At 6 am on the first Monday in April, Andrea Guzman was due to report for a 12-hour shift as an EMT in West New York—her first day back after two weeks out sick. “I couldn’t sleep the night before,” she says. “I felt like a rookie. I was terrified.”
But she was far from a rookie. At 29, she had already spent six years in the emergency medical service and was just one step away from her paramedic’s license. But the world to which she was returning was far more dangerous than the world she had left. The Covid-19 wave had swamped the northeast corner of New Jersey where she worked. Emergency rooms were overrun. There were triage tents outside and patients on ventilators lining hallways inside. EMTs and paramedics were racing to keep up with the flood of 911 calls. People were dying.
They were dying of what Guzman had just survived.
“The shortness of breath was the scariest thing I have ever experienced. To get from the bed to the bathroom felt like you’d worked out for 20 minutes of continuous running,” she says. “I should have gone to the hospital, but I was so scared to end up intubated that I didn’t go. By the grace of God, I recovered, but my body doesn’t feel the same.”
She had reason to be scared. A week before she was leveled by the virus—“like a train hit me,” she says—one of her EMT partners on a St. Clare’s Hospital ambulance in Passaic did something he never did: He left early, complaining of a bad headache. “He never complained of anything,” she says of Israel Tolentino, who was also a Passaic firefighter. He died two weeks later, while she was quarantined, the first Covid-19 victim among the state’s Emergency Medical Services community. “Izzy was the first one to pass, and I was the last one to work with him.”
Guzman worked her first three days back in West New York—like many EMTs, she works at multiple agencies—handling as many as 20 or more calls a day, three times as many as usual. Then, she worked three days in Passaic, witnessing just how capricious, vicious and swift Covid-19 can be. “We had one patient on oxygen, we had the paramedics, we were doing everything we could for him, and he looked at me and said, ‘I feel like I’m dying,’ and he went into cardiac arrest just like that, in a matter of seconds,” she says. “We were turning into the hospital, and they were able to get him back in the ER, and I was like, ‘All right, good,’ because he was a young guy. And then I came back with another patient, and he was gone. He coded again, and they were unable to get him back this time. We have to take a deep breath and go on to the next.”
Back in Passaic, Tolentino wasn’t the only colleague missing. Guzman’s supervisor, Kevin Leiva, had died a week later—the state’s second EMT Covid death.
“I was outside the building, crying,” Guzman says. “Things are not the same. Just three weeks before, we were all together and everything was fine.”
In her first four weeks back, she had just two days off. “I know people call us heroes and everything, but you know, some days I don’t feel like one,” she says.
The main weapon that New Jersey has against Covid-19 in 2020 is the same weapon France had against the bubonic plague in 1348: retreat. Close the door and try to keep it out. But somebody has to open the door and go out on the streets to confront an enemy that nobody can see. While most of us retreat, some of us advance.
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“I call them invisible bullets,” says John Grembowiec, chairman of the New Jersey EMS Task Force, and the EMS director at University Hospital in Newark. “Everything you touch and breathe, you have to worry about.”
First responders are the first line of defense: the EMTs and paramedics who answer the calls of frightened people who feel air escaping their lungs like a balloon deflating; the police who face the plague of bad behavior that persists even in a pandemic; the firefighters who quell the accidental conflagrations that pay no heed to lockdown orders. Their sirens are a discordant chorus of fear and hope—fear that those invisible bullets have penetrated another body, hope that someone is out there to help; fear that something else has gone wrong, hope that someone is trying to fix it.
The toll—not fully tallied—has been high. At deadline of this story, the New Jersey EMS Task Force, based on a survey to which just over half of the state’s EMS agencies responded, reported that 640 EMS personnel had tested positive for Covid-19; 13 died from it. According to the Office of the Attorney General, 495 New Jersey law enforcement officers tested positive; eight died. And according to a Division of Fire Safety survey, to which about two-thirds of the state’s fire departments responded, 190 firefighters tested positive; four died.
Anyone who doubts the severity of the virus outbreak that has paralyzed New Jersey needs only talk to the first responders who have seen it up close and who reach for the grimmest language when describing it.
“Like a war zone,” says Michelle Idler, a senior paramedic at University Hospital.
“We’re in doomsday scenario,” says Billy Vanides, another senior paramedic at University. “This is nothing like we’ve ever seen.”
“I’ve probably seen more death in the last three weeks than I did in my whole career,” says North Bergen EMS Chief Dave Prina.
“There’s just so much tragedy that these first responders are seeing on a daily basis it’s tough to even comprehend,” says Mike McCabe, chief of operations for McCabe Ambulance in Bayonne, EMS coordinator for the Hudson County office of Emergency Management and the North leader of the New Jersey EMS Task Force.
“A prolonged emergency,” says Deputy Chief Larry Cattano of the Perth Amboy police department.
The virus is inescapable, upending first responders’ jobs and threatening their health and safety wherever they go. “This officer was just doing what he was supposed to do, got called because this guy decided to assault his wife,” Cattano says about a domestic-violence call during which a Perth Amboy officer was spat on by a man who said he had the coronavirus. The state attorney general’s office took over prosecution of that case and several similar ones, upgrading the charges to terroristic threats during a state of emergency (2nd degree). The officer was quarantined and returned to duty after he tested negative. “He’s just there doing his job, and he needs this extra thing thrown upon him—the thought of, Am I infecting my family now?”
In Jersey City, some new fire-academy graduates found themselves on virus duty before they were even sworn in, helping people who lined up at the city’s coronavirous testing center at fire department headquarters. “It’s kind of what we signed up for as firefighters, to help other people,” says T.J. Cleary, who is following three uncles and two cousins into the department.
“Some of them were really bad off to where they couldn’t stand, couldn’t talk—something I didn’t expect at all,” says Khalil Jackson, who has wanted to become a firefighter since he was four, riding in the back seat of his grandmother’s car, asking her to follow the sirens to a fire.
After three weeks at the testing site, they were assigned to fire stations, and at 12:33 am on their first night, an alarm came in: a two-family house on Cator Avenue. They helped contain the smoky fire to two rooms on the first floor; nobody was injured. “So my first day on, I had my first fire,” Jackson says.
Streets everywhere have been emptier during the lockdown. Traffic was flowing easily on what is usually the clogged artery of Communipaw Avenue in the section of Jersey City that police officers Shane O’Brien and Dylan Solt patrol on the evening shift. “There are people out, but we’re just trying to send them on their way,” Solt says.
O’Brien and Solt have been partners for most of the two years they have been on the force. Now, they wear masks around their necks as they drive, pulling them up whenever they get out, as they did a few nights after the fire, at the scene of a fatal shooting on Brinkerhoff Street. “This time, we put our masks on,” O’Brien says. “That’s the only thing different from what we would usually do with a shooting victim.”
But for EMTs and paramedics, as they race to keep pace with the surging stream of Covid-19 victims, everything is different.
“This has been their time to shine and really show what it is they can do, and have done, in the face of danger,” Hudson County’s McCabe says. “We’re the ones going in.”
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“I can now repeat the instruction card for CPR with my eyes closed,” says Norbert Gosiewski, who works as both an EMT and a dispatcher for McCabe Ambulance, guiding panicked callers through resuscitation efforts as he sends help their way. “I can regurgitate it from muscle memory because I’ve said it so many times.”
It started with what they termed “FC” calls—people with a fever and cough, alarmed that they might have contracted the virus. But as hospitals filled and state-issued protocols changed, EMTs and paramedics began doing something they never imagined they would: field triage—determining which patients might be better off treated at home instead of in a hospital.
“The hysteria has eased, but the severity of the calls is worse,” says Gosiewski, who started volunteering as an EMT in high school after becoming enthralled with the TV show ER. “People are now calling when they’re really sick.”
EMTs now have to tell the families of people they take to the hospital something they never thought they would: that the family can’t go, too. Gosiewski remembers one woman he took to the hospital. “She did not want to go by herself,” he recalls. “The fear in her face, and the fear in her husband’s face, and not knowing if they were going to see one another broke my heart. It’s like going into a black hole, and you don’t know if the person is going to come out. The helplessness in that man’s face—it’s unexplainable. It leaves me speechless.”
Gosiewski has not gotten sick, but some of his coworkers have. “For a lot of people, anxiety plays a major role—they think they’re going to die,” says Sergio Sosa, a McCabe EMT who returned to work after testing positive and quarantining. “I can actually tell them, ‘Listen, you’re going to be okay and I know that because I’m okay, I did it, I dealt with it. I’ve been in your shoes.”
On Sosa’s first shift back, four of his calls were to patients who were either unresponsive or unconscious, all Covid-19-related. “Basically, people were just dropping like flies,” says Sosa, 41, who decided on an EMS career after starting as a volunteer in his late 30s and reviving a cardiac-arrest patient through CPR. It was only the second time he had performed CPR, and the man later came back to thank him for saving his life.
One call on that first shift after quarantine was from a woman whose Covid-19–positive husband had lost consciousness after she got him into the car to take him to the hospital. Heavy rain was falling as Sosa put him into the ambulance. Another was from the family of a man in his 40s. “They thought he was sleeping off a cold, but when they went to check on him, he was barely breathing,” Sosa says.
So great was the need and so strained was the system that the statewide EMS Task Force mobilized its largest operation since its formation in the wake of 9/11: field hospital tents, oxygen trailers, emergency cots and medical ambulance buses that, early on, before nursing homes were overwhelmed by the virus, evacuated 79 elderly residents from a Woodbridge nursing home. It also brought reinforcements from across the country that staged in the parking lot of MetLife Stadium: 75 EMT and paramedic units in the first batch, followed by 100 more.
“They’re watching the news, and they’re seeing these reports of massive death and highly infectious disease, and they still raised their hands and said, ‘I’ll go to New Jersey,’” says Mike Bascom, team leader for the task force and the Monmouth County EMS coordinator.
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At University Hospital, on a day when it all seemed as if it might collapse, some paramedics raised their hands, too. On the morning of April 4, a Saturday, Billy Vanides was on his first day off after working 10 days straight on a paramedic truck. Then his phone rang. “They said the ER needs help; if you can show up, show up. So I got out of bed, and 40 minutes later I was in the ER,” he says.
The ER was overloaded with Covid-19 patients and short of nurses, and the call for paramedics was a Hail Mary pass the hospital hadn’t tried before. “The nursing staff looked at us, and they were in awe that we showed up to help,” he says. “Some of them were in tears.”
Sixteen people from the EMS department—nine paramedics and seven nurses—turned up to help that day. “I was just amazed that people came out of the woodwork when that call went out to help,” says EMS Task Force chairman Grembowiec. “I had some tears in my own eyes hearing that.”
Michelle Idler answered the call, too. “The busiest night I’ve had on the street doesn’t compare to the eight hours in the emergency department that day,” she says.
They inserted IV lines, did EKGs and blood work, helped with intubations and moved patients. Idler was particularly struck by a young man, not much older than she, who was struggling to breathe and was finally put on a ventilator. “It’s easy to talk yourself into thinking that, because you’re young and you’re healthy, you’re invincible, but something like that really does its best to rock that belief from you,” says Idler, 29. “I think we’ve all kind of resigned ourselves that we’re going to get it, if not from a patient, then from a coworker.”
She and Vanides have both since been called occasionally to help out again when the ER is swamped. “Wherever they need me is where I’m going. Wherever we need to go, we’ll go,” Vanides says. “This is what we do. When things are bad, we don’t think about it—we just go.”Click here to leave a comment