EMS workers expected to keep working after coronavirus exposure

FDNY paramedic Christell Cadet, 34, is hospitalized after she was diagnosed with coronavirus.

(CNN)Earlier this week, Christell Cadet was a healthy 34-year-old working as a paramedic in New York City. On Tuesday, she started having shortness of breath. By Wednesday, her symptoms were so severe she had to be hospitalized.

Cadet spoke to CNN through labored breaths and coughing from her hospital bed Friday, hours after she found out she'd tested positive for Covid-19, the illness caused by coronavirus. She says she has asthma, but it's normally well-controlled. She never expected to be one of many who are hospitalized by the virus.
"I did not think it was going to get me this bad," Cadet said. "My asthma is really under control otherwise."
Cadet had been working "light duty" for the past several weeks, taking care of maintenance around the Fire Department of New York station where she works. She had no patient contact and stayed in the station. As officials began to warn the public to maintain "social distancing," Cadet said her only contact with the outside world was through her work as an "essential worker."
    She stayed at the station but said her co-workers responded to multiple calls where they came in contact with people who were showing symptoms of the coronavirus. Some of the people they treated later tested positive for the virus, her coworkers told her.
    "I wasn't even having patient contact, just exposed to my co-workers," Cadet said.
    When asked about Cadet's case, FDNY spokesman Jim Long said, "Covid-19 is at the level of community exposure and has been for many days."
    He added that 15 members of the fire department had tested positive for coronavirus, and that there were no reports of breaches in personal protective equipment on coronavirus-related calls.
    Cadet says there are not enough masks or protective gear and that exposure is inevitable.
    "Cross-contamination is eventually going to happen. Everybody's calling 911, everybody's got symptoms," Cadet said. "We are the first line of defense. We're going to go somewhere and we're going to treat this patient, we're going to do the best to decontaminate our ambulance and then go onto the next assignment. Everybody's going to come in contact."
    FDNY has an entire unit tasked with monitoring the level of protective equipment like masks, Long said.
    "We're good as we speak right now, but every day that adjusts and changes," Long said.
    This week the guidelines for FDNY's workers changed. They are now expected to continue working after exposure to patients who have tested positive for Covid-19, as long as they aren't showing symptoms of the virus, said Oren Barzilay, the president of the union that represents EMTs, paramedics and fire inspectors in the FDNY.
    The guidelines say that because there is now "sustained community transmission" of the virus in New York City, quarantining people who travel or come in contact with Covid-19 positive cases "is no longer scientifically valid."
    "It's like putting fuel on fire. It makes no sense to us that they're asking us to continue spreading this virus," Barzilay said.
    The coronavirus is highly contagious and is mainly spread by people who are already showing symptoms, like fever, cough or difficulty breathing. It can lead to respiratory complications and, in some cases, death. The Centers for Disease Control and Prevention says spread of the virus may be possible before people even show symptoms.
    Long said that FDNY workers could continue to work as long as they don't have symptoms. He said that firefighters, EMS and other workers at FDNY will be "tracked" daily after encountering someone who tested positive for coronavirus.
    "They'll be responsible for taking a look and checking in on their health -- taking their temperature, do they have a cough, is it a new cough, sore throat?" Long said. "They'll report back to us on a daily basis."
    Long said if FDNY workers show symptoms, they would be placed under a seven-day quarantine and could return to work if they remained fever free for three days. The workers would be paid and the time off would not count against their leave. This is a change from the department's previous 14-day quarantine policy, before city guidelines were changed regarding health care workers quarantining if exposed to a positive coronavirus case.
    He said that as of Friday, 127 members of the fire department had been quarantined after coming in contact with people who tested positive for coronavirus. That was before the new guidelines came out this week. Those already under quarantine will remain there for two weeks and can return to work if they don't have symptoms, Long said.
    Information and guidelines are constantly changing, Long said, and FDNY is working to do what's best for their workers.
    "This is a completely different event than we're accustomed to. It's not a fire, it's not a building collapse. The road we're traveling is unknown and we're learning, at times, as we go," Long said. "We're trying to identify what's good for our membership, what's good for their families and ultimately the people that we serve."
    EMS workers aren't the only people expected to continue working after being exposed to patients who test positive for the highly contagious virus. The New York City Department of Health and Mental Hygiene released guidelines Tuesday about what health care workers should do after being exposed to patients who tested positive for Covid-19. The CDC has similar guidelines.
    "If you are a health care worker who has had a known high-risk exposure to a patient(s) with confirmed Covid-19, you should take extra care to monitor your health but can keep working," according to New York City's health department guidelines. "There is no requirement for 14 day quarantine of healthcare workers with high-risk exposures in the setting of sustained community transmission as we have in New York City."
    But EMS workers present a unique problem over other health care workers who are based in hospitals and clinics, they often are coming into people's homes, Barzilay said, adding that they often respond to calls from the elderly or immunocompromised.
      "We are now putting other people's lives at risk," Barzilay said. "Now they've exposed this elderly person to the coronavirus."
      Cadet said she believes she'll spend the next two days in the hospital, hooked up to oxygen. She can't go home now, she said, because she fears exposing elderly family members to the virus.