A pandemic pivot
The interior of Rescue Inc.’s mobile vaccine clinic, which was designed and built by Rescue Inc. personnel earlier this year.

A pandemic pivot

Rescue Inc.’s mobile vaccination program, started in the early days of the Covid vaccine, is now a huge piece of the public health response, bringing shots within easy access of thousands of people in three counties. But the nonprofit ambulance company’s leader is also bracing for a new reality, predicting financial challenges and staffing problems in a post-Covid Vermont.

BRATTLEBORO — Drew Hazelton has devoted his life to emergency medical services and has seen a lot at Rescue Inc., “but emergency services are different in the middle of a pandemic from the way things used to be.”

Rescue Inc. was asked by the Vermont Department of Health to bring vaccines to the elderly and those who have difficulties getting out of their homes when they first became available in January this year.

The nonprofit was happy to help, and what started as a medical service on its home turf has turned into a regional effort adding Windsor Country, then Orange County.

Rescue Inc. mobile vaccination clinics have logged 160,000 miles delivering shots, all within the state. Daily, the operation delivers between 700 and 1,000 vaccines per day.

As chief of operations, it was Hazelton's job to get things started.

“We still have a volunteer squad,” he says. “Most of them are specialists in our Technical Rescue Team. We have about 20 members who specialize in vehicle extrication, search and rescue work, swift-water, and ice rescue work - that sort of thing.”

So Hazelton asked them to shift their adrenaline-fueled routine and spend their time administering vaccines, mostly to older people in their homes.

“They were very supportive,” he says.

“We go to where the patients are, so that work was a natural fit for us. At that time, we worked mostly in Windham County. The state was quick to realize that there was an unserved population, so they reached out and asked us for help.”

During that time, the Department of Health was getting the public vaccinated by setting up clinics, grouping Vermonters by age. As those older than 65 were served and increasing numbers of people began to quality for vaccination, it became apparent that the state would need more help.

Hazelton remembers how quickly the need for vaccines escalated.

“It's been a steady growth as the need has increased. In February, we were looking at ways to access populations that were being underserved,” he says.

As a result, Rescue “decided to try the trailer-based clinic approach and take the vaccine to the people,” Hazelton says. “The state equipped us with the temperature monitors, transportation coolers, and all the equipment that we needed.”

Starting with one trailer purchased with the promise of reimbursement through both the federal government and the state, the program grew very quickly.

A portable vaccine process

Those original 20 volunteers have turned into a specialized group of 12 full-time employees who are on the road five to six days per week, using a system that remains entirely portable.

“At this point, we have a setup where we can offer three different kinds of boosters in a clinic that will service 500 people in a matter of hours,” says Hazelton.

Four trailers arrive at a school, firehouse, or local community center and are parked to form a square. In one tent, registration folks greet people as they arrive, helping them fill out a bit of paperwork.

Then people are escorted through the tent to one of the three trailers, one for each of the three vaccines available. Inside, four or five Rescue employees sit in folding chairs ready to ask questions and then give the vaccine in an environment that is friendly, light, and easy.

From there, it's back to the original tent, where one is dismissed and asked to wait in their cars for a designated time to be sure there are no aftereffects. All one must do is beep their horn, and a staff member will come to help. The system is managed quickly and efficiently.

“Within the last year, we've done 250 to 275 clinics,” recalls Hazelton, “with very few issues or reactions.”

A collaborative effort

The job has gotten larger.

“As the Health Department identifies an area that is underserved, or the vaccination rates are not as high, a clinic is set up,” Hazelton explains.

And that can be pretty much anywhere.

“If you can name a venue where people might be, we've set up a vaccination clinic there,” he says. “We've gone to county fairs, into the Department of Corrections, to downtown Burlington, even all the way to Newport, Vermont.”

And Rescue has needed to be nimble to address the needs of a fast-changing pandemic.

“We add resources as the demand for boosters has increased,” Hazelton says. “The pandemic has changed over the two years, and we've quickly changed with it to provide the necessary services as quickly as those changes occur, with the help of the state of Vermont Health Department.”

In response to Rescue's requests, the state responds by helping with the cost of the equipment.

“It's been a very smooth process,” he says. “It's a team effort.”

“We've met and worked with some awesome people all over the state,” he adds.

As they travel to areas around the state, Rescue reaches out to the services around them: local fire departments, and smaller emergency medical service groups for additional personnel to help them in the areas they serve. The federal government reimburses the labor costs for the vaccine program.

Staffing challenges hit home

How has the pandemic affected Rescue's regular work - aiding people who call for help during medical emergencies?

“When the pandemic first began and most people were at home, we were struggling,” Hazelton acknowledges.

Rescue Inc. is now fully staffed, but some employees left, not wanting to expose their families to the Coronavirus, especially in the days before a vaccine was fully available.

Hazelton knows that when the pandemic is over, he will then face the challenge of staffing with a nationwide shortage of EMS workers.

The programs that provide the education for emergency medical workers have been dormant because of Covid, creating a void of new people entering the EMS trade. Statewide, the EMS system has lost approximately 400 EMS workers over the last two years - approximately 12 percent of its workforce.

“There are only 2,800 EMS workers statewide, so being down 400 providers is a pretty significant number,” Hazelton notes.

“We've been grateful for state and federal support because we're still not generating the revenue to cover the costs of the actual services we provide,” he says. “It's a different world now that Covid is here. We're fortunate for the federal stabilization money, which also supports EMS staff,” says Hazelton.

There are other issues as well. Because of Covid, hospitals have also lost a significant number of health care workers. That means a decrease in the number of beds available, and the system is stressed by more admissions of those with acute COVID-19.

This means that Rescue Inc. ambulances will sometimes need to go farther to find a bed for their critical care patients.

Hazelton shakes his head.

“This means that sometimes, we might pick up a patient at Grace Cottage Hospital, but need to transport them, not to Keene or Dartmouth or BMH as we used to, but we might need to drive them as far away as Hartford, Conn., or even Portland, Maine.”

“These transports can take as long as eight to ten hours from the time we pick up the patient to the time we return to Brattleboro, so even with 10 ambulances, this also stresses our system,” he adds.

“We must keep reaching out, further and further away to find availability of care,” Hazelton continues. “We have more patients than we have hospital beds at this point in time.”

'Come down and talk to us'

Hazelton offers effusive praise for his team at Rescue, Inc., which - pandemic or no pandemic - runs between 6,500 to 7,000 emergency calls per year.

“I can't say enough about the men and women who are out on the street every day,” he says. “They are doing a ton of work in a difficult scenario. Not only do we have the pandemic to deal with, but we also have our usual medical emergencies, mental health emergencies, and drug overdose calls.”

And then, of course, there are the vaccines.

Hazelton smiles.

“Since the pandemic began, we've delivered tens of thousands,” he says, “and we're not done yet. We're working with the state health department to create clinics in the smaller towns, some of which will be set up for just walk-ins.”

“We'll be coming to all hilltowns around us, making sure that anyone who wants one, has an opportunity to get vaccinated,” he says.

Walk-ins are welcome. Those who wish to schedule a vaccination or a booster shot can find the clinic schedule on the Rescue Inc. Facebook page or call 802-380-7057.

Vermonters can also schedule an appointment with the Department of Health at bit.ly/643-vaccine.

To those who are unsure and have still not decided if they want to be vaccinated, Hazelton has this advice.

“If you're not sure, come down and talk with us,” he says. “We'll explain how it all works and we'll be supportive of you.”

“You make your own decisions,” he adds. “If you decide to get a shot, that's great. If you just come for information, that's great, too.”

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