Stefan Hofer, President and Operations Manager of West Traill Ambulance Service, North Dakota, said they have received only a couple of calls, which were not related to COVID, in the past two months, although the number of cases increased by 20 to 30 percent.

The company covers over 1,500 miles of the North Dakota area and serves approximately 10,000 people in the state.

In April, private EMS ambulance service companies across the country received around $350 million in COVID-19 relief funds, but they said they ran out of money within weeks. And a few months later, there is an increasing need for ambulance service due to coronavirus resurgence.

Hofer said he is unsure how long his company will service if the companies do not receive additional federal funds. He said he might lose employees soon, meaning his service may answer fewer calls.

“This isn’t going to be over tomorrow, and that’s the big thing,” Hofer said. “We got to make sure that we can still take care of people six months from now, and that’s what’s gotten really hard to figure out.”

The American Ambulance Association (AAA) sent a letter to the US Department of Health and Human Services (HHS), stating, “The 911 emergency medical system throughout the United States is at a breaking point. Without additional relief, it seems likely to break, even as we enter the third surge of the virus in the Mid-West and the West.”

A spokesperson of HHS said the agency has delivered around $107 billion to over 550,000 ambulance service providers across the nation. The agency also opened the third round of funding of $20 billion in November. However, the agency said the third phase of funding comes with a limit.

Jim Finger, CEO, Regional Ambulance Service Past President, AAA, said, “All the funding that the federal government gave us, whether it was PPP [Paycheck Protection Program] funding or money from HHS, all of that is long gone.”

“But we still have all these issues, and we’re trying to find ways to financially survive and continue to do our jobs,” he added.

Aarron Reinert, AAA President, said, “America’s ambulance services provide skilled, on-demand health care round-the-clock to every family in our nation, despite soaring costs and decreased revenue driven by the COVID-19 pandemic.”

“These financial challenges are exacerbated by staffing shortages as EMTs and paramedics quarantine after exposure to or infection by a coronavirus,” he added. The article originally appeared on NBS News.