FirstNet will use 'special' SIMs that are issued to properly vetted first responders. In the event of major disaster or terrorist activity, the provider can institute this prioritization or even prevent all other normal user SIMs from accessing the towers. This would have been immensely valuable during the events of 9/11 and other disasters where every single user tries to get onto the limited available service (due to the event) at once. For large events in Washington, DC, the providers have mobile cell sites that can be installed to reduce the saturation/congestion on the permanent network.
COWs have been available for some time, to support large events, or for disaster recovery. Makes sense.
Mobile cell sites - Wikipedia
Once we moved away from analog networks (way back now), the first thing that should have been designed in is EMS prioritization. And, I believe, to some extent, it was.
Dedicated EMS comms networks do go down, aren't compatible with other geographies service, (or even other local supporting services), don't cover certain areas well, etc...... lots of reasons that EMS will need to use cell networks.
If I'm trying to get in touch with family or friends during an emergency, I'd be frustrated by any comms delays I'd have to deal with...... at the same time, I want EMS to have top priority on whatever comms networks are still up and running...... like any other sane person would.
Rgds, D.