Thread by @scottlynch78

Okay! Let's talk a bit about risk management and our not-so-excellent friend, the novel coronavirus COVID-19.

Why should you pay attention to a single thing I type?

Because unlike some other Robin Hoods, I can talk with an English accent.

1/23

Just kidding. My English accents are crap.

I was a paid-on-call firefighter from 2005-2016. In addition to firefighting school, I was also required to earn a certification in Hazmat (HAZardous MATerials) Operations and re-certify annually. Ten more times, that was.

2/23

I was also required to train as an EMR (Emergency Medical Responder), and I picked up a bunch of other certifications and special classes, including incident management, confined space operations, water rescue, fire officer, post-mortem procedures, etc.

3/23

I am not an epidemiologist. What I do have is a deep and drilled-to-the-point-of-numb-disbelief knowledge of emergency operations, scene safety, and personal protection at the ground level for a wide variety of incidents, including, alas, serious biohazards.

4/23

So, I have seen a wide variety of well-meaning questions from people in a variety of emotional states, asking about bandanas, scarves, masks, gloves, space suits, etc. And I'll tell you what, I'll do one more thread tomorrow about BSI (Body Substance Isolation).

5/23

But for now, in re. the question "ZOMG, what kind of mask/gloves/etc. do I need at the moment," I really want you to take one big mental step back and realize that you are framing the question COMPLETELY backwards.

6/23

Personal protective equipment is your last

absolutely last

NOT first

LAST

line of defense against a hazardous exposure of any sort.

That's how an emergency responder or a hazmat planner or an industrial hygienist looks at the world. You should, too.

7/23

The guy who taught my fire department's annual hazmat refresher course (such a cool old guy I named a minor pirate in my second novel after him) had a background in industry, and explained how to approach a safety threat from that perspective.

8/23

Let's say you run a factory that etches microchips using a horribly toxic corrosive chemical. The placeholder name for hypothetical chemicals in this guy's lectures was always "Ethyl Methyl Bad Shit." I loved that. "Ethyl Methyl Bad Shit." I bequeath that term to you.

9/23

You need to control human exposure to Ethyl Methyl Bad Shit in and around your factory. So you follow a hierarchy of controls that goes like this:

1. Elimination/Substitution
2. Engineering measures

-- BIG DESIRABILITY GAP --

3. Personal safety gear on human beings

10/23

Elimination/substitution: Do you really NEED Ethyl Methyl Bad Shit for your factory's etching process? Are you SURE? Can you maybe replace it with Ethyl Methyl Less Bad Shit? Or even Ethyl Methyl Mostly Benign Shit? Because if so, that would be simply the best.

11/23

If you absolutely cannot avoid having a hazard as part of your factory's process, your next step is engineering controls. Can you maximize human isolation from Ethyl Methyl Whatever Shit? Can you seal it in its own environment? If yes, good. Not BEST, but good.

12/23

Only as an absolutely last resort, if you MUST have the bad shit in your factory, and you CAN'T isolate it with environmental safeguards, do you let people deal with it wearing personal protective equipment. This is the LEAST comfortable and efficient exposure control.

13/23

(Also, this is an accurate but slightly simplified version of something the dude called the "hierarchy of controls" and you can absolutely look that term up online if you want the complete thing, God knoweth why)

14/23

So, this is where you come in, saying "Hey, I'm worried about this virus, what sort of mask and gloves and so forth should I be wearing?"

And by now you realize the ideal answer is: None. You shouldn't be wearing a single fuckin' article of protective gear. Nada!

15/23

Because the question you should be asking, before you ever get to "what sort of PPE do I need," is:

HOW DO I AVOID A POTENTIAL EXPOSURE SITUATION ENTIRELY?

That's the gold standard, the top of the hierarchy, the first goal.

Avoid. Potential. Exposures. PERIOD.

16/23

If you cannot eliminate the need to place yourself in a potential exposure situation ("I must leave the house to get groceries or we will starve," for example), then you need to move down the hierarchy. Think about the environment(s) in which you will be operating.

17/23

"I can get to the grocery store on the subway," you tell yourself. "I can also walk a few blocks, or take my bike." All other hazards or issues aside the subway probably offers the BIGGEST risk of potential viral exposure. So choose a travel method with better odds.

18/23

You will not always have a perfect choice, or the luxury of remaining in isolation. But this is how you need to try approaching the next few weeks, for your health and for that of many others.

Do I NEED to risk exposure?

If yes, do I NEED to risk it in THIS manner?

19/23

Only after you have squeezed those two questions as hard as you can should you even begin to approach the question of "right, how do I dress to protect myself against exposure?" PPE can fail and humans can fuck up, but you don't catch 100% of the viruses you never meet.

20/23

Your goal should not be to walk blithely into potential exposures trusting a piece of paper tied over your face to never break. Your goal should be to throw EVERY obstacle you can between yourself and any potential elective exposure. Stay calm, but think about this.

21/23

The first question is always: Should I be doing this at all?

The next question: Can I change the way I do this to make it less risky?

The last, last, ALWAYS last question: What should I be wearing to do this?

The hierarchy of controls is a POWERFUL safety tool.

22/23

Are you still here? Okay. Thanks for reading. Please try to take this seriously. Stay calm, live and fight in hope, but take this seriously for yourself and others. Tomorrow I will teach you the esoteric chant of the trainee EMR:

"BSI, Scene Safe! BSI, Scene Safe!"

23/23