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In a critical medical emergency, eight minutes can mean the difference between life and death.
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In Durham County, that response time is under pressure as population growth, more traffic and a shortage of staffed ambulances stretch the county’s emergency medical services system. Many residents worry that life-saving help simply won’t arrive in time.
“I am always a first-responder advocate, always,” said Pam Andrews, a retired teacher and president of the Preserve Rural Durham advocacy group. “We’re really trying to push to get them the adequate services they need, so someone doesn’t die in the line of duty, and an innocent citizen doesn’t die from lack of services.”
As residential development continues to sweep across Durham County, local emergency medical services are struggling to keep pace.
Durham County Emergency Medical Services has surpassed 60,000 calls in each of the past two fiscal years and, on average, takes eight minutes to respond to a call. EMS Director Mike Lockhart said the department has 12 to 19 ambulances at peak times and needs about 32 to adequately respond to emergencies.
“Demand for services has outpaced our ability to supply those services in what we feel is a timely and appropriate fashion,” Lockhart said in an interview with The News & Observer. “The county’s growth and our call volume go hand in hand.”
Lockhart said the department is trying to add staff and replace aging ambulances. But the steps being taken now will not immediately resolve the gap between the number of calls coming in and the number of units available to answer them.
Over the last decade, Durham County has grown by 15.4% to more than 347,240 residents. That’s about 40,000 new residents since 2016. That reality is colliding with residents’ experience of a fast-changing county where new housing is being approved along roads strained by traffic.
When ambulances are unavailable, or only a minimum number remain in service, Durham County EMS places lower-acuity (non-life-threatening) calls in a queue, Lockhart said. The practice helps keep units available for critical, life-threatening emergencies.
Because of the lack of staffed ambulances, and the lack of enough vehicles overall, the average hold time is about 35 minutes. A person who falls and thinks they have injured a knee, for example, could be asked to wait before an ambulance is dispatched.
Lockhart wants residents to know that, if they call 911, help is coming, but “it may not be right away.”
“Obviously, that’s not what we’re trying to do. That’s not what we want to do,” he said. “But until we reach a point where our supply can meet the demand, that’s the situation that we find ourselves in.”
The county added 12 EMS positions in the fiscal year that began July 1. County Commissioner Mike Lee said the county has also raised pay and is recruiting, but hiring remains difficult because neighboring jurisdictions are competing for the same employees.
“Positions are one thing, but response times are something else,” Lee said. “We learned that adding a new ambulance, one new actual ambulance, will help draw down those times.”
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So, why is the county adding only one new ambulance but hiring a new dozen new people?
“The bad news is that with the pandemic, ambulance manufacturing times went from six months to three years,” Lockhart said. “That’s been a significant effort for us to try to overcome.”
Durham began its ambulance replacement plan in 2022 and has been ordering five or six ambulances a year, Lockhart said. A new, fully equipped ambulance for the county costs over $415,600, according to EMS.
The county placed an eleven-ambulance order in early 2023, and now five of those are finally arriving this year. By the end of 2028, Lockhart said the county expects to have replaced 28 ambulances.
For Pam Andrews, president of Preserve Rural Durham, the debate over emergency response and infrastructure is personal. A lifelong southeast Durham County resident along N.C. 98,she said traffic has been increasingly difficult to get in and out of her driveway.
Preserve Rural Durham has tracked over 5,600 acres slated for development in southeast Durham, estimating that ongoing projects could bring over 50,000 new residents to the area. Some of those projects include the 120-unit Sagebrook Townhomes and the Perry Farm development, a 665-unit housing project on 280 acres along Kemp Road.
“How can you keep building when we don’t have infrastructure, fire, police, emergency services, schools, libraries, parks?” asked Andrews. “We don’t have any food [stores] out here in southeast Durham. There’s no commercial. We have one little Food Lion.”
Andrews said local planning approvals have repeatedly moved forward without properly evaluating whether emergency services meet required levels of service under county guidelines, such as Policy 119. The policy states new developments within the Urban Growth Boundary must meet established levels of service for emergency services and community safety.
“When we are stretching our first responders, it puts their lives in jeopardy. It also puts the citizens’ lives in jeopardy, and it’s very scary,” she said. “If I were looking to buy somewhere, I don’t know that this would be where I would land without knowing adequate infrastructure is there.”
Lockhart said EMS leadership has recently begun making a “concerted effort” to work with city and county planning departments to offer recommendations on the impact of new developments.
Lee highlighted his role on the joint City-County Planning Committee, saying that both bodies are starting to make infrastructure a priority as housing decisions are made.
“People don’t feel that elected officials see or hear the complaints,” Lee said. “But we live here as well. We feel the pain. We feel the traffic; we feel the struggles. We feel the response times ourselves because we live right here too.”
NC Reality Check is an N&O series holding those in power accountable and shining a light on public issues that affect the Triangle or North Carolina. Have a suggestion for a future story? Email [email protected].
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This story was originally published September 8, 2026 at 8:08 AM.