Palm Coast Mayor Milissa Holland signed an emergency declaration for Palm Coast similar to one she signs during the last hurricane emergency. County Commission Chairman Dave Sullivan said he will sign a similar declaration Monday evening. The declarations give local governments broader latitude executing certain contracts while also giving them authority to tag certain expenses as emergency-related, making them subsequently reimbursable by the Federal Emergency Management Administration.
Concurrently, the Palm Coast Fire Department has opted to “limit” its response to medical calls to life-threatening emergencies only, in order to reduce the chance of exposure to the coronavirus and diminish the chance that its personnel might be infected or required to be pulled off the ranks for 14-day observation.
“After meeting with Flagler County Emergency Management and seeing some of the fire departments in the country that have been affected by Covid-19 positive diagnosis, I have determined the Palm Coast will limit all response to medical calls effective Monday, March 16,” Palm Coast Fire Chief Jerry Forte said in an email to local fire rescue and other first-responding officials Friday. “Any calls that are not considered “life threatening” will not have an engine response until the threat of the spread of Covid 19 has been reduced. Keeping as many fire suppression apparatus in service is paramount for the duration of this emergency.”
He added: “This action taken today is to not only reduce the possibility of spreading the virus from one employee to another, but to limit what interactions we have with senior citizens who are the most vulnerable in the community. Limiting crew interactions with other department members and the public will also be helpful in reducing contamination.” Specifically, while dispatching will continue, “we will not respond to medical calls unless asked by the transport crews if they need extra hands on medical calls that are considered ‘Life Threatening,'” Forte wrote. “Once on scene, the officer will determine how many engine company personnel will be needed at the patients side. I urge all personnel to limit access on any medical calls that you happen to come across.”
The change is a reflection of a rapidly changing landscape across the country and the world regarding what protocols to apply in response to the coronavirus–and specifically, what measures must be implemented to limit the spread of the infection. The Centers for Disease Control has issued guidance for Emergency Medical Services personnel, disseminated and amplified by agencies including the U.S. Fire Administration and the International Fire Chiefs Association, among others.
Dispatch’s approach “should never supersede the provision of pre-arrival instructions to the caller when immediate lifesaving interventions (e.g., CPR or the Heimlich maneuver) are indicated,” the CDC guidance states. But the CDC is recommending sharply different protocols for PUIs, meaning “people under investigation,” or people who report symptoms that may lead to such investigations.
Normally, when a medical call is dispatched from 911, a Palm Coast Fire Department fire truck and a Flagler County Fire Rescue ambulance head to the call, either together or from separate fire stations, depending on where each is located. The first to respond begins to administer aid, and if hospital transport is required, then the rescue carries it out. With the new protocol in place, Palm Coast Fire Department spokesman Patrick Juliano said, Palm Coast will still respond to critical calls, but when it comes to responding to patients with flu-like symptoms or less-critical symptoms, the response will be limited.
“I don’t want that to be misconstrued that we’re withholding care, that is absolutely not the case,” Juliano said. “We will respond but we’re trying to be ready for the next call.” Palm Coast firefighters will still respond, for example, to calls involving chest pain, difficulties breathing, diabetic issues, strokes and other life-threatening emergencies or assisting the invalid, Juliano said.
And if a call is dispatched out of one of the two city fire stations where a county ambulance is not co-located, then the city’s firefighter-paramedics will respond regardless, Forte said. “We’re also going to limit the amount of people that go into a call,” he said. “We’re trying to stay ahead of the action. For our department, I absolutely don’t want to put people in a position where they get quarantined, and we lose an engine company.”
The decision did not please Don Petito, Flagler County’s fire chief. “I received an email late Friday from Jerry Forte that they were not going to run medical calls starting Monday,” Petito said, referring to the Palm Coast fire chief. “I was not consulted.”
“That’s a major change, I would have thought we’d have a meeting about it but we hadn’t,” Petito said, describing the advantage of having both agencies respond in terms of timing: whichever unit is closest to a call gets there first and gets to work. “It’ll put a bigger strain on us because we’re going to have to make response time without their help. They want to make sure that their people don’t get sick so they’re available for fires, which is 1 percent of our calls.”
“Last time I checked I don’t have to consult Petito about the operations in Palm Coast,” Forte said this afternoon. “I’m doing what’s best for the citizens of Palm Coast. I gave him the information on Friday, if he had a concern he could have called me.”
First responders are not protecting themselves only for their own sake but for that of residents, Juliano said, since responders are in contact with large numbers of people anyway–and limiting their exposure to residents is a precautionary measure. “It’s not juts like we picked up and went home, that is absolutely not the case,” Juliano said.
The CDC’s guidance specifies that limiting exposure on certain medical calls is essential down to isolating the ambulance driver from the patient compartment and keeping pass-through doors and windows tightly shut.
Meanwhile, local governments continue to tailor the ever-evolving and unchartered course of the emergency to their daily operations.
“We have our meeting tomorrow so we’ll sign ours then,” County Commission Chairman Dave Sullivan said. The County Commission is meeting Monday at 5 p.m. as it normally does, at the Government Services Building. The commission is recommending that people watch on the web rather than show up in person. “I don’t think a piece of paper makes a whole lot of difference other than future pay-backs and things like that.” He said “I don’t think there’s a whole lot we’re not doing that we could do.” The county is not at the point where people have to be ordered to stay in their homes unless they’re sick, Sullivan said. “I want to do what’s right, but I think we’re doing everything that we can do.”
County government will still hold its bi-weekly commission meeting Monday evening, but County Manager Jerry Cameron said personnel will be in place to escort anyone out of the room who may display indications of flu-like symptoms, and future commission meetings may be held without an in-person audience, though measures would be taken to enable participation–and the meetings would still be kept transparent.
“This is kind of like surfing, you don’t want to be too far in front of the wave, and you certainly don’t want to be behind it,” Cameron said this afternoon. “We may well stop face to face meetings if we get any contamination of any degree.”
The county is ceasing congregate meals for the elderly, and will be distributing the meals to individuals instead.
“As the impact of the ongoing Coronavirus pandemic continues to shape our daily lives, affecting how, where, and when we work, getting sick or anxious, or worrying if our families are at risk,” the mayor said in her declaration, “it’s easy to feel like your individual actions may not matter in the grand scheme of things. But every single one of us plays a part in our community’s health.”
The declaration stops well short of any additional measures not recommended by the state and local health departments. It does not call for more restrictive movement, as some cities in certain parts of the nation are beginning to call for, nor does it suggest any limitations on business activity. “Please shop responsibly and be respectful of your neighbors,” the mayor said in the declaration. “Most importantly, remember that none of us [is] alone.”