2020 has been one of the seemingly unprecedented challenges for the American fire service in confronting a global pandemic crisis of the COVID-19 virus.
During the year first responders have borne the brunt of being on the front lines or 'tip of the spear' in responding to persons affected by the pandemic and infected with the virus.
personal protective measures
During this struggle, numerous first responders themselves have become ill with contracting the virus and many have tragically succumbed. Additionally, many first responders have quarantined following Center for Disease Control post-exposure guidance which has a substantial impact on operations in many departments throughout the United States.
During the time of the pandemic, everyone has wrestled with protocols assuring proper personal protective measures and sanitizing protocols are affording the highest levels of protection in place relative to the threat.
'long hauler' effects
These effects have included the pulmonary systems, circulatory and coagulopathy, inflammation
Additionally, as vaccines have become more widely available various published reports of first responder acceptance of vaccines have varied widely as have the reported rates of vaccination amongst first responders. These NYC first responders fear COVID-19 vaccine side effects.
The literature has begun reporting on syndrome(s) being termed 'long hauler' effects from residual effects of COVID-19 infection. These effects have included the pulmonary systems, circulatory and coagulopathy, inflammation, and neurological effects amongst others.
inflammatory heart issues
- Study probes the ‘long-haul’ effects of COVID-19 | Hub. One particular study found that close to eighty percent (80%) of COVID-19 survivors had inflammatory heart issues that were identified on magnetic resonance imaging scans two months after initial re-infection.
- Lingering effects of COVID-19 infection on the heart | LLUH News. These initial and preliminary reports and smaller studies have been typically in general population and not specific to first responders.
However, there is growing dialogue among fire service occupational health researchers and American fire service pioneers aimed at the need for paying close attention to the ongoing effects that exposure to COVID may have on the long-term physical and systems of firefighters, including behavioral health and readiness.
long-term hauler syndrome
The thirteen essential job tasks, as defined by the NFPA can potentially be impacted/impaired
W.S. Darley and Life Scan Wellness Centers have partnered for a webinar on this very topic with myself and Dr. Sara Jahnke, Denise Smith, and Lori Moore-Merrell at 10:00 am EST on April 16.
The potential 'long hauler' effect on first responders has many potentially untoward consequences individually and to organizations. The thirteen essential job tasks, as defined by the National Fire Protection Association (NFPA), can potentially be impacted/impaired by some of the currently described effects of COVID-19 long-term hauler syndrome.
hypercoagulability and clotting
IAFF Guide to NFPA 1582. Other national cardiac researchers, such as Dr. Denise Smith, have expressed concern given the reports of hypercoagulability and clotting and Captain Frank Leto of the FDNY Counseling Unit of the behavioral health impacts and toll on the ability to perform. (personal correspondence).
In perspective, the environment we operate within with heat extremes/stress and emotional strain is unlike most any other professions or callings. These same concerns have been raised in high-performance athletes which firefighters have been called, 'Tactical Athletes' due to the rigors of the job.
occupational health, wellness
James Zagorda 9/11 Health and Compensation Act of 2010 for “World Trade Center Health Program”
So the obvious question is, where do we go from here? Users have some lessons in the history of tragedy impacting first responders' occupational health, wellness, and survival, including the horrific attacks of September 11, 2001, on this Nation and at 'Ground Zero' and New York City’s Twin Towers among other attacks prongs.
With that exposure of such a magnitude of those at Ground Zero on September 11, 200,1, and working the site for so many days and weeks after, the James Zagorda 9/11 Health and Compensation Act of 2010 was established to create the 'World Trade Center Health Program' for screenings and treatment to be funded for emergency responders, recovery and clean up workers and volunteers at the World Trade Centers, the Pentagon, and the crash site near Shanksville, Pennsylvania.
medical surveillance program
The notion of a medical surveillance program to monitor the long-term health consequences of COVID-19 exposure in first responders would seem prudent to consider. Also, exposure tracking for potential exposures and re-exposures for health compensation coverage is an essential element of personal protection.
Lastly, having a comprehensive and occupationally tailored first responder baseline physical is essential in determining baseline health status, including the presence of COVID-19 antibodies and a thorough systems evaluation that can be repeated annually per NFPA 1582 and NFPA 1583 examinations.