Long Term Consequences of COVID to First Responders: A Warning Flag

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This past year has one of seemingly unprecedented challenges for the American fire service in confronting a global pandemic crisis of the COVID-19 virus.

During the course of the year first responders have borne the brunt of being of the front lines or “tip of the spear” in responding to persons affected by the pandemic and infected with the virus. During the course of this struggle numerous first responders themselves have become ill with contracting the virus and many have tragically succumbed. Additionally, many first responders have quarantined following Center for Disease Control post exposure guidance and having a substantial impact on operations in many departments throughout the United States.

During the time of pandemic, we have wrestled with protocols assuring proper personal protective measures and sanitizing protocols are affording the highest levels of protection are in place relative to the threat.

Additionally, as vaccines have become more widely available various published reports of first responder acceptance of vaccines has varied widely as have the reported rates of vaccination amongst first responders. These NYC first responders fear COVID-19 vaccine side effects.

The literature has been begun reporting on syndrome(s) being termed “long hauler” effect from residual effects of COVID infection. These effects have included the pulmonary systems, circulatory and coagulopathy, inflammation, and neurological effects amongst others. Study probes the 'long-haul' effects of COVID-19 | Hub. One particular study found that close to eighty percent (80%) of COVID-19 survivors had inflammatory heart issues that were identified on magnetic resonance imaging scans two months after initial re-infection. Lingering effects of COVID-19 infection on the heart | LLUH News These initial and preliminary reports and smaller studies have been typically in general population and not specific to first responders. However, there is growing dialogue among fire service occupational health researchers and American fire service leaders aimed at the need for paying close attention to the ongoing effects that exposure to COVID may have on the long term physical and systems of firefighters, including behavioral health and readiness. In fact, W.S Darley and Life Scan Wellness Centers have partnered for a webinar on this very topic with myself and Dr. Sara Jahnke, Denise Smith and Lori Moore-Merrell at 10:00 am EST on April 16.

The potential “long hauler” effect in first responders has many potentially untoward consequences individually and to organizations. The thirteen essential job tasks, as defined by the National Fire Protection Association (NFPA), can potentially be impacted/impaired by some of the currently described effects of COVID long hauler syndrome. IAFF Guide to NFPA 1582. Other national cardiac researches, such as Dr. Denise Smith, have expressed concern given the reports of hyper coagulability and clotting and Captain Frank Leto of the FDNY Counseling Unit of the behavioral health impacts and toll on the ability to perform. (personal correspondence). In perspective the environment we operate within with heat extremes/stress and emotion strain is unlike most any other professions or callings. These same concerns have been raised in high performance athletes which firefighters have been coined, “Tactical athletes” due to the rigors of the job. What Does the Coronavirus Do to an Athlete's Body?

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So the obvious question, where do we go from here? We have some lessons in history of tragedy impacting first responders occupational health, wellness and survival including the horrific attacks of September 11, 2001 on this Nation and at “Ground Zero” and New York City’s Twin Towers among other attack prongs. With that exposure of such a magnitude of those at Ground Zero on September 11, 2001 and working the site for so many days and weeks after, the James Zagorda 9/11 Health and Compensation Act of 2010 was established to create the “World Trade Center Health Program” for screenings and treatment to be funded for emergency responders, recovery and clean up workers and volunteers at the World Trade Centers, the Pentagon, and the crash site near Shanksville, Pennsylvania. Program Statistics - World Trade Center Health Program.

 The notion of a medical surveillance program to monitor the long term health consequences of COVID exposure in first responders would seem prudent to consider. Also, exposure tracking for potential exposures and re-exposures for health compensation coverage is also an essential element of personal protection. Lastly, having a comprehensive and occupationally tailored first responder baseline physical in essential in determining baseline health status, including the presence of COVID antibodies and a through systems evaluation that can be repeated annually in accordance with NFPA 1582 and NFPA 1583 examinations.
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Todd J. LeDuc, MS, CFO, FIFirE, retired after nearly 30 years as executive assistant fire chief of Broward County, Florida, an internationally accredited career metro department. He serves as Chief Strategy Officer for Life Scan Wellness Centers, a national provider of comprehensive physicals and early detection exams. He has served as a board member of the International Association of Fire Chief’s Safety, Health & Survival Section for nearly two decades. He is a peer reviewer for both professional credentialing and agency accreditation with the Center for Public Safety Excellence. He is the editor of Surviving the Fire Service (Fire Engineering Books) and serves on numerous advisory boards, publications and research projects. He can be contacted at Todd.LeDuc@lifescanwellness.com