The ECHO Team was created in 2014 in response to the Ebola outbreak that threatened the United States and originally was comprised of 12 Paramedics that received advanced training in the use of Personal Protective Equipment specialized for use during the care of a person with a suspected highly infectious disease (HID.) Pittsburgh EMS became one of less than 10 agencies in the state that was prepared to handle a patient with a confirmed HID diagnosis. Over the years the team participated in numerous exercises and training events and sent a portion of the team to the Center for Domestic Preparedness to complete their HID training program. The Team has more recently been utilized for the COVID-19 pandemic providing expertise in PPE donning and doffing as well as post-care decontamination of units. The ECHO Team also participates in COVID-19 testing missions and transport missions of known positive cases.