He worked through the SARS outbreak in 2003, battling exhaustion and overtime on top of 12-hour shifts helping to save lives.But a veteran Toronto paramedic says that was nothing compared to the call volumes he and his co-workers are seeing during the COVID-19 pandemic. Now, he says, those who answer the calls for help need help themselves."Mentally, physiologically, emotionally, I'm definitely burnt out," he told CBC Toronto, but he also realizes he can't stop to rest — not when daily case counts of COVID-19 have spiked to the point that the province has put the city under a lockdown that will last at least 28 days. "I know I also have a duty to respond."CBC News has agreed to withhold the paramedic's identity to protect him from possible reprisals. The 20-year veteran says he's worried."I've seen paramedics doing calls at the end of their shift and their hands are trembling, and I don't know if that's hunger, exhaustion, or what," he said. "But they're still out there doing the calls because they know the citizens need them."System 'in dire straits right now'Mike Merriman, who heads the unit that represents Toronto paramedics as part of CUPE Local 416, spoke to CBC News at an ambulance bay in Scarborough as an emergency vehicle pulled in after a call. Five minutes later, it sped out again."The system is really in dire straits right now," he said. "We're running on overtime daily and something has to give."> We're running on overtime daily and something has to give. \- CUPE Local 416 president Mike MerrimanParamedics, Merriman added, are used to going above and beyond, but work at its current pace isn't sustainable and many, he said, are reaching a breaking point."They're calling me all the time, some in actual tears, because they just can't keep up the pace [and are] needing relief." "They're not getting their lunches. They're not getting any breaks," he said.Repeated deep cleaning between calls and the safe donning and removal of personal protective equipment add another layer to the already heavy workload, Merriman says.Another paramedic, speaking on CBC's Metro Morning on condition of anonymity because of concern about reprisals, added "every day I'm not at work, I check my phone and there will be an overtime call out for every single shift, sometimes up to a week in advance." Ontario Nurses Association also concernedOther front-line workers are also feeling the pressure. Ontario Nurses Association president Vicki McKenna is hearing from her members about burnout. "I can hear it in their voices," said McKenna."Nurses are telling me ... 'I just don't know how long I can keep this up.'"Burnout, therapist Amy Deacon explains, often presents itself as mental and physical exhaustion, but detachment is also a symptom. "We can't afford for these front-line workers to be detached from their work, but that's one of the most common signs of burnout," said Deacon, the founder of an organization called Toronto Wellness Counselling."It's been well researched that people are less effective.There's lower productivity because they are just so spent, they are so exhausted that they don't have the resources to show up at work and be their best selves."The union representing Toronto paramedics is calling for part-time staff to be made full-time to help ease some of the pressure.City to address fatigue and mental healthThis week, Toronto council adopted an amendment requesting the city's chief people officer and the chief of Toronto Paramedic Services, in collaboration and consultation with CUPE Local 416, address staff fatigue and mental health among front-line paramedics. They're expected to report back in February of next year.While they wait, Deacon says there are several things she would tell front-line workers to do."Put down your phones, put down your social media and do a 10-minute meditation, watch one less episode of Netflix and go for a walk outside."Sleep, she says, is vital. And if front-line workers are not sleeping well, she recommends connecting with a doctor."I think it's also incumbent on us as a community and as a collective to really show up for these front-line workers, people ... putting their lives and their families at risk to protect us."Protecting people is something the veteran paramedic says he wants to continue doing, but he doesn't know how much longer he can do it.."Being able to do the job well and properly needs to be a priority as well, and we're getting to a point where we are not able to do that."