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By Orville Williams

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Facing public scrutiny over the use of an ambulance designated to transport patients suspected of having Covid-19, the management of the Antigua and Barbuda Emergency Medical Services (ABEMS) has refuted several claims, including that of “unethical” actions.

The scrutiny likely originated from an anonymous letter posted to the online platforms of local media groups on Tuesday, in which the author questioned whether the EMS is contributing to the spread of Covid-19 in the country.

In that letter, the author cited “reports from members of the public who have sought the assistance of the EMS” and “verification from practicing technicians”, that the EMS has been known to deploy an ambulance – designated as the Infectious Control Unit (ICU) to transport suspected Covid-19 cases – to “respond to emergency calls for persons not suspected as having the virus”.

The author also referred to a memo allegedly sent recently by the EMS management to its staff, reminding that the ICU ambulance would be used to respond to non-Covid-19-related emergencies, “as authorised by management.”

That action was labelled “unethical” by the author, who argued that it “exposes members of the public, medics [and others] to a high risk of infection”, while it was also alleged that the position was taken from a place of “mismanagement”, rather than a lack of adequate resources.

The management of the EMS responded to the concerns surrounding the use of the ICU ambulance later on Tuesday, assuring in a media statement that “all provisions have been made to ensure that both the Emergency Medical Technicians (EMTs) and the patients being transported and treated by the EMTs are protected.”

The statement acknowledged that the ICU ambulance was indeed used to respond to non-Covid-19-related emergencies, but clarified that it was not a general practice.

It explained that that situation “only occurs if there is a backlog of calls and it becomes absolutely necessary, in order to provide care in a timely manner to patients who may be critically ill”. The ambulance is only dispatched for that reason, the statement added, after authorization is given by the management.

The management also sought to assure that “all ambulances – including the ICU – are sanitised between each call, to reduce the chance of transmitting the virus between patients. With these protocols, the statement added that no EMT has tested positive for Covid-19 to date, “even after coming into contact with individuals who test positive on a daily basis”.

Concerns like these – while understandable – are not limited to Antigua and Barbuda, given the devastating impact of the pandemic in virtually every country across the world.

In September last year, the Journal of Emergency Medical Services (JEMS) published a piece, questioning whether EMS agencies were contributing to the spread of Covid-19 in the US. The article noted that emergency responders are not necessarily as prepared to tackle the pandemic as many would think, due to dwindling resources, unnecessary bureaucracies and a never-before-seen burden on the healthcare system. 

A national study involving nearly 200 active EMS personnel in 47 US states, showed that “decontamination practices and pandemic response training are extremely lacking, and could be costing people their lives”.

More specifically, 43 percent of said personnel reported that they do not sanitise their stethoscope frequently, while nearly a third of those surveyed were unsure of when a Covid-19 patient was infectious.

Following that study, JEMS concluded that more training and sensitisation was needed in the US to adequately prepare EMS personnel to handle possible Covid-19 patients, but given the declarations from the ABEMS management, it would appear that they are at least on the right track.