In the thick of the pandemic’s first wave last spring, volunteer EMT Joe Horowitz barely caught a breath between 911 calls from patients sick with COVID-19. 

“I remember very specifically, we had like criticals and criticals and criticals, back-to-back-to-back,” Horowitz, 22, said, referring to the deluge of calls for help—people in respiratory distress, experiencing difficulty breathing or in cardiac arrest. "I was just like, is it going to stop? Is this going to end? Like, is it going to get better?” 

The Teaneck Volunteer Ambulance Corps—which service a suburban town of 42,000 residents—was in the heart of New Jersey’s spring outbreak, working the frontlines to transport patients to overwhelmed area hospitals or, in many instances, waiting for a paramedic to pronounce someone dead.

Now, with cases surging across the state and hospitalizations reaching levels not seen since mid-May, the volunteer crew says at most, they’re only taking a handful of COVID-19-related calls a week. While paramedics continue responding to calls for COVID-19 cases, they are nowhere near the volume they witnessed in the spring.

“We’ve definitely had more patients we’ve transported who have tested positive or been around someone who was positive,” said Chief Jacob Finklestein, 25. “But we’re definitely not seeing the same type of grave medical conditions that we were seeing in March and April for the most part.”

Hospital and EMT leaders say that’s partly because testing is more widespread, meaning cases are confirmed earlier, allowing people to seek appropriate medical treatment without relying on an ambulance to rush them to a hospital. Doctors also know more about the virus, and those infected in the second wave tend to be younger and don’t seem to be waiting as long to get medical help. 

Volunteer Amiel Rimberg, 22, responds to a motor vehicle accident on the highway on Dec. 10, 2020. “I don’t think we will see anything like what we saw before,” he said.

“That doesn't mean that people aren't still getting sick, and it doesn't mean that they don't still need care,” Barbara Platt, president of the EMS Council of New Jersey, an advocacy group for paramedics, said. “They're just not all necessarily calling 911.” 

Platt added that “it’s definitely not as chaotic,” but with another round of holidays around the corner and the projected peak of hospitalizations expected by mid-January, it’s impossible to predict just high demand will get.

In New Jersey, hospitalizations of known or confirmed cases have reached 3,700, double the numbers from early November. But hospitals say they’re better prepared, with more personal protective equipment, better treatment, and much more bed capacity. 

“In the spring, this was a brand new virus that nobody had seen before and New Jersey was one of the first hot spots,” Kerry McKean Kelly, a spokesperson for the New Jersey Hospital Association, said. “In many ways, New Jersey providers on the front lines wrote the playbook.”

She said the state’s 71 hospitals have a total of 21,000 beds. Hospitals are at 70% capacity with both COVID-10 and non-COVID-19 patients. That leaves 6,300 available beds.

At the height of the pandemic in April, New Jersey had 8,200 COVID-19 hospitalizations. The state’s models project a second wave peak in mid-January. In the worst-case scenario, hospitalizations could surpass April’s crest but more moderate projections estimate 6,300 hospitalizations for COVID-19 during the height of the second wave.

“I don’t think we will see anything like what we saw before. We might see smaller waves,” Amiel Rimberg, 22, another EMT volunteer, said.

EMTs with the Teaneck Volunteer Ambulance Corps wait between calls at the station on Dec. 10, 2020. Chief Jacob Finklestein, 25, speaks to volunteer Kelly Pavel during a night shift. He says they’re only getting a few COVID-related calls a week, compared to the spring when every call was a COVID call.

Teaneck's infection rate was slightly higher than New York City’s in the spring. Back in April, volunteer EMTs were burning through personal protective equipment and relying on half the number of staff to respond to calls because many of them were out sick, on quarantine, or didn’t feel comfortable working their shifts. 

But then, they say the COVID-19-related calls in Teaneck suddenly stopped. There was one call in May and none in June, July, and August. The reprieve helped the volunteers take some time to mentally and physically self-care, including losing the weight they gained from all the food donated by locals during the outbreak’s spring peak. 

“I started thinking about myself again,” Horowitz, a senior in college, said. 

COVID-19 cases in the state began rising again in September. In Teaneck, township manager Dean Kazinci said they’re seeing seven to 10 cases a day, compared to 15-20 cases in the spring. Deaths remained flat at 107 over the summer and recently rose to 108. 

Now, many of the volunteers are back responding to calls or living with their family members again after moving out to keep them safe in the spring. Crew members are also wearing surgical masks on every call, reserving N-95 masks for suspected COVID-19 cases. 

“We’ve just been stocking up because we’re afraid if things become hard to get again,” Finklestein said. 

Finklestein said some gear like face shields and gowns became much easier to buy but N-95s are still hard to come by, especially for a small non-profit trying to bid against larger companies or school districts. If things stay relatively calm, Finklestein said he’ll have enough supplies for three months but, if calls spike again, he’ll run out in two weeks. 

Chief Jacob Finklestein, 25, responding to calls on Dec. 10, 2020. He said the ambulance crew has not seen a dramatic increase in 911 calls even as cases surge across the state and hospitalizations double in the last month.

On a recent night shift, there were no COVID-19 calls. A woman who had chest pains was taken to the hospital, where the Teaneck ambulance was the only one at the emergency room entrance. 

“On a normal day, even without COVID, this whole area would be filled with ambulances but it’s empty now. We are the only ones here,” Finklestein said as his ambulance up pulled up. In the first wave of the pandemic, Finklestein said, he’d have to wait as long as 45 minutes with a patient in his ambulance until a bed opened up. The wait times and the refrigerated trucks for bodies are now gone. 

Days are a lot quieter for the Teaneck EMTs. They’re back to responding to more normal calls, like car crashes and slip and falls. But volunteer Leah Kahan said the team still faces risks.

“It’s definitely scary, we know we have the protections, we know we have the PPE. But you still never know,” she said.