First responders worried about dwindling supply of surgical, N95 masks

Gregory C. Miglino Jr., chief of the South Country Ambulance Company, is worried about the dwindling supply of surgical and N95 masks, as well as disinfectants the company uses more often to wipe down the interior of ambulances. Credit: Newsday/Thomas A. Ferrara
Front-line health professionals on Long Island say they’re confident the respirator masks and other precautions they’re taking against the new coronavirus will protect them, as they gird for an increase in cases and some ramp up use of the devices.
“Our biggest problem is we expect … that the surge capacity is not there to handle the projected amount of calls that we’re going to receive” if the number of cases rises dramatically, said Gregory C. Miglino Jr., chief of the South Country Ambulance Company, which serves residents in central Suffolk County.
The company’s 126 volunteer paramedics and emergency medical technicians long have donned N95 respirator masks when they respond to a call from someone with a respiratory illness, such as the flu, he said. Now, if someone calls complaining of, for example, leg pain and “we enter the house and the individual is coughing but it’s not associated with what we’ve been dispatched there for, we are asking those individuals to voluntarily agree to wear a mask,” he said.
In addition, Miglino said, he’s now allowing first responders to choose whether to wear a mask when no respiratory condition is reported. That is geared in part toward EMTs and paramedics with health conditions like diabetes that make them more susceptible to serious cases of COVID-19, he said.
Like other health care workers, Miglino is worried about the dwindling supply of surgical and N95 masks, as well as disinfectants the ambulance company uses more often to wipe down the interior of ambulances, door handles, cardiac monitors and other surfaces.
“They’re physically not in the supply chain,” he said. “We each day attempt to purchase more masks.”
The company also is developing a plan for handling calls at places such as nursing homes, so that patients are taken to a spot near the entrance before the paramedics and EMTs arrive. That way, first responders don’t have to walk through the entire building. That helps protect nursing home residents, who are among those most likely to experience severe symptoms from the virus, or death, as well as ambulance volunteers, he said.
Dr. Paula Lester, a gerontologist with inpatients and outpatients at NYU Winthrop Hospital in Mineola who also works at a nursing home, said she’s confident in the precautions she takes, and those the hospital has imposed, such as barring sick visitors. But she worries that if she were to contract the virus, she would expose her patients.
“I am concerned as a healthy person that I don’t want to share this, if I were to God forbid get it, with any of my patients,” she said. “You don’t want to be responsible for sharing that with people who are more vulnerable.”
Lester said some of her patients are afraid of contracting the virus.
“I’ve had patients cancel their appointments, because it’s a routine visit, and they feel OK, but they don’t want to expose themselves to anybody else,” she said.
Yet even those older adults who stay home could be vulnerable if family members or home health aides take care of them, because “even if the older adult stays home and is isolated, their caregivers are coming and going, and that is definitely a risk.”
She is encouraging family members to have a backup plan if caregivers for their loved ones get sick.
Hauppauge-based Medical Associates New York last week began asking staff members to wear masks whenever they treat seniors, immunocompromised patients and those with respiratory illness, said Dr. Raj Raina, CEO of the practice, which has six Long Island and Queens offices.
“I took this extra measure to give them more confidence and reassurance that they’re safe,” said Raina, who is a primary care physician.
Raina said he’s not worried about himself, because of the protective equipment he wears and because as a healthy 55-year-old, if he were to contract the virus, “I should get better just like any other viral infection.”
At the entrance to Mount Sinai South Nassau hospital’s emergency room, there is increased screening of people with symptoms of COVID-19 and the flu, and those patients are given masks and then isolated, said Dr. Josh Kugler, chair of emergency services for the Oceanside hospital.
South Nassau has set up a temperature-controlled tent outside its emergency department in case there is a large increase in patients, so they can be isolated there during screening, he said.
Kugler and others wear gloves, face shields and gowns with someone who has COVID-19 symptoms, in addition to the N95 mask, because of evidence the virus is spread via physical contact, he said.
But, Kugler said, the virus has not made him nervous about treating patients.
“I think everybody on the front lines is well prepared," he said. "We deal with infectious issues all the time, and we deal with many other issues that are life-threatening and potentially hazardous to ourselves."

South Country Ambulance Company Chief of Department Gregory C. Miglino Jr. in the Bellport Hardquarters on Thursday. He and his EMT's have concerns over protective equipment supplies available for fighting the COVID-19 pandemic. Credit: Newsday/Thomas A. Ferrara