corridor — Pemberton, Whistler, Squamish — is a growing area that we are seeing increased call volumes, and we don’t have the resources. The resources haven’t met the demand.”

Provincewide, he said, calls are going up 6% a year, and anecdotally, he hears it is up more than that in the Sea to Sky.

Studies show paramedics and other first responders are already at risk of Acute Stress Disorder (ASD) and Post Traumatic Stress Disorder (PTSD) due to their jobs’ very nature.

When a paramedic is going from call-to-call-to-call, with extra pandemic protocols, and doing extra cleaning, that doesn’t leave a lot of time for preventative mental health measures to protect paramedics, Clifford said.

“Through COVID, what it has exposed is our staffing and workload challenges. We are under-resourced, and we are relying on on-call members who put in long hours,” he said. “Whistler, Squamish, and Pemberton rely on on-call members, which means part-time members that come up there.”

He noted that when an on-call paramedic is waiting for a call to come in, they earn reduced wages.

“That is an old model that is not really sustainable for urban and metro areas, and busy areas like [Squamish],” he said. “That has really impacted [paramedics] wellness, and what it has exposed is that is not the way to sustain a full-time ambulance service.”

He noted with a single-car accident on the Sea to Sky Highway that draws out two or three of the ambulances in the area, on a day when there is a routine transfer and another typical local call, corridor resources can be tapped out.

“You don’t always staff for the peaks, but you have to have a minimum, based on the call demand. That is something we have been working with the municipalities as well as with the provincial government on.”

BC Emergency Health Services has six ambulance stations responding in the Sea to Sky Corridor: West Vancouver, North Vancouver, Lions Bay, Squamish, Whistler, and Pemberton. There are approximately 180 paramedics throughout the region.

According to Clifford, Whistler and Squamish each have two full-time Emergency Paramedics on during the day and two during the night, with one extra resource added in Whistler during the ski season.

Asked about Clifford’s assessment of the region’s lack of resources, a spokesperson for BC Emergency Health Services acknowledged the pandemic has taken its toll.

“The COVID-19 pandemic has been both physically and mentally exhausting for our front-line employees, and we appreciate their incredible dedication during these challenging times,” the spokesperson said in an email to The Chief.

“To help respond to patients during the pandemic, especially in rural, remote and Indigenous communities, BCEHS has added 55 additional ground ambulances, and five additional air ambulances, plus additional staffing to support patient care throughout the province. As part of this, specifically in the Sea to Sky region, BCEHS has staffed three additional ambulances in Squamish, Pemberton, and Whistler. The Whistler ambulance includes an additional Advanced Care paramedic for the region. BCEHS is preparing a longer-term staffing and resource strategy that will include more resources especially in rural, remote and Indigenous communities.”

Vaccines

Paramedics have begun to get the COVID-19 vaccine, though not in all areas.

“As of last week, 1,400 paramedics of our 4,500 in the province have been vaccinated," Clifford said.

He said many in the Fraser Health region were first up because that is where the higher percentages were. Many paramedics have also gotten their first vaccines in remote northern communities, he said.

“We are happy to get them when we can,” he said. “Obviously, we’re high risk in the sense that we responded to all those care homes and those uncontrolled ambulances and people’s residences...

Most paramedics really appreciate that we need to be patient and we appreciate that we are recognized for the role we do and we don’t want to take away from any of the most vulnerable.”

Facing the COVID-19 deniers

Seeing COVID-19 deniers online and in real life is a frustration for paramedics, Clifford acknowledged.

Due to the virus, paramedics worry about exposing their loved ones to what they bring home.

“You go home. It is on your mind all the time,” he said.

“It is frustrating when people say it is not real when you have been to a call,” he said. “It is very real, and it frustrates me that people can’t just follow basic protocols. It is very frustrating to see [that] when we are doing our part and we are treating people, and we are seeing real, real scenarios of people who are dying and sick from COVID. There’s no question it is real,” he said, adding that those like Dr. Bonnie Henry, who is leading us through this have done a good job.

There’s no reason not to follow protocols.



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