By Rick Edinger and Gregory Noll
It is no exaggeration to say that we are living in unprecedented times. Although global pandemics have been well documented in our history books, most people alive today have not experienced a pandemic at all, much less on the scale that the COVID-19 (coronavirus) has visited upon us. In the arena of personal protective equipment (PPE), decontamination and personal protective measures, the experts in guidance, use, and protocols tend to be laboratory and healthcare workers. In the realm of public safety, it’s the hazmat response personnel and EMS professionals who are likely being looked to for advice and guidance in PPE and decontamination best practices.
As our national leaders and subject-matter experts (SMEs) say, a wartime-like footing will be needed to defeat this virus. Experts are also telling us that this crisis should be thought of as a marathon and not a sprint. Normal response paradigms will need critical evaluation and may need to be discarded altogether. Innovation and critical thinking will prosper over the “we’ve always done it this way” mentality. Healthcare workers and public safety responders are the front-line soldiers in this battle and a wartime mentality needs to be instilled in these personnel to allow for the proper management of this crisis.
This pandemic has resulted in healthcare systems being overwhelmed, critical resources being in short supply, and a world economy with negative impacts that may last for years. Fear and apprehension prevail and nothing shakes the public like seeing face masks and hazmat-type PPE in public settings. It’s important that we recognize these conditions and alleviate the fears of the public through public communications measures when possible. Like other public safety officials, hazmat response program leaders must stay current with the ever-changing conditions and guidance forthcoming from this evolving crisis. Thankfully, emergency response organizations such as the International Association of Fire Chiefs, International Associations of Fire Fighters, and International Association of Chiefs of Police are providing timely and accurate COVID-19 guidance for the public safety community. While CDC and NIOSH should be your primary sources of information, another good source of information specifically for emergency responders is the Emergency Responder Tips, LLC Web site at https://emergencyresponsetips.com.
Leaders of hazmat response programs should view the pandemic preparation and response activities through short, medium, and long-term lenses. Short term, the immediate need is to provide proper guidance, expertise, and resources to local officials, public safety agency leaders, and government planners. It’s likely that the hazmat response program has existing (and probably rapidly depleting) resources on hand including respiratory protection equipment, isolation garments, and other PPE resources that are of immediate need. If a locality is in need of decontamination expertise and resources, the hazmat team is typically the first “go-to” resource that is engaged. Hazmat response programs have established vendors and a supply stream that can be of use in replenishing supplies. We can step in and fill some gaps. All of this is what we do every day.
Responders should maintain a realistic, fact-based and science-driven perspective of both the problem and options for protecting the community while ensuring the safety of emergency responders. The hazmat response community employ the concept of risk-based response on a daily basis. While COVID-19 scenarios may not be a “hazmat incident” from a chemical perspective, they are a “hazmat incident” when viewed from a health and safety perspective.
Consider some of the following:
- HM 101: If you don’t get the material on you, you don’t get hurt. Remember the differences between exposure and contamination – being exposed does not mean that one is contaminated.
- PPE isn’t your first line of defense–it’s your last line of defense. Remember the Hierarchy of Controls—engineering controls, such as ventilation systems inside an ambulance, and administrative controls and procedures to minimize potential exposures when dealing with suspected infectious disease patients—should be an integral part of our protection strategy.
- The selection of PPE (respiratory and skin protection) should be based upon a risk-based process that considers the type of scenario, the tasks performed by emergency responders, and the risk of contamination.
- The information gathered by emergency communications from the initial caller can be critical in providing emergency responders with an improved situational awareness of both the scenario and the potential for infectious exposure. If your agency does not currently maintain COVID-19 call screening protocols, these should be instituted as soon as possible.
- Traditional response assignments for EMS calls involving the potential for infectious exposure may have to be modified to minimize the number of responders potentially exposed.
- Emergency responders will do all the “right things” to minimize cross contamination in the field and then forget the basic principles once they return to their station and initiate clean-up and related tasks. Food preparation and serving at the station level can be a vulnerability, especially when provided by groups and volunteers who have good intentions but who do not practice basic food safety and contamination control measures.
During this crisis it can be expected that government agencies may task hazmat personnel with additional duties, such as performing respiratory equipment fit testing. The hazmat response team (HMRT) could be the primary caretakers if a locality is maintaining a strategic national medication stockpile. HMRT members may be tasked with providing internal decontamination services for facilities, vehicles, and equipment. The list of possibilities goes on.
Since most HMRT’s are staffed with dual-role responders, managing time and resources to address both the emerging pandemic threats and normal “day-to-day” hazmat incident response responsibilities becomes a primary duty of the hazmat response program leadership. HMRT’s may soon be faced with depleted resources (people, equipment, etc.) when a non-COVID-19 related hazmat incident occurs. It is highly important that hazmat program leaders keep the entire picture in view and don’t get caught off-guard when other emergencies requiring hazmat response capabilities arise.
Medium term and as the pandemic subsides, it will be important for hazmat response programs to evaluate resources, restock supplies, and evaluate short and long-term program impacts and needs. Predictably, as the pandemic response and concurrent successes and failures will teach us a lot about future threats, it will be important for hazmat program managers to identify resource needs and voice lessons learned as the post-pandemic assessment begins. Depending on community needs and public safety resources available, the role of the local hazmat response program may have been expanded during this crisis and expectations of future capabilities and performance will need to be assessed and validated. Changes will need to be implemented in program scope, resources, and practices to address the new model that exists. Additionally, as the pandemic recedes, it is highly likely that local and state public finances will be negatively impacted and recovery could take time. In an environment where budget cuts could become the norm, hazmat program managers must ensure that the program’s needs are addressed and resources replenished as budgets are reallocated following the pandemic response.
Long term, there are likely many opportunities for improvement that will arise from this crisis. The philosopher George Santayana was quoted as saying: “Those who cannot remember the past are condemned to repeat it.” In the near-term, pandemic preparation and response capabilities will now be in the forefront of emergency planning activities. Future planning considerations may include the following:
- Professional relationships that previously did not exist among public health and public safety officials will need to be further developed and maintained.
- Local emergency planning committees (LEPCs) remain an under-utilized tool for bringing together key stakeholders and facilitating local /regional emergency preparedness. LEPC’s can be leveraged to continue these conversations and advanced planning which will hopefully stem from this public health emergency.
- While stockpiles of PPE and decontamination equipment will likely be increased, the historical challenge remains: how will they be managed and sustained over time? After 9/11, some equipment that was obtained remained unused and degraded on backroom shelves for years after. We must become smarter with managing our resources after this crisis.
- New research on field testing for bio-scenarios, PPE, and decontamination techniques will likely emerge.
In all of these instances and more, there are a multitude of opportunities for hazmat emergency response programs to engage and assist with needed resources and expertise. As advanced planning discussions ensue, hazmat program managers need to be in those discussions. We shouldn’t return to normal operations assuming that the COVID-19 pandemic is a once in a lifetime event.
“To each there comes in their lifetime a special moment when they are figuratively tapped on the shoulder and offered the chance to do a very special thing, unique to them and fitted to their talents. What a tragedy if that moment finds them unprepared or unqualified for that which could have been their finest hour.”Winston Churchill
This too shall pass, but it is critical that hazardous materials responders ensure that lessons learned are applied to future planning, resource management, and response activities. It would be a tragedy and great mistake to treat this pandemic as a one-and-done emergency incident. Our nation was not the same after September 11th and it will not be the same, for better and worse, following COVID-19.
Rick Edinger served in the fire service for over 45 years retiring in 2018 as the deputy chief of a large metro fire and EMS agency. He previously served as the vice-chairperson of the International Association of Fire Chiefs (IAFC) Hazardous Materials Committee and currently serves as the chairperson of the National Fire Protection Association (NFPA) Technical Committee on Hazardous Materials Response.
Greg Noll is a member of the Fire Engineering Editorial Advisory Board and has 50 years of emergency services experience. The co-author of nine textbooks on HM/special operations emergency response topics, he is a current member and past chairperson of the NFPA Technical Committee on Hazardous Materials Response. In 2019 he was inducted into the National Fire Heritage Center – Hall of Legends, Legacies and Leaders.