There wasn’t a cloud in the sky on the evening of March 31, when Kate Arms ran outside to lead the first responders parade she’d helped organize.

She didn’t know what to expect. She’d only made the simple email request 24 hours earlier, sent out to Rochester fire, police, law enforcement, and paramedics: Could they all drive past St. Marys Hospital, Methodist Hospital, and Olmsted Medical Center with their lights on as a show of support and gratitude for health care staff and their patients?

“There were too many cars to count. We saw everybody lining the sidewalks, firefighters and police officers climbing up onto Truck 12 waving their signs,” says Arms, assistant supervisor of operations for Mayo Clinic Ambulance. Then she was surprised to hear the unmistakable helicopter blades of Mayo One. For a brief second, she wondered if it was bringing in a patient. But when the chopper began hovering—when it held its place in the air above St. Marys—she knew it, too, had come to show support.

“And you could see patients looking through the windows, and nurses coming out from their day shifts getting ready to go home, and it meant something to them,” says Arms, her voice breaking. “And that was just really cool that we could do something that meant something to them. I don’t even have the words to describe it, it was just a really overwhelming sense of pride. It was a moment in my career I don’t think I’ll ever forget.”

At what point did you realize the importance of preparing for the COVID-19 pandemic?

I think it’s important to note—and maybe it’s not something the general public is aware of—that we’re always preparing for a pandemic. I’ve been a paramedic for the past 16 years and, whether SARS or Ebola, there’s always been some sort of pandemic training going on, ongoing preparation and updating plans. So when things started ramping up with COVID-19 in China, and definitely when King County, Washington got hit pretty hard, we started saying all right, how do we learn from other agencies and countries so that we’re prepared for when this comes here? I’m also privileged to sit on Rochester Fire’s EMS group, and one of the very first things that we did was a joint agency collaboration. We got Rochester police involved, pulled Public Health in, and we started talking about what this looks like and how we can approach this as a collaborative effort. That was in mid-to-late February, before there were any cases even confirmed here in Minnesota.

What specific things did you do to prepare the Mayo Clinic Ambulance operations?

Around that same timeline our emergency management and planning team started dusting off those plans from Ebola and SARS, and deciding what we needed to change based on what we know about this particular virus. The more we learn about COVID-19, the more things change so it’s been kind of an exhausting process. But we wanted to make sure we were as educated and prepared as possible, which they didn’t necessarily have the opportunity to do in Washington, where at one point they had close to 50 firefighters quarantined for 14 days because they’d all been exposed. So that was a big takeaway for us—how do we keep our people safe and also make sure we don’t have a workforce reduction issue so we can continue to serve our community? But we’re grateful that the PPE we use for COVID-19 is stuff we already have in our truck to use on a daily basis—unlike with Ebola, which required a specific team and specific PPE that we rarely used, and it was a really big ordeal to transport an Ebola patient. We’re taking an extra minute or two to prep before going into a house. We’ve implemented a 24/7 physician on call [so] when we have a COVID-related situation we can talk to that emergency department doctor.

Can you give one example of how tough it has been as a frontline worker?

I think the thing that we hear the most from our frontline team members is the fear of taking COVID-19 home. What if I give it to my spouse or child or parents? What if there’s not a ventilator or an ICU bed available for them? What if they’re in the hospital and I’m unable to save their life? That’s my job, to save lives—what if theirs is the life I can’t save? I think that’s the thing that weighs most heavily on us as frontline team members. This is something outside of our control. Something unprecedented in our careers.

How do you navigate that fear and stress?

What I encourage myself and my staff with is that nobody quite gets it like we do. The person sitting next to me in the front seat of the ambulance probably understands this better than anybody else in my life. So we’re relying on each other to empathize, and also remind each other of the science: We’re wearing our PPE. We’re doing all the things that we know about to mitigate risk. We’re also providing extra snacks, offering time off to give staff a little bit of a mental health break, and just providing a listening ear whenever we can. Seven days a week, we have an all-staff conference call where everyone can hear directly from our senior leadership on updates. The information changes day by day, but knowledge is power. It helps our staff feel safe.

And then we already had our Resiliency Program, which provides mental health and wellness resources because we do know there’s a high rate of burnout, depression, anxiety, even suicide in EMS and we want our staff to be strong and healthy. I think it’s to the praise and recognition of our leadership that they are constantly trying to improve how we do things. So when something like a pandemic happens, we already have things in place that support us as frontline team members, rather than trying to scramble backwards and get things in place.

What are some positives you’ve seen from the Rochester community’s response to this crisis?

Just the sense that we’re all in this together. I’ve seen goodwill and kindness, compassionate people stepping up. We’ve had auto body shops drop off masks for us. And while our PPE supply is good, we know that there are other first responding agencies in the surrounding areas that work on a volunteer basis and they’re out of PPE. So I can take this generosity and pay it forward. And we see that all the time. People are so quick to stop us and thank us right now. That recognition, that gratitude and sense of purpose, goes a long way. There’s a silver lining in everything. If you look for the good in a situation, you’ll find it. It doesn’t erase the bad. I don’t want to minimize the suffering for people who have lost loved ones or for people who are sick. But there is still good in this situation. And I’m grateful for how our community has joined together with a sense of camaraderie and unity to survive and thrive through this together.