COVID-19’s Threat to 911 May Be Inside the Call Center

APCO members are “extremely concerned” about maintaining staff to respond to 911 calls at public safety answering points, said Senior Counsel Mark Reddish. “A crisis in staffing” preceded the pandemic “in 911 centers throughout the country,” with high attrition, he said. “Then you think about having a forced quarantine and maybe losing 25% or more of your staff -- that’s what makes people so anxious.”

An influx of calls isn’t as much of a concern as “ensuring you have appropriate staffing levels,” said NENA 9-1-1 and PSAP Operations Director April Heinze: most PSAPs can’t support remote working.

What to do if one or more 911 centers must be shut down is an important question, said NASNA Executive Director Harriet Rennie-Brown: “How are they going to start re-shifting that workload?” The concern is one infected staff member putting co-workers at risk, she said. Keeping 911 centers “clean and healthy” is critical “because that’s always been a closed environment,” said Rennie-Brown, citing her experience as Michigan’s 911 administrator during the H1N1 swine flu. Call takers should have their own headsets, she said.

To mitigate COVID-19 spread into the PSAP, some centers are restricting who can come on the floor, NENA CEO Brian Fontes said. Centers may have arrangements with other operations to handle call loads if a facility shuts, he said. Other steps include limiting staff travel, giving individual employees their own mice and keyboards, and increasing cleaning, said Reddish. Centers are referring to and sometimes revising continuity-of-operations plans, he said.

Reddish heard one center is considering quarantining healthy staff at work if someone is infected. The center has a kitchen and locker room, and cots would be provided, he said. It "isn’t that an agency’s about to do that tomorrow,” but it's about planning for an extreme situation and doing what you "need to do to continue serving the public and [first] responders.” Rennie-Brown said “everybody is looking at what their options are.”

“911 across the nation has been preparing with emergency management for the last few weeks,” said Heinze. Much planning was done for the 2003 SARS outbreak, she noted. It’s “not very difficult to take those pre-plans and update them and move them forward.” Refresh call intake protocols and account for any adjustments to first responder dispatching, she recommended.

People were worried about personnel risk during 2014’s Ebola outbreak, noted Reddish, who was a responder then. “What might be different about [coronavirus] is there is more a feeling of community risk.”

Sharing Information

“The big thing right now is the unknown,” so information sharing is critical, said Rennie-Brown. “People are hungry for reliable information.” State 911 administrators are coordinating resources for 911 centers, and NASNA posts guidance, she said. “Many 911 centers are reminding people that CDC.gov is the definitive place for accurate and up-to-date information on COVID-19.”

Public outreach that explains whom to call and when can help reduce non-emergency calls to 911, said Reddish. APCO set up a webpage and forum.

NENA shared guidance on when to call 911: Do so "if you are exhibiting emergency warning signs of COVID-19 that may include a high fever, difficulty breathing/shortness of breath, persistent pain/pressure in the chest, confusion, or bluish lips/face.” Resources are here.

Washington state’s 911 office “has been in lock step with the WA Department of Health and Emergency Management Division,” said the office in a message shared with us by Rennie-Brown. “DOH has drafted guidance and questions that we have pushed out to our PSAPs to ask when they get a call with potential infection.” The office reminded PSAPs to be prepared to invoke continuity-of-operations plans “because if one person tests positive in a PSAP it will likely be shut down even if only for a brief time.”

“We are following recommendations from the Oklahoma health department for 9-1-1 employees and putting out education material to management,” and ensuring PSAPs have emergency medical guide cards with additional questions, said the Oklahoma state 911 office in another email shared by NASNA.

NG-911

NG-911’s interoperability and ability to shift calls would give “a lot more flexibility in the face of the unknown,” said Rennie-Brown.

Most states don’t have NG-911 and it’s partly deployed in others. The technology would allow calls to be quickly routed if a center were hard hit, NENA's Fontes said. Medical data points such as if the caller has a fever and is part of the vulnerable population could be associated with an NG-911 call, he said. “That would better prepare responders” and hospitals where the individual is going, he said.

If a 911 center doesn’t have enough staff or is shut down, it’s not simple to transfer calls elsewhere under the legacy system, said Reddish. “It’s not the case where calls dynamically get re-routed, necessarily.” Wider deployment of NG-911 would allow that, he said. Call takers can’t work remotely, though the idea of virtual call centers “gets kicked around” in NG-911 conversations, he said.

Alabama has an NG-911 network. Its next-gen core services and Emergency Services IP Network provider INdigital has a “pandemic policy routing” procedure and other network flexibility capabilities “so that we can keep our 9-1-1 calls answered … even by someone not sitting in a PSAP, should a PSAP suffer an exposure,” said the Alabama 911 office in an email shared by Rennie-Brown.

APCO implemented employee travel restrictions and is allowing remote working "to reduce close interaction with others," CEO Derek Poarch emailed members and others Wednesday. "There will be representatives of key departments on a rotational basis in the office every day from 8 a.m. to 4 p.m. EDT."