PULSE Magazine | April 2020 Issue

P U L S E ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION April 2020

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April 2020

Contents

Featured News

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NATIONAL PUBLIC SAFETY TELECOMMUNICATORS WEEK National Public Safety Telecommunicators Week (April 12-18th) honors the thousands of men and women throughout the United States who respond to emer- gency calls for assistance, dispatch emergency profes- sionals and equipment, and render life-saving, pre- arrival instructions to the citizens of our great nation.

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A PERSONAL MESSAGE OF THANKS TO ATCEMS MEDICS A special video thanks from the former Secretary of Homeland Security & Pennsylvania Governor, Tom Ridge .

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AUSTIN AND SURROUNDING COMMUNITIES HAVE UNITED TO FIND WAYS TO HELP EACH OTHER Through the generosity of our community we are making a meaningful difference in supporting each other through this pandemic.

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#LETSSTAYHOME

ATCEMS employees encourage folks to stay healthy by staying home through a social media hashtag and picture campaign.

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ATCEMS LAUNCHES COVID-19 DASHBOARD AND INTRODUCES CLINICAL CONSULT LINE The new dashboard provides daily data sets specific to Austin-Travis County EMS responses during COVID-19 event and the activity of their newly developed COVID Clinical Consult Line (CCCL).

VIDEO STORY FROM THE AUSTIN AMERICAN- STATESMAN: FIRST RESPONDERS FIGHT ON THE FRONT LINES DURING CORONAVIRUS. Watch the video the AAS produced about front line first responders here in Austin and Travis County.

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Division News

In Every Issue

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FLEET/FACILITIES UPDATE

WHAT IS: THE HISTORY OF PANDEMICS

Last week Austin-Travis County Emergency Medical Services placed our first new ambulance with a Dodge 5500 RAM chassis in service at Medic-16.

Disease and illnesses have plagued humanity since the earliest days, our mortal flaw. However, it was not until the marked shift to agrarian communities that the scale and spread of these diseases in- creased dramatically.

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ATCEMS CE CAPTAINS PRODUCE NEW VIDEO DEMONSTRATING PROPER REMOVAL AND DISPOSAL OF USED GLOVES As we see more and more people in our community utilizing gloves while performing their essential activities, our ATCEMS CE team would like to share the proper way of removing and disposing of your used gloves.

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CUSTOMER SERVICE SURVEY

Results from the ATCEMS Customer Callback Program.

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National Public Safety Telecommunicators Week National Public Safety Telecommunicators Week honors the thousands of men and women throughout the United States who respond to emergency calls for assistance, dispatch emergency professionals and equipment, and render life-saving, pre-arrival instructions to the citizens of our great nation. The employees of Austin Travis County Emergency Medical Services are proud to join in recognizing the dedication of our telecommunications personnel. These professionals are to be commended for their tireless efforts to support field responders and provide critical services within our community.

Communications personnel are professional, resourceful, and compassionate. They are living examples of our agency’s core values and a vital part of the ATCEMS family. They are to be commended for the work they do 24 hours a day, seven days a week, 365 days a year. Telecommunication medics are the first contact for Austin/ Travis County residents and who need emergency services, they are the calm reassuring voice during chaos. They are the eyes and ears of emergency responders our guiding angels who ensure the safety of responders. These dedicated men and women not only operate during medical emergencies but also natural disasters and other catastrophic events with nerves of steel and hearts of gold.

Public safety telecommunications personnel are an integral part of every public safety agency. Please take the time to say, ‘Thank you for your service,’ to all our TELECOMMUNCATION PROFESSIONALS.

April 12 - 18, 2020

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Austin and surrounding communities have united to find ways to help one another . Through the generosity of our community we are making a meaningful difference in supporting each other through this pandemic.

Amid all the chaos this state wide shut- down may be causing, we’re also seeing some sublime examples of the community coming together. Many hardships have been created due to COVID19. Individuals, organizations and business have stood up and taken action to help those in need within our community. Some have done so through virtual fund- raising to help those with economic diffi- culties, to companies shutting down nor- mal production to manufacture masks and gowns for the medical community on the front lines. Neighbors, individuals and or-

ganizations sewing masks, shopping for the elderly and providing food for those in need. The list of good deeds is endless. It is inspiring to see how we can and do come together as a community in the time of need and rise above the challeng- es before us. The next few pages are further examples of the extraordinary work that is taking place all around us everyday.

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ATCEMS has greatly appreciated the gowns that were made by Austin’s Couch Potatoes Furni- ture. These gowns are crucial to the protection of our frontline medics during this pandemic crisis. “We understand things are tough right now, it's your support that keeps us going. Our retail shops may be closed for the time being, but our furniture production remains open and has changed gears to produce PPE masks and gowns for local frontline heroes. We’re more than happy to dedicate our time, machinery, and work towards helping our heroes on the frontline” stated the Austin’s Couch Potatoes website.

#FurnishtheFrontline

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ATCEMS and CAP METRO Exchange Masks

ATCEMS exchanged 6,000 surgical masks for 6,000 N95 masks with our partners at Capital Metro . We appreciate the fact that they recognized that we had the need for these masks.

Through different measures, CapMetro has been able to create social distancing between their frontline staff and customers, and the disposable surgical masks they received from ATCEMS today will help protect them as well.

In appreciation for the healthcare workers, police officers, firefighters and paramedics who are committed to our health and safety, McDonald’s will offer free Thank You Meals, between Wednesday, April 22 and Tuesday, May 5, as a token of appreciation for their selfless service,” McDonald’s said in a statement. During breakfast hours, front-line workers will have the option to choose an Egg McMuffin, Chicken McGriddle or a bacon, egg and cheese biscuit. Each comes with a side of hash browns and a soft drink, tea or hot coffee. In the afternoon and at night, frontline workers will be able to choose a double cheeseburger, 6-piece McNug- gets or a Filet-O-Fish. Each comes with a side of small fries and a soft drink, tea or hot coffee .

Free Thank You Meals to First Responders

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Local Austinite and Academy Award-winning actor Matthew McConaughey and his wife Camila donate masks to Austin first responders. Matthew’s wife Camila stated on her Instagram page “Our mission is to protect those who pro- tect us, by providing healthcare workers, firefighters, police officers, and others with approxi- mately 80,000 masks needed to battle the COVID19 virus. Matthew and I, our friends Bill and Tracey Marshall have teamed up with the organization #BStrong. We are passionate about help- ing first responders from our hometown Austin - Texas, Louisiana and nationwide as we combat this national pandemic.”

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By Stacy Rickard, Spectrum NEWS Central Texas Alcohol Companies Switch From Booze to Making Hand Sanitizer Central Texas-based Desert Door Distillery is creating and packaging tens of thousands of bottles of hand sanitizer to give out for free to first responders and medical workers on the front lines fighting COVID-19.

The Alcohol and Tobacco Tax and Trade Bureau has authorized permitted distilleries nationwide to start producing ethanol-based hand sanitizers to address the demand during the COVID-19 pandemic. Several Central Texas distilleries have joined in, making the switch from their normal routines of creating booze.  They’re following WHO and FDA standards  Making hand sanitizer helps keep their staff working  Hand sanitizer contains alcohol Tito's Vodka in Austin, Desert Door Distillery in Driftwood, Milan & Greene Whiskey in Blanco, Still Austin Whiskey Co. in Austin, Deep Eddy Vodka in Austin, and Haye Rum in Stonewall are all in on the hand sanitizer game, prioritizing supplies for medical professionals and first responders. Middleton Brewing in San Marcos has created a surface sanitizer concentrate. Veteran-owned Desert Door Distillery focuses on producing "sotol," a distilled spirit from wild- harvested sotol plants. Desert Door jumped on the hand sanitizer-making train when they first heard about "panic buying" a few weeks ago. Their plan is to prioritize donating the sanitizer to the medical community, first responders, vulnerable populations, and then the local community. "Our leadership style, our core value system, who we are, started with the military, so we come from a place of service, first and foremost. And we saw what people were doing in terms of hoarding it and trying to sell it at large prices," said co-founder Ryan Campbell. "When we saw the raid on supplies and we started looking at all these other shutdowns that were happening, the idea and the thought process was 'well what can Desert Door do to like participate and help during this whole thing?"

recipes for making hand sanitizer.’ We came across this World Health Organization guidance on how to make hand sanitizer out in the field when there's like pandemic outbreaks and things like Ebola and that kind of stuff," Campbell said. "And if you look at the three main ingredients, it's hydrogen peroxide, glycerin, and 80 percent alcohol. We don't make it that high but I knew we had the capabilities of doing that. And then on top of it, you need distilled water, well we've got a giant still so we can make distilled water from it as well."

The staff, who otherwise might have been out of work, is putting in hours creating, bottling and packaging the sanitizer.

"We had to shut our tasting room. Our tasting room does really well. We're one the top tasting rooms in the state. What was great though is, you know, I have a tasting room staff that normally I would have had to send home, and instead I've been able to keep them gainfully employed working on this," Campbell said. "I know it's important at this time that we all stay at home but we're doing something that's providing a public service. And so it's great that my employees are able to come out of here now and actually be proactive and be engaged in this time and it feel like they're doing something, rather than just being a spectator to what's happening in the world." The distillery has already donated 5,000 bottles to first responders across the state, including Austin Police, University of Texas Police, Cedar Park Police and Hays County Sheriff’s Office. Their goal is to bottle 20,000 to send out and keep the flow going as long as there's a need. “We're a small business, and we've made a very sizable investment in doing this so we want to be able to keep doing it. So if other corporations want to get along with us and help go on this journey together, we’d be more than happy to have anybody’s support.”

The sanitizer is made according to WHO and FDA standards. "So I started Googling ‘what are the different

The founders of Desert Door say as veterans, their goal is to be at the forefront of this issue, instead of sitting on the sidelines.

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“Our leadership style, our core value system, who we are we are started with the military, so we come from a place of service, first and foremost," Campbell said. “So our whole idea was is ‘yes you could technically sell this’ but now you're kind of capitalizing on a horrible circumstance to profit yourself. And we just think it's much more im- portant to give it out there, to make it easy.” Desert Door is welcoming donations through a Go- FundMe to help create more bottles. They're also encouraging others who are capable to follow suit and switch production to hand sanitizer. "We want a whole bunch of other distilleries to get involved and to do this but I think it's really im- portant that we're following those standards so that everybody is able to continue to do it going forward. We are looking for opportunities out there in the community that need hand sanitizer. We don't know where all the needs are, so people can reach out to us and contact us on our website. And we're also looking for other corpo- rate sponsors who want to go through this with us."

If you are a local first responder the best way to reach the distillery is: info@desertdoor.com. There will be another com- munity pick-up day soon once the distillery catch- es up on orders. At this time, the distillery is only able to supply locally and they will not be shipping individual bottles or bulk orders out of the state.

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Video Story from the Austin American-Statesman: First responders fight on the front lines during coronavirus While the COVID-19 pandemic has drastically altered life for people all over the globe, first re- sponders are still rushing to emergencies as they always have. ATCEMS Medics and firefighters are donning significantly more protective equipment to tend to the sick and the injured, but they still worry they could eventually fall ill. The Austin American Statesman talked to Austin-Travis County Emergency Medical Services, Manchaca Fire Rescue, & Pflugerville Fire Department about the challenges of being a first responder during a pandem- ic crisis.

A personal message of support and thanks to the men and women of Austin-Travis County Emergency Medical Services from former Secretary of Homeland Security & Pennsylvania Governor, Tom Ridge.

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Last week Austin-Travis County Emergency Medical Services placed our first new ambulance with a Dodge 5500 RAM chassis in service at Medic-16.

We moved from a 4500 to 5500 RAM chassis for the extra weight capacity which im- proves safety during harsh road driving and sudden maneuvers. It will provide a signif- icantly better ride as well due to the addition of the liquid spring suspension system in the rear. The 2019 RAM also has a key-less ignition button. Crews will be able to carry the key fob and once they enter the cab be able to start the unit with the push of a button. Once on scene they can walk away from the unit and press the lock key on the fob and all the doors will lock. The truck will continue to run without the key fob in the cab. All future ambulances will come this way.

You may notice in the picture that it does not have the large Ranch Hand bumper that you've gotten accustomed to seeing. These trucks are so new that after market com- panies have not developed a bumper for this model yet.

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#LetsStayHome

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ATCEMS CE Captains Produce Video Demonstrating Proper Removal and Disposal of Used Gloves As we see more and more people in our community utilizing gloves while performing their essential activities, our ATCEMS CE team would like to share the proper way of removing and disposing of your used gloves. 1. Perform hand hygiene. (Wash your hands with soap and water for 20 seconds. If soap and water aren't available use an alcohol based hand sanitizer.) 2. Pinch the outside of the glove about an inch or two down from the top edge inside the wrist. 3. Peel downwards, away from the wrist, turning the glove inside out 4. Pull the glove away until it’s removed from the hand. 5. You may dispose of the first glove or hold the inside-out glove with the gloved hand. 6. With your gloveless hand, slide your fingers under the wrist of the glove, do not touch the outside surface of the glove. 7. Repeat step 3. Peel downwards, away from the wrist, turning the glove inside out. 8. Continue pulling the glove down, away from the wrist, turning the glove inside out 9. If still holding first glove, pull down and over the first glove. This ensures that both gloves are inside out, one glove enveloped inside the other, with no contaminants on the bare hands. 10. Dispose of the gloves in a proper bin. 11. Perform hand hygiene including front and back of forearms up to elbow. (Wash your hands with soap and water for 20 seconds. If soap and water aren't available use an alcohol based hand sanitizer.) The technique shown in the video is below:

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Austin-Travis County Emergency Medical Services Commander C. Lester will be participating in a 1 hour webinar titled "How EMS Leaders Are Using Mobile Technology to Manage the Covid-19 Crisis and Beyond" on April 28, 2020 at 1:00 PM EDT / 12:00 PM CDT / 10:00 AM PDT / 5:00 PM GMT In the largest pandemic of our lifetime, learn how clinical leaders in both Texas and Colorado are using mobile technology to not only manage the COVID-19 crisis, but also lay the foundation for the new reality of EMS, including Mobile Integrated Healthcare, Community Paramedicine, and Telehealth. ATCEMS Commander Chris Lester to Participate in Upcoming JEMS Webinar on April 28th, 2020

The presenters will share tangible takeaways that you can apply to your own organization, including:

- Mitigating patient surge, - Limiting transfers of a patient to those that absolutely need it, - Protecting frontline clinicians from unnecessary exposure, - Preserving PPE (Gloves/Masks/etc.), and - Providing secure outpatient isolation communication.

Don’t miss out on this important event. Register here: https://bit.ly/Tech_Webinar

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ATCEMS Launches COVID-19 Dashboard and Introduces Clinical Consult Line

Dashboard provides daily data sets specific to Austin-Travis County EMS responses during COVID-19 event and the activity of their newly developed COVID Clinical Consult Line (CCCL)

Since the onset of the COVID-19 Pandemic here in Austin and Travis County, Austin- Travis County Emergency Medical Services has made multiple changes to better serve the public, assist the overall medical system, and protect our medics and public safety partners. One major addition to our operations was the development and implementation of our COVID-19 Clinical Consult Line (CCCL). This line is staffed around the clock by fifteen (15) ATCEMS Medics that have been specially trained and credentialed by the Office Of The Medical Director - City Of Austin-Travis County . This resource provides another layer of triage, direction, and guidance to our field medics and other regional Public Safety partners while they are responding to and/or on-scene of a COVID-19 suspected incident. Upon receipt of a call for help to our ATCEMS Communications Center from 9-1-1, our Communications Medics begin the initial triage and dispatch of our emergency response assets. Once it’s been determined that the incident is potentially COVID-19 related, a CCCL medic will be conferenced in on the call to provide further COVID-19 specific tri- age that may include the use of telemedicine. These specially trained medics further screen the 9-1-1 callers and provide alternate instructions and guidance to all involved parties…the caller, responding ATCEMS Medics and first responders. This can include a no transport directive. If no transport is determined to be the best course of action for the patient, the responders and the medical system, the patient will be provided the next best steps for their continuum of care which may include remaining at home. How this works:

We plan to provide the dashboard daily throughout our continued response and mitigation of this pandemic.

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Random Fun Pics

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The Del Valle Station is still making progress with exterior concrete and interior drywall and electrical.

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Discover

Linings

Little rays of light, these silver linings, are imperative to our health right now. It’s okay to share them. It doesn’t mean you’re putting your head in the sand. It doesn’t mean you’re ignoring the facts or being careless. It doesn’t mean you aren’t taking COVID-19 seriously and doing your part.

What it does mean is that you are taking care of yourself and your family. Because even if they only last a minute, we all need these silver linings now more than ever. It’s okay to see the wonderful and peaceful through this mess. It’s okay . When you see something that brightens your day during this whole situation and you share it with friends, family, or on social media, it can be contagious.

Silver linings have the power to ignite a spark in other people. Not only do you reap the benefits from your little win, whether it’s painting your nails, donating money, taking your dog for a walk, or seeing co -workers on a virtual meeting, your joy and hope just might be the thing that makes someone else feel a little more at ease. It may be the thing that helps you parent a little better. It may be the thing that makes you sleep a little more soundly. And a bunch of thankful snippets will be the stepping stones that get us through. So share those silver linings. The world needs them now more than ever. For example, the expression “Every cloud has a silver lining” focuses on finding something positive in a gloomy situation. Just because it’s hard to notice silver linings during dark times, that doesn’t mean that there aren’t any. Focusing on positive things doesn’t make your problems any less serious—but it does make the situation easier to bear. Here are a few positive things that came come out of challenging times: 1. You become more compassionate and less judgmental. Experiencing suffering yourself can make you more compassionate towards others who are suffering. Often, when witnessing others’ hardships, people look for reasons to blame the victim for their plight (e. g ., “He’s struggling financially because he doesn’t work hard enough," or, "She’s sick because she worked too hard and didn’t take care of herself’), thereby reducing their own sense of vulnerability. But when you’ve suffered deeply, you’re more likely to recognize that everyone is vulnerable, and that bad things happen to good people all the time. Someone else’s suffering no longer represents a threat, but rather can be a source of connection and kinship. 2. You discover that you’re stronger than you thought you were. In the early stages of a negative life event, you may think to yourself, “There’s no way I can get through this.” But somehow, day by day, you manage to put one foot in front of the other, despite the pain you may feel. One of the things that hardship does is show you your true strength the strength you didn’t know you had until it was really tested. Supporting this idea, research on affective forecast- ing suggests that we tend to overestimate how devastated we’ll be by negative life events and how long the pain will last—in other words, we’re more resilient than we think. 3. You learn who your true friends are. In difficult times, certain relationships are likely to deepen, while others may fade away. Discovering that some people are fair-weather friends, disappearing when you need them most, can be painful, but it’s also an opportunity to develop a new appreciation for the people who do stick around, and to focus your energy on those relationships. Research suggests that sometimes even weaker social ties— people you weren’t very close with to begin with—can rise to the occasion and prove to be very supportive in high- stress situations. 4. You get greater clarity on what you want in life. Sometimes a crisis can jolt you into re-evaluating your life in a major way. It can force you to ask yourself if you’re really doing what makes you happy and spending your time how you want to, or with the people you want to spend it with. Jarring as these re-evaluations can be, they can push you to make positive changes that may not have seemed like realistic possibilities before, for one reason or another— fear of failure, concerns about what other people would think, or just the inertia of the status

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quo . But these factors just don’t carry as much weight when the reality that life is fragile and unpredictable takes hold.

5. You find joy in unexpected places. When your world is shaken up, it can cast a dark cloud over everything, making it difficult to enjoy what you once enjoyed. But sometimes joy can sneak up on you in the most unexpected ways and remind you that there is still beauty in the world, despite all the suffering.

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Austin EMS Ambulance (The Texan/Brad Johnson)

Austin EMS Battles Coronavirus on the Frontlines as the City Reels The Texan spoke with two EMS professionals about how their job conditions and demands have changed as a result of the coronavirus.

Last week, The Texan spoke with Austin police about how their job has changed since coronavirus became the presiding topic of society today. But they are not the only ones whose jobs have become more dangerous. Texas’ healthcare workers have seen their work- places transform into de facto war zones as the global pandemic has continued to spread. Austin EMS Clinical Specialist Phil Barquer Emergency Medical Services (EMS) workers are oftentimes the first in line. Austin EMS has 37 24-hour ambulances, nine 12 hour daytime trucks, and two day-time paramedic response units that focus outside city limits. Four of those 37 are considered “special operations” units three of which are considered “rescue” trucks. Those rescue units have been on the front- line of this pandemic for some time now. The Texan spoke with Phil Barquer, a clinical specialist with Austin’s Rescue Team and is also a part of the Central Texas Infectious Disease Response Unit. All specialists first must start out in the field as a regular EMS responder. But after some time and specialized training, individuals can join these specialty units. The department receives about 112,000 calls a year for anything ranging from cardiac arrest to a homeless person overdosing on K2. Barquer’s unit gets dispatched to a lot of unknown situations, but ever since getting state-assigned to the Diamond Princess cases in San Antonio they’ve been on the front line of this pandemic in Texas. “Now that we have the community-acquired spread of the disease, we’re more at-risk from getting it anywhere, not just at work,” said Barquer. Contracting the disease not only would limit their ability to treat people who need it, if symptoms don’t develop quickly, it could be spread to their patients or colleagues unknowingly. Selena Xie, president of the Austin Emergency Medical Services Association (EMSA), spoke with The Texan about how things have changed over the past month. “Everything has changed. We have basically recreated an entire EMS agency from scratch.”

Xie doesn’t go out on calls, but in her role as association president, she fields calls constantly and does what she can to support her members to complete their responsibilities in the safest and most efficient way possible. Austin EMSA had its first medic test positive for coronavirus last week. Even despite all the precau- tions taken such as the masks, eye shields, full- body suits, gloves, and more this was almost bound to happen because of their outsized expo- sure. “As the virus has spread into the community, all of our units are taking care of coronavirus patients rather than just the specialty units,” she continued. Circumstances have escalated, Xie stated, from first taking care of the Diamond Princess patients at Lackland Air Force Base in San Antonio, to focusing on the few cases within the community, to now shifting care to the entire community. “Our policies and procedures change almost every day dictating anything from what level of personal protective equipment we’re wearing to protocols for caring for patients,” she added. The depart- ment provides all the personal protective equip- ment (PPEs) the medics need. Another complicating factor is the rapidly changing body of research on the virus there is still confusion about whether it is an airborne disease According to Xie, this depends wholly upon the size of the droplets, and she stated that while it may be somewhat in between, it can be consid- ered droplet based. Still, the EMS workers are approaching precautions as if both are the case to be on the safe side. “Factors like these and more are constantly in flux.” Barquer described the high level of caution re- quired after a shift, saying, “We must ensure the gowns are contained when removed to prevent any splash or splatter from the gown onto other surfaces that can be transmitted. It’s not as sim- ple as pulling the gown and gloves off and throw- ing them in a trash bag.” And when sanitizing their ambulances after a shift, or solely a droplet-transmitted one. Austin EMSA President Selena Xie

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methods are used such as the typical disin- fectant wipes (known as “gross decon”) to aero- sol-based methods (known as “technical de- con”). Gross decon occurs after every call and technical decon is used for more serious cases, including COVID-19 calls. Decontamination can take anywhere between 15 and 30 minutes to sufficiently sterilize the units. When calling 911, Xie stressed how important it is to convey accurate information to the dis- patcher so the correct decisions can be made on how to proceed. If inaccuracies are conveyed, that can lead to time lost, or worse, the transmission of the disease. For Barquer personally, the rise of the disease has stressed his personal life — not only because of his job but for his wife, who is an ER nurse. He stressed, “The two of us both go home after a shift and wonder ‘Is today the day we’re getting sick or is it just allergies?’” Both Barquer and his wife take their tempera- tures every 12 hours to monitor their health. After his call down to San Antonio, Barquer caught the flu, but because of the similarities between that and COVID-19, it had to be initially treated as if it was the latter. He was isolated accordingly until it was determined not to be COVID-19. “Probably 95 percent of my waking moments, I spend worrying about my staff, trying to make improvements for them,” Xie said. As the coro- navirus situation has developed, Xie has been working 16-hour days. Xie continued, “For frontline staff, it has changed the way they view the job. It’s always been dangerous, but now they are some of the most at-risk and it has really changed their conduct.” Some medics, she stated, are sleeping in campers to mitigate the chance of infecting their compromised family members. “It has turned how we do EMS completely on its head,” Xie underscored. More and more of Barquer’s colleagues, including himself, have been tested for COVID-19 as their exposure increases. This test, which Barquer described as painful, involves deep nostril swabs. To the public, Barquer stressed, “Make sure you adhere to the social distancing guidelines as best you can to keep the rate of the spread down. Together with that, we’ll all get through this.” “A lot of people are concerned that the streets are empty, but we view it as a sign of the community coming together to fight through this disease and ensure we come out stronger as a community,” he concluded. Ever since the disease began surfacing in China, Barquer’s superior had game-planned in case it reached closer to home. This preparation has saved them countless hours adjusting to the new normal, but all the precautions in the world can- not fully prepare one for a global pandemic.

“I’m really proud of our medics for adjusting so quickly to this new world we live in,” Xie emphasized. Mitigation is the name of the game, and Austin’s EMS has readily prepared to take this mission on.

Clinical Specialist Phil Barquer

Austin EMSA President Selena Xie

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WHAT IS...

The History Of Pandemics?

Disease and illnesses have plagued humanity since the earliest days, our mortal flaw. However, it was not until the marked shift to agrarian communities that the scale and spread of these diseases in- creased dramatically. Widespread trade created new opportunities for human and animal interactions that sped up such epidemics. Malaria, tuberculosis, leprosy, influen- za, smallpox, and others first appeared during these early years.

The more civilized humans became with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems the more likely pandem- ics would occur. Here are some of the major pandemics that have occurred over time:

Name

Time period

Type / Pre-human host

Death toll

Believed to be either smallpox or measles

Antonine Plague

165-180

5M

Japanese smallpox Plague of Justinian

735-737 541-542

Variola major virus

1M

Yersinia pestis bacteria / Rats, fleas 30-50M

Black Death

1347-1351

Yersinia pestis bacteria / Rats, fleas 200M

New World Smallpox

1520 – onwards Variola major virus

56M

Great Plague of London 1665

Yersinia pestis bacteria / Rats, fleas 100,000

Italian plague

1629-1631

Yersinia pestis bacteria / Rats, fleas 1M

Cholera Pandemics 1-6 1817-1923

V. cholerae bacteria

1M+

Third Plague

1885

Yersinia pestis bacteria / Rats, fleas 12M (China and India)

Yellow Fever

Late 1800s

Virus / Mosquitoes

100,000-150,000 (U.S.)

Russian Flu

1889-1890

Believed to be H2N2 (avian origin)

1M

Spanish Flu

1918-1919

H1N1 virus / Pigs

40-50M

Asian Flu

1957-1958

H2N2 virus

1.1M

Hong Kong Flu

1968-1970

H3N2 virus

1M

HIV/AIDS

1981-present

Virus / Chimpanzees

25-35M

Swine Flu

2009-2010

H1N1 virus / Pigs

200,000

SARS

2002-2003

Coronavirus / Bats, Civets

770

Ebola

2014-2016

Ebolavirus / Wild animals

11,000

MERS

2015-Present

Coronavirus / Bats, camels

850

28 Coronavirus – Unknown (possibly pangolins)

139,500 (Johns Hopkins University estimate 4/16

COVID-19

2019-Present

Despite the persistence of disease and pandemics throughout history, there’s one consistent trend over time a gradual reduction in the death rate. Healthcare improvements and understanding the factors that incubate pandemics have been power- ful tools in mitigating their impact. Wrath of the Gods In many ancient societies, people believed that spirits and gods inflicted disease and destruction upon those that deserved their wrath. This unscientific perception often led to disastrous re- sponses that resulted in the deaths of thousands, if not millions. In the case of Justinian’s plague, the Byzantine historian Procopius of Caesarea traced the origins of the plague (the Yersinia pestis bacteria) to China and northeast India, via land and sea trade routes to Egypt where it entered the Byzantine Empire through Mediterranean ports. Despite his apparent knowledge of the role geography and trade played in this spread, Procopius laid blame for the outbreak on the Emperor Justinian, declaring him to be either a devil, or invoking God’s punishment for his evil ways. Some historians found that this event could have dashed Emperor Justinian’s efforts to reunite the Western and Eastern remnants of the Roman Empire, and marked the beginning of the Dark Ages. Luckily, humanity’s understanding of the causes of disease has improved, and this is resulting in a drastic improvement in the response to modern pandemics, albeit slow and incomplete. Importing Disease The practice of quarantine began during the 14th century, in an effort to protect coastal cities from plague epidemics. Cautious port authorities re- quired ships arriving in Venice from infected ports to sit at anchor for 40 days before landing the origin of the word quarantine from the Italian “quaranta giorni”, or 40 days. One of the first instances of relying on geography and statistical analysis was in mid-19th century London, during a cholera outbreak. In 1854, Dr. John Snow came to the conclusion that cholera was spreading via tainted water and decided to display neighborhood mortality data directly on a map. This method revealed a cluster of cases around a specific pump from which people were drawing their water from. While the interactions created through trade and urban life play a pivotal role, it is also the virulent nature of particular diseases that indicate the trajectory of a pandemic. Tracking Infectiousness Scientists use a basic measure to track the infectiousness of a disease called the reproduction number — also known as R0 or “R naught.” This

number tells us how many susceptible people, on average, each sick person will in turn infect. Measles tops the list, being the most contagious with a R0 range of 12-18. This means a single person can infect, on average, 12 to 18 people in an unvaccinated population. While measles may be the most virulent, vaccina- tion efforts and herd immunity can curb its spread. The more people are immune to a disease, the less likely it is to proliferate, making vaccinations critical to prevent the resurgence of known and treatable diseases. It’s hard to calculate and forecast the true impact of COVID-19, as the outbreak is still ongoing and researchers are still learning about this new form of coronavirus. Urbanization and the Spread of Disease We arrive at where we began, with rising global connections and interactions as a driving force behind pandemics. From small hunting and gathering tribes to the metropolis, humanity’s reliance on one another has also sparked opportunities for disease to spread. Urbanization in the developing world is bringing more and more rural residents into denser neighborhoods, while population increases are put- ting greater pressure on the environment. At the same time, passenger air traffic nearly doubled in the past decade. These macro trends are having a profound impact on the spread of infectious disease. As organizations and governments around the world ask for citizens to practice social distancing to help reduce the rate of infection, the digital world is allowing people to maintain connections and commerce like never before.

Editor’s Note: The COVID-19 pandemic is in its early stages and it is obviously impossible to predict its future impact. This post and infographic are meant to provide historical context, and we will continue to update it as time goes on to maintain its accuracy.

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Customer Service Response:

310 calls were made during January The questions asked focused on measurable

customer service actions.

Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 83.33% of the patients rated the customer service they received at a 5 and 15.48% rated their service at a 4. The average rating overall was 4.82 out of 5 for customer service.

The response we obtained from our customers is evidence of the great medics we have and the

tremendous job they do each and every day.

Patient Comments:

 “They were very professional. Please let them know just how much I appreciate them.”

 “They were great, please let her know how much I appreciate her help. She was my angel.”

 “The medics were amazing. We are in the process of planning my father's funeral, but if you can just let those guys know we appreciate them I would appreciate that so much.”

 “They were extremely elegant and they stayed with me for a while to make sure I was taken care of. Perfectly amazing! Helped me to the gurney.”

 “They were understanding and caring and persuaded me to go to the hospital. I really called about my missing item and the situation around that, but the medics saw that I needed care.”

32  “They were so nice and so kind. We have a very good conversation that helped distract me from some of the pain.”  “I have no complaints with ATCEMS. They are the best. They were so caring and helped me get com- fortable from the intense pain I was in before I got to the hospital. They told me I was a very good patient. I pray for them every day.”

Customer Service Response:

343 calls were made during February The questions asked focused on measurable

customer service actions.

Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 78.49% of the patients rated the customer service they received at a 5 and 13.98% rated their service at a 4. The average rating overall was 4.62 out of 5 for customer service.

The response we obtained from our customers is evidence of the great medics we have and the

tremendous job they do each and every day.

Patient Comments:

 “Everything was excellent, couldn't have been any better.”

 “They were very professional, and could not have done a better job.”

“The medics were awesome.”

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 “They were very compassionate and very professional, the medics went over and above.”

“The service was excellent.”

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 “They made her feel very comfortable, they were very professional. Please let them know just how thankful we are.”

“They were calm and helpful.”

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 “The medics were very knowledgeable and professional.”

“They were kind and gentle.”

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Customer Service Response:

384 calls were made during March The questions asked focused on measurable

customer service actions.

Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 83.75% of the patients rated the customer service they received at a 5 and 10% rated their service at a 4. The average rating overall was 4.74 out of 5 for customer service.

The response we obtained from our customers is evidence of the great medics we have and the

tremendous job they do each and every day.

Patient Comments:

 “They were very attentive to all our needs, please let them know just how much we appreciated their care.”

 “They were very pleasant and reassuring.”

 “They made me feel like I was going to be ok. They did an amazing job.”

 “They treated me with dignity and were very respectful.”

 “They were awesome, they couldn't have been any better.”

 “The medic was great, and all went well.”

 “They were very professional and pleasant.”

 “They couldn't have done any better, they were awesome.”

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 “The medics did a great job, very professional.”

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