After Mississauga firefighter tests positive for COVID-19, emergency system braces for an influx of patients

A Mississauga firefighter has tested positive for COVID-19, with three of his colleagues self-isolating, marking the first emergency worker to be infected with the novel coronavirus.

In Peel, police, fire and paramedic services are the first wave of frontline workers dealing with COVID-19. Nurses, doctors and hospital staff may spend the most time with patients, but are given an overview of the situation before treating them.

Although the Region of Peel has introduced a verbal screening process for those calling 911, emergency service staff still enter situations where the novel coronavirus could be present without their knowledge. 

Mississauga Fire and Emergency Services (MFES) is generally associated with responding to burning buildings, faulty carbon monoxide detectors and roadside collisions. Despite what the name and popular culture would suggest, the majority of calls attended by Mississauga’s firefighters are medical.

An agreement between Peel Paramedics and the City of Mississauga sees the fire service dispatched to a diverse range of calls. In medical emergencies, firefighters are often the first ones on the scenes of life-threatening situations, where time is of the essence. 

When a call comes in, 911 dispatchers evaluate if the fire service or paramedics are better placed to respond by weighing risk, transportation and other factors in line with a tiered response agreement. For calls such as heart attacks when life-saving, basic first aid is required quickly, fire services are often sent first.

When a 911 calls comes in, dispatchers determine whether paramedics or firefighters are better positioned to respond.

“In a vast majority of situations, MFES can provide quicker initial contact with the patient as a result of the geographical disbursement of fire stations across the city,” Mississauga’s Fire Master Plan (2019) reads. “In medical related emergencies, rapid, efficient and effective delivery of emergency medical response for life threatening 911 calls is a critical element in patient survivability.”

On Thursday, the total number of COVID-19 cases in the Region of Peel sat at 362, with 53 new positive results confirmed. On Tuesday, an outbreak was also declared at Credit Valley hospital, operated by Trillium Health Partners.

As the pandemic continues in Peel, paramedic services will become stretched and slower to respond, which could see the fire service stepping up to bridge the gap. 

“The fire service […] is positioned to complement and enhance the EMS delivery system across Ontario, thus significantly improving patient outcomes,” the document adds. 

While COVID-19 cases continue to spike, Mississauga’s emergency services delivery hasn’t yet become overtaxed, city spokesperson Catherine Monast said on Monday. To date, fire call volumes remain steady, with each emergency service fulfilling its traditional role. 

However, the current situation is likely to be the calm before the storm, according to President of the Mississauga Fire Fighters Association Chris Varcoe. At the moment, firefighters are limiting their interaction with suspected COVID-19 patients through the region’s screening process, a luxury they may not have in the coming weeks.

“They're supposed to be screening and I understand that there's a talk that if a patient is confirmed [COVID-19] positive, we’re not going to go to those [calls],” Varcoe explained. “From a therapeutic standpoint there’s nothing we can do [for COVID-19 patients] and we won’t be transporting them to hospital. But, as the illness ramps up, I'm certain that we're going to see a staggering increase in our call volumes and there will be more exposure.”

“We're always concerned when our people interact, particularly in light of a pandemic, but we are taking precautions and doing everything in as safe a manner as possible,” he added. “We are concerned about where this is going to go, with respect to the call volumes that we're going to see.” 

“Just looking around [the world] […] where we are in 10 days to three weeks is going to be critical for us and we'll see how effective we were as citizens for physical distancing and trying to flatten the curve.”

Both Monast and Varcoe said firefighters were currently equipped with enough personal protective equipment and that they are monitoring the situation. 

Data in Mississauga’s 2020 budget document relating to 2014-18 shows 53 percent of all calls for the fire and emergency services in Mississauga were for medical issues, with 89 percent of them for asphyxia, respiratory issues or chest pains and suspected heart attacks. 

As a stream of harrowing stories come out of Lombardy in Northern Italy or New York in the United States illustrate, these sorts of medical calls could begin to inundate Mississauga's emergency services as COVID-19 continues. Paramedics in other parts of the world are left with impossible decisions, with 911 systems overwhelmed by the pandemic. 

Increased pressure on hospitals and ICUs globally has led to health services asking those with symptoms of the virus to stay home for as long as possible. This is designed to keep only people who need urgent medical care in the hospitals, but leads to patients entering hospitals with advanced symptoms of the virus. Those patients may need to be transported by emergency services and will likely call 911 experiencing dangerous symptoms of COVID-19, including shortness of breath and other respiratory issues.

In Peel, if it comes to that, the pressure will fall first on the paramedic service which would ultimately share some of that strain with colleagues in fire.

Due to the extremely contagious nature of the virus, it is also likely members of the health service, paramedics and firefighters will fall ill. As this happens, the services will need to work together to carry the strain of call volume, while also organizing internally to allow a constant supply of staff and drivers. 

Before the pandemic, the city’s fire service was already struggling to deal with calls in a timely manner. The response time for the fire service is currently more than twice the target time due to a lack of investment in the service by past administrations. With the threat of staff shortages coming in conjunction with increased medical calls, fire services will face serious challenges in the near future. 

“We're always concerned,” Varcoe explained, putting emphasis on responsibility to the city and union members, rather than a specific fear. “We're concerned about our response times … and we are developing contingency plans to deal with [a possible influx of patients].” 

He said that the service is not currently looking to recruit nor transfer in backups to cover for staff shortages, but there are strict screening processes in place at fire stations to stop the spread. Varcoe said the union and city were working together to “get creative” with staffing rotations to keep “trucks on the road” and allow firefighters to respond to “any scenario.” 

Email: [email protected]

Twitter: @isaaccallan

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