FIRST RESPONDER COVID CONCERNS

COVID STUDY STUDY REVEALS FIRST RESPONDER COVID CONCERNS

DCU report highlights challenges, worries and ethical dilemmas faced during pandemic.

Anew report from DCU’s Listen project looking at the experiences of pre-hospital first responders during the COVID-19 pandemic has revealed that contracting the virus and passing it on to loved ones was the primary source of concern for the emergency services.

Some 82% of respondents to the survey of 815 first responders from the National Ambulance Service, Dublin Fire Brigade and other fire services nationwide, as well as Civil Defence highlighted this as the main worry they experienced, but rising transmission rates (63%), having family with underlying conditions (35%), lack of adherence to lockdown and social distancing regulations by the public (22%) and worry about the general uncertainty of what society was being faced with (21%) were also cited as causes for concern.

RISK

Not surprisingly, the report also reveals that 92% of respondents believe their occupation placed them at a higher risk of contracting COVID-19, largely due to regular contact with infected or asymptomatic patients.

In general, first responders rated the risk to the country as a whole as much larger than the risk to their own family in particular, with 42% of respondents saying the impact on their home was high or very high, and 87% saying the impact on the country was high or very high.

A lack of facilities and vital safety equipment needed for protection and sanitisation in some areas and organisations was also a major cause of distress for these frontline workers, with 23% of ambulance workers saying they felt they were not provided with adequate PPE. On the other hand, more than 90% of Fire Service respondents said their organisation did provide adequate PPE.

The report also reveals that first responders have faced a range of ethical dilemmas such as bringing people to hospitals while knowing this increased the risk of infection to the patient.

Respondents also felt conflicted by having to stop families from accompanying their loved ones to hospital, knowing they may never see them again, while decisions concerning ventilation and resuscitation were often challenging.

Conflict and stress were also evident regarding the duty of care to patients and the duty of care and safety to a first responder’s own family.

SUPPORT

When it came to how they felt their own organisation valued their role during the pandemic, 61% of NAS participants said they felt their role in their agency’s response is valued, while for both the Fire Service and Civil Defence this figure was at 83%.

Despite their concerns, the vast majority of respondents (80%) said they were prepared and willing to work extended hours/days as required, motivated by a sense of duty and comradeship, while the public outpouring of gratitude and the community spirit brought about by adversity proved to be sources of strength and support to participants.

The most prominent type of support articulated by participants was moral support and praise coming from members of the public, the communities in which they lived, and communities in which they served. Respondents referenced the many acts of kindness and gratitude, which often manifested as gifts and donations of food from businesses and individuals alike.

Trust in the Government’s leadership and the expert guidance from the Chief Medical Officer were also factors that mitigated some of the stress and concern for these frontline workers during the pandemic.

When it came to confidence in themselves, and whether they felt prepared to work during another pandemic, more than 84% said they would.

CHANGES

When asked what they would change about the pandemic response in Ireland, the most common answer was earlier action on lockdown, followed by earlier education and communication on the transmission of the disease, PPE stockpiles, faster closing of borders, a more consistent application of protocols across agencies, faster input from management and leadership positions, and earlier and increased enforcement of social distancing and restriction guidelines.

Respondents also called for earlier and more testing and tracing, and more effective preparation once it became apparent the virus was coming. They called for better and faster locking down of nursing homes, and no discharging of patients from hospitals to vulnerable nursing homes, despite the fears of the health service being overwhelmed, as well as increased availability of masks and sanitisers.

The Listen project, funded as part of DCU’s COVID-19 Research and Innovation Hub, aimed to highlight the experiences of first responders who have been completing testing, medical assessment and initial treatment of suspected COVID-19 cases in a range of settings and across several organisations. Gathering data collected during the first lockdown period between 30 April and 17 May, after which Government eased restrictions as part of Phase 1 of reopening society and business, it looks at levels of risk, impact and worry in relation to the pandemic, as well as the perception of preparedness and response, alongside their experience of staff safety, health and wellbeing.

Report co-author Professor Caroline McMullan said of the report’s importance: “This research records the voice of an often overlooked, yet critical element of the COVID-19 response, and gives us all an opportunity to learn from their response.

“Notwithstanding all the worries, duties of care, ethical dilemmas and risks, first responders continued their work as pre-hospital healthcare professionals during the most unprecedented and challenging health emergency in the history of the State. The public’s acknowledgement of their work reflects the outstanding debt owed by society to first responders during this pandemic.”