There are hard days on the job — and then there are pandemic hard days on the job.

It was a succession of such days last spring that Greenwich Emergency Medical Service responder Walter Hughes says he doubts he will ever be able to shake off.

“I had a guy who went from conscious and alert, talking to me, to within 10 minutes of the ER going on a ventilator,” Hughes said. “The look on that guy’s face — I’ve been in this business for 30 years, but this has probably been one of the most challenging times. ... It’s a lot.”

Pandemic stress cascaded into Hughes’ colleagues at GEMS. Paramedics repeatedly faced limitations on the use of devices that assist people in breathing, COVID-19 protocols preventing the use of nebulizers due to the release of aerosol particles.

Safety protocols helped many GEMS employees avoid contracting COVID-19, including Hughes’ daughter and fellow paramedic Kristina, who worked with him on a life-saving situation this year. But Walter Hughes would end up as one of the handfuls of GEMS staff to be laid low by a coronavirus, with the crews the very definition of essential workers.

“It knocked me out for two-and-a-half weeks,” Hughes said. “For seven or eight days, it was an effort just to get out of bed. ... I lost 11 pounds.”

GEMS, confronted with unforeseen challenges as a result of coronavirus, is one of 49 employers in Fairfield, New Haven, and Litchfield counties on the list of Top Workplaces, named by Hearst Connecticut Media in three size categories. The nonprofit finished No. 3 among small employers with fewer than 125 people.

Click here for complete coverage of the region’s Top Workplaces for 2020.

Click here for a searchable list of the 49 Top Workplaces winners for 2020.

And like other health-related businesses, GEMS has emerged the stronger for it, in the view of Colin Bassett, director of quality assurance. Bassett is in the cohort of Connecticut managers who breathed COVID-19 — the issue, not the virus itself — almost every moment during the height of the pandemic.

At a time when just about every business is hyper-focused on employee safety, Bassett, and others like him who oversee wellbeing in emergency medicine and transport, have been point guards in a game of life and death during coronavirus. He searches for any way to help the Greenwich ambulance operator’s staff stay safe — and keep morale up through it all.

“The level of uncertainty for myself and our employees — we didn’t know what this virus was,” Bassett said. “Until you start seeing the numbers tallying up on your screen on a daily basis, you don’t realize nobody alive has seen anything like this,” Bassett said.

Health businesses stressed

GEMS exemplifies a central theme in 2020: More so than any other time in memory, maintaining safe and positive workplaces became a civic duty as the coronavirus pandemic upended businesses.

That’s all the more true in the health sector, which accounts for more Hearst Connecticut Media Top Workplace companies than any other, with nine of the 49 on this year’s list. Others include the Stratford Visiting Nurses Association; the McCall Center for Behavioral Health in Torrington; Aware Recovery Center in Wallingford; Physical Therapy and Sports Medicine Centers in West Hartford; and Autism Behavioral Health a Danbury firm that started in 2016 and is No. 2 on the small employer's list.

Many participated in the U.S. government’s Paycheck Protection Program with forgivable loans for businesses to pay employees in an effort to avoid the mass disruption to the economy those actions could produce. GEMS received aid listed as $350,000 to $1 million, less than some emergency services companies on the list.

In the first few months of the pandemic, about two of every five calls to Greenwich Emergency Medical Service involved a patient who was subsequently confirmed to have coronavirus, Bassett said. GEMS curtailed volunteer service and had several staff afflicted with COVID-19, all of them recovering.

“There was so much conflicting data out there and rumor and speculation, and not a ton of hard facts to go by,” he said. “I know that made me very uneasy, and if I’m having a hard time with it then I know my crews were.”

Jangled nerves

In July, the Centers for Disease Control & Prevention issued updated guidance for ambulance operators. Unlike the gatekeeper environment of a hospital, CDC noted, EMS operators had extra challenges to include the need to make quick decisions; the tight quarters aboard ambulances; and the limited information for paramedics.

Bassett made it his mission to gather all the latest information and get it into the hands of its ambulance crews and other staff, such that some jocularly dubbed “Colin’s COVID Corner” his weekly Zoom call to spread the word.

As of October 8, more Connecticut employees will be able to return to the workplace, with Gov. Ned Lamont initiating Phase 3 of the state’s reopening plan. Most businesses will be able to run their premises at 75 percent capacity, up from the 50 percent ceiling that has been in place since mid-May.

Jangled nerves will be the norm, if an August survey is any indication of some 300 businesses by the Norwalk-based human resources consultancy OperationsInc, itself a Top Workplaces winner this year, for the eight-time. About one in five respondents noted they have fielded complaints from their workers about colleagues or visitors not adhering to rules in place intended to reduce the chances of virus transmission.

For emergency response companies such as GEMS, the jangled nerves are not just based on fear, but the experience.

“We’re the ones who go in and deal with bad things,” Bassett said, “and we walk away more or less intact — and we have to in order to perform this job well, you have to be able to take what you are seeing and handle it.”

Staff Writer Rob Marchant contributed to this report.