COVID-19 Response & Updates – North East Mobile Health Services

November 15, 2020

NEMHS EMS Providers test positive for COVID-19

In the interest of transparency and public safety, we are writing to inform you that on Wednesday, November 11, we were notified by the Maine CDC that a member of the North East Mobile Health Services’ (NEMHS) team stationed at our Rockport location tested positive for COVID-19. In addition to our stringent protocols already in place, we instituted all subsequent protocols prescribed in our COVID-19 response plan, which was informed by state and federal CDC guidelines and Maine EMS guidelines. This included the immediate isolation of the positive team member at their home.

Through ongoing contact tracing efforts with the Maine CDC, we identified all exposed team members and placed them under quarantine. However, as healthcare professionals and first responders, they are deemed by the CDC to be “critical infrastructure workers” vital to the continuation of essential functions. This is done to ensure there is no interruption of emergency medical services during a pandemic. Consequently, they were permitted to continue working under the following CDC and Maine EMS guidelines, which we have explicitly followed to ensure public safety.

Of note, the guidelines require a negative Binax test before returning to work, the worker remain asymptomatic, continued testing on 7-day intervals through the 14-day quarantine period, daily pre-work screening, twice daily temperature checks, and the continued wearing of medical-grade PPE, including masks and eye protection. Finally, as a redundancy, NEMHS also requires exposed team members to obtain a PCR test to confirm the Binax test.

After following these guidelines, Maine CDC notified us today that 3 additional asymptomatic team members have since received positive PCR tests after receiving negative Binax tests. Accordingly, they are isolating at home and contact tracing has been expanded to include the close contacts of these additional team members. As an added precaution, we have now ordered all team members stationed at the Rockport location to obtain a PCR test, regardless of suspected exposure.

We understand that this development naturally raises concerns and additional questions. With regard to services, we can confidently state that there will be no interruption of emergency or transport services. With regard to public exposure, that is still being determined by the CDC through contact tracing. Anyone suspected to have been exposed will be contacted by the CDC. We are also including an FAQ with this statement to provide additional detail and assurance that we are stringently following all protocols to protect the public we serve, which is our mission as frontline healthcare professionals.

The COVID-19 pandemic has both exacerbated the need for our mission and our risk of exposure. Our team members accept the increased risk to their own safety to ensure the mission continues, and as an organization, we take all possible measures to ensure their safety and the public’s safety.

To date, our team has responded to 1,690 calls where exposure to COVID-19 was suspected or confirmed. Given that volume, our team understands that despite every best effort contraction is still very possible for frontline healthcare workers, especially as cases continue to spike in our service area, much of which has been designated “yellow” by the state. Their continued service is therefore not only a testament to their selflessness, but to their diligence in following safety protocols as these are our first positive tests of the pandemic.

We will continue to keep you informed of any relevant developments that impact our services or the communities we serve. We welcome any questions or concerns you may have and are dedicated to working with you to alleviate them as we continue to provide the critical services you rely on during this pandemic.

COVID-19 FAQs

1. How far back was exposure determined to have potentially existed?

To ensure as thorough a contact tracing effort as possible, we are tracing back 14 days from the date of the last shift of the first employee to test positive.

2. Was the exposure limited to one of your locations or does it include multiple locations?

Exposure has thus far been limited to our Rockport and Brunswick locations.

3. How many people work at the Rockport location?

We have 24 team members at our Rockport location. Not all were exposed, but we are requiring all to obtain PCR tests.

4. With this impact your services?

This will not impact our services or result in any interruption of emergency coverage.

5. Were any members of the public exposed, particularly in the performance of the employees’ jobs?

Maine CDC is conducting contact tracing to determine if any members of the public were exposed. We will update this information once contact tracing has been completed.

6. If so, what is being done for them and who is monitoring their condition?

Maine CDC is conducting contact tracing and any member of the public determined to have been potentially exposed will be notified by the Maine CDC. The Maine CDC will also provide those who were potentially exposed with subsequent guidance and monitoring.

7. What if I recently received services from NEMHS and was potentially exposed?

Maine CDC is conducting contact tracing and you will be notified if you were potentially exposed. Maine CDC will provide you with subsequent guidance and monitoring.
If you do not hear from the CDC, then you have not been exposed.
We are cooperating to the fullest extent with the CDC’s contact tracing efforts.

8. Who are the team members that tested positive and what are their positions?

HIPPA and other privacy concerns prohibit us from divulging personally identifiable information.

9. When were you made aware of the positive tests?

We received the first confirmed positive result on November 11, 2020 and the subsequent 3 confirmed positive tests on November 13, 2020.

10. What protocols and precautions have NEMHS taken since the first positive test?

The infected team member was immediately isolated at home and contact tracing was initiated. The same protocols were initiated for the subsequent positive team members.
Since the onset of the pandemic, NEMHS has had universal masks policies in place while at work-in the ambulance and while at the station, unless sleeping.
All ambulances and workstations are regularly disinfected.
PPE is worn during all patient encounters.
As is standing practice, should a test produce a positive result the team member would not be allowed to return to work and would be subject to full at-home isolation until cleared by the CDC; and should a team member present any symptoms they would also be removed from work and would quarantine at home subject to testing.

11. Were additional team members exposed? If so, are they under quarantine?

Yes, contact tracing has determined that other team members have been exposed and they are under quarantine. We have also ordered all team members stationed at our Rockport location to obtain PCR tests regardless of suspected exposure.
However, as healthcare professionals and first responders, they are deemed by the CDC to be “critical infrastructure workers” vital to the continuation of essential functions.
Consequently, they are permitted to continue working under the following CDC guidelines and all other standing protocols, which we will be explicitly following to ensure public safety: https://www.cdc.gov/coronavirus/2019-ncov/community/critical-workers/implementing-safety-practices.html.
Of note, the guidelines require a negative Binax test before returning to work, the worker remain asymptomatic, continued testing on 7-day intervals through the 14-day quarantine period, daily pre-work screening, twice daily temperature checks, and the continued wearing of medical-grade PPE, including masks and eye protection. Finally, as a redundancy, NEMHS also requires exposed team members to obtain a PCR test to confirm the Binax test.
As is standing practice, should a test produce a positive result the team member would not be allowed to return to work and would be subject to full at-home isolation until cleared by the CDC; and should a team member present any symptoms they would also be removed from work and would quarantine at home subject to testing.
We are also working with all clients to establish additional protocols as may be necessary and alleviate any concerns they may have in receiving care or transport from our team.
members. Again, only asymptomatic team members with negative test results are allowed to return to work.

12. When will you have results of the first COVID tests for potentially exposed team members?

All of the administered Binax tests returned negative results. However, subsequent PCR tests returned 3 positives. We are therefore no longer administering the Binax test and are requiring PCR tests.
We will have the results of the PCR tests for the full initial group of exposed team members on Saturday, November 14. PCR test results for the remaining team members stationed at our Rockport location should be known by Monday.
As a reminder, per CDC rules we are considered critical infrastructure workers and can therefore return to work while awaiting test results, so long as we are asymptomatic.
All exposed team members that returned to work received the negative Binax test and remained asymptomatic.
In light of the false-negatives produced by the Binax test, going forward, exposed team members will be permitted by Maine EMS to return to work if they are asymptomatic while they await PCR test results.

13. Did any exposed team members return to work knowing they were positive or symptomatic?

No. As prescribed by Maine CDC and Maine EMS guidance for critical infrastructure workers, all exposed team members were only allowed to return to work after receiving a negative Binax test and confirming they were asymptomatic.
We adhered to those guidelines and administered the PCR redundancy, which has proven to be a prudent addition to our protocols.

14. Is the Binax test reliable?

The Binax test has proven reliable for symptomatic people and therefore errs on the side false positives, not false negatives.
However, given this experience, we are no longer going to utilize the Binax test and are instead requiring PCR tests.

15. What are the state and federal CDC guidelines that authorize continued performance for critical infrastructure workers?

16. In light of the false negative Binax tests, are you altering your protocols?

Yes, going forward, exposed team members will be permitted by Maine EMS to return to work if they are asymptomatic while they await PCR test results.

17. Do you know the circumstances of how the initial employee contracted COVID?

Do to the extent of community spread across Maine, it is not possible to definitively determine how our team member contracted COVID-19.

18. Was the employee tested out of routine or because they presented symptoms?

HIPPA and other privacy concerns prohibit us from divulging personal medical information.

19. What is the health status of the positive employees and are they hospitalized?

HIPPA and other privacy concerns prohibit us from divulging personal medical information.

20. What towns and clients did the team members serve while potentially contagious?

That is currently being determined through contact tracing.
We are working with all clients to establish additional protocols as may be necessary and alleviate any concerns they may have in receiving care or transport from our team members.

21. Where can we go for additional information?

For additional questions please contact Maria Russell, NEMHS’s infectious control officer:
(207) 510-0073 or mrussell@nemhs.com.
Maine CDC
Maine EMS