As a boy, Robert Weber chased the blazing lights and roaring sirens of fire engines down the streets of Brooklyn, New York.
He hung out at the Engine 247 firehouse, eating ham heroes with extra mayonnaise, and "learning everything about everything to be the best firefighter in the world," said his wife, Daniellle Weber, who grew up next door.
They married in their 20s and settled in Port Monmouth, New Jersey, where Weber joined the ranks of the more than 1 million firefighters America calls upon when stovetops, factory floors and forest canopies burst into flames.
Weber was ready for any emergency, his wife said. Then COVID-19 swept through.
Firefighters like Weber are often the first on the scene following a 911 call. Many are trained as emergency medical technicians and paramedics, responsible for stabilizing and transporting those in distress to the hospital. But with the pandemic, even those not medically trained are suddenly at high risk of coronavirus infection.
Firefighters have not been commonly counted among the ranks of front-line health care workers getting infected on the job. KHN and The Guardian are investigating 1,500 such deaths in the pandemic, including nearly 100 firefighters.
In normal times, firefighters respond to 36 million medical calls a year nationally, according to Gary Ludwig, president of the International Association of Fire Chiefs. That role has only grown in 2020. "These days, we pump more oxygen than water," Ludwig said.
In mid-March, Weber told his wife he noticed a new pattern in the emergency calls: people with sky-high temperatures, burning lungs and searing leg pain.
Within a week, Weber's fever ignited, too.
"This job isn't just meatball subs and football anymore"
Snohomish County, Washington — just north of Seattle — reported the first confirmed U.S. COVID case on Jan. 20. Within days, area fire departments "went straight into high gear," Lt. Brian Wallace said.
Within weeks, the Seattle paramedic said, his crew had responded to scores of COVID emergencies. In the ensuing months, the crew stood up the city's testing sites "out of thin air," Wallace said. Since June, teams of firefighters have performed over 125,000 tests, a critical service in a city where over 25,000 residents had tested positive as of late October.
Wallace calls his team a "public health workforce that's stepped up."
Firefighters elsewhere did, too. In Phoenix's Maricopa County, which is still notching new peaks in COVID cases, firefighters each shift receive dozens of emergency calls for symptoms related to the virus. Since March, firefighters have registered over 3,000 known exposures — but "that's just the tip of the iceberg," said Capt. Scott Douglas, the Phoenix Fire Department's public information officer, "this job isn't just meatball subs and football anymore."
In Washington, D.C. — with over 24,000 COVID cases tallied since March — firefighters have been exposed in at least 3,000 incidents, said Dr. Robert Holman, medical director of the city's fire department.
They've helped in other ways, too: Firefighters like Oluwafunmike Omasere, who serves in the city's poverty-stricken Anacostia neighborhood, have bridged "all the other social gaps that are killing people." They've fed people, distributed clothes and offered public health education about the virus.
"If it weren't for us," Omasere said, "I'm not sure who'd be there for these communities."
"We're going in completely unarmed"
For the more than 200 million Americans living in rural areas, one fire engine might cover miles and miles of land.
Case in point: the miles surrounding Dakota City, Nebraska. That's steak country, home to one of the country's largest meat processing plants, owned by Tyson Foods. And it's on Patrick Moore, the town's first assistant fire chief, to ensure the plant's 4,300 employees and their neighbors stay safe. The firehouse has a proud history, including in 1929 buying the town's first motorcar: a flame-red Model A.
"We made a promise to this community that we'd take care of them," Moore said. COVID-19 has tested that promise. By the time 669 employees tested positive at Tyson's plant on April 30, calls to the firehouse had quadrupled, coming from all corners of its 70-square-mile jurisdiction. "It all snowballed, so bad, so fast," Moore said.
Resources of all kinds — linens, masks, sanitizer — evaporated in Dakota City. "We've been on our own," Moore said.
Ludwig, of IAFC, said firefighters have ranked low on the priority list for emergency equipment shipped from the Strategic National Stockpile. As stand-ins for "the real stuff," firehouses have cobbled together ponchos, raincoats and bandannas. "But we all know these don't do a damn thing," he said.
In May, Ludwig sent a letter to Congress requesting additional emergency funding, resources and testing to support the efforts of firehouses. He's been lobbying in D.C. ever since. Months later, the efforts haven't amounted to much.
"We're at the tip of the spear, yet we're going in completely unarmed," Ludwig said. It's been "disastrous."
As of Dec. 9, more than 29,000 of the International Association of Fire Fighters' 320,000 members had been exposed to the COVID virus on the job. Many were unable to get tested, said Tim Burn, the union's press secretary. Of those who did, 3,812 tested positive; 21 have died.
Moore, in Dakota City, got it from a man found unconscious in his bathtub. The patient's son told the crew he was "clean." Yet three days later, Moore got a call: The man had tested positive.
Within days, Moore's energy level sunk "somewhere between nothing and zero." He was hospitalized in early June, recovered and was back on emergency calls by Independence Day. He couldn't stand for long, so he took on the role of driver. Moore said he's still not at full strength.
As the virus has pummeled the Great Plains, calls to Moore's department are up nearly 70% since September. Only a handful of his guys are still making ambulance runs, and most have gotten sick themselves. "We're holding down the fort," he said, "but it ain't easy."
It's the same story inside firehouses across the nation. In Idaho's Sun Valley, Chief Taan Robrahn — and one-fifth of his company — contracted COVID after a ski convention. In New Orleans, Aaron Mischler, associate president of the city's firefighter union, got it during Mardi Gras — as did 10% of the force. In Naples, Florida, almost 25% of Chief Peter DiMaria's members got it. And in D.C., Houston and Phoenix collectively, over 500 firefighters tested positive — while an additional 3,500 were forced into quarantine.
Quarantining, of course, can put loved ones at risk too: Robrahn's wife and their three-year-old twins got it. "Mercifully," Robrahn said, the family recovered.
DiMaria, whose 18-year-old has a heart defect, has been spared so far. But after Big Tony, a close colleague under his command, died of COVID-19 — and after spending months resuscitating people with heart attacks and respiratory distress induced by the virus — he's as concerned as ever.
"For the first time in my life," DiMaria said, "I questioned my career choice."
"It weighs heavy"
The distress of these emergency calls resounds in gasps, wailing, tears.
Some departments — including Houston and Dakota City — have taken on another burden: removing the bodies of those killed by the virus. "You can't unsee this stuff," said Samuel Peña, chief of Houston's department, "the emotional toll, it weighs heavy on all of us."
Into winter, firefighters have endured a second surge. "We're battle-weary," Peña said, "but there's no end in sight."
Meanwhile, Mischler said, tax revenue is plummeting, forcing budget cuts, layoffs and hiring freezes, "at the very moment we need the reinforcements more than ever." And in the volunteer departments, which constitute 67% of the national fire workforce, recruitment pipelines are running dry.
So people like Robert Weber filled the gaps on nights and weekends, which for the New Jersey firefighter proved disastrous.
On March 26, the day after his fever rose, Weber was hospitalized. His was an up-and-down course. On April 15, his wife got a call: Come immediately, the doctor said.
Weber died before she pulled into the hospital parking lot.
* * *
This story is part of "Lost on the Frontline," an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please share their story.
Subscribe to KHN's free Morning Briefing.