Kevin Jura, ALB 2020 ALM 2022

I’ve been a paramedic for 20 years, working 24, 48, and even 60 hour shifts at a time.

The hardest challenge I’ve faced is accepting the fact that you cannot save everyone. I have unfortunately had to deal with several mass casualty events, where there was someone who was alive, but if I stopped and took care of them, I’d lose three or four others. It took awhile for me to finally let go of the anguish, and, for MASH fans out there, there is a line that I always remember: “Rule number one is, you can’t save them all. Rule number two is, you can’t change rule number one.” After these 20 years, I have developed a greater respect for life and for understanding my patients better, too.

When you learn all these pharmacological or biochemical terms like acid base or beta or alpha blockers as you train to become a paramedic, you absorb the knowledge, but do you really understand it? It’s only after being in the field and truly experiencing it that the light bulb finally clicks on.

One piece of advice I have learned and taught over the years to EMT students is, “Just because you can, doesn’t mean you should.” Use basic life support before advanced life support. Yes, you have the tools, but you don’t have to go straight to the sledgehammer when a small rock sculpting chisel and hammer will work.

I’ve spent the last 20 plus years in the field as an administrator for public safety and public health.

Before coming to Boston and Harvard, I ran the Strategic National Stockpile (SNS) for the state of Maryland. The biggest issue with the SNS is in some part the lack of funding, but also the lack of maintaining the stockpile life and the mission of the SNS itself. The SNS is lucky in that it has access to the FDA’s Shelf Life Extension Program or SLEP. When a medication is getting ready to expire, the pharmacists at the SNS take a certain percentage of the lots expiring and test them for efficacy. If still effective, they are relabeled with a new expiration date and a modification to the lot number. For example, if you test a batch of Cipro with the lot number of 123456, and expiration of 10/01/2020, and it was still effective, it would be relabeled with the new information of: 123456A and expiration date of 10/01/2023. A medication can be “SLEP’d” a total of three times (suffixes A - C). Once a medication with the “C” suffix expires, it has to be destroyed, replaced, and restocked. That has not always been kept up with because the different presidential administrations often see it as costing X number of dollars and not getting a return on investment. Well, you see what’s happened when you don’t maintain the stockpile.

Also, the government largely focused the SNS on defending against Anthrax attacks and only have just started placing greater emphasis on issues like emerging infectious diseases (EIDs).

When I ran the Stockpile for Maryland, the workflow followed that the CDC (or, now, the Assistant Secretary for Preparedness and Response) has 12 hours to get the initial SNS push-package to the states. In Maryland, I had 12 hours to distribute the 24 Maryland jurisdictions (23 counties & the Independent City of Baltimore). The 24 jurisdictions then only have 24 hours to dispense the medication to 8-10 million (depending on the time of year) residents, tourists, commuters, and everyone else in Maryland over our 24 jurisdictions. We were also responsible as the primary backup to the District of Columbia.

After the 2001 Anthrax attacks, we had become focused primarily on making sure we could get the Anthrax treatment out within its critical 48 hour time slot. While pandemics, natural disasters, man made disasters, and terrorist events were part of our planning, they were not the priority. But when Ebola, Zika, and other outbreaks happened, we then started placing a greater priority on them and making in depth plans to address pandemics and infectious diseases. I was fortunate to serve on Maryland’s statewide EID Committee during and after Ebola and Zika.

I’m currently working on my Master’s and will hopefully get accepted into a GSAS or HSPH PhD \ DrPH program afterwards. I plan to write my thesis and dissertation on the failure of the Strategic National Stockpile during COVID and the World Health Organization’s failure as well. If anyone has any ideas, suggestions, or want to talk, please reach out to me. For members who are reading this and are interested in going into infectious disease, check out the CDC’s Epidemiological Intelligence Service (https://www.cdc.gov/eis/index.html) or their other fellowships. And for a movie recommendation that very closely aligns with reality, check out Contagion.

Kevin Jura, NRP (contact: kevin.jura@alumni.harvard.edu)

Current Graduate Student at Harvard Extension School studying International Relations, focusing on International Security. He previously earned his Bachelor’s of Liberal Arts cum laude from the Harvard Extension School.

Compiled and interviewed by Felicia Ho