NARBERTH, Pa. — The patient's fever was so high that paramedic Tim Mumford could feel the heat radiating off the man's skin through two layers of latex gloves. He fought for air in short, rapid gulps, drawing so little that his face was tinged with blue.

Pressing a stethoscope to the 56-year-old man's chest, Mumford knew his patient needed more than an oxygen mask to survive the six-mile trip to Bryn Mawr Hospital. He also knew that opening the man's airways would spray the coronavirus all over the back of the ambulance. Essentially a sealed metal box.

“Get out of the truck,” Mumford told his partner, Joe Ellis, also a paramedic with Narberth Ambulance.

Mumford went to work on tavern owner Jim Griesser. He got him to the hospital alive, hopefully with enough time for doctors to place him on a ventilator. Mumford had a bad feeling about Griesser's chances. He tried not to dwell on it. Sometimes fixating on your rear-view mirror makes it harder to focus on the next 911 call ahead, Mumford explained.

Mumford then called his wife, a nurse at Christiana Hospital in Delaware. “Take the kids to your parents' house,” he told her.

Five days later, the paramedic woke up with a screaming headache and a sore throat, fearful of coronavirus but relieved to know he hadn't exposed his 3-year-old son and 11-month-old daughter. Or his partner.

Mumford, 34, was one of nine members of Narberth Ambulance who had to self-quarantine after a coronavirus exposure or positive test. Now, for the first time in his nearly 30 years as volunteer chief of Narberth Ambulance, Christopher Flanagan said he fears for his team's safety. The 50 paid staffers and roughly 80 volunteers of Narberth Ambulance sleep, cook, and eat together. They bicker and tease and console one another. Like any tight-knit family.

“This makes me nauseous. I'm scared for them. I can see the stress in their face,” said Flanagan, whose military buzz cut matches his no-nonsense demeanor. He also is police superintendent in Radnor Township.

“When they see a call come in and they know that they are going to put themselves at high risk again, maybe five, six times in a day, that makes me ill. I want to protect them. I want to do something about it, and it's just not that easy.”

[naviga:h3]New rules[/naviga:h3]

Narberth Ambulance responds to 911 calls across five towns that straddle Montgomery and Delaware Counties: Lower Merion, Narberth, Haverford, Conshohocken, and West Conshohocken.

On March 21, just days after Gov. Tom Wolf put Montgomery County on lockdown, Flanagan got on a video conference call with 78 company members. He laid out new protocols designed to limit staff exposure to the virus and reserve precious personal protection gear, like N95 masks, gowns, Tyvek suits, gloves. And banned hanging out at the station house when not on duty — a real departure for this team.

“Any questions?” Flanagan asked.

Paramedic Amanda Csanady, her voice wobbly, asked the question on everyone's mind: “Are we going to die?”

Csanady, 37, was alone in her Conshohocken apartment, her mind spinning: Is our system going to break down? What if the cops all get sick? Who is going to stop the looters?

Living alone has its pros and cons. “I don't have to worry about coming home and infecting my family, but it's also like, you are now in the apocalypse alone. You are just there with you and your thoughts — and the cat who hates me,” Csanady said.

She's used to being in control of her health. “You can't catch a heart attack,” she said, while eating Greek yogurt mixed with chia and flax seeds for breakfast during a recent shift.

During the video conference, Flanagan saw she was near tears. He texted: “I will call you after call, Chris.” He made a mental note to have stress management reach out to her.

“We can't take a chance with their mental health and their spirit,” he said. “If you break that, then you don't have anything left.”

[naviga:h3]An expensive fight[/naviga:h3]

Before COVID-19, many of the company's roughly 10,000 annual calls were car accidents caused by commuters heading in and out of Philadelphia. Or sports-related injuries from universities and schools in the area.

Calls are way down now, and so is the nonprofit's primary source of revenue — billing insurance companies for hospital transports.

But fighting this virus is expensive. Each day, the company goes through gallons of a disinfectant called “quat,” short for quaternary ammonium cation. They hose down everything in the station at 6 a.m., 2 p.m., and 10 p.m.

At 2 p.m. on a recent Saturday, volunteer Sean Littlewood, an ICU nurse at Jefferson University Hospital, appeared in the doorway of the station's common living area with a CO2 tank on a hand-truck dolly. The gas-filled cylinder powers a paint sprayer filled with quat. Fellow company members hopped off dorm-like wood couches with boxy blue cushions and scattered like insects. Littlewood fumigated every inch, from the worn pink carpeting to dining room tabletop. A haze filled the room.

“I don't like breathing it,” said EMT Eric McKeever, as he Googled “quat” on his smartphone. “Did you read that quat causes severe skin burns and eye damage?”

“Makes sense,” Battalion Chief Drew Hallowell responded. “I've washed my hands with it and my hands are still attached.”

“For now,” quipped volunteer Danielle Levine, a resident physician at Jefferson University Hospital.

[naviga:h3]A cruel trick[/naviga:h3]

The first call on a Saturday morning came from a Bala Cynwyd nursing home. A 94-year-old woman with COVID in respiratory distress. At 6:46 a.m., Lt. Patrick Glynn stood near the ambulance as Hallowell headed inside with a stretcher on wheels. To limit exposure and save on masks and Tyvek suits, only one paramedic goes inside. Nursing home staff bring patients to the lobby when possible, under the chief's new rules.

This was at least their fourth trip here in two days. “We'll see somebody in Room 201. Then we'll go back a few hours later for the person in Room 202 and et cetera,” said Glynn, who wore a half-face respirator and a yellow disposable gown over his uniform.

“The person will be alive, but it's a question of, `What kind of alive, you know?”'

Of the coronavirus-positive 911 calls, roughly 90 percent have come from one of the area's 14 nursing homes or rehabilitation centers, according to Narberth Ambulance statistics from March 15 to April 18.