In his 17 years as an emergency medical provider, Anthony Almojera thought he had seen it all. 鈥淪hootings, stabbings, people on fire, you name it,鈥 he said. Then came covid-19.
Before the pandemic, Almojera said it was normal to respond to one or two cardiac arrests calls a week; now he鈥檚 grown used to several each shift. One day last spring, responders took 鈥 more than any day in his department鈥檚 history, including 9/11.
An emergency medical services lieutenant and union leader with the City Fire Department, Almojera said he has seen more death in the past year than in his previous decade of work. 鈥淲e can鈥檛 possibly process the traumas, because we鈥檙e still in the trauma,鈥 he said.
EMS work has long been grueling and poorly paid. New FDNY hires , or $200 more than what is considered the poverty threshold for a four-person household in New York City. (That figure is on par with .) Employee turnover is high: In fiscal year 2019, of EMTs and paramedics left their jobs.
But covid-19 has added a new layer of precarity to the work. According to Oren Barzilay, the Local 2507 union president, nearly half of its 4,400 emergency medical technicians and paramedics have tested positive for the covid virus. Five have died, though that figure doesn鈥檛 account for first responders who worked for private emergency response companies. Nationwide, at least 128 medical first responders of covid, according to Lost on the Frontline, an investigation by KHN and The Guardian.
The problem of EMS pay was in the spotlight in December, when the New York Post outed paramedic Lauren Caitlyn Kwei for relying on an OnlyFans page to make extra money. Kwei, who works for a private ambulance company, : 鈥淢y First Responder sisters and brothers are suffering 鈥 exhausted for months, reusing months old PPE, being refused hazard pay, and watching our fellow healthcare workers dying in front of our eyes.鈥 She added: 鈥淓MS are the lowest paid first responders in NYC which leads to 50+ hour weeks and sometimes three jobs.鈥
Almojera earns $70,000 annually as a lieutenant, but his paramedic colleagues鈥 salaries in non-leadership roles are capped at around after five years on the job. He earns extra income as a paramedic at area racetracks and conducting defibrillator inspections. He has colleagues who drive for Uber, deliver for GrubHub and stock grocery shelves on the side. 鈥淭here are certain jobs that deserve all your time and effort,鈥 Almojera said. 鈥淭his should be your only job.鈥
For Liana Espinal, a paramedic, union delegate and 13-year veteran of the FDNY, a sense of camaraderie and the opportunity to serve her fellow Brooklynites compensated for low pay and exhausting shifts. For years she was willing to take on overtime and even a second job with a private ambulance company to make ends meet.
But covid changed that. The department switched from eight- to 12-hour shifts last summer, leaving Espinal, a single mother of three, too exhausted to pick up overtime. Like many health care workers, she isolated from her children at the outset of the pandemic to avoid potentially exposing them to the coronavirus, leaving them in the care of her own mother; she described being separated from her 1-year-old son as 鈥渄evastating.鈥 Despite working round-the-clock to get the city through the early days of the pandemic, she often had to choose between paying rent on time or paying utility bills.
鈥淎fter working this year, for me personally, it doesn鈥檛 feel worth it anymore,鈥 she said. She is two exams shy of finishing a nursing degree she started studying for before the pandemic. She said the last year has only strengthened her resolve to shift careers.
The pandemic has disproportionately claimed Black and brown lives 鈥 Black and Hispanic people were than white people to die of covid 鈥 and those disparities extend to health care workers. Lost on the Frontline has found that of health care workers who have died of covid were non-white.
All five of the department鈥檚 EMS employees who died of covid were non-white.
They included Idris Bey, 60, a former Marine and 9/11 first responder who was known to stay cool under pressure. He was an avid reader who bought new books each time he got a paycheck.
Richard Seaberry, 63, was looking forward to retiring to be near his young granddaughter.
, 58, left behind four children when she died in December, just as the coronavirus vaccine became available to first responders in New York City. According to the City Council鈥檚 finance division, of EMS workers are minorities.
Do you know of a colleague or loved one who should be included in the 鈥淟ost On The Frontline鈥 series? Please .
Almojera and Espinal see a racial component to pay disparities within the FDNY. Firefighters with five years on the job can make more than $100,000, including overtime and holiday pay, whereas paramedics and EMTs cap out at $65,000 and $50,000, respectively. According to finance division, 77% of New York firefighters are white.
鈥淢y counterpart fire lieutenants make almost $40,000 more than me,鈥 Almojera said. 鈥淚鈥檝e delivered 15 babies. I鈥檝e been covered head to toe in blood. I mean, what do you pay for that? You can at least pay us like the other 911 agencies.鈥
An FDNY spokesperson declined to comment on salaries, saying that pay is negotiated between the unions and the city.
The last year has also exacted an emotional toll on an already stressed workforce. Three of the FDNY鈥檚 EMS workers died by suicide in 2020. John Mondello Jr, 23, a recent EMS academy graduate, in April. Matthew Keene, 38, a nine-year veteran, in June. Brandon Dorsa, 36, who had struggled with injuries from a 2015 workplace accident, in July.
Family and colleagues told local news outlets that Mondello and Keene were struggling with trauma as a result of the pandemic. Last spring, New York Mayor Bill de Blasio and first lady Chirlane McCray between the U.S. Department of Defense and city agencies to help front-line health workers cope with the stress of working through the pandemic. But many EMS workers that the program has been difficult to access.
鈥淭here aren鈥檛 a lot of resources for people, so a lot of EMS internalize what they go through,鈥 Almojera said. 鈥淚t鈥檚 not normal to see the things that we see.鈥
Issues regarding pay and mental health challenges predate the pandemic: A national conducted in 2015 found EMS providers were much more likely than the general population to struggle with stress and contemplate suicide.
Almojera knew Keene and last spoke with him a week before his death. 鈥淵ou can鈥檛 say enough nice things about the guy,鈥 he said. 鈥淚 wish he had mentioned even a hint of [his struggles] on the phone. And I would have shared how I was feeling through all this.鈥
He said he has felt a mix of pride, exhaustion and resignation over the past year. 鈥淚鈥檝e seen the magic that you can do on the job,鈥 Almojera said. 鈥淎nd I鈥檝e seen my brothers and sisters on this job cry after calls.鈥
Almojera is now representing his union in talks with the city to renegotiate EMS and paramedic contracts. He said he hopes that city officials will think of the hardships he and his fellow first responders endured over the past year when they come to the negotiating table to discuss pay raises. But early talks have not been encouraging.
鈥淎fter all the sacrifices made by our members,鈥 he said. 鈥淚 don鈥檛 know whether to be angry, flip the table, or just shrug my shoulders and give up.鈥
This story is part of 鈥,鈥 an ongoing project from and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please .
