COVID-19 Response Procedures

CTIF is working to collect news links, Lessons Learned and procedures, new or existing, relating to the novel Corona virus pandemic. More information will follow.

During a pandemic like COVID-19, with national or regional quarantines being put in place, new procedures will have to be quickly put in place - and sometimes need to made up on the fly as first responders are thrown into unknown territory.  We have gathered some recent information, and are working to add more as more information becomes available and is verified. CTIF would rather provide a smaller amount of information at this time, than flood the website with info that may become overwhelming.  If you have information about new procedures, or Lessons Learned from the field, please contact us. 

Photo: (Above) A Slovenian EMS-worker undressing his hazmat PPE. Screenshot from an instructional video by the Slovenian Fire Academy

Left: A Belgian firefighter decontaminating during the corona outbreak. Photo: Belgian fire services

All physical CTIF meetings - including Delegates Assembly 2020 and the annual CTIF Seminar - are postponed until further notice. More information on DA 2020 will be sent out to members shortly. 

Given the wide spread COVID-19 pandemic crisis around the globe, CTIF advices all members to exercise extreme caution when it comes to travel – and if possible restrict all interactions to virtual meetings on the internet. All CTIF functions are currently being arranged entirely through virtual solutions, by phone, video conference, mail and other solutions. Several of CTIF´s Commissions decided early on in the pandemic to cancel their meetings and go virtual, in order to take the lead in precautionary measures during the COVID-19 pandemic. The CTIF Executive Committee has been meeting virtually since late 2018, as a compliment to their bi yearly physical meetings, so the transition to a virtual meeting environment was therefore smooth for CTIF´s governing body.

Wildfire season and COVID-19: How to safely evacuate?

Firefighters in areas prone to forest fires are now scrambling for creative ideas on how to create safe procedures during the COVID-19 pandemic. It is particularly large scale evacuations that could be difficult without spreading the virus in already vulnerable communities. According to  Chris Godley, emergency management director for Sonoma County, a community which dealt with difficult wildfires in 2017 and 2019, developing safe evacuation procedures is a major focus for the fire department. Normally, residents would be lodged in large community centers but now, with the risk of spreading the virus, the risks may outweigh the benefits. Dividing evacuees into smaller groups in empty hotel rooms is a possible solution. 

Nations with Mandatory TB Vaccines Show Fewer Coronavirus Deaths: Countries with mandatory policies to vaccinate against tuberculosis register fewer coronavirus deaths than countries that don’t have those policies, a new study has found. The preliminary study posted on medRxiv, a site for unpublished medical research, finds a correlation between countries that require citizens to get the bacillus Calmette-Guerin (BCG) vaccine and those showing fewer number of confirmed cases and deaths from Covid-19. At least six countries are running trials that involve giving frontline health workers and elderly people the BCG vaccine to see whether it can indeed provide some level of protection against the new coronavirus.

Finland, ‘Prepper Nation of the Nordics,’ Isn’t Worried About Masks Unlike their Scandinavian neighbors, the Finns never stopped stockpiling after the Cold War. Now Finland sits on an enviable supply of medical and survival gear in the Covid-19 era.  When the coronavirus hit, the Finnish government tapped into its supply of medical equipment for the first time since World War II. “Finland is the prepper nation of the Nordics, always ready for a major catastrophe or a World War III,” said Magnus Hakenstad, a scholar at the Norwegian Institute for Defence Studies.

Coronavirus can live in your body for up to 37 days, according to new study: A new study in The Lancet medical journal published Wednesday found that the novel coronavirus lived in the respiratory tracts of some patients for more than five weeks.   "This has important implications for both patient isolation decision making and guidance around the length of antiviral treatment," the authors of the study concluded.

Researchers may have found a way to safely reuse masks during the COVID-19 crisis: A team of researchers are claiming N95 respirator masks could be safely sterilized using common hospital equipment. According to Dr Kumar, who leads the tests, some masks could be decontaminated up to ten times. This could be a way to fight shortages and safely reuse some types of medical masks that are normally thrown away, according to an article on CBC News. 

Finland enlists social influencers in fight against Covid-19: Government advice sent to bloggers, rappers and writers to get to those not reached by traditional media. Finland has enlisted social influencers in the government’s efforts to contain the coronavirus pandemic. “We can reach a large part of the public in Finland through official communications and traditional media, but it’s clear the authorities’ messaging doesn’t always reach all population groups,” the government communications director, Päivi Anttikoski, said.

Repeated exposure = greater risk for complications? 70 doctors have died in Italy: Health care workers could be more at risk than previously thought, according to the Italian Medical Association. Wednesday April 1, it was announced that around 70 doctors who had performed house calls with patients infected with COVID-19 about a month ago in Italy have died in the illness. The Italian Medical Association now warn that higher exposure to corona could lead to more serious illness.

Italy´s advice: "Isolate the infected into separate hospitals": "The biggest mistake we made was to admit patients infected with COVID-19 into (regular) hospitals throughout the region," said Carlo Borghetti, the vice-premier of Lombardy, an economically crucial region with a population of 10 million. "We should have immediately set up separate structures exclusively for people sick with coronavirus. I recommend the rest of the world do this, to not send COVID patients into health-care facilities that are still uninfected."

Austria and Slovenia both pass laws to make masks mandatory when shopping at supermarkets: This is not a substitute for physical distancing. It is only an additional tightening measure," said Austrian government Chancellor Sebastian Kurz (ÖVP) in statement.  It will also be permissible to wear self-made masks: "The less you sneeze and cough, the less danger there is - every form of mouth covering helps." Protection is mandatory in Austria as soon as supermarkets can offer the masks. In Slovenia the new law went into effect already on Monday March 30th. 

How to disinfect an ambulance: Instructional video from Belgium: Ambulance ‘disinfection area’: 0:08 Message for paramedics: place all used and contaminated material visible on the stretcher or table in advance. This way, it won´t get mixed up. 0:15 Message for paramedics: The sanitary cell must be free of porous material beforehand. Otherwise we consider that as waste. Watch video here

COVID-19 Chinese Consultation Center:  To address the concerns of Chinese nationals worldwide, the Jack Ma Foundation and the Alibaba Foundation have urgently launched a COVID-19 International Medical Expert Communication Center. The handbook can be downloaded for free as a pdf or read directly online.

Singapore and Covid-19: After SARS and H1N1, Singapore built a system for tracking and containing epidemics. South Korea, Taiwan, and others did too—here's what they learned. Detailed data can also tell epidemiologists what to expect about the dynamics of the disease, helping guide more targeted responses. “Highly detailed surveillance data will be critical for understanding the outbreak,” says Justin Lessler, an epidemiologist at the Johns Hopkins School of Public Health.

Some scientists now believe masks could be crucial to stop the COVID-19 spread:  After a former FDA administrator suggested every person should wear a mask in public for an extra layer of protection (for others), the CDC in the US is now considering adding wearing masks to its recommendations. But the group isn't talking about medical masks – especially not N95 masks. Here´s what the Washinton Post learned about the possible new US directives:

EMS Hygienic Recommendations for washing of clothes: Two factors can have an effect on the virus:

• The effectiveness of the laundry detergent.
• Higher temperatures above 60 degrees Celsius. 

Washing at temperatures higher than 60° denatures proteins, so this also applies to viral proteins.
In the case that the laundry detergent is unable to sufficiently penetrate into the textile fiber, the heat will also help to deactivate the viruses. More in COVID19 First Responder Data Base

UK Firefighters agree to deliver food and collect dead bodies: The UK will use firefighters to help deliver food, retrieve dead bodies and drive ambulances as it braces for the looming peak of the coronavirus outbreak.Under a deal struck between the Fire Brigades Union (FBU), Fire chiefs and Fire and Rescue Employers, firefighters will continue to respond to their usual emergencies but will now also carry out new tasks, according to Matt Wrack, FBU general secretary.

The Austrian Fire Brigade Association feels extra tasks is too risky: A political push to deploy firefighters for assistance work (bringing food to old people, support supermarkets etc.) is not acceptable risk according to the Austrian Fire Brigade Association, who feels fire departments have to be careful with their resources or they could be risking a shutdown of entire fire stations.  "The protection of critical infrastructure, which also includes fire stations, has priority and should not be used as a contact point for the public too hastily", writes Albert Kern, president of the Austrian Fire Brigade Association, in a recent press release.

COVID-19 could spark a community mental-health crisis: There are acute mental-health issues in communities affected,  addicts in recovery without access to physical meetings; economic anxiety from job losses, financial instability and business closures; depression fuelled by physical seclusion; feelings of isolation, loneliness, panic and fear. 

The Canadian military assigns rapid response teams to help out their most northern communities:  The military has mobilized 24,000 full-time and part-time members to respond to calls from provinces and northern Indigenous communities for help with pandemic measures, Defence Minister Harjit Sajjan said Monday. These "rapid reaction" teams will be available for a range of missions, such as delivering medical supplies and supporting remote communities that may be vulnerable to COVID-19 outbreaks.

Death of U.S. flight attendant raises call for COVID-19 testing and protective suits for flight crews: Around the world, flight crews are on the front line, taking large risks while bringing their citizens home. Unions are becoming increasingly vocal in demanding better protective equipment, including protective suits or gowns, and mandatory flight crew testing for COVID-19.

Spain stops all non essential commercial activities until April 9th: The Spanish government will stop all commercial activities beyond the essentials. The background is that several intensive care units are about to collapse. This measure was adopted at an extraordinary ministerial meeting on Sunday, the Ministry of Labor, Economy and Social Affairs announced in a Twitter message. Spain is already  number two in Europe after Italy in the number of confirmed COVID-19 cases. 

Norwegian town built a make shift airport corona hospital in nine hours
A large influx of travelers at Oslo Airport gave the municipality of Ullensaker an urgent need to isolate travelers with corona symptoms. In only nine hours a separate "corona hospital" was established. A number of travelers who have arrived at Oslo Airport in the past week have been quarantined in a hotel.  In order to safeguard the travelers who have shown clear influenza symptoms, the municipality has been assisted by the hospital of LHL - the National Association for Heart and Lung Disease - at Olso Gardermoen Airport.

Instructional videos for COVID-19 pandemic procedures from the Slovenian Fire Academy: Links to simple videos the Slovenian national fire school prepared for Slovenian firefighters upon their request. Some have english subtitles, others are self explanatory as they are just video with no spoken audio.

Social Unrest and International Conflict: ICG report warns of the effects of lessening peace keeping efforts : Leaders of the world's 20 biggest economies met in an extraordinary virtual meeting on Thursday. But the COVID-19 crisis also represents a risk to social order and could further inflame already intractable wars across the globe, says a stark assessment released this week by the International Crisis Group (ICG).

Wet markets selling live animals a problem also outside of China: The continued existence of wildlife markets, which are considered potential breeding grounds for the spread of harmful viruses, means it's just a matter of time before the world is hit with another deadly pandemic, some scientists suggest.

FRANCE: Protocol & training videos for ambulances, specific for Coronavirus: Specific PPE, protocol to dress and undress. As little possible contact between rescuers and patients. Driver not at all in contact with the victim contact if possible. Dedicated ambulance for not urgent operation with Coronavirus. Disinfection of all materials/ambulance at the end of the operation.

If you've lost your sense of smell or taste, you could be a 'hidden carrier' of the coronavirus A sudden loss of smell could be a symptom of the coronavirus, according to leading rhinologists in the UK. Evidence from South Korea, China, and Italy suggests that many patients with COVID-19 may have experienced a loss of smell without any other symptoms.

Coronavirus: A Five-Step Reset for Fire and Emergency Leaders As the Coronavirus pandemic sweeps the world, FIRE Editor Andrew Lynch outlines the key elements required to transform our approach. 1) Resetting the Ecosystem. 2) Resetting Fire and Rescue 3) Resetting Dynamic Leaders 4) Resetting Resilient Communities 5) Resetting Connected Communities

China closes borders to foreigners, fearing 2nd wave of COVID-19. (China Daily/Reuters)  Chinese borders will shut Saturday for all foreigners, including those with visas and residency permits. China announced Thursday.  Already passengers arriving from abroad are questioned, examined, swabbed and tested for COVID-19. Then they're whisked off for two weeks of quarantine at a government facility.

Several countries are erecting field hospitals in war like measures to prepare for an onslaught of corona patients Sweden's first field hospital is ready to receive corona patients for the first time since WWII. Earlier this week, Spain announced that they had converted a sports area in Madrid into a field hospital with over 1300 intensive care beds.

WHO is considering "airborne precautions" for medical staff after a new study showed the coronavirus can survive in the air in some settings. The coronavirus can go airborne, staying suspended in the air depending on factors such as heat and humidity, WHO officials said. Health officials recommend medical staff wear so-called N95 masks because they filter out about 95% of all liquid or airborne particles. Coronavirus lives for hours in air particles and days on surfaces, new US study shows: Researchers found the virus was detectable in aerosols for up to three hours, up to four hours on copper and up to 24 hours on cardboard. COVID-19 can also last up to three days on plastic and stainless steel, the scientists concluded.

Information for First Responders on Maintaining Operational Capabilities During a Pandemic During a severe pandemic, workloads will increase, and staff sizes will diminish as employees and their families become ill or are quarantined. Contingency planning can help reduce the worst impacts; smart planning can save lives. This document provides the following kinds of information for first responders...

New disinfection system in Tehran: (From the National CTIF Committee at TFD)  During the Coronavirus  pandemic, firefighters conduct comprehensive disinfection work throughout Iran's capital, Tehran, in an attempt to slow the spread of deadly Coronavirus. Last week seven new disinfection equipment units were added to  theTFD system to increase the speed and efficiency of disinfection process by using less human resources in these operations and clean much more infected surfaces in Tehran. About 500 TFD crews wearing protective suits carry out daily disinfection operations at more than 200 public places including subway stations, main Bus Hub, main streets, freeways, gas stations, fresh fruit and vegetable markets, hospitals outer spaces, homeless shelters, etc, using more than 200 specialized heavy and light vehicles and equipment.

IFEMA becomes the "largest hospital in Spain": 1,396 beds enabled in less than 24 hours in a rapid response at the level of China

 In less than 24 hours, the IFEMA fairground in Madrid has been adapted to enable 1,396 beds. "There are no precedents in our country. In less than 24 hours we have assigned three pavilions and have put them into operation in the face of the urgency that this situation requires," Eduardo López-Puertas, IFEMA general director, told RNE .

Adapted infrastructure:  The fair in Madrid is "the largest hospital in Spain Turning empty sports areas into hospitals? The president of the SRA, Daniel Pelegrina offered it to the governments, national and to the City. If the pandemic spreads, it would be a solution for treating mild patients. In the face of the increase in coronavirus cases, and in a few hours they transformed the fairground of the Spanish capital into the largest hospital in Spain ; a possibility that is already being analyzed in Buenos Aires with the property of the Rural de Palermo.

COVID-19: PPE conservation, disinfection, firefighter isolation and quarantine (webinar)

The International Association of Fire Chiefs (IAFC) leadership and staff discuss in detail PPE conservation and disinfection and firefighter isolation and quarantine, among other topics. Also an update on the equipment supply chain.

Coronavirus: What Fire Chiefs Need to Know (webinar)

Fire departments are on the front lines of the effort to combat the Coronavirus (COVID-19). In this webinar, The International Association of Fire Chiefs (IAFC) leadership and staff discuss their views on the most important information for fire chiefs to know when developing plans to treat patients and protect first responders.

Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)

During the early stage of the outbreak, the main strategy focused on preventing the exportation of cases from Wuhan and other priority areas of Hubei Province. During the second stage of the outbreak, the main strategy was to reduce the intensity of the epidemic and to slow down the increase in cases. The third stage of the outbreak focused on reducing clusters of cases, thoroughly controlling the epidemic, and striking a balance between epidemic prevention and control, sustainable economic and social development, the unified command, standardized guidance, and scientific evidence-based policy implementation.  New technologies were applied such as the use of big data and artificial intelligence. READ MORE

WHO-recommended Handrub Formulations, Alternative Recipe:

- 2 parts 96% alcohol (isopropyl alcohol) or vodka
- 1 part (aloe vera) hand gel
- 8 to 10 drops of essential oil, such as lavender, lemon, cinnamon or peppermint
- Mixing bowl, Spatula, Funnel, Plastic container. If desired: a few drops of tea tree-oil.

New Guidelines on CPR When COVID-19 Is Known or Suspected

— Avoiding infection during aerosol-generating procedures: Special precautions should be taken when resuscitating people in cardiac arrest with known or suspected COVID-19 coronavirus, according to guidance from the American Heart Association (AHA).The interim guidance, drawn mostly from CDC recommendations, focused on procedures that generate aerosols -- such as CPR, endotracheal intubation, and non-invasive ventilation -- and thus pose an extra risk for transmitting the virus that causes COVID-19. Guide for Prehospital Care: "When COVID-19 is suspected in a patient needing emergency transport..."

Difficult Triage: Who lives and who dies?

"In the weeks ahead, physicians may be asked to make decisions that they have never before had to face, and for which many of them will not be prepared," the authors of a new triage study warned. The authors encouraged clinicians to "proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups" prior to patients' health deteriorating. Otherwise, the "debilitating and disabling distress" these decisions could have include devastating consequences for clinicians, as withdrawing a ventilator against the wishes of a patient or surrogate is "unprecedented for most physicians who practice in well-resourced countries."

Why Italy was hit so hard and so fast by COVID-19 Lessons learned from Italy's pandemic: "Act now or risk being in worse shape than Italy within two weeks".  This is former Italian prime minister Matteo Renzi's stark warning to other countries not yet heavily infected. The Italian coronavirus outbreak began on Feb. 18, when a 38-year old athletic male with breathing problems was repeatedly turned away from his doctor's office and the local hospital without being tested. He unknowingly spread COVID-19 to dozens of people over several days. According to a hospital administrator in the area, Dr. Lorenzo Casani,  "We know that Patient 1 went in and out at least three or four times from the emergency room, so he spread the virus to other patients and also to the health-care workers."In Italy, the virus spread quickly from the smaller towns in the north to the big city of Milan. Then it exploded.... READ MORE 

With Corona response, new procedures will have to be quickly put in place - and sometimes need to made up on the fly as first responders are thrown into unknown territory. Read how CTIF member Marco Aimo Boot operates in Piedmont, Italy during the current Corona-shutdown of his region.

CTIF strongly advices to not travel and restrict as many interactions as possible to virtual meetings.  The general concern of the CTIF is how the Corona virus will affect medical resources in member countries, given an even larger spread of the virus in the future. It is highly contagious and the demand for hospital care becomes very high in dealing with the more severe cases. Given the rapid spread of the virus, it makes the Covid-19 outbreak different from other pandemics in recent years.

First responders handbook: Hazardous materials CBRNE

Decontamination of Subways: London underground trial report Two separate tests were completed to EN Standard 14476:2013+A2:2019. The first was against Vaccinia; sometimes referred to as the ‘mother ship’ of double enveloped viruses (that are particularly hard to inactivate), with the subsequent test against the nominated (and globally accepted) surrogate for COVID19; feline coronavirus.

The handbook is intended for use by the first responders of the emergency services from the moment they receive an alarm up to the first 30 minutes on scene at an incident.

This handbook for hazardous materials was produced by virtue of Nordic collaboration in accordance with the Haga Declaration. Local and national representatives from the fire & rescue service, emergency medical services (EMS), and the police in Sweden and Norway cooperated on producing the handbook.

A Belgian initiative has started up a new website, Covidfirstresponse.com. We are especially linking to the section called "Alternative Protocols" which contains new procedures from a number of our member countries during the pandemic.  In this database, the website creators aim to bundle all information that can help first responders protect themselves and others during the COVID19 outbreak, and are also inviting other first responders to participate by creating an account and uploading their own material. How do you disinfect a fire station? Videos from Belgium´s Covidfirstresponse.com These videos have been made with limited resources and limited time in order to serve as a first help for fire departments in fighting COVID19.. Do not hesitate to reach out with feedback by by email to covidfirstresponse@gmail.com.  Improvise your own safety isolation gear: If you are facing shortage of protective gear in your hashtag#COVID19 response then this can be your solution: Make your own protective apron or (c)overall. They can be made out of polyester of cotton. We also have confirmation that water (60°C) and soap are efficient to disinfect them. This means they are reuasable. Check this link with instructions. We will keep adding info.

Download the handbook here