Lessons learned on Colorado’s Cameron Peak Fire where 76 people tested positive for COVID-19

The largest wildfire in the recorded history of Colorado, the Cameron Peak Fire, will be remembered for the 209,913 acres that burned, but also for how COVID-19 affected the personnel and the suppression of the fire.

A Facilitated Learning Analysis conducted by a team of seven people found that in the months after the fire started on August 13, 2020 west of Fort Collins, 76 workers at the fire tested positive for the virus and a total of 273 had to be quarantined at various times over the course of the fire. Two were hospitalized.

The Analysis is lengthy, full of facts about how the outbreak affected the personnel and the management of the fire. The document has 250 Lessons Learned which are broken down into 14 types of resources (e.g. Finance Unit, Contractors) and 7 categories (e.g. COVID mitigations and testing/contact tracing).

It’s a lot to digest, but it’s best to start with the eight-minute video.

The report was written relatively early in the incident when only 21 had tested positive and 214 had been quarantined.

Of the two individuals that had to be hospitalized, one, called “Rico” in the report, was thought to be so close to death that tentative plans were being made about steps that would have to be taken after his demise, complicated by the fact that he was not a federal or state employee, but worked on an engine for an out of state contractor.

“Being a contract employee, could travel for his family be paid for? What about an Honor Guard or giving them a flag?” the report said. “There was confusion within the local unit, the fire management teams, and the RO about what could legally be done for different classifications of employees (federal, AD, contract, etc.) and this created a lot of tension. Everyone wanted to honor the intention set by the Chief to take care of people. However, the boundaries posed by the contract, policy, and federal purchasing law were limiting everyone to act on their desire to help.”

Rico was admitted to the hospital on August 24 and by the 31^st was placed on a ventilator. The machine breathed for him while in a medically induced coma until he was weaned off on October 7. In December he was released to a rehab center.

Surprisingly, this wasn’t Rico’s first time dealing with COVID-19. According to the report he had been hospitalized back in the spring with complications from COVID-19.

This was the first time in the United States that a person on a large wildfire had to be admitted to a hospital due to the pandemic. There were dozens of unanticipated issues that developed as 273 tested positive. It created issues that none of the personnel on the nine incident management teams that rotated through the incident had ever dealt with.

In reading the report and learning about one unique problem after another, it seemed like everything that could have gone wrong did go wrong in dealing with the multiple COVID-19 breakouts on the fire. The term that kept popping into my mind was, sh**show.

For example, a firefighter on an AD crew from another region who had COVID-19 symptoms was dropped off at the hospital for testing. Called “Brett” in the report, he tested positive, but was not admitted and was released at 5:30 a.m. There was no one keeping track of him, no liaison, and he waited outside the hospital for 14 hours until he was transported to a hotel for quarantine. He had nothing. All of his gear was at the fire. Obviously he needed a few necessities to exist on his own for what could be two weeks. Transporting Brett’s gear bag to the hotel proved to be challenging, since it was suspected of being compromised by the virus. The Incident Management Team WANTED to help, but they were hamstrung by policies that would not allow Forest Service funds to be used to buy this kid a change of underwear or shaving equipment.

The Buying Team, trying to figure out how to help Brett without getting themselves fired, considered setting up a commissary, even though none of them had seen one set up in years. The way it worked in the old days was, the fire would stock commonly needed items, like toiletries, underwear, socks, or tobacco products, and forestry technicians would pay for them with the money coming out of their pay check. But the Buying Team was hesitant to establish one because no one had done it in years and the policy seemed out of date. Finally, an Incident Management Team member used $100 of their own money to purchase some items for Brett.

Below are excerpts from the report.

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In the time since Rico came out of the coma, he has learned his Worker’s Compensation claim was denied because he was unable to pinpoint when and where he contracted the virus at work, which only adds to the complexity of his situation. Although Rico can’t change his own circumstance, he’s hopeful other firefighters can learn something from his experience.

Based on the hotel fall-out experience with Brett on September 2 and finance questions brought up about who pays for hotels and meals when AD resources are quarantined or isolated, a safety officer, with input from finance, developed a letter intended to provide guidance to the Southeast AD Crew. The hope was to provide answers to common concerns right from the beginning and avoid confusion. This letter defined quarantine; instructed resources to cooperate with county public health and stay in their hotel rooms; restricted travel; and informed the crew they would be self-sufficient during this time and must arrange and pay for their own food and hotel. This letter was handed out to the Southeast AD Crew as they arrived at the hotel to start their isolation and quarantine period and created a slew of unintended consequences.

The first time the NIMO team became aware of this letter was when it was sent to them from Region 8. The inconsistency between this document and the press release did not go unnoticed. “We will take care of you — wait –hope you can take care of yourself.” The IMT and NIMO overhead were upset this letter contradicted the message of “taking care of everyone” they had been actively promoting.

Unable to leave their rooms, but having to provide for themselves, the crew had to rely solely on food delivery ordered through apps on their phone to obtain meals the first part of their stay. Frustrated with the lack of support for Brett and his crew, leadership from their sponsoring organization arranged for a Forest Service representative from Region 8 to travel to Colorado to act as a crew liaison. After arriving, the liaison was ultimately able to help Brett and the rest of the Southeast AD Crew with timesheets, CA-1s and CA-2s, as well as other needs. The State Fire Chief also stepped in to help, purchasing several personal items like clothing and toiletries and overnighting them to Brett.

When it comes to COVID-19, imagining the worst-case scenario can be difficult and even harder to plan for. One realization from the Cameron Peak Fire’s COVID outbreak was that the domino effect happens quickly. While you may only have one COVID-positive person on a fire, that one exposure may result in thirty people having to be in a 14-day quarantine due to close contact. And don’t forget, there will still be a fire to manage, one that is possibly making a significant run. This can obviously put a strain on the remaining fire resources as well as logistics.

Something that many people from the Cameron Peak Fire recognized was that their early season COVID-19-based scenario and simulation trainings did not prepare them for the issues they ran into in the field. Logistical issues revolving around geographic locations created significant challenges in regard to amenities for mass quarantines, cell service, food delivery to quarantined individuals, reliance on virtual positions, providing shelter for firefighters during extreme temperature shifts at high elevation, and much more.

When the COVID Coordinator finally received access to the state’s COVID-19 test result database [of tested fire personnel after the Medical Unit Leader who had the access needed to be quickly demobed due to a family situation] he discovered that searching through the database was a heavy load. Eventually, he deciphered four more positive COVID-19 cases from the original mass testing event at Jack’s Gulch. However, he only had names and didn’t know what crew they belonged to. Matching those names to their crew proved difficult as many crews were not being fully manifested in the IROC system and names on Crew Time Reports were not matching the formal names provided at testing.

Once someone is admitted to the hospital with the potential for a long-duration stay, transition the point of contact from the IMT to the local unit or region to provide consistency. An Incident within an Incident (IWI) Team put together at the regional level for a firefighter hospitalized with a serious case of COVID-19, allowed the Cameron Peak Fire IMT to focus on the fire and provide support for resources in and out of quarantine. The sooner the (IWI) team starts the better. An IWI could have been established as soon as the first COVID-19 case was hospitalized but was delayed by a few days because people were unsure of how exactly to handle it.

The COVID IMT requested a brief tactical pause so they could build a COVID-related IAP and develop a communication strategy that would convey the needed information without revealing HIPAA-related medical details. Up to this point, a single point of contact had not been designated and regional employees were reaching out to multiple IMT members wanting information. This created confusion and inconsistency in the information being passed on. The COVID IMT ultimately built a spreadsheet to properly document and track all COVID cases and designated only specific people to convey COVID numbers to ensure daily information updates were accurate. The protocols created during this timeframe were extremely useful going forward.