Troy Chamber President, Tara Tomcsik-Husak interviews Vince Waryas, Executive Director of Alliance Mobile Heath.

VINCE: COVID-19 has impacted everyone in some way. Whether it be a family member, friend, or loved one, we all know someone who is being affected. Perhaps they are not medically affected but rather affected through a layoff, change in work arrangements, job description(s), or some other way. Any way you look at it, we are all affected.

 

TARA: I completely agree, no one has escaped from this pandemic. Personally, I have already lost 7 people I know to covid, in less than 3 weeks. We are also seeing the impact of this virus on so many industries from large corporations to small businesses. I have watched several businesses shut down, not knowing when the “we are open” sign will be placed back in their window.

It’s been difficult for everyone. With that being said, I know this must have drastically changed the Ambulatory Services Industry and your team of first responders. What have been some of the hurdles or changes the team at Alliance Mobile Health had to endure?

VINCE: The role of First Responders has changed in many ways. We have always known that any call can became a dangerous situation at any time, but now every call we respond to is a potential life threat. Responders must treat every single person they interact with as a potential infection control hazard.

The days of screening patients by asking a few questions and maybe taking a temperature have proven to be ineffective ways of drawing a reasonable conclusion in many cases. We are seeing positive cases where the patient has no symptoms whatsoever, and symptoms so severe that the patient needs to be placed on a ventilator to try and sustain life, and almost everything in between. As a result, we have adopted a policy to wear a N95 mask on every call we respond to. We have also adopted new assessment and treatment procedures to limit exposure and decrease potential contamination of crews and equipment.

 

TARA: Has there been any dramatic changes to your services because of these safety concerns?

VINCE: One unfortunate result of the increased protection measures is the need to disallow friends or family to ride in ambulances to hospitals with the patients. This is still allowed on a case by case basis such as if a minor child is transported. A parent or guardian may ride along in the patient compartment, but for the rescue crews’ safety, no additional riders may ride in the front cab to reduce possible contamination of that area.

TARA: I would guess that Alliance has been busier than ever during this crisis. Have you seen a large increase in calls?

VINCE: Initially when the governor enacted the shelter in place order (Executive Order 2020-21), most rescue services saw a decline in requests for emergency services. This was largely due to the decrease in traffic on roadways leading to fewer car accidents, fewer manual labor positions led to fewer heart attacks and diabetic emergencies, etc. Since that time the number of requests has increased again, only now we are seeing more and more complaints of fever, chills, difficulty in breathing, and other flu-like symptoms. Demographically speaking the ratio of sick persons and difficulty in breathing (DIB) type calls versus all other types of calls is running about 45% for the sick and DIB and 55% for all others.

TARA: As safety needs to be the number one priority for your team, do you have enough Personal Protective Equipment (PPE) to be safe? How are you ensuring the safety of your team?

VINCE: First Responders much like all other healthcare workers have found it necessary to conserve personal protective equipment (PPE) in order to ensure that we do not run out. We have adopted decontamination procedures based on scientific studies and data to help reduce the contamination to the N95 masks and increase their working life. Cleaning and decontamination of the ambulances and equipment after every call is a must, and spare uniforms in case someone gets contaminated must be on hand.

Our crews are performing admirably in the face of many risk factors that they face each day. There is a bit of anxiety that can come from trying to protect yourself from something you cannot see, but they are trained in methods to protect themselves from infectious diseases and their associated modes of transmission. Comfort comes from training, and the confidence in their equipment to do its job, as well as confidence in their employer to provide that training and equipment. As an additional step to ensure our staff has the information they need, we publish daily updates to the entire staff that address the progress of the disease, the latest intel on what is happening in the state, county, and local jurisdictions, updates to new and updated medical protocols, services available, planning and operations, treatment and healthy habit updates, and many more topics.

Additionally, over the last few weeks we have been tracking the number of positive cases of COVID-19 that we have transported and are notifying the individual staff members of which patients that they transported, have returned as positive cases. This data is only partial as we do not get information from every hospital, and there are many cases that simply do not get tested. So we will never know for sure the actual total number of cases that we work with, but we inform those staff members of the information that we can.

TARA: Have you seen anything in the field that people should look out for regarding symptoms. We all seem to hear about fevers and shortness of breath, but have you seen any trends or have any feedback for staying safe?

VINCE: So far, we know that COVID-19 is transmitted via water droplets in the air from people sneezing and/or coughing. This transmission method is causing the majority of the respiratory symptoms that we are hearing about. However, it is also capable of being transmitted via fecal/oral route. This transmission method tends to show symptoms more like norovirus with nausea, vomiting and diarrhea being prominent. Precautions that everyone should follow to avoid transmitting or receiving the virus include social distancing, frequent hand washing using soap and water and good scrubbing technique, eating a healthy diet, getting sufficient rest, and taking care not to touch your face, mouth or eyes.

Social distancing is very important because a standard cough can spray droplets up to 6 feet away, a typical sneeze can spray droplets up to 12 feet away. Being aware of what you touch and frequent hand washing is important because all those droplets will eventually fall onto surfaces that you may touch such as door handles, table tops, computer keyboards, or any other surface you may touch and can live on that surface for several days.

TARA: It seems like we get new data on a weekly basis. We are still staying home and staying safe but have also added wearing masks to do the minimal essential activities, like getting groceries or takeout. What is your take on all of these precautions? What else should we be doing to keep ourselves and our family safe?

VINCE: Wearing a mask anytime you are out in public is certainly encouraged.  A mask will better protect you from others, and it will also protect them from you.  Remember that even if you don’t have any symptoms, you could still be carrying the disease and may be contagious to others. The more knowledge and understanding that people have regarding how the viruses spread, the better they will be able to reduce the amount and speed of that spread. It is also important for all of us to protect those people in society who may be more susceptible to the disease. Some groups of individuals that have a higher risk of a poor outcome are those with diabetes, heart disease, and Chronic Obstructive Pulmonary Disease (COPD).

If you have a family member or friend with chronic medical conditions, please do your part to protect them by staying home and away from them. Just because you don’t feel sick, does not mean you are not carrying the disease.

TARA: Not to change the subject, but I see in some of the pictures a sweet looking dog all dressed up in safety gear. Do you have an official mascot at Alliance Mobile Health? Who is this mystery pup?

 

VINCE: Her name is Shelby and she is a Labrador Retriever. Actually, she is my dog and does not have an “official” title or position, but she comes to work every day with me and acts as a bit of a therapy dog (although she is not trained as such). Everyone loves her and loves having her around and she seems to lessen the stress for everyone. A little backstory for you, I started bringing her to work every day when I discovered she had cancer and was deemed terminal, with only 1-2 months to live. Two weeks ago, she was not able to breathe anymore and was anxious and in a lot of pain. I knew it was “time” and took her to an Emergency Vet Hospital to be put down. The Emergency Vet had a different opinion than my previous vet on matters, so she underwent emergency surgery that night to remove a 10 lb. tumor that was inside her abdomen. Tissue samples were sent to MSU for testing and results came back last Friday as benign. I guess you could say she is my little miracle. She has been by my side for 12 years like a shadow, and I am so blessed that I will be able to keep her by my side for at least a few more years yet! Shelby is doing very well and has become full of life again. She is still coming to work with me, while she heals, and continues to bring smiles to our entire team.

TARA: What a wonderful way to end an interview on a positive note. Thank you, Vince and please thank your entire team of first responders (including Shelby) at Alliance Mobile Health. They are all true heroes and we are so appreciative of their hard work and dedication to the safety of our community. And just to reiterate the sign you have posted on your door, Thank You for being Brave. Stay Safe.

To feature your company in the Blog Series: The Effects of COVID-19 on Industry, please contact Troy Chamber President, Tara Tomcsik-Husak.
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