It’s been over a year since the pandemic started, and emergency medical professionals have been among the most impacted populations. They have faced furloughs and layoffs, lost revenue, illness and quarantines, changes in job descriptions, and biosecurity measures like never seen before.

EMS are considered essential workers, so when most of the population was ordered to stay at home, emergency medical services employees were at the forefront of the pandemic, risking their and their family’s lives to protect others.

So, what have we learned from the pandemic? How has the pandemic changed the EMS profession as we know it? Here we will discuss the effects COVID-19 had on the EMS community and what we can expect from the future.

What Has the EMS Community Learned from the Pandemic?

Most EMS agencies across the country discovered they were unprepared and overwhelmed when the pandemic hit. Not only did agencies have to manage the outbreak, but they had to help educate the public on the actual risks of contracting the virus.

Non-medical civilians were buying up N95 masks and disposable gloves, leaving first responders vulnerable and having to reuse single-use masks. Shortly after realizing the shortage of N95 and surgical masks, the Centers for Disease Control (CDC) advised these critical resources should be prioritized for healthcare personnel.

Pink pegboard with a mask and the words 'don't panic.'

EMS providers were able to use the CDC’s information to educate the public about the risks of the virus and what mask was appropriate to help stop the spread. Educating communities with these guidelines helped reduce the number of N95 masks being bought by non-healthcare individuals, decreased anxiety in the community, and assisted the patient’s decision-making regarding when to seek medical care.

Ironically, many emergency agencies had a reduced call volume compared to years before. Studies show there are many reasons for this decrease, one of which was that most of the community was hesitant to go to the hospital at the risk of being infected or burdening the healthcare system.

With the decrease in calls and loss of revenue, many agencies were forced to furlough or lay off employees. Some employees chose to leave their profession and take early retirement rather than risk infecting their families.

Others were reassigned to COVID testing centers or skilled nursing facilities to cover staff infected with COVID. Many EMS professionals decided to change careers using their skills and knowledge, such as working towards becoming a Certified Respiratory Therapist or Critical Care Nurse.

While OSHA requires agencies to have infection control measures in place, when COVID first appeared, EMS agencies were instantly required to increase their biosecurity measures and the response protocols to each call.

Many companies had to add an additional EMT to their units which were only in charge of driving and decontaminating the unit after each call. These heightened decontamination measures could add up to an extra hour to each call, further contributing to a loss in revenue.

How the Pandemic Has Changed the Future of EMS

COVID-19 has undoubtedly changed the future of EMS training, protocols, and operations across the country. Some of these changes will be temporary, while some will become permanent.

Below are changes to the EMS industry we have already observed as well as what we can expect to see in the near future.


Initial and continuing education have most recently been delivered on an online platform due to social distancing and biosecurity measures. This dramatically impacts the “hands-on” clinical training that is required for certification and licensing.

In March of 2020, EMT and paramedic schools were closing down to help curb the spread of the virus. EMS educators had less than two weeks to convert their active, in-person curricula into virtual, contactless classrooms. Like the EMS profession, educators had to be dynamic and resourceful to make this happen.

The emotional health of first responders has become a larger priority in the EMS community. EMS personnel can expect more training on mental health issues, warning signs, and emotional health support options. Other types of education that might be introduced include pandemic preparedness, public education about pathogens, and increased biosecurity training.


Many jurisdictions are modifying cardiac and respiratory arrest protocols to limit exposure to airborne diseases. Other protocols include treating the patient in a specific place or transporting them to alternative destinations such as urgent care clinics to decrease the workload at hospitals.

Some states allow rapid COVID-19 testing in the field, while others allow paramedics to perform ALS skills in a hospital. When treating in place, providing rapid COVID-19 testing, or transporting to other locations, agencies need to develop a plan for payment of their services.


Some changes affecting EMS operations include requiring all personnel to wear eye protection and masks when interacting with any patient. This requirement will increase the amount needed in the budget to cover the additional PPE. Many agencies now require all personnel to have their temperature taken and a negative COVID test before starting their shift, also affecting the operations budget.


One way EMS agencies are increasing their revenue is through telemedicine consultations. This is when EMS partners with a telehealth practitioner to provide medical services to patients virtually. A company called Pulsara has developed an app that allows patients and EMS providers to communicate directly with their physicians and hospitals, developing treatment plans while offering exceptional patient care.

Moving Forward

Although many EMS professionals were either furloughed, laid off, or retired early, there is still a high demand for EMTs and paramedics. Employment of EMTs and paramedics is projected to grow by 6% until 2029, which is faster than the average for all other occupations. If working in EMS is something you aspire to do, there are opportunities to do most, if not all, of your preparation, studying, and training online.

The most significant take-away from this pandemic is that EMS agencies must be better prepared for the ongoing and future pandemics. The most critical concern for any pathogen is personal protection and agency preparedness.

Many EMS providers found a shortage of supplies when manufacturers could not keep up with the demand. It is recommended to prioritize preparing and stockpiling up on supplies to be better prepared for the future. Using the COVID-19 pandemic as a learning experience will improve EMS agencies’ response to the next one.