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The novel coronavirus hit the San Jose Fire Department in a way no one expected

“For all the work we’d done to prepare our responders as they engaged patients in the community, we didn’t think our exposures would come internally,” said Sapien, a 30-year veteran with the department.

Because firefighters live, eat and work together, they’re particularly vulnerable to spreading an infection to one another. In Oakland, for instance, the century-old fire station on International Boulevard is too small for social distancing. Lockers and other barriers divide the dorm-like sleeping quarters, but the kitchen and common areas are cramped. At shift change, as many as 15 firefighters could be at Station 4, jostling one another with nearly every move.

“There’s really no way for us to get around that; it can be quite a challenge,” said Lt. Dan Robertson, who works at the station.

Like other first responders, Robertson has changed his habits. Before leaving a shift, he showers and leaves his uniform in the firehouse. When he gets home, he showers again. Crews disinfect the station multiple times a day.

Inside ambulances, two responders likewise work in close proximity, sitting about three feet from each other on a call, said Jocelyn Paulson, a paramedic in Santa Clara County and union leader. When there’s a patient, a family member, and a trainee, that number jumps to five, which has prompted paramedics to limit who can ride along.

An asthmatic who often gets allergies, Paulson vigilantly tracks any sneeze or cough to make sure she’s in shape to come to work. But “it’s a trust factor” that the person sitting next to her is doing the same, she said.

Those realities collide uncomfortably with new research San Jose News  out of China and Italy showing that people with mild or no symptoms of COVID-19 are the main drivers of the pandemic’s spread.  That knowledge — along with concerns that PPE supplies might not last through projected surges of patients at local hospitals — has left many first responders feeling even more vulnerable.

“We, right now, don’t know how many people truly have COVID-19,” Paulson said.

“I’m the last person who wants to come down with COVID,” she added. “I have to put that down at the door and put the uniform on.”

‘A smokeless fire’
The novel coronavirus hit the San Jose Fire Department in a way no one expected.

On Feb. 28, the same day that Santa Clara County announced its first case from community transmission, a firefighter returned from a medical call to report a possible exposure. It turned out to be a false alarm — flu, not COVID-19.

But the relief lasted just a week. On March 6, the department got wind one of its own firefighters, whom the department is not naming, had been hospitalized with an illness soon confirmed to be COVID-19.

“That’s when things became very real for us in San Jose,” Sapien said.

First, department and health officials raced to track down the firefighter’s every recent contact. It was, as Sapien put it, “quite a few” people, from his own regular crew to those at a second station to fellow attendees at a training event. All of those contacts occurred prior to the firefighter developing symptoms.

On the morning of March 12, when Santa Clara County’s cases had ticked up to 48, San Jose officials lined up for a news conference at the airport to explain what was unfolding inside the fire department. Even as the news conference started, the number of exposed firefighters was in flux.

“I can tell you it’s in excess of fifty,” said City Manager Dave Sykes when pressed for an estimate. Someone in the audience gasped.

Within hours, officials confirmed that 80 firefighters had been exposed — and four had so far tested positive. They ordered a deep-cleaning of Fire Station 9 at 3410 Ross Ave., Fire Station 31 at 3100 Ruby Ave., as well as the fire training center at 255 South Montgomery St.

Even as some firefighters came back to work after negative tests, firefighters were instilled with a looming sense that the infection could be anywhere — or everywhere.

“It’s almost like sending firefighters to a smokeless fire — how do you know where it is?” Sapien said.

With 10 percent of firefighters exposed, the department scrambled to prevent more infections. Stations turned into medical laboratories, cleaned between shifts with disinfectant. Meantime, the department stocked up on thermometers to test employees outside the firehouse when they arrived for the start of a shift.

In the field, firefighters were told to take the “one-in” approach, with just one person — suited up in a mask, full gown and gloves — responding to those in distress initially to minimize contact and save precious gear.

Still, living in such close quarters, “it’s hard” for firefighters to prevent the spread of the disease, said Nick Jewell, professor of biostatistics at UC Berkeley School of Public Health, likening the department’s outbreak to those within households.

“It’s like a giant family, given they’re working in close quarters and having lots of contacts,” Jewell said. “This guy was out there, at risk, and bingo, he brought it back unbeknownst to himself, and there was some mixing in ‘the family.’”

The number of positive tests in San Jose crept upward. By March 16, the fire department counted 10 positive cases. At that point, county health officials said they would prioritize testing for first responders to “ensure we can stay as fully staffed as possible” across critical agencies.

By March 20, there were 13 cases. As of this week, there are 15, including two who have since recovered.

All but one of the positives have been linked back to the first patient or Press Release Distribution Services In San Jose occurred during that initial period of spread, Sapien said. The public health tool providing that knowledge — known as contact tracing — has in the meantime been abandoned by the county as cases multiplied apace: In the three weeks since the fire department reported its first positive, Santa Clara County’s case count exploded from 66 to more than 1,000.

As of this week, the department was down to monitoring 28 people, including the positives — a steep drop since the initial 80 exposures. The rigorous cleaning, PPE and temperature-taking protocols will stay.

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