FossilMedic asks about:

Pandemic Staffing

It was a winter storm that was supposed to leave less than an inch of snow by dawn, but dropped 18″ by 5 am. For the Washington DC area, this is a major storm. Schools were closed, the federal government was allowing unscheduled leave for non-critical employees and the duty deputy fire chief had been up since 3 am, opening the “snow desk.”

By 8 am the fire department was upstaffed for a major storm. Then the duty deputy chief got an unexpected call. The municipality contracted out the service that provides medical transportation to the poor and needy, using sedans and vans. The contractor was calling the fire department because he had over 15 clients scheduled for dialysis today. When would the ambulances arrive?

After many phone calls, the chief learned that the municipality obligated the fire department to handle dialysis patient transports during inclement weather. He diverted resources to make the dialysis treatments, using four suburbans with two person crews. He also assigned a couple of ambulances to meet the 40 some transports between 9 am and 9 pm. The paramedics and firefighters rose to the challenge that day. For the balance of that contract, the snow desk included assigning an ems supervisor and six units to handle dialysis trips.

I was reminded of this incident while attending a presentation by Battalion Chief Jennie Collins and Captain Rob Clemens describing their experience in planning for a pandemic in Prince William County, Virginia. Their concern was how the fire and rescue department would deliver emergency services if, as predicted, 25 to 35% of the workforce would not come to work. They are either sick or caring for a family member that is sick.

This effort became an all-hazard county-wide approach to delivering essential county services during a major situation that would reduce the available workforce. The first challenge was to answer the question of what county services or activities were the most essential. Emergency response was the most essential for the fire and rescue department.

The second step was identifying critical positions four persons deep. For example, who is the fourth person down the organizational chart who will cover the fire chief’s position?

The third step was to identify critical positions that were not four persons deep and identify other county employees who could be cross-trained to cover that position. If the libraries are closed, what critical positions can be covered by the librarians?

The discussion of this experience included the phenomena of one county agency assuming that another agency would cover their vacancies, with public safety and public works getting the most “love” from other agencies. There is an assumption by other agencies that public safety and public works have excess resources.

Some emergency planners caution that those directly involved in patient care may have a higher absentee rate, perhaps as high as 40%. That may be due to fear of infection or, as a health care provider, a higher demand to take care of sick family members.

One of the other attendees made a troubling observation. He is a two-hatter, working as a career firefighter/paramedic in a large municipality as well as serving his hometown community as a volunteer chief. His hometown county is covered by all volunteer rescue squads and fire departments. A recent survey of the volunteer workforce revealed that about 85% of the active volunteers are two-hatters, working as a public safety professional in another jurisdiction.

If a pandemic strikes, the two-hatters that are not sick or staying home to care for sick family members will be working extended shifts for their employer, perhaps as severe as a 12 hour on and 12 hour off continuous duty disaster schedule. That will leave little time to serve their hometown volunteer department.

Trackback This Post | Subscribe to the comments through RSS Feed