Impact of the COVID-19 pandemic response on the Emergency Medical Services workforce, Texas, USA

Abstract

Introduction: The physical and mental health impacts of the coronavirus disease 2019 (COVID-19) response on healthcare workers has been extensively studied; less is known about impacts specific to the prehospital Emergency Medical Service’s (EMS) workforce. However, given data about the physical and psychological impacts to EMS workers participating in prior emergencies and disasters, the response to the COVID-19 pandemic likely increased risk among the EMS workforce. Methods: EMS agencies in the State of Texas were stratified according to agency structure, eg, fire-based, nonfire-based governmental, hospital-based private, nonhospital-based private, and other. A systematic sample of 10 agencies was selected from each of the five strata. An interview guide was developed to collect information about prior experience with disaster or emergency response, professional roles since the start of the COVID-19 pandemic, and alternations to professional roles and EMS systems during both prior responses and the COVID-19 response. Interviews were transcribed and inductively coded to identify themes. Results: Five themes were identified in qualitative interviews. These included 1) early pandemic lessons, 2) protocol changes, 3) personal stressors, 4) professional stressors, and 5) lessons learned. Increased workloads, operational changes, fear of transmission to friends and family, and fatigue from working conditions were emphasized by participants. However, adaptations are being identified that could help EMS agencies and their workforces maintain resilience, even during an ongoing emergency response. Discussion: The COVID-19 response created unique professional and personal stressors to the EMS workforce and limited access to coping mechanisms previously used to reduce stress. Targeted studies are needed to guide the implementation of evidence-based interventions to protect the well-being of EMS personnel now and during future public health emergency and disaster responses.