COVID-19 Toolkit

IAFF MEMBER COVID-19 DEATHS

We are asking all affiliates to complete our COVID-19 tracking survey for reporting the number of IAFF members/fire-EMS personnel in your local/fire department who have tested positive for coronavirus or have been quarantined or in isolation.

November 8, 2021 – See the IAFF’s fact sheet on COVID-19 booster shots.

October 4, 2021 – The Firefighter Resource Network presents Doc Talk with Dr. James Augustine, a medical expert for the IAFC COVID Task Force. Watch Here

September 20, 2021 – The Firefighter Resource Network presents Doc Talk with Dr. James Augustine, a medical expert for the IAFC COVID Task Force. Watch Here

September 2, 2021 – The IAFF continues to encourage and strongly recommend that all members be vaccinated to prevent the spread of disease. Watch GP Kelly’s video encouraging every member to help prevent the loss of more of our members to this virus by getting vaccinated.

August 23, 2021 – The U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 Vaccine for the prevention of COVID-19 disease in individuals 16 years of age and older. This is the first FDA-approved COVID-19 vaccine. The vaccine continues to be available under emergency use authorization (EUA) for individuals 12 through 15 years of age and for the administration of a third dose (booster shot) in certain immunocompromised individuals.

August 19, 2021 – Join Edward A. Kelly IAFF General President today at 2:30 p.m. for a live discussion with Fire Engineering Editor Chief Bobby Halton on vaccine mandates.

August 10, 2021 – Edward A. Kelly and Frank Lima have a special message for IAFF members about COVID-19 vaccinations.

August 3, 2021 — California Ruling on COVID-19 Vaccines Favors Labor

August 1, 2021 — Delta Variant FAQs

July 30, 2021 – Read the IAFF’s statement on COVID-19 vaccine mandates.

May 2021

May 19, 2021 – With the release of the COVID-19 vaccines, the IAFF has worked hard to educate members on the facts about the vaccine and address concerns so our members are informed and armed with information to consider about being vaccinated against the COVID-19 virus. The IAFF will be hosting an informative FREE webinar in cooperation with the Centers for Disease Control and Prevention (CDC) and the National Institute for Occupational Safety and Health (NIOSH) on the COVID-19 vaccine and answer questions from members. The one-hour webinar, which will be offered twice on June 2 and June 3, features subject matter experts from the IAFF, CDC/NIOSH and fire department medical directors from the field who will discuss the efficacy and safety of the vaccine.

April 2021

April 29, 2021 – This important webinar addresses the provisions in the American Rescue Plan that benefit fire fighters and fire departments.

April 26, 2021 – Check out our newly updated Vaccine Informational Chart for detailed information on all the vaccines available in the U.S. and Canada.

March 2021

March 26, 2021 – The IAFF has produced a COVID-19 Policy and Guidance document for the U.S. and Canada. (Note: The Canadian version is being translated into French and will be released soon.) These documents identify and compile best practices and resources into one document to assist departments with the best ways of handling this public health emergency. They can also be found in the Resource section of this toolkit.

March 24, 2021 – New FAQs and a chart comparing COVID-19 vaccines can be found in the Vaccine section.

March 18, 2021 – The CDC has released its latest interim guidance for vaccinated people. Visit the Vaccine section for more information.

March 1, 2021 – Guidelines for for ventilating fire stations have been added to the Resources section of this webpage:

- Precautionary Measures for Recirculation of Air in the Fire Station
- ASHRAE Guidance for Building Operations During the COVID-19 Pandemic

February 2021

February 10, 2021 – As vaccination efforts ramp up, we have developed vaccination distribution guidelines designed to assist affiliates who want to participate in developing a vaccine distribution program. We encourage affiliate leaders and their department administrators to work with their state and local offices of emergency management and health departments, inform the respective decision makers of the capabilities of fire fighters and EMS practitioners and encourage participation in a coordinated multidisciplinary effort.

February 8, 2021 – In cooperation with the International Association of Fire Chiefs (IAFC), we have prepared a Fire Service Congressional COVID Priorities document outlining how Congress can help America’s fire fighters as they fight the pandemic. We encourage you to share this document with your U.S. representative and U.S. senators and speak with them about COVID’s impact in your local community.

January 2021

January 12, 2021 – The IAFF has provided COVID-19 vaccine FAQs in the Vaccine section of this resource.

December 2020

December 16 – Review the IAFF’s latest factsheet on vaccines.

December 15 – The IAFF issues a position statement on the importance of members getting vaccinated against the coronavirus (SARS-CoV-2) for their own protection and the protection of their brothers and sisters, family members, friends and communities.

December 10 – It is critical that our members are protected through vaccinations to maintain their readiness to respond to COVID-19 and other emergencies, as we have clearly entered the second wave of the disease amidst flu season. The IAFF is also working with our medical professionals to provide additional information to members on vaccine safety and efficacy.

The IAFF has advocated for and the federal government has recommended fire fighters and emergency medical personnel receive top tier priority in the distribution of a vaccine. The Centers for Disease Control and Prevention (CDC) is making recommendations to the states that our members be among the first to receive a vaccine (although there is no federal requirement that states do so).

A fact sheet and the IAFF’s position regarding the COVID-19 vaccine are forthcoming.

December 1 – The International Association of Fire Fighters issued a press release urging governors and state health officials to make career and volunteer fire fighters, paramedics and EMTs a top priority level for COVID-19 vaccines. We are vital parts of the national public health system and should be treated at the same priority as other frontline healthcare workers and hospital staff.

November 2020

November 16 – The federal government has recommended fire fighters and emergency medical personnel receive top tier priority in the distribution of a future vaccine, due in no small part to our advocacy. Unfortunately, although the Centers for Disease Control and Prevention (CDC) is making recommendations to the states that our members be among the first to receive a vaccine, there is no federal requirement that states do so. It is urgent that you contact your governor and insist that fire fighters and emergency medical personnel be among the first to receive the COVID-19 vaccine when it becomes available, as well as engage your political allies to urge them to also weigh in with your governor.

We have compiled talking points to assist you as you make your case.

To be clear, each state is responsible for its own distribution plan and there is no federal guarantee that fire fighters and emergency medical personnel will remain among the top tier for distribution. It is our understanding that several states have already indicated first responders will not be among the first to receive the vaccine.

For additional information or assistance, contact the IAFF Department of Governmental Affairs.

October 2020

October 16 – Not since the 1918 Spanish flu pandemic has there been a national emergency with such a globally devastating impact as COVID-19. From the beginning, this union has been at the forefront to protect our members working on the frontlines and to ensure they have the resources, tools and support to respond while keeping their families and communities safe. We stayed ahead of most federal organizations in providing guidance to prepare members to respond during this pandemic.

To document our efforts, we have prepared a COVID-19 Interim After Action Report to detail the challenges our union, our affiliates and our members have faced – and continue to face as the coronavirus continues to spread with cases on the rise – along with steps the IAFF took to address many of these challenges, the guidance and resources we developed and our recommendations for work we still need to do on our members’ behalf on these issues. This project was an extraordinary collaborative effort during this pandemic by headquarters staff from across our programmatic divisions.

The report serves as a reference of the challenges we faced, what we learned and what we did to resolve many of these issues encountered during the initial phases of this pandemic, and what we still need to do.

September 2020

September 21 – The Centers for Disease Control and Prevention (CDC) put out guidance updating the COVID-19 routes of transmission on Friday, September 18, identifying airborne or aerosolized transmission of the virus as the main route of exposure. On Monday, September 21, the CDC abruptly reverted to its previous guidance about how the virus is transmitted, removing language about airborne transmission. The IAFF believes there is enough evidence to support the latest claims that COVID-19 may be spread through respiratory droplets or small particles such as aerosols, and we have updated our COVID-19 facts with this information. Our position is supported by 239 scientists who sent a letter to the World Health Organization in July 2020 stating these findings.

September 20 – To assist with navigating when a member should return to work following a high-risk exposure to COVID-19, the IAFF put together a flowchart to help members and departments determine the appropriate time and symptom monitoring required for those who do and do not test positive to return to work.

September 18 – This EMS PPE Supply Estimator serves as a tool for Emergency Medical Services (EMS) response agencies to evaluate their current PPE supply and projected PPE needs. This is a response to a request from rural stakeholders.

September 16 – As part of the IAFF Mask Up Campaign, we are encouraging members to share photos (or use provided infographics) of themselves wearing masks while on duty to promote the use of masks in all fire departments to slow the spread of COVID-19.

September 4 – Review the latest COVID-19 Return to Work guidelines.

August 2020

August 14 – NHTSA COVID Resource Reporting Tool: The National Highway Traffic Safety Administration (NHTSA) is requesting fire departments complete the COVID Resource Reporting Tool on a weekly basis to help track the need for PPE or other COVID-19 assistance by the federal government.

August 12 – On a special Fire Wire podcast, California Professional Firefighters (CPF) President Brian Rice and Health and Safety and EMS Director Mike Feyh talk with Brothers Baker and Aldecoa, and their partners – Stacey Baker and Nikki Jackson – who are also COVID-19 survivors. The families discuss their fight against the disease, the physical and mental toll it took, and the devastating impact it had on their lives and families.

July 2020

July 30 – The U.S. Food and Drug Administration (FDA) has recently issued a warning to consumers and healthcare providers regarding some hand sanitizer products labeled to contain ethanol, also known as ethyl alcohol, that have tested positive for methanol contamination. The FDA has compiled a list of hand sanitizers containing methanol.

July 22 – Congress passes legislation to establish presumptive benefits for COVID-19.

July 16 – As COVID-19 cases and exposures continue to grow and new hotspots are identified, make sure you have the latest guidance, best practices and information to protect your health and safety and the public’s safety as you remain on the frontlines of this pandemic: 7 Best Practices to Reduce COVID-19 Exposure.

July 15 – Given the wide-ranging benefits that regular exercise can have on our physical, emotional and mental health, it is critical to stay connected and continue to support, motivate and challenge each other to stay safe, stay healthy and stay active. New fitness guides have been added to our COVID-19 resources:

July 9 – Mayday Events on the Rise During COVID-19
Mayday events have increased 35% during the COVID-19 pandemic and recent civil unrest, according to Don Abbott, former assistant fire chief of the Warren Township (Indiana) Fire Department, who has pioneered the study of thousands of Mayday events, including video, radio traffic and surveys dating back to 2015.

June 2020

June 12 – For members in recovery from an alcohol or substance use disorder, public restrictions imposed by the COVID-19 pandemic can pose unique threats and challenges to an established recovery plan. To support continued recovery during these unprecedented times, we are offering IAFF online recovery meetings for members coping with or in recovery from an alcohol or substance use problem. Attend a Meeting

June 8 – The IAFF has released guidance on Multisystem Inflammatory Syndrome in Children (MIS-C) related to COVID-19.

June 5 – We are saddened by the news that Local 22 member Eric Gore passed away from COVID-19 on June 2. Our hearts go out to his family and Local 22 brothers and sisters.

June 3 – See the IAFF’s updated guidance for resuming CPAT testing.

June 2 – See these new training videos from the San Antonio Fire Department featuring guidelines for designing and safely performing testing at skilled nursing homes and large-scale testing sites:

May 2020

May 28 – IAFF General President Harold Schaitberger is quoted in today’s Washington Post story on the risk fire fighters and paramedics face without having the proper PPE they need during the coronavirus pandemic.

May 26 – Check out brand-new IAFF exercise guides, designed with the current environment in mind. More guides like these can be found in the Resources tab.

May 22 – Some states are starting to require fire fighters to assist with performing testing on residents in skilled nursing homes. These are hot zones and often the tasks are out of the scope of individuals’ training or practice. This testing guidance on best practices includes how to safely perform testing for both the nursing home residents and fire fighters.

May 20 – Until an effective vaccine is available, testing for COVID-19 can help slow the spread of the disease. Check out the new tab added to this resource page on COVID-19 Testing.

May 19 – With the significant health concerns related to COVID-19 and all the restrictions across the U.S. and Canada, the IAFF Executive Board on May 14, 2020, approved a motion to conduct the 2020 Fallen Fire Fighter Memorial ceremony without attendees, broadcasting it as a respectful virtual ceremony on September 19, 2020. We will still be engraving members’ names on our Wall of Honor this year and will note those etched on our Memorial during the virtual ceremony. All 2020 honoree families will be invited to attend the 2021 Fallen Fire Fighter Memorial where our fallen members will receive proper recognition along with those lost in 2020 at a traditional ceremony, with all families receiving their flag.

May 18 – The Federal Emergency Management Agency (FEMA) has extended the deadline for applications for FY 2019 Staffing for SAFER grant funding to 5:00 p.m. on May 27, 2020. There is $350 million available in federal grants to add fire fighters to departments in need. Career, combination and volunteer fire departments are eligible to apply. Learn More

May 13 – The IAFF Financial Corporation is hosting a webinar Thursday, May 14 at 3:00 p.m. EDT on mortgage relief options with experts from CrossCountry Mortgage. Experts will discuss mortgage relief options, where to turn for help and how to avoid scams.

May 8 – During these times of uncertainty when we are encouraged to stay indoors, avoid group settings and practice physical distancing, it can be challenging to stay physically active. These IAFF exercise and physical activity resources can help:

May 7 – During a disease outbreak or pandemic, it is normal to have some anxiety about contracting the virus. However, if fear of COVID-19 is causing you or someone you love significant anxiety, these strategies can help you cope. Find more IAFF behavioral health resources here.

May 1 – In our latest IAFF Podcast, members of the IAFF Health and Safety Division discuss our behavioral health initiatives during COVID-19.

April 2020

April 29 – We have developed Guidance for Fire Department and Union Operations to assist affiliates and their fire departments in returning to normal operations in accordance with federal, state and local guidance as communities begin to reopen to maintain the health and safety of our workforce as we continue to provide optimum service to our communities during this transition.

Our Fire Fighter Resilience During COVID-19 campaign beginning May 1 focuses on movement, nutrition, wellness, resilience, sleep and many other topics, and features health and wellness subject matter experts. Learn more …

April 28 – In response to the COVID-19 pandemic, Hilton is donating one million room nights for frontline medical professionals in the United States (the Hilton link above will prompt you to log in to the IAFF website if you have not already). See our Hotels section for more offers.

April 24 – The IAFF continues to urge Congress to provide direct funding to fire and EMS to provide the tools and resources to keep our members on the frontines when communities need them most during this COVID-19 pandemic.

April 23 – See our Testing for COVID-19 Fact Sheet for important information about molecular and antibody testing.

April 22 – Coping With Grief During COVID-19 is our new resource for grieving in this era of social distancing, including the inability to gather and mourn with loved ones, which can make it difficult for some to move forward.

April 21 – Read the IAFF’s latest guidance document on identifying counterfeit respirators, which are being falsely marketed and sold as NIOSH-approved.

April 20 – Affiliate leaders from across the United States and Canada discuss how they’re using this toolkit to communicate to their members, the public, the media and elected officials about responding to the COVID-19 pandemic in the latest episode of the The Kitchen Table.

April 17 – Protecting Your Finances in a Pandemic: IAFF members are on the frontlines, but some spouses may be out of work due to stay-at-home orders. If this is the case for your family and you are under financial stress, these are financial moves can you make right now.

April 16 – Beginning Monday, April 20, we will be offering online recovery meetings for members coping with or in recovery from an alcohol or substance use problem.

April 14 – Our latest episode of The Kitchen Table features four affiliate leaders from some of the states hit hardest by COVID-19 who share their experiences and discuss how they are addressing the challenges of keeping members safe while keeping up with changing protocols and guidelines.

April 13 – EXERCISE AT HOME – Unlimited options to meet your needs with limited-to-no equipment! New ideas posted every week.

April 12 – As feds play ‘backup,’ states take unorthodox steps to compete in cutthroat global market for coronavirus supplies

April 11 – Reduce the spread of COVID-19 by following our COVID-19 Best Practices: Social Distancing Guidelines for non-response work-related activities.

April 10 – See our updated guidance on surgical masks and cloth facemasks. While surgical masks are preferred as they provide more protection, cloth masks can be substituted at the station or at home. It is important to remember that facemasks are not worn to prevent exposure, but rather to limit the transmission of COVID-19 if an individual is asymptomatic.

April 9 – Watch our newest episode of the Kitchen Table addressing many of the health and safety issues affecting you on the frontlines during this COVID-19 pandemic, including preparation and personal protective equipment (PPE), exposure documentation, quarantine and protocols and guidelines.

April 8 – The following hotels are offering special rates and discounts to healthcare workers, including fire fighters and emergency medical personnel, who are on the frontlines in the fight against the spread of COVID-19 and may need a place to stay close to their work location or to self-quarantine away from their homes and families to protect their loved ones.

The Warriors Research Institute (WRI) – run by IAFF Behavioral Health partner Dr. Suzy Gulliver – is offering telemental health services at no cost to all IAFF members in the United States. Learn more here.

April 7 – Public Assistance grants are available to support organizations with extraordinary costs associated with this event, including:

Overtime or personnel backfill cost
Expendable supplies, such as disinfectants, medical supplies and personal protective equipment (PPE) (masks, gloves and gowns)
Apparatus usage

April 6 – This episode of The Kitchen Table addresses many of the legal considerations and responsibilities affiliates need to know to conduct your union business during this COVID-19 crisis.

April 3 – COVID-19 Guidance on Surgical/Cloth Masks

New video: COVID-19: The IAFF Has Your Back

April 2 – IAFF announces guidance on Candidate Physical Ability Test (CPAT) testing during the COVID-19 pandemic.

April 1 – The Center of Medicare and Medicaid Services (CMS) has relaxed some requirements, allowing fire departments to:

Transport patients to alternative destinations, such as urgent care, community mental health facilities, physician’s offices and patient’s homes
Submit for reimbursement to CMS for the transport the same way as if transported to the hospital
Provide telehealth services through a contracted physician to assist with treat and release with no transport
Fire departments cannot bill for telehealth services directly but can arrange with the providing doctor. This is also a good way to lessen the burden on 9-1-1 call volume

March 2020

March 31 – The IAFF has developed checklists for decontaminating apparatus after a potential exposure and cleaning stations during this pandemic.

March 30 – Watch this video message from General President Harold Schaitberger on how the IAFF is working to secure the tools and resources you need to fight the coronavirus (COVID-19) pandemic.

March 28 – The Federal Emergency Management Agency (FEMA)/Health and Human Services Healthcare Resilience Task Force has established that fire/EMS agencies are at the same level of priority for PPE as hospitals, healthcare facilities and workers. See guidance for submitting resupply requests.

March 27 – Congress completed its work on an economic stimulus package intended to address the response to and impact of the COVID-19 pandemic. The bill includes significant resources for fire and EMS as follows:

$45 billion for the Disaster Relief Fund to reimburse fire and EMS departments for expenses related to the response to the virus.
$100 million in funding through the Assistance to Firefighters (FIRE Act) grant program, earmarked specifically for PPE and related supplies.
$100 billion to reimburse healthcare providers, including EMS, for healthcare expenses or lost revenue, including costs related to medical supplies and equipment, such as PPE, increased workforce expenses and surge capacity.
$41 million for the National Forest System and Wildland Fire Management for PPE and baseline health testing.

The CDC/NIOSH has updated the Ryan White Act to include COVID-19. Hospitals are now mandated to notify emergency response employees of any exposure to a positive COVID-19 patient.

March 25 – 10 Things Your Local Should Be Doing for COVID-19 Response helps identify the most important issues facing members and provide the information and resources needed to ensure best practices are in place.

March 24 – The IAFF has developed a new, more dynamic data tool to help you document exposures among members in your local/fire department and in departments across both countries. Once reported, this data will be available in real time so that we have a clearer picture of the impact of COVID-19 on our members and affiliates across the United States and Canada.

March 23 – Pearson Vue^© has agreed to begin limited reopening of state-owned testing centers within colleges and universities as a means of allowing more than 12,000 students to take emergency medical technician (EMT) and paramedic certification exams. This positive news follows a letter from General President Harold Schaitberger to the National Governors Association (NGA) to get more EMTs and paramedics certified as we respond to the COVID-19 pandemic.

March 21 – Watch our new video on self screening and post the Self-Screening Guidelines poster in every fire station.

Review the IAFF Return to Work guidelines.

Use the National Fire Operations Reporting System (NFORS) Exposure mobile app to help in collecting national exposure data for all fire fighters and paramedics. Watch the demo video on how to enter data.

March 20 – The IAFF’s Jim Brinkley talks with MSNBC about the dire need for additional PPE for fire fighters and paramedics on the frontlines of the COVID-19 pandemic.

March 19 – Watch our new video on proper PPE donning and doffing techniques.

Listen to our IAFF COVID-19 Podcast

March 18 – The IAFF addresses shortage of PPE on Fox News.

See our self-screening guidelines for posting in every fire station.

March 17 – See our new COVID-19 Post-Exposure/Quarantine Symptom Monitoring Tracker. This form can be used to track signs and symptoms following an exposure and while in quarantine.

March 13 – The president announced an emergency declaration to address the coronavirus pandemic. The declaration will free up nearly $50 billion in disaster money to fight the spread of the virus and expand capacity at hospitals and reduce other health regulations that could slow action.

March 12 – The IAFF has sent a letter to Secretary of Health and Human Services Alex Azar objecting to the conclusions and recommendations of the CDC’s updated Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States.

March 11 – One of the new coronavirus cases is a fire fighter in Kirkland who may have helped with transporting ill patients from Life Care to area hospitals. Thirty-one Kirkland fire fighters and three police officers are in quarantine, while six have been released after completing their quarantine period without developing symptoms. Most are in isolation or quarantine at home.

March 10 – More than 50 members in Washington state are under quarantine for possible exposure to COVID-19.

March 6 – We will be livestreaming a COVID-19 Briefing on Tuesday, March 10 from 8:00-9:00 a.m. (EDT) on our efforts to ensure we address the needs of our members on the frontlines responding to patients who may be infected or who are quarantined or isolated due to possible exposure.

March 4 – Nine quarantined members in Washington state, along with seven family members with flu-like symptoms, are being tested for the coronavirus.

February 2020

February 28 – More than 25 members were exposed and subsequently quarantined in Washington state in relation to calls they ran to the nursing home where it has been confirmed that the first death from the coronavirus occurred. Learn More

February 26 – The global death toll neared 2,800 with a total of about 80,000 confirmed infection cases reported globally.

February 18 – There were approximately 400 U.S. citizens onboard the Diamond Princess cruise ship. The U.S. government disembarked the majority of the U.S. citizens from the ship and brought them back to the United States on February 18. Of those brought back, 14 passengers tested positive for COVID-19 and are being treated at a medical facility in Omaha, Nebraska. The other passengers will be subject to a 14-day, federal quarantine and be housed at two existing federal quarantine sites for repatriated travelers: Travis Air Force Base in California and Joint Base San Antonio-Lackland in Texas.

February 13 – The death toll in mainland China hit 1,300, with nearly 60,000 infections recorded. Meanwhile, Japan confirmed its first death from the virus.

January 2020

January 31 – The Secretary of the Department of Health and Human Services (DHHS) declared a public health emergency in the United States on January 31, 2020. The emergency declaration gives state, tribal and local health departments the ability to request that DHHS provide funding, supplies and resources to respond to COVID-19.

January 30 – WHO declared the COVID-19 outbreak a public health emergency of international concern on January 30, 2020, after they identified that the novel coronavirus is expected to continue spreading internationally and may appear in any country.

January 27 – The CDC has raised the travel advisory to a Level 3 warning: Avoid all nonessential travel to China. Chinese authorities are imposing quarantines and restricting travel throughout the country. There is also a Level 4 warning to not travel to the Hubei province, China, due to novel coronavirus first identified in Wuhan, China.

January 17 – As a second death was reported in Wuhan, health authorities in the U.S. announced that three airports would start screening passengers arriving from the city. Authorities in the United States, Nepal, France, Australia, Malaysia, Singapore, South Korea, Vietnam and Taiwan confirmed cases over the following days.

January 7 – Officials announced they had identified a new virus, according to the WHO. The novel virus was named 2019-nCoV and was identified as belonging to the coronavirus family, which includes SARS and the common cold.

December 2019

December 31, 2019 – China alerted WHO to several cases of unusual pneumonia in Wuhan, a port city of 11 million people in the central Hubei province. The virus was unknown.

Vaccines

Guidance for Vaccinated People

The Centers for Disease Control and Prevention (CDC) on March 8, 2021, released its latest interim guidance, the Interim Public Health Recommendations for Fully Vaccinated People. This is the first of several recommendations the CDC will announce on returning to normalcy, emphasizing that the vaccine is needed to reach herd immunity and remove all restrictions.

The latest guidance is for individuals who are considered fully vaccinated, defined as more than two weeks following the second dose of the two-dose Moderna or Pfizer vaccine, or more than two weeks following the one-dose Johnson & Johnson vaccine.

The latest recommendations are designed for households, not places of work; however, because fire stations/fire halls are considered extended homes for IAFF members, the guidance can be modified to address our members’ needs. It is important to still follow prevention methods, such as staying home when sick, monitoring for signs and symptoms, washing hands frequently, maintaining a social distance of 6 feet (2 meters) and sanitizing surfaces in the station.

Facemasks can be removed, but other prevention methods should still be taken* when an entire shift/station is 100% vaccinated.

Facemasks must be worn and all prevention methods should be taken when an entire shift/station is not 100% vaccinated. If only one person is not vaccinated, facemasks should still be worn along with social distancing. In addition, facemasks should be worn:

During change of shift until the company officer verifies everyone is vaccinated.
When there are visitors at the station.
While responding to any call (emergency or non-emergency).
Any activities outside the station (stores, restaurants, social gatherings, etc.)

CDC recommendations are federal recommendations; it is still important to follow your state, provincial or local public health departments for further guidance and recommendations. As more become vaccinated or the science evolves, the CDC will be updating its recommendations accordingly, and the IAFF will as well.

We recognize that under some circumstances, including sincere religious objections or a bona fide medical reason, fire fighters may object to being vaccinated. These members may be able to obtain an exemption or reasonable accommodation from their fire departments. The IAFF recommends following guidelines from the NFPA 1581 Standard.

*NOTE: Even if your department meets the metrics to no longer require masking, we strongly recommend members to continue to wear a facemask as they can still prevent other diseases (influenza, common colds, etc.). The limited guidance changes are based on science; however, the science currently does not fully support that a vaccinated individual is not a carrier. Therefore, if you live with a high-risk individual, we strongly recommend continuing to wear a facemask at the station.

COVID-19 Vaccine FAQs

What are the Pfizer/BioNTech and Moderna COVID-19 vaccines and how do they work?

The COVID-19 vaccine reduces the risk of serious illness from COVID-19. These COVID-19 vaccines are designed to help the body identify the unique spike proteins found in each coronavirus particle. The Pfizer and Moderna COVID-19 vaccines work by teaching your immune system how to recognize and fight the virus that causes COVID-19; this reduces your risk of contracting COVID-19. The vaccines cannot cause the infection. In response to receiving a vaccine, the body is then primed to produce antibodies without becoming ill with COVID-19.

What is the Janssen/Johnson & Johnson vaccine and how does it work?

The Janssen/Johnson & Johnson (J&J) vaccine, like the Pfizer and Moderna vaccines, reduce the risk of serious illness from COVID-19 and cannot cause a COVID-19 infection. The J&J vaccine does differ, however, as it is a viral vector vaccine. These vaccines use a modified, harmless version of a different virus that instructs human cells to make the SARS-CoV 2 spike protein, then triggers an immune response. The main benefit of the J&J vaccine is that it is a one-dose vaccine. Two weeks following the one dose you are considered fully vaccinated.

Only approved in Canada What is the AstraZeneca vaccine and how does it work?

The AstraZeneca vaccine, like the other vaccines, will reduce the risk of serious illness from COVID-19 and does not cause a COVID-19 infection. The AstraZeneca vaccine, like the J&J vaccine, is a viral vector vaccine. These vaccines use a modified, harmless version of a different virus that instructs human cells to make the SARS-CoV 2 spike protein, then triggers an immune response. But unlike the J&J vaccine, this is a two-dose vaccine like Pfizer and Moderna, whereby the second dose is administered between four to 12 weeks following the first dose.

Why is a vaccine necessary?

The vaccine will be the turning point of this pandemic. To reduce the risk of COVID-19 and return to normalcy, individuals must get vaccinated to achieve herd immunity to COVID-19. Herd immunity is a term used to describe when enough people have protection – either from previous infection or vaccination — that it is unlikely a virus or bacteria can spread and cause disease in a community.

Those who have had COVID-19 may have some natural protection, but it is unclear how long this protection lasts as some individuals have been re-infected with COVID-19. It is recommended that an infected individual get vaccinated 90 days post infection. Natural protection is not enough to stop this pandemic; the COVID-19 vaccine is necessary whether or not you’ve already contracted COVID-19. The vaccine will help protect you (along with wearing a mask, washing your hands, social distancing and self-monitoring) and reduce the risk of the disease, particularly in people at increased risk for severe illness from COVID-19.

What are variants of COVID-19 and how can vaccines prevent new variants?

When a virus widely circulates in a population, causing many infections, this increases opportunities for a virus to spread. The virus is constantly replicating, and this increases the opportunity to undergo changes, or mutations. Typically, most viral mutations have little-to-no impact on the virus’s ability to cause infections and disease but depending on where the changes are located in the virus’s genetic material, they may affect a virus’s properties, such as transmission (for example, it may spread more or less easily) or severity (for example, it may cause more or less severe disease).

This is what we are seeing with the COVID-19 variants. Currently there are four main variants: the United Kingdom (UK) identified a variant called B.1.1.7 (Alpha); the South Africa variant called B.1.351 (Beta); the Brazil variant called P.1 (Gamma); and the India variant called B.1.617.2 (Delta). These have all been identified in many countries around the world. The Delta variant is currently the most prominent in the United States due to its high transmissibility. In addition to prevention methods, it is important to vaccinate against COVID-19. As more people get vaccinated, public health organizations and agencies expect virus circulation to decrease, and lead to fewer mutations. Even if the vaccines are less effective against the variants, they are still showing protection against severe illness and hospitalization.

Are the vaccines effective?

None of the COVID-19 vaccines on the market is 100% effective; in general, most vaccines are not. Vaccine efficacy/effectiveness is interpreted as the percentage of individuals who have received the vaccine and have reduction in disease among that group. According to the CDC, “vaccine efficacy is used when a study is carried out under ideal conditions, for example, during a clinical trial. Vaccine effectiveness is used when a study is carried out under typical field (that is, less than perfectly controlled) conditions.”

The Pfizer, Moderna and J&J vaccines, currently the only vaccines to receive an Emergency Use Authorization (EUA) to be distributed in the United States. Pfizer and Moderna are molecular RNA based (not a live virus) and both vaccines have around a 95% efficacy rate; Pfizer drops to about 64% against the Delta variant. The J&J vaccine has shown to have an efficacy of around 66% in preventing moderate to severe COVID-19 disease and 86% efficacy at reducing severe illness and hospitalizations. Moderna and J&J have not concluded their analysis on the efficacy of their vaccines against the Delta variant.

Canada has authorized Pfizer, Moderna, J&J and the AstraZeneca vaccines. AstraZeneca has an efficacy rate of 70-90%, but it also protects against severe symptoms and hospitalization.

How many doses of the COVID-19 vaccine are needed? If two doses, do I need to get both vaccine shots?

The number of doses of a COVID-19 vaccine will depend on the type of vaccine administered. The COVID-19 vaccines that have been approved to date include Pfizer, Moderna and AstraZeneca (in Canada), all which require two doses given approximately one month apart. The Johnson & Johnson vaccine requires only one dose. If you receive the Pfizer, Moderna, or AstraZeneca vaccine, you must receive two doses and it is recommended they be the same vaccine manufacturer to develop a level of antibodies to reduce the risk of contracting COVID-19.

Are COVID-19 vaccines safe?

Yes, these vaccines are extremely safe. In the United States, for any COVID-19 vaccine to receive an EUA, it must be deemed safe. The Food and Drug Administration (FDA) will not issue an EUA for a vaccine if the safety data is in question. Before an EUA can be issued for a vaccine, the FDA must first determine that the known and potential benefits outweigh the known and potential risks. An EUA submission includes all safety data accumulated from phase 1, phase 2 and phase 3 studies.

Once the EUA is issued, the FDA expects the vaccine manufacturer to continue active follow-up for safety data among individuals who receive the vaccine under an EUA. The FDA also expects manufacturers that receive an EUA to continue their clinical trials to pursue full licensure. It is important to note that if an adverse event occurs in reaction to a vaccine, it typically happens immediately or within seven days of vaccination.

Pfizer, Moderna and the J&J vaccines have EUAs from the FDA. Health Canada has authorized Pfizer, Moderna, J&J and AstraZeneca.

What are the side effects of the vaccine?

Vaccines may have minimal side effects that include pain, soreness and redness at the injection site, body aches, fatigue and mild fever that may present for up to 48 hours following the injection. These minimal side effects are not COVID-19, but rather your immune system ramping up to produce antibodies to fight against COVID-19 if exposed to it. This is common with all vaccines.

There are rare severe side effects that have been associated with the COVID-19 vaccines:

Anaphylaxis after COVID-19 vaccination is rare and has occurred in approximately two to five people per million vaccinated in the United States.
Thrombosis with thrombocytopenia syndrome (TTS) after Johnson & Johnson’s Janssen (J&J/Janssen) and AstraZenecaCOVID-19 vaccination is More than 13 million doses of the J&J/Janssen COVID-19 vaccine have been given in the United States and TTS was identified in 39 confirmed cases. Women under 50 are at the highest risk.
Reports of Guillain-Barré Syndrome (GBS) in people who have received the J&J/Janssen COVID-19 vaccine. Around 100 preliminary reports of GBS out of about 13 million does.
Myocarditis and pericarditis after mRNA vaccinations are rare. As of July 19, 2021, VAERS has received 1,148 reports of myocarditis or pericarditis among people ages 30 and younger who received COVID-19 vaccine.
Reports of death after COVID-19 vaccination are rare. More than 339 million doses of COVID-19 vaccines were administered in the United States and there were 6,207 reports of death (0.0018%) among people who received a COVID-19 vaccine.

For more information about severe side effects – https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html.

Once vaccinated, do I still need to wear a mask, social distance, etc.?

According to the CDC, fully vaccinated individuals do not need to wear a mask, but should continue to practice prevention measures. For those who are high-risk individuals or live with someone who is not vaccinated, we do recommend you continue to wear a mask. As you navigate this pandemic, there is nothing wrong with continuing to wear a mask even if you are fully vaccinated.

When should I get the COVID-19 vaccine?

The IAFF strongly recommends all IAFF members receive the vaccine as soon as it’s available.

Receiving any dose of a COVID-19 vaccine may present minimal side effects for up to 48 hours following the injection; therefore, we recommend members receive their vaccine at the end of their shift to help avoid using sick leave or leaving a shift understaffed.

The IAFF strongly recommends departments provide vaccines to members on shift, but vaccination appointments should be made near change of shift to account for those who may develop mild side effects.

Will the COVID-19 vaccine impact me if I am pregnant or planning to get pregnant?

The COVID-19 vaccine is recommended for anyone trying to become pregnant now or who wants to get pregnant in the future. There is currently no evidence that COVID-19 vaccination causes any problems with pregnancy, and there is no evidence that fertility problems are a side effect of the COVID-19 vaccine. Consult with your OB/GYN physician for further information and guidance prior to getting the vaccine.

Can I breastfeed after getting the COVID-19 vaccine?

Limited data on breastfeeding and the COVID-19 vaccine are available, but currently, all authorized COVID-19 vaccines can be offered to people who are pregnant or breastfeeding. The COVID-19 vaccines authorized are non-replicating vaccines, meaning they create an immune response but do not reproduce inside host cells. Because non-replicating vaccines pose no risk for lactating people or their infants, COVID-19 vaccines are also thought to not be a risk to the breastfed infant. Therefore, lactating people may choose to be vaccinated. Also, some early reporting has detected antibodies in infants that are breastfeeding. Consult with your OB/GYN before getting the vaccine.

Common Misconceptions

MYTH: You can contract COVID-19 from the vaccine.
FACT: None of the COVID-19 vaccines currently used in the United States or Canada uses a live virus. These vaccines are designed to teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes, this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity, but they are not symptoms of COVID-19. However, you can still contract COVID-19 post vaccination until the antibodies rise to a sufficient level, which science suggests occurs between 10-14 days after the second dose.

MYTH: COVID-19 vaccines will alter your DNA.
FACT: According to the CDC, the first COVID-19 vaccines are messenger RNA, or mRNA, vaccines. Messenger RNA vaccines instruct cells in the body how to have an immune response; they will not interact or change the DNA of your cells. Human cells break down and rid themselves of the messenger RNA soon after they have finished using the instructions.

Additional IAFF Resources

Videos

Message From General President Edward Kelly on COVID-19 Vaccines

COVID-19 Vaccine: Message From President Rice

IAFF COVID-19 Vaccine Webinar

A Message to IAFF Members About Vaccination

Signs/Symptoms &
Transmission Prevention

Signs and Symptoms

The reported illnesses for COVID-19 have ranged from mild symptoms to severe illness and death.

The onset of symptoms may appear 2-14 days after exposure and generally are categorized as flu-like symptoms. The main symptoms remain:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

This list is updated as the CDC learns more about COVID-19.

Protect Yourself and Others

The best way to prevent illness is to avoid exposure to this virus. Take steps to slow the spread by following the IAFF’s 7 Best Practices to Reduce COVID-19 Exposure. Of those 7 best practices, the IAFF highly recommends every member follow these prevention measures:

WEAR A FACEMASK. Until a vaccine is readily available, we know the virus is spread through droplets and aerosolization. Facemasks will prevent the transmission of COVID-19 – which will provide you some protection and protection for your brothers and sisters and immediate family members. Wear facemasks or surgical masks (or cloth masks if there is a shortage of surgical masks) while on duty in the fire station and when in public, as well as when riding in fire apparatus together.
SOCIAL DISTANCE. Maintain good social distance (about 6 feet), including in sleeping quarters, and avoid congregating in common areas. This is very important in preventing the spread of COVID-19.
PRACTICE HAND HYGIENE AND DECONTAMINATE STATION. Wash your hands often with soap and water. If soap and water are not available, use a hand sanitizer* that contains at least 60% alcohol. Routinely clean and disinfect frequently touched surfaces.
SELF SCREEN. All fire fighters/emergency medical personnel must be vigilant about symptom monitoring to identify symptoms early and prevent exposures.

Transmission

The virus that causes COVID-19 is spreading very easily and sustainably between people. Information from the ongoing COVID-19 pandemic suggest that this virus is spreading more efficiently than influenza.

Person to Person: The virus is thought to spread mainly from person-to-person by those who are in close contact with one another (within about 6 feet) through – most commonly – respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks or breathes.
- These particles can be inhaled into the nose, mouth, airways and lungs and cause infection. This is thought to be the main way the virus spreads.
- There is growing evidence that droplets and airborne particles can (1) remain suspended in the air to be breathed in by others and (2) travel distances beyond 6 feet (for example, during choir practice, in restaurants or in fitness classes).

Can you spread COVID-19 without showing signs and symptoms?

People are thought to be most contagious when they are symptomatic. However, we now know that an asymptomatic person could be shedding a viral load (contagious) for up to 48 hours prior to becoming symptomatic.

Although this is not thought to be the main way the virus spreads, some cases of COVID-19 spreading before people show symptoms have been reported.

PPE & Decontamination

Protection

Recommended Guidelines for Selection, Care and Cleaning/Sanitization of Structural Fire Fighting Personal Protective Clothing
The IAFF recommends N95 or P100 with eye protection
- N95 and higher levels of respiratory protection require fit testing

Respiratory Protection Standard.
Fit Testing Procedures and Requirements – Fit Testing Procedures

- On March 14, 2020, OSHA issued Temporary Enforcement Guidance: Healthcare Respiratory Protection Annual Fit-Testing for N95 Filtering Facepieces During the COVID-19 Outbreak (eye protection should be face shield or goggles).
- Surgical masks with plastic eye lenses are inappropriate PPE for patient care
If possible and tolerated, place a surgical mask on patients to minimize exposure
Use a clean, non-sterile, long-sleeved, fluid-resistant gown
Gloves
Use either single-use, disposable equipment or dedicated equipment to decontaminate. If equipment needs to be shared among patients, clean and disinfect between each patient using ethyl alcohol (70%) or bleach solution (ratio of ¼ cup of bleach in a gallon of water)
Hand washing
Minimize patient contact in poorly ventilated areas
Disinfect the ambulance with bleach solution
- Routinely clean and disinfect patient-contact areas

If your department has a limited supply and inventory of N95 respirators, exam gloves, protective eyewear and impervious gowns, the CDC has posted a PPE Strategy Burn Calculator spreadsheet to assist departments with tracking PPE usage for the next few weeks to assist with the logistics component of reordering PPE supplies for your members.
For more information about PPE, visit the resources tab.

Respirator Information

Counterfeit Respirators:
- Counterfeit respirators are products that are falsely marketed and sold as NIOSH-approved respirators. The consequences are that many of these counterfeit respirators may not provide appropriate respiratory protection to workers.
- For more information on counterfeit respirators, see the CDC guidance on Counterfeit Respirators/Misrepresentation of NIOSH-Approval
Respirator Assessment
- The National Personal Protective Technology Laboratory (NPPTL) has completed international assessments for respirators that are not NIOSH approved. These assessments are not a part of the NIOSH respirator approval process and will in no way lead to or preclude NIOSH approval through the official approval process, but the list does identify the filtration efficiency. See list of reviewed products.
Extend the Lifetime of Respirators/Reuse Resources
- How to Extend the Life of Respiratory Equipment
- Decontaminating and Reusing Respirators
  - Ultraviolet germicidal irradiation (UVGI), vaporous hydrogen peroxide (VHP), and moist heat showed the most promise as potential methods to decontaminate filtering facepiece respirators (FFRs). Therefore, researchers, decontamination companies, healthcare systems or individual hospitals should focus current efforts on these technologies. Specifically, the effectiveness of using these methods should be explored further with specific FFR models based on the manufacturer’s support to better understand the impact on the respirator performance, including filtration and fit. The respirator manufacturer should be consulted about the impact of the method on its respirators before considering the use of any method. No current data exist to support the effectiveness of these decontamination methods specifically against SARS-CoV-2 on any FFRs. Other pathogens may also be present on FFRs and limited data only exist for other pathogens. Further work is needed to ensure SARS-CoV-2 and other pathogens are inactivated. Therefore, even after decontamination, these FFRs should be handled carefully.

Decontaminating Gear and Equipment

Dispose of disposable respirator, respirator filters, gloves and other disposable equipment/supplies used at the scene as bio-hazardous waste.
If the turnout gear or station uniform is visibly contaminated by bodily fluid, it should be placed in a biohazard bag at the scene and washed following prescribed laundry procedures. Chlorinated bleach shall not be used with any fire fighter protective clothing. Fire departments should follow the decontamination guidelines in National Fire Protection Association (NFPA) 1851, Standard on Selection, Care, and Maintenance of Structural Fire Fighting Protective Ensembles.
Non-disposable respirators shall be cleaned and disinfected in accordance with manufacturer’s recommendation.
See the EPA’s list of Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-Cov-2, the Cause of COVID-19 as of March 3, 2020.
- When looking up products on the EPA website, do not be concerned by the fact that the answer to the emerging viral pathogen claim questions is no. This is NOT a concern. Per the EPA, “All products on this list meet EPA’s criteria for use against SARS-CoV-2, including those marked as No in this column.” The emerging viral pathogen claim has to do with whether the virus is standard/old/well-known or emerging, not how hard it is to kill.
Find more information about infection control against COVID-19 here under the section Cleaning EMS Transport Vehicles After Transporting a PUI or Patient with Confirmed COVID-19.

Decontaminating the Ambulance and the Station

UV-C lights have been used for many years in ambulances for disinfection. It is important to note that this cannot be the ONLY means of disinfection. UV-C lights will disinfect surfaces (it is a surface technique and will not penetrate fabrics) on which there is direct access for the appropriate period of time (time is related to energy of the UV-C lamps). This affects surfaces that are at an angle to the lights or are shadowed by other surfaces. UV light disinfection appears to be effective against coronavirus. Efficacy, however, is highly variable and related to the placement of the lights, light intensity, contact times, surface type, etc.

The benefits of UV-C include effectiveness on flat surfaces at 90-degree angles (walls, floors, ceilings, etc.) and personnel are not required to enter the contamination zone. The limitations are that the power decreases over distance (light must be close enough to surface) and if the surfaces are not flat, it may not decontaminate the shadowed areas.

You must perform an appropriate decontamination before using UV-C light. These steps include:

If the material to be decontaminated is considered airborne, all doors to the ambulance should be left open to allow for any airborne particles to settle or exhaust. The time required for one complete air exchange in a standard size ambulance using passive ventilation (low wind conditions) is approximately 10 minutes or six air changes per hour (ACH). This correlates to 90% efficiency in 23 minutes, 99% efficiency in 46 minutes and 99.9% efficiency in 69 minutes.
Clean all soiled surfaces.
Disinfect contaminated surfaces with a chemical disinfectant (preferably applied using an electrostatic sprayer for complete coverage).
Follow up with UV-C disinfection, if desired, prior to returning to service.

Preparedness

As the coronavirus (COVID-19) cases and exposures continue to grow, we want to make sure you have the latest information to protect your health and safety and the public’s when responding to potential COVID-19 cases.

Preparation

Review your department’s exposure control plan.
Review the Influenza Factsheet 2020
Plan to meet or connect with local and state health departments to discuss policies, procedures and precautions.
Maintain an adequate supply of N95 and surgical masks and monitor the availability of both masks with your medical supply vendor.
Review Checklist for the 10 Things Your Local Should Be Doing for COVID-19 Response
Routinely check the IAFF website for more information about COVID-19.

How to Request PPE Supplies

This information will help inform the allocation of state and federal PPE resources. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to be a challenge during the COVID-19 pandemic. Following the appropriate process for requesting supplies is critical to ensuring you are able to receive needed PPE supplies.

Requests for reordering of PPE should be made through the normal request process. Due to shortages, the entire order may not be able to be filled.
To request additional PPE supplies from state or federal resources for unmet needs, you must submit requests through your established local emergency management structure. Depending on the state, your request may be processed through the emergency management chain or through the public health chain to state-level emergency management. From the state level, it will be transmitted to FEMA.
When submitting a request, please include the following information:

- Agency
- Specific material and quantity request
- Detailed risk/exposure justification for the request
- Current on-hand requested supplies
- Burn rate of current supplies – to provide estimate of time remaining for current supply
- Other information pertinent to the request
- Alternatives that are available, if any, and risks associated with pending gaps (for information regarding PPE alternatives and optimization strategies, click here.)

IAFF Department Guidance Documents

Guidance for Fire Department and Union Operations to assist departments as their states reopen.
Risk Assessment for Potential Exposure for identifying high and low exposures
Return to Work Procedures as members recover from COVID-19 or recover from signs/symptoms of the COVID-19 virus (fever, cough, shortness of breath)
Post-Exposure/Quarantine Symptom Monitoring Tracker for helping recovered members return to work and guidance for monitoring their signs and symptoms
COVID-19 Self-Screening Guidelines for members to follow twice daily
COVID-19 Prevent the Spread Flyer to post throughout the fire station to assist members with the best practices to prevent the spread of COVID-19.

Potential Exposure

If you treat a patient who shows signs and symptoms addressed below, document potential exposures according to your exposure control plan.
Potential exposures should also be documented using the National Fire Operations Reporting System (NFORS) Exposure Mobile App. This will assist in collecting national exposure data for all fire fighters and paramedics.
- NFORS app poster for printing
- NFORS app sample video
Notify your infection control officer.
If you present signs and symptoms, immediately follow up with your healthcare provider and identify your exposure.

Dispatch Protocols

Recommendations for 911 PSAPs

Municipalities and local EMS authorities should coordinate with state and local public health, PSAPs and other emergency call centers to determine the need for modified caller queries about COVID-19.
Dispatch questions related to COVID-19 should be asked for all emergencies (Police, Fire, EMS)
Development of modified caller queries should be closely coordinated with an EMS medical director and informed by local, state and federal public health authorities, including the city or county health department(s), state health department(s) and the CDC.
PSAPs or Emergency Medical Dispatch (EMD) centers (as appropriate) should question callers and determine the possibility that this call concerns a person who may have signs or symptoms and risk factors for COVID-19.
More information: Guidance for Emergency Medical Services Systems and 9-1-1 Public Safety Answering Points (PSAPs) for COVID-19 in the United States

Questions Dispatch Centers Should Be Asking to Screen for COVID-19:

What is the address of the emergency?
What is the phone number you are calling from?
Okay, tell me exactly what happened.
How old is the patient?
Is the patient awake?
Is the patient breathing?

If the patient is awake and breathing, before proceeding to the chief complaint protocol, ask the three questions below:

Is the patient short of breath?
Does the patient have a fever?
Does the patient have a cough?

If YES to two out of the three questions, a pre-alert message should be sent to the responding crews informing them to don the appropriate PPE for COVID-19. The response configuration should be modified to minimize the number of first responders being exposed to a person under investigation.

Testing

COVID-19 Testing Information

Until an effective vaccine is available, testing for COVID-19 can help slow the spread of the disease. The two main methods are testing for the molecular presence of the disease or testing for antibodies to the disease. Molecular tests are more capable of informing whether you have active virus, while serological tests inform whether you have been exposed to or have some level of immunity to the virus.

More research is necessary to determine the accuracy of serologic test results for COVID-19 and how to best use this technology to slow or stop the spread of this disease. The IAFF supports the recommendation from the Food and Drug Administration (FDA) that results from antibody testing alone should not be used to diagnose or exclude COVID-19 infection or to inform infection status.

Currently, the IAFF advises against the use of serologic testing alone as the basis of return-to-work decisions. Rather, such determinations should be through an evaluation by a healthcare provider.

Download a printable version of the IAFF guidance on testing.

For more information on guidelines for COVID-19 antibody testing, see the CDC’s antibody testing interim guidance document.

Testing Protocol:

Call your healthcare professional if:

You feel sick with fever or chills, cough, shortness of breath or difficulty breathing, or new loss of taste or smell. According to the CDC, other COVID-19 symptoms include muscle or body aches, headache, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea. You should call your healthcare professional if you have these beyond what is normal for you (e.g., a runny nose is common with seasonal allergies).
Have been in close contact with a person known to have COVID-19.

Your healthcare professional will work with your state’s public health department and CDC to determine if you need to be tested for COVID-19.

Testing may be limited to individuals showing symptoms, but this varies based on test availability. Personnel should expect COVID-19 test results 24-48 hours post testing, but this too will vary based on testing capabilities.

Testing in Skilled Nursing Homes

Some states are starting to require fire fighters to assist with performing testing on residents in skilled nursing homes. These are hot zones and often the tasks are out of the scope of individuals’ training or practice. This testing guidance on best practices includes how to safely perform testing for both the nursing home residents and fire fighters.

The San Antonio Fire Department has developed training videos to assist in creating guidelines for designing and safely performing testing at skilled nursing homes and large-scale testing:

SARS-COV-2 and COVID-19

Coronavirus is a family of viruses, including the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as some common colds. SARS-CoV-2 is the virus that causes Coronavirus disease 2019 (COVID-19). The serologic tests and polymerase chain reaction (PCR) tests are used to identify SARS-CoV-2 nucleic acid to determine if individuals have COVID-19.

Laboratory Testing

Infectious disease testing related to the COVID-19 disease:

	Molecular	Serologic
Detects for the presence of…	the genetic material (RNA) of the virus. Any viral nucleic acid present in the patient’s sample is amplified by polymerase chain reaction (PCR)	host antibodies against viral antigens (an immune response)
Suitable Samples	nasopharyngeal swabs, oropharyngeal swabs, expectorated sputum, saliva	blood via finger prick

The FDA has authorized that serologic testing is limited to laboratories and licensed healthcare providers at the point of care.

Detection of Viral RNA

Tests that detect viral RNA levels can identify current infections and suggest infectivity and transmission risk for others. Currently, the most widely used RNA test on the market is the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), a real-time test (turnaround time from 15 minutes to several days) for the detection of nucleic acid from SARS-CoV-2 in upper and lower respiratory specimens (such as nasal, nasopharyngeal or oropharyngeal swabs) collected from individuals suspected of COVID-19. Negative results do not mean there is no COVID-19 infection and should not be used as the sole basis for patient management decisions.

Multiple studies have identified false negative results on initial PCR tests, but it’s not clear why this happens. Reasons may include stage of illness, lower amounts of virus in certain anatomic sites and in certain patients, and suboptimal sample collection methods. Overall, the FDA has asserted that FDA-authorized nucleic acid amplification tests for COVID-19 meeting emergency use authorization criteria are highly reliable. Thus, these tests are currently the gold standard. However, these tests are not at a level of production that is close to meeting national needs.

Detection of Host Immune Response

Tests that identify host immune response are referred to as serological tests and are intended to be administered as simple blood tests. These tests can indicate whether an individual has been previously exposed to COVID-19. Antibody test results are important in detecting infections in individuals with few or no symptoms and have been used in conjunction with RT-PCR results in establishing a diagnosis or exclusion of COVID-19 infection. IgM and IgG are the two major antibodies assessed by serologic testing.

IgM antibodies typically appear earlier within the course of infection – within days to about one week after the onset of symptoms. The antibodies can persist for a week to a few months.
IgG antibodies develop later in the course of infection, typically appearing in the bloodstream around two weeks after infection and may last for months to several years.

Those with IgM antibodies are likely in an early stage of infection, even if they don’t have any symptoms. Ideally, fire fighters with these markers should highly consider undergoing quarantine plus a reflex PCR test to confirm infectivity.

Emergency Use Authorization

During public health emergencies declared under section 564 of the Federal Food, Drug and Cosmetic (FD&C) Act, the FDA is able to issue Emergency Use Authorizations (EUAs) when certain criteria are met that allows for the use and distribution of potentially life-saving medical products to diagnose, treat, or prevent the disease, which can include diagnostic tests. EUAs are a shortcut in the FDA approval process that allows products to be used that have not gone through the full FDA approval process which sometimes can take years.

According to the FDA, there are currently no FDA-approved or cleared test to diagnose or detect COVID-19. Therefore, the FDA has issued several Emergency Use Authorizations (EUAs) for the use of new diagnostic tests to detect the SARS-CoV-2 virus, which causes COVID-19.

Review the list of EUA approved tests.

The FDA has also evaluated the performances of the EUA Serologic Test. The performance of these tests is described by their “sensitivity,” or their ability to identify those with antibodies to SARS-CoV-2 (true positive rate), and their “specificity,” or their ability to identify those without antibodies to SARS-CoV-2 (true negative rate). View the results.

Hotel Offers

The following hotels are offering special rates and discounts to healthcare workers, including fire fighters and emergency medical personnel, who are on the frontlines in the fight against the spread of COVID-19 and may need a place to stay close to their work location or to self-quarantine away from their homes and families to protect their loved ones.

Furnished Quarters
Hilton – no IAFF member log-in required.
Hilton benefits for first responders only – IAFF log in required.
Hyatt – Hyatt is offering a special discounted rate for first responders working on the frontlines or behind the scenes of the COVID-19 crisis. Visit Hyatt.com and enter ESSENTIAL under the special offer code.
IHG Hotels and Resorts
Marriott
Red Roof Inn

Resources

IAFF Guidance Documents