All hands on deck

In the 00s, when I was on a 3-day week, there was time to scan the literature outside the narrow field of my specialisation. I came across a polemic about disaster training for medical students. In the wake of the 2005 Kashmir Earthquake, with 90,000 corpses, 3 million displaced people, and the Winter snows imminent, the Pakistan government called for qualified personnel to come and help. The cited story is about how two final year medical students felt completely unprepared for the task they were bussed into. "Disaster management is an essential component of medical training, but unfortunately this component is largely missing from medical and nursing curricula. Our experience shows how a lack of training in disaster management can have unfortunate consequences for both patients and health-care students."  Reading between the lines, I think the boys done good even if they made mistakes. But should we, as a society, devote time and effort to prepare for Disasters when these are, almost by definition, vanishingly rare?

My pal Russ who hangs out on Twitter, flagged for me a comment / question by RTE's health correspondent Fergal Bowers @FergalBowers: Got a query on COVID-19 testing. Says we have dozens of empty laboratories in universities/technical colleges in the country. We have laboratory technicians & scientists underemployed. What would it take to outfit empty labs with extra equipment (if necessary) & retrain staff?

Now that's a good question. We shuttered The Institute for classes a week ago, although the buildings remain open . . . to facilitate staff developing on-line tuition protocols.  I'm far too old a dog to learn the new trick of on-line teaching and I can't bank the knowledge for my future in teaching because this time next year, I will be at Lunch-in-Longford Free Travel for Wrinklies rather than remedial math classes. Fergal's question addresses whether, and to what extent, it is useful to recruit idle workers in one area to  fill vacancies in Front Line. Because there is an emergency here-and-now-and-escalating and we want Effectives not passengers and dogoodniks.

You can't do Covid-19 testing in your garage or kitchen, not least because it is a highly contagious and potentially fatal microbe. The testing laboratory has to be safe for the workers and contained so that nothing escapes into the water supply. We don't want to have it like Pirbright releasing foot&mouth virus into the drains in 2007. The Man has decided there are 4 Biological Safety Levels BSLs of containment consonant with differential risk:

• BSL1 - infectious agents or toxins not known to consistently cause disease in healthy adults
• BSL2 - infectious agents or toxins that pose a risk if accidentally inhaled, swallowed, or exposed to the skin
• BSL3 - infectious agents or toxins that may be transmitted through the air and cause potentially lethal infection through inhalation exposure
• BSL4 - infectious agents or toxins that pose a high risk of aerosol-transmitted laboratory infections and life-threatening disease for which no vaccine or therapy is available

At The Institute we recently reviewed our stocks of microbes used for teaching and research because our management reckoned that upgrading the facilities to allow our students to learn how to work with characterize, for example Staphylococcus aureus [BSL2] would not be cost effective. The irony of course is that most Irish students will have some Staph A up their noses and 30% of any class will have MRSA [multiprev] there minding its own business and killing nobody. So sorry Fergal, we have no lab that can be easily or cheaply upgraded to BSL3.

One of my colleagues at work is a trained microbiologist, since she was 8, that's what she wanted to be. After four years of college and a PhD, she landed a peach job working in BSL3 lab working at The Frontiers of science, but with a frisson of extra excitement because of the potential risk and the necessity to a) know what she was doing and b) do it really carefully and reliably. As I said before needle-stick injuries are tolerable in a sweat-shop making underpants for Marks & Spencer but not so much if dealing with anthrax or Ebola. She stuck it for a week, at the end of which her hands were in ribbons from all the hand-washing. She took a week's sick leave to recover them. But they were back at code red within days of her return to work, so she went to work in the food and bevvy industry; which also has a high demand for competent microbiologists. So sorry Fergal, not every qualified lab-scientist, no matter how willing, is going to be useful in a Covid-19 testing lab.

Scientists are sadly narrow and over-specialised to be really on top of your field, you must have a narrow field. Keats and Shelley were the last two English poets who were at all up to date with their chemical knowledge [JBS Haldane]. Now it is difficult to be up to date on a single molecule in a named species: you'd have to read 6 papers a day, 7 days a week, to know everything published about TLR4 last year. That being said, as articulated by Danny Schnitzler here two days ago, the mindset of a scientist is a transferable skill: attention to detail, basic numeracy, knowing which end of an eppendorf [L] to open; keeping your work-space orderly; lab coat and safety-glasses all the time; following the protocol righteously; recording the results honestly. The local hospital has contacted The Institute to donate some of those always-on safety-glasses; presumably because there are none in the shops. I have 3 pairs as spares for students who forget theirs.
There are loads of other people who are re-purposing their staff and facilities:

• distillers making hand-sanitizer instead of gin
• parking concessions using their vans to deliver prescriptions rather than car-clamps
• laid-off child-minders facebooking themselves up against nurses whose creche is closed
• live-streaming children's story-tellers
• hot meals for doctors as they stagger from their shift

I don't myself believe we need training for disaster management. We will be fine if we train our youngsters to be imaginative, adaptable and willing to test themselves.
“A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects.”