Much is still unknown about COVID-19, but since it was discovered, it's clear that an infection can become fatal — fast.
When an outbreak hit Rochester’s homeless population, a group of paramedics stepped up to bring clinical care to unhoused people who were diagnosed with COVID-19.
The Mayo Clinic community paramedic program was established to bring care to people who need it before health concerns turn into an emergency.
“It started before COVID,” said Rozalina McCoy, Mayo endocrinologist who led the effort to establish the community paramedic program. “COVID gave us more opportunities to show what we can do to help.”
COVID-19 struck Rochester’s homeless population in early December.
Olmsted County made space available for people without homes to quarantine at 105 N. Broadway Ave. The City of Rochester also converted space at 200 Fourth St. SE for COVID quarantine. Before the end of the month, the community paramedic team was making regular visits to people quarantining at both locations.
Initially, the community paramedic program was a pilot program focused on treating people with chronic illness such as diabetes. However, as COVID-19 hit, some of the participating paramedics were given clearance to devote more of their workweek hours to community paramedicine. McCoy said neither the decision makers at Mayo nor the paramedics had any hesitance to provide regular checkups to homeless COVID patients.
Serving the underserved
Jill Ryan Schultz began her path to becoming a paramedic by volunteering as an emergency medical technician with the Claremont Area Fire Department. Schultz said she wanted to learn new skills — specifically, basic emergency medicine. Living in rural Claremont, Schultz was aware how dangerous the farm work she and her neighbors undertook and that emergency help is often several minutes away.
The choice opened a new career for her, as well as helped her neighbors.
“I think I (responded to) all my neighbors within 6 miles,” she said.
Schultz continued her training to become a paramedic, and has now spent nearly 20 years helping educate and train new paramedics at Mayo Clinic.
Joining the community paramedic team was another chance to learn and challenge herself, she said.
Even though she was told her COVID vaccination was at least two weeks out, Schultz said she had no reservations about providing care for patients with COVID.
“These people need help,” she said.
That was the attitude across the board from the community paramedic team, said Glenn Lyden, Mayo Clinic Medical Transport spokesman.
“It’s very unselfish,” he said. “It’s pretty remarkable the response we’ve gotten from our frontline team members.”
In addition to Schultz, Zack Stickler, Teresa Swenson, Candice Darling, Pete Carlson and Chad Liedl make up the community paramedicine team.
As COVID-19 was spreading in the community, Schultz joined paramedic crews for emergency calls. Taking precautions against COVID was part of new operating procedures. Providing care to homeless COVID patients took away the uncertainty whether someone had COVID, Schultz said.
“We had the proper PPE,” she said.
“I actually have more peace of mind going in knowing for sure someone is (COVID) positive,” Stickler said.
Stickler and Schultz said the response to the program so far has been overwhelmingly positive. However, the community paramedics had to gain the trust of their patients first.
Dan Fifield, founder of The Landing, helped facilitate the outreach.
“The fact that he welcomed us was a big sign to the community that we’re OK,” Lyden said.
Fifeld, a former emergency room nurse, has seen what happens when preventable illnesses or treatable conditions get ignored.
At the peak of the outbreak, about 15 homeless people were being treated for COVID-19.
McCoy said she’s concerned there may be more cases that haven’t been identified. She said the paramedics’ treatment might give more people dealing with homelessness reassurance they need to get tested for COVID-19.
“To me, the biggest gap we face right now is testing,” McCoy said. “Testing is key to containment.”
COVID testing and other preventive treatment is what will keep paramedics from having to respond to an emergency situation. That’s the point of the program, Lyden said.
“This is setting up a new template for patient care,” he said. “I think we’re finding we don’t want to go back to the way it was before.”
Waiting until a health condition becomes an emergency to seek treatment likely means higher costs and a worse outcome. Emergency paramedic calls are also stressful and sometimes dangerous.
“When people call 911, they’re usually calling you on somebody’s worst day,” Schultz said.
The community paramedic program lets paramedics build trust and learn the medical history of a patient.
Fifeld said that’s part of the key to the Landing’s success, as well.
“We go out and get to know these individuals,” he said. “They open up to you, and you get to learn about what’s right and what’s wrong, and what’s not working in their lives.”
The community paramedics have worked to engender that same kind of trust, he said.
“They need to come out, and they need to volunteer and get to know who their client base is going to be,” Fifeld said. “That way, they’re not some new face saying, ‘I need to take your temperature.’ ”
Fifeld said he plans to continue to work with the community paramedics after the COVID pandemic ends. Fifeld gave up his office in the former fire station turned shelter to convert the room into a clinic space.
Schultz said she also foresees the program continuing and growing.
“It’s enjoyable to be a part of this team when it’s getting started and to see how far it goes,” she said.