There is another term besides COVID-19 and coronavirus describing the deadly pandemic infective agent. Maine Emergency Medical Service dispatchers are using positive U-21 and negative U-21 in alerting paramedics about possible contact with patients infected with a deadly airborne virus. Maine EMS officials adopted the code in March to warn paramedics about possible infected patients without alarming residents, according to Maine EMS Director J. Sam Hurley. Dispatchers radio paramedics a patient is either U-21 positive or negative. The designation will alert paramedics to the type of mask to wear upon arrival. 

A positive U-21 requires wearing an N-95 respirator mask and negative requires a cloth surgical mask. “Regardless of the call, we’re required to wear a mask,” said Boothbay Region Ambulance Director Scott Lash. “This pre-screening prepares us for arriving on the scene where we take their temperature. We wear a mask and protective clothing before attending to any patient.”

U-21 positives identify COVID-19, tuberculosis and other deadly airborne viruses which are tabulated by Maine EMS to gauge how fast viruses are spreading across a state or a region. On March 3, Maine EMS activated the Emerging Infectious Disease Screening (EIDS) Tool for emergency medical calls. The U-21 code was developed and disseminated to emergency medical dispatchers and EMS clinicians at the same time to standardize the term. The term combines Universal Precautions (U) and Maine Criminal Justice Academy’s 10 code for a phone call, 10-21 (21). The code alerts first repsonders that dispatch has more information and they may want to call in about precautions for treating a potentially infected patient. 

“While we don’t typically encourage codes, we do know that it is sometimes necessary to communicate in code to avoid panicking the public or passing on sensitive information. We felt strongly enough, in this case, to authorize the use of this code statewide,”  Hurley said. 

Maine EMS compiles data on all 911 medical assistance calls. Maine EMS requires each clinician completing a patient care report to document a given EIDS code. The data is a tool used as a quality improvement/assurance system.  As of July 5, only 0.2% of the 61,397 negative U-21 reports have been a “false negative.” “If once on the scene, a paramedic observes a cough each of these incidents are reviewed individually as part of a continuous quality improvement/assurance system to ensure first responder health and safety,” Hurley said.