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#72: Opiates and COVID-19
78 Plays4 years ago
In this episode of The Accidental Safety Pro Podcast, series host Jill James interviews Eric Persaud. Eric is a doctoral candidate in public health at the Department of Environmental and Occupational Health Sciences, at the State University of New York, Downstate Health Sciences University, and Eric will soon be defending his dissertation. Eric has a lot of insight on ways the pandemic has affected us in ways that might otherwise go unseen to the general public, like the rise in opiate overdose deaths.
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Transcript
Introduction to Eric Persaud and His Research
00:00:10
Speaker
This is the Accidental Safety Pro, brought to you by HSI. This episode is recorded April 2nd, 2021. My name is Jill James, HSI's Chief Safety Officer, and today I'm joined by Eric Persaud. Eric is a doctoral candidate in public health at the Department of Environmental and Occupational Health Sciences, State University of New York, Downstate Health Sciences University, and Eric will soon be defending his dissertation.
00:00:38
Speaker
Eric focuses on evaluating and researching training programs related to preparing workers for emergencies and disasters in hazardous workplaces. He's been involved in evaluation and research associated with fentanyl and first responders, opiates in the workplace, and protecting workers from COVID-19.
00:00:56
Speaker
He's also a contracted training program evaluator with the NIEHS or the National Institute of Environmental Health Sciences worker training program. Eric joins us today from his home in New York. Eric, welcome to the show. Glad to be here, Jill.
Journey from Geology to Public Health
00:01:15
Speaker
Well, I would like to know how a guy who started out as a geologist, because you've told me that before and I don't know the story yet,
00:01:25
Speaker
First of all, I guess how do you become a geologist? And then second, what's the leap into health and safety? You know, that's, that's probably the one question most people ask me. When it comes to what I'm doing now, they are like, wait a sec. Wait a sec. Where, where and how did that happen? Back, back in college, I, I got an in for engineering. And I remember,
00:01:52
Speaker
The first thing I was going to do was not do engineering. I just, I looked at it and I saw labs and I saw lack of communication and lack of touch and feel what the world and you know, geology kind of grew to me. The earth sciences grew to me because I've always been into these environmental issues and these sciences and the world that has itself in a hole. And when I switched over to geology and finished up my bachelor's
00:02:22
Speaker
I was planning to do a master's in geology as well. But then my mom unfortunately got very sick and I decided it was probably best to stay home and get a job and maybe do the master's online or something. So I did my master's online through North Carolina State University. And- You finished it in geology? And I ended up doing it in environmental assessment.
00:02:51
Speaker
Okay, yeah, so the environmental assessments like one of these funny things where it's kind of looking at exposures to chemicals or things within the environment and That combination and starting to work as a geologist for this construction company Gave me my thing. I think my first opportunity to start learning and start applying myself and
00:03:19
Speaker
When it came to the work itself, we were doing environmental remediation. So it was like tanks and groundwater and contamination. And it kind of went well with the masters. The masters was about contamination and it went hand in hand, kind of went nicely together. And I remember one day I'm in the office, getting ready to go out into the field.
00:03:46
Speaker
And our vice president of the company, this is a small little construction company in Queens, you know, full of plumbers and one or two electricians here and there, a couple of laborers. It's a small place, a half union, half not union. And I heard the VP talking to, you know, the owner, the president, and they were chatting about cleaning these tanks, these chemical tanks.
00:04:15
Speaker
And the guy is like, Hey, why don't we just drop this chemical in here? And it'll neutralize everything. Cause the chemical was this corrosive sodium hypochlorite or bleach. Okay. And I stopped and I looked at him and I called him stupid and he looked at me. Yeah. He looked at me and I was like, where did that come from? Cause I'm a pretty,
00:04:37
Speaker
generally quiet guy when it comes to work. I was like, you're gonna kill somebody. You're gonna drop something in there and it's gonna blow it up. And he's like, oh, you know about this stuff? I was like, well, I know enough about that. He's like, oh, okay, can you take care of it? And that was how I thrust randomly into chemicals.
00:04:59
Speaker
and randomly into hazardous materials and within the next week I was out with a few other guys and we went out to clean these chemical tanks. Digiologists was out there inside of a tank with a power washer and a vacuum truck vacuuming out the sodium hypochlorite bleach with power washing with water and
00:05:27
Speaker
The reason I had to go in was because the other two guys is in confined
Advocacy for Worker Safety
00:05:30
Speaker
space. You typically have three folks. One, it was a pretty big guy, so he wasn't getting in the hole. You're the one who fit in the hole, so that's why you went. The other guy had hurt his leg recently, so I don't know if I believe him. Maybe that was a little far-fetched to not get into the hole when I was the young guy. And there I was, cleaning tanks, day in, day out.
00:05:59
Speaker
kind of doing the safety on the side for it as well. Did you even know anything about confined space entry or like any of that before you got in that tank? I knew as much as we knew from the regular hazmat training, which if you're familiar with, and I'm sure you are, but to our viewers that may be less than familiar with it.
00:06:20
Speaker
It's a 40-hour class where you sit in a room and you listen to someone tell you stuff, but you don't actually go out and enter these spaces, right? Sure. Well, for this instance, some of them are more practical hands-on. So no, I had never been in a confined space before I entered that confined space for the first time. I had never worn a level B hazmat suit, the stuff that looks like sci-fi movie material.
00:06:46
Speaker
But here I was jumping in the tank. And at the same time, looking up the health and safety related to it, because our workplace being a small location didn't have a health and safety person really, right? It was basically the employer. And the employer was like, Sure, go ahead, take care of it, you know. So I was managing health and safety kind of unofficially. Kept this title of geologist, even though realistically, I had no longer done anything with geology. And
00:07:17
Speaker
was doing these hazardous material jobs throughout the city. And I decided, you know, I saw so many folks going into these tanks and doing these chemical works in a dangerous manner. A lot of people, not just me, were unsure of how to go about doing that work. Yeah.
00:07:43
Speaker
Uh, I had folks mentioned to me, you know, Oh, it looks like water. And they just jumped right in with a regular suit. You know, well, when, you know, side of hydrochloric can look a little bit, you know, if you look at beach and you pour it out from a distance, maybe in a dark space, it kind of looks like water. Yeah. And stories like that. People wearing the wrong kinds of PPE and getting burned. Uh, it inspired me to actually make my master's thesis about chemical tank cleaners.
00:08:12
Speaker
and about the risk perceptions that they were facing. Interesting. And that was kind of my transition from being so heavy into the environmental sciences to kind of pairing it with the occupational health sciences and looking at it through the lens of a worker and through the people who have to deal with these situations.
00:08:38
Speaker
And it all wrapped around your first-hand experience with it. Yeah, yeah. And I think having that experience at the same time while doing the academics of it helped me out greatly because when I spoke about the health and safety to other folks that I worked with and those that in the academic setting, I had lived it too, right? So you're not going to
00:09:06
Speaker
challenge me in the sense that, hey, you're not, you're this young guy that doesn't know what you're talking about. I've lived through it. I've had the accidents and the injuries and things like that. Yeah, so you came in with street cred right away, even though you were a recent college grad. Yeah, the hard knocks. Yep. That's awesome. So how long did you continue cleaning tanks? And then like, what happened next? Or are you still doing that?
00:09:36
Speaker
I, when I finished up the master's degree, I decided to give the doctor a chance, right? My advisor in my master's program, bless her heart, reached out to me and was like, hey, you know, I think you should consider it. So I applied to a few kind of vaguely public health programs throughout New York City and throughout parts of the country.
00:10:02
Speaker
And they all rejected me. I lacked academic background. I had a lot of work experience, but I think for the sake of academics, it was a bit limited because it came from these environmental sciences. And I was applying for these public health programs. So I had almost given up on it. I was like, man, it's going to clean tanks.
00:10:28
Speaker
And my advisor really pushed me one more time and she was like, you know what? Try for this one university downstate. And I was like, okay, you know what? I'll send out one more application, one last attempt. And I got an in, I got an email from downstate and I was about to accept it on, unfortunately, the very next day my mother passed from cancer. Oh man.
00:10:58
Speaker
Yeah, and it was a difficult time to make a decision of doing a degree, you know, and these other responsibilities. And I had to make a decision kind of quickly. And I sat on it and I sat on it. And I looked at it and it's like, I spent my whole life caring about these issues. You know, I've cared about them for as long as I can remember sciences and health and the environment.
00:11:29
Speaker
And I felt so deeply passionate to address these issues, to care about these issues, and to see so many workers being put into working conditions that were so dangerous and unsafe, I couldn't turn it down. So eventually I decided to take the program. I got in conditionally, because once again, my background was in public health. But it's turned out very well. And I continued to clean tanks and do that chemical work.
00:11:59
Speaker
throughout the early part of the document. So about, I would say the first two years of it, about year four, I was getting up at five o'clock in the morning, heading out to a city job, going into tanks, cleaning them, sweating from head to toe, deconning, you know, around two o'clock, someone will hose me down, decon me.
00:12:27
Speaker
And I'd jump in my car, drive to Brooklyn, take a class from, you know, I would actually take a shower right before class, change off. So I wasn't too much of a mess, you know? Yeah. And I would go into class half a week, go for a few hours. You know, these are very discussionary based classes. The doctorate, I think, was a great opportunity to talk to other people
00:12:54
Speaker
who are like-minded and passionate about these issues, maybe slightly different things, but at the end of the day, passionate about what they were passionate about, and we would have deep discussions, so you had to be awake. You had to be participatory. You couldn't coast in this. You couldn't coast. And I would finish around, you know, get home around eight, nine o'clock, eat some dinner, but then I have to do the schoolwork, you know.
00:13:21
Speaker
or have to do whatever was required. So I'll be up till midnight, one o'clock, still doing it, get a few hours of sleep and repeat over and over for years. Oh my gosh, Eric. How many people do you think, do you think anybody else in your doctoral program had that kind of a schedule going on? I mean, it seems like this would be an
00:13:46
Speaker
I think one of the challenges for many folks who want to do higher academics is that your day-to-day life doesn't stop. When you're an undergrad, maybe you could say, hey, I'm just going to spend, some people are very fortunate and in a great position where they can take those four years to just focus on school. That's your life.
00:14:12
Speaker
I was not in such a position, but the beautiful thing about downstate was that they understood the staff and the students also understood that we were professionals. We had our own responsibilities and we were coming from day jobs or families and other things. So there was an understanding and I think other students also had a high burden of stress and work and they were working as well.
00:14:38
Speaker
My situation was, I think, a bit unique, of course, like everybody else's situation. But it was definitely a difficult, difficult journey, but at the same time, a very important journey, because I learned from those experiences. I'm over there talking about work, but I work, right?
Study on Fentanyl Exposure and Opioid Training
00:15:03
Speaker
And I think that perspective and the challenges really helped me understand and relate later on to people when they discussed the stress or the challenges that they would face, managing life and work, managing families or responsibilities or other things in their day-to-day life that may create that stressful environment and understanding from my own perspective, that stressful environment, as well as the working conditions on and off the job,
00:15:33
Speaker
has helped me greatly in being able to relate and care about these issues, not just as a statistic, but as a person. Right. And what those stresses put on a worker that increases risk as well. It gives you a different lens. Well, I mean, you're within, you know, we're recording in April of 2021, you're within weeks of defending your dissertation, is that it?
00:16:03
Speaker
Yeah, I'm going to defend most likely May 6th. Wish me luck. Everybody was listening. And I was able to finish, I think a lot sooner because around December of 2018, after about two years of that workload, I was like, you know, I need to really focus. I need to really take this risk and truly commit to this. Is this a hobby or is this something that
00:16:33
Speaker
I'm trying to really care about and bring real change. And I ended up taking a huge risk and I quit my job in a very peaceful, loving way. My employer is a great guy and I respect those folks. But I let them understood that I needed to take this risk. I needed to truly commit to this. And I left with no job in sight. Wait.
00:17:01
Speaker
on average folks take a couple of well more years to finish and it was a day to day just looking at my bank account go down week by week and I had one research opportunity at the time and it was to look at the risk perceptions
00:17:24
Speaker
of first responders to fentanyl exposure. Fentanyl is this opioid, it's a drug that is used legally in the hospital to reduce pain, for example, for folks who may have cancer as patches, but it can also be used illegally and illicitly as a misused substance to get high and relieve pain in that manner. And when
00:17:54
Speaker
I was looking at this issue is because at the time, there was a lot of misinformation, a lot of confusion as it relates to how dangerous fentanyl was. And I did a survey with the Christian Reagan Hard Center for Emergency Response Studies at John Jay College.
00:18:16
Speaker
And me and the principal investigator, we published a study, a survey of about 200 folks or so who were first responders in New York state. And we found that there was a number of issues, including many first responders believed that you could use hand sanitizer to clean off the fentanyl, when in reality that led to more absorption. Or so many of them felt that briefly just touching it can kill them, when in fact that wasn't the case.
00:18:46
Speaker
And there was a need to bring about training, bring about better education for first responders as it relates to this issue to reduce the panic and concerns that were misguided in that community. And our study was basically the first of the kind, at least to my knowledge, to do that.
00:19:07
Speaker
And I had done the study for a couple hundred dollars. It was nothing. I needed a field experience for university, as well as an issue that I was really concerned about. And it was a combination to get it done, right? Yeah. As you're watching your bank account go down, you chose a passion project. You chose a passion project that means a lot for a couple hundred dollars. Yeah.
00:19:38
Speaker
the, of course, the account was dwindling week by week, I couldn't sleep. And by chance, I think the director of the worker training program that you had mentioned before, the National Institute of Health's worker training program, Chip Hughes, had read that paper and heard about me through my advisor.
00:20:02
Speaker
And we started talking because at the same time, they were doing work related to fentanyl first responders. And little to my understanding at the time, I was using their information to train myself. They have training tools online to train myself on the subject and prepare myself to deal with this issue. So connecting the dots without even realizing I had connected dots
00:20:26
Speaker
We had started talking little by little over the phone in these group conversations and they were planning on doing and opioids in the workplace prevention and response training program. So in the summer of 2019, CHIP and the NIH had offered me to do sort of like an internship or a fellowship or so to go ahead and
00:20:52
Speaker
As once again, part of that field experience that I needed through the doctorate evaluate that training program. So we went around the country and delivered a training. I believe a former person on your, your podcast, Jonathan Rosen was the instructor of that program. And I evaluated the program to find, you know, what was working, what was not working, how we were addressing stigma and addiction. And.
00:21:21
Speaker
It started off a little rocky. I remember the first session we had was with the Department of Energy. It was down in Hanford, Washington. And a beautiful place, wonderful people. And we were having a little bit of a rocky presentation because at the end of it, some folks had built up some anger towards the idea that opioid use disorder
00:21:50
Speaker
is it is not a disease it is that they felt that it was a lack of willpower sure which in fact opioid use disorder is a disease and it's not a lack of willpower and like any addiction yeah like any addiction and the connection between work and opioid use and a misuse was challenged in that meeting it was the first one it was the first pilot training
00:22:21
Speaker
And we had left a little shaken, you know, we had left a little, a little, a little beaten down because people were challenging you. They were, they were challenging it. They were having a hard time, you know, changing their preconceived notions to stigma and addiction in a six hour class. It was unlikely, right? To change these inherent beliefs that had already come in, in a simple awareness course.
00:22:50
Speaker
We made some adjustments. We emphasized it further. And in later courses, we saw that folks were getting it. They were understanding the addiction and how stigma as well as opioid use disorder as a disease. And one challenge had a lot to do with the fact that the Department of Energy had a very punitive policy, a very zero-tolerance statement because it's federal government.
00:23:18
Speaker
And even though some of those members in the class who would privately come up to me and told me that they were dealing with addiction, they couldn't say it publicly because they would lose their job. They would lose their security clearance and therefore in a sense their job. And they weren't in any position to take any actions, to do anything from the training to deal with the crisis at hand because of that restriction.
00:23:48
Speaker
Yeah. So I mean, that really leaves you in
Balancing Studies and Passion Projects
00:23:51
Speaker
like a precarious position, right? I mean, people are confessing essentially to you and, and maybe it's the first time they've told anybody and they need help. And so what do you do? Yeah, it's a, it's, it's really, it's really something to, to have that happen. And we tried to create that environment where, you know, to be comfortable talking about the uncomfortable. Sounds like you did.
00:24:18
Speaker
And later on we started to see more and more success. We adjusted it. And I was still going to school. I had, you know, we published a report on that doc, excuse me, on that program. And around the same time, even though this was going on and we were, I was learning so much and really feeling truly connected to these issues.
00:24:47
Speaker
I had dwindled down to about a hundred bucks. So I was like, you know, I want to keep doing this. I want to keep being here. Yeah. But I need some money. You know, I kind of have to think about lunch every once in a while. Right. Yeah. Yeah. Yeah. And paying the mortgage and all the other things. Yeah. So I had this. I've been thinking about.
00:25:14
Speaker
leaving at that, you know, finishing once this internship kind of work was done, I'd have to probably go back and do some other kind of work. Right. And I don't know where I got a fellowship award from downstate. It was a couple grand for I guess good grades and some work. And it was the first time they had ever given the award out. And it came
00:25:38
Speaker
It came the same day that I had to pay a bill with the only a hundred dollars that I had left. Oh my gosh. And it was, it saved me. It saved me for, you know, the couple more weeks or so that I needed, uh, to keep going. And around the universe, the universe came together. Yeah. The universe once in a while, it happens. I suppose once in a while, a star aligns here and there. And around the same time, you know, chip WTP had offered me to continue working with them to fund my dissertation.
00:26:08
Speaker
And at that time, I didn't even have a dissertation. I didn't even know how to spell the word. I still don't really know how to spell the word, to be honest. And they wanted me to continue evaluating that program. They organized an instructor course to improve the confidence of those who would go back from the training to deliver training themselves, as well as a leadership program. So the leadership program was to help
00:26:35
Speaker
those who were already in a position of leadership to implement policies and programs as it relates to opioid use in the workplace. Because that pilot program that we ran in the summer of 2019 was focused mainly on rank and file workers, those that may not have been really much in a position to do such actions, and it was geared more on awareness level.
00:26:58
Speaker
So I continued working with them, now funding my dissertation, and now I could, you know, have lunch at once every one. And it paid the bills and such. And I continued doing work with them. I evaluated their training program and still doing it to now, up to this day, looking at the follow-up and seeing what kind of actions folks took from the training, as well as how it's been working.
00:27:26
Speaker
And lo and behold, this thing happened, it's called COVID-19. I don't know if you've heard about it. It happened in the middle of us getting ready to launch the instructor and the leadership course.
00:27:41
Speaker
I was just gonna say like, did you get a chance? Okay, so yeah, please continue. Yeah. And we had meant to do it in person, right? We had meant to do these trainings and evaluations in person. And like much of the world, we had to shift rapidly to an online format. You know, wearing shorts and a nice shirt on your zoom calls.
00:28:08
Speaker
And we continue to deliver the training online. Of course, we met a lot of challenges. A lot of folks were not zoom competent yet. You know, I don't even know if I'm really so zoom competent. Oh, I know. I mean, I think it's just because we switched between so many platforms every day as a new old which one am I on? Yeah. Yeah. And I mean, it sounds like this training that you were doing. I mean, it's
00:28:31
Speaker
I mean, it deals with some pretty intimate topics, right? And so how you get that intimacy, you know, over zoom, when you haven't met people before, it sounds like a challenge. Yeah, in the beginning, that was a real troubling concern. You know, how are we going to have such an intimate discussion about such personal topics?
00:28:56
Speaker
in an environment where you could kind of zone out. You could kind of like click off your little screen. You can have your TV in the background or something. But what we found was when we created this environment to have such discussion that many folks, if not all folks, were in some way, shape, or form.
00:29:19
Speaker
being touched by addiction. And it may not have been just them. It could have been their son, their daughter, their wife, their friend, their coworker, someone in their community. And we were trying to change a lot of hearts there. And I think we really succeeded in getting to that, especially Jonathan as the instructor. And we brought in folks who had that lived experience
00:29:48
Speaker
who could talk about it, who could talk from that place that they were in and may still be in. And that allowed us to have those conversations. And we had an environment that was allowing us to talk in such a way, even though it was via Zoom, even though at the time there was such a lack of social connectedness and a need to adapt our methods under social distancing.
00:30:17
Speaker
we were able to relate. We were able to have these difficult discussions. And I think we went a long way, you know. Now they don't know the results of the six month follow-up because I just finished it, but- Okay. This breaking news? Yeah, this is breaking news for your podcast.
Adapting Training Programs for COVID-19
00:30:35
Speaker
And clearly the pandemic had a lot to do with hurting folks' ability to go out and take some actions because there was a lack of resources and such a focus on that.
00:30:49
Speaker
but many folks were able to go back and do training. Many people were able to take some kind of organizational level actions, those and those in leadership positions. So we found some success that the training program has helped contribute to programs around the country, as well as increasing policies and programs related to opioid use, and injury prevention. So Eric,
00:31:19
Speaker
you know, COVID upended things. Did you have to stop? I mean, obviously you continued of what you were doing. You were just explaining that, but at what point did you have to shift gears and then focus on COVID? I mean, what have you kept going with what you were doing with opioid work with Jonathan? Yeah, so we're continuing to this day, still doing the opioid program. We never let off.
00:31:50
Speaker
And during the time, you know, when everything first happened back in March, 2020, I was pretty much volatile by, by NIH and CHIP to evaluate their COVID program, the, the initial results, those early program results, the training that I know that you and vivid HSI run and
00:32:20
Speaker
I looked at the two main questions that were asked, those evaluation questions as it relates to, you know, the confidence in the program and increasing knowledge. And it was some early results. And I think it had me involved in the COVID discussion, involved in addressing COVID.
00:32:40
Speaker
from a training point level and getting that support to developing and implementing and disseminating these occupational safety and health and infection control worker training programs. But it was on a voluntary basis. It was CHIP in an NIH knowing that they needed to put together an assembly of an army of public health and occupational health science folks to address these issues at a time,
00:33:10
Speaker
they're trying to conduct training under, you know, under a time of crisis. Right. Right. Right. I mean, which is, which is what they specialize in, but not in the way that it's ever been done before, because you couldn't, you couldn't deploy the trainers. Yeah. And I, you know, I've heard them regale stories, uh, of how they've addressed these issues in the past, say 9 11 jumping on the pile, you know,
00:33:34
Speaker
hurricane Katrina going down there in the recovery efforts so in the past it's been so much more hands-on and now being deployed is in a different format you know it's on your phone and on the computer and finding ways to address these issues when you're not in physical touch
00:34:01
Speaker
Do you think that made your evaluation easier or harder? I think it's difficult to compare because it's never happened, right? It's never been in that situation. And that's also the thing with evaluating under these disastrous circumstances is that there is no playbook. There is no
00:34:28
Speaker
Oh, you know what? I'm just going to take this and shave off the title and put a new title. And that's it. No, they're, it's an emerging, rapidly evolving situation that changes day to day. And it needed that flexibility, not just from the response, but the responders on how we evaluate and put together training. Yeah, I mean, yeah, go ahead. Oh, no, continue.
00:34:56
Speaker
I was just thinking that, you know, even your evaluation of the opioid training, um, that you did, I mean, you started in person and you, and you're continuing in a virtual space, you know, so that's, that's, has, you know, must have impacted the way that you evaluate too, you know, kind of like the before enduring and just the delivery, right?
00:35:19
Speaker
Yeah, it was really important that we also look at the delivery of these trainings, right? So from the opioid perspective, part of the evaluation is looking at how that training was delivered. And making sure that the process of which we deliver the training is effective. And generally, we found that it was. The questions that we asked to probe those kind of inquiries found that it was effective.
00:35:48
Speaker
with the limitation that Zoom was not people's favorite option. And now that I am working with the NIH as their program evaluator for COVID-19, we are continuing in that same vein. We're using online methods to look at these program directors as well as institutional and cohort, excuse me, I'll repeat that, consortium leaders.
00:36:18
Speaker
on how they've addressed COVID-19 and how they've put together training programs and how they've looked at addressing not just their own organization, but as well as the community. And this evaluation, I hope can help us understand what lessons we can learn and how we can improve going forward. You know, the COVID-19 training program,
00:36:47
Speaker
was based heavily on the Ebola training program. And having that infectious disease response training situation and program as well as infrastructure gave the worker training program, I think the capacity to rapidly respond to COVID-19. And from what I'm hoping is that we use these lessons that we're learning now.
00:37:15
Speaker
We use these lessons that we are faced right now and the mistakes that people have made throughout this response so that the next time something happens, the next time, because there will be a next time, right? There will always be some issue, not just a pandemic, but there's always a disaster. There's always some kind of crisis.
Impact of COVID-19 on Workplace Dynamics
00:37:37
Speaker
And knowing that we have the ability
00:37:41
Speaker
to produce training under those situations of crisis can help us fight that good fight. Yeah, I mean, it really was.
00:37:52
Speaker
amazing to be just a part of it as I was in the last year to see how people pull together and how all these experts pull together with all the rapidly as everything is changing in real time and everything has to be adjusted message wise on a week to week, month to month basis.
00:38:14
Speaker
Eric, what do you think is next in terms of training with COVID-19? Or do you have a sense of that? I mean, we're not done with this pandemic yet, and we keep learning new things every day. What do you feel is kind of the next iteration of training that we're going to see? So I have, in my opinion, two major
00:38:42
Speaker
focuses, I believe that will come from COVID-19 ongoing. First off, after a response, there's a recovery. And when you look at the connection between substance misuse as well as COVID-19, you can see that there are a lot of people right now who are still suffering from substance use. We're still seeing these upticks in overdose deaths.
00:39:11
Speaker
I don't remember the exact numbers, but I believe back in 2017, it was nearly 130 people a day were dying from these opioid related overdoses. And that number may have only been going up and up, right? Only being up ticking because of the stress and the pain that folks are enduring right now. And I believe we need to focus on people's mental health.
00:39:43
Speaker
And the way that stress and our resiliency to coping with such stress is paramount, not just now, but going on. People are going to need to recover. People have gone through a difficult time and it's our responsibility to be there for them, to understand that this is important to everybody, that there should be no stigma in addressing people's mental health.
00:40:15
Speaker
So true. You know, as we're looking at what we hope is the nearing of the finish line of the pandemic, you know, we hope. I have talked to so many people just in my personal life in the last couple of weeks
00:40:35
Speaker
who are having anxiety about what's next. You know, like anxiety in the sense of returning to whatever is our new normal and kind of walking back into pieces and parts of life that was. And just the anxiety of that.
00:40:55
Speaker
which I don't think we maybe could have anticipated because it would just be like, oh, goody, everything's back. But there's, you know, I'm hearing from people who have great interpretation about it. Yeah, there's going to be a lasting impact.
00:41:13
Speaker
on so many people's mental health and the way they just look at the world, right? The way you look at the world has changed. The way we look at a workplace has changed, right? Look at how many people will no longer see their offices. And is that a good thing? Is that really a good thing? I don't know. Sometimes I wonder, you know, you get to stay home, but being home, is that really,
00:41:42
Speaker
the right thing for you. Maybe in some situations I understand that it could be very helpful, but for a lot of people, work is part of a big part of your life and your community. Work is where you see people most of the time during the day, where you talk to people most of the time during the day, where you learn from other people, where you get a perspective on so much more and
00:42:09
Speaker
to see more and more people gonna continue to be based from home. I'm not sure if that's the right thing. And then we look at so many people who weren't home, who were essential and not them being essential, but their work was essential. And because they did essential work, their work was taken as the predominantly important thing
00:42:39
Speaker
rather than the health of the worker themselves, it almost seemed like we sacrificed worker health for the broader public health. Yeah, for the output. For the meat packer wasn't the main issue, it was the meat. The grocery store worker wasn't the main issue, it was the groceries on the shelf. How do we go back
00:43:10
Speaker
Or really, well, we can't really go back, but how do we go forward remembering that these are people? How do we go forward not labeling work as just the output and not the person? I don't know. I really hope there's been some kind of an awareness to the contribution of human work and what that means.
00:43:41
Speaker
I hope that people are thinking about that in a way that maybe they didn't because they couldn't or didn't have access to it or it just never crossed their mind. You know, like you brought up meat packing and it's an industry that I've worked in and it's an industry that when I was with OSHA I investigated many, many times. And just having been in those facilities, I've never picked up a package of
00:44:11
Speaker
any kind of protein and not thought about the number of hands that had to touch it to get it into my hands, you know? I mean, the luxury of picking up skinless, boneless chicken breast is really a luxury when you, you know, because I can see in my head the number of people in the hands and the machinery that made that possible.
00:44:41
Speaker
to be able to be privileged enough to pick that up and take it home. I agree. And they've been doing this work the whole time. Yeah. And what this situation has really brought forward
00:44:57
Speaker
is that these issues existed before, right? They didn't just pop up. Oh, shucks, Eric. I didn't realize this thing happened. No, we've known many times that we are not prepared for an infectious disease event. We've known that we are not handling substance use the right way. We've known
00:45:18
Speaker
that there are racial inequalities, there are food insecurities, there are housing disparities throughout this country. That isn't a new figure or fact. It's just now that you can't hide from it. It's in your face once it was not in your face and you could avoid it. But the awareness level is on a level that
00:45:42
Speaker
If you don't know it by now, you're never going to know it. That's right. I mean, cause you're literally stepping over it on, you know, like you can't really close your eyes to this. It's everywhere. Yeah.
Safety Concerns in Mass Vaccinations
00:45:52
Speaker
Yeah. Wow. So, so you see the future of a focus and more training on recovery, like you said, um, with mental health and resiliency. Do you see other things coming up? I mean, in your opinion, so was responding to COVID-19 recently, uh,
00:46:13
Speaker
myself and Dr. Amber Mitchell, we were concerned about needle stick injuries. And someone very dear to me, you know, had told me, and she's a nurse, had told me that once she had a needle stick injury, this was, you know, some time ago.
00:46:35
Speaker
And she relegated all the pain, all the uncertainty and the fear that she endured when that happened to her, right? What to do, the risk to our health. And that pain, I could hear it. And when I hear and know that we are about to launch, and we are in the midst of, excuse me, launching,
00:47:04
Speaker
such mass vaccinations and we're continually steadying up our vaccination efforts throughout the country and expanding away from these traditional hospital settings into non-hospital settings, churches and community centers, art of people who are going to give you these injections and these vaccinations, how well are they trained? How safe are they to go about doing this?
00:47:36
Speaker
And we need to not just train the people who are going through this, but give them the safe working conditions to do it. It isn't just for this one moment, one time, we should address their safety. We need to address it all the time. We need underlying health and safety
00:48:02
Speaker
actions, like safe staffing. Right. Right. And we yeah, and we don't ignore the safety piece because we're in an emergency and we need to get as many shots in arms as possible. Because the the casualties will be these people who are doing the vaccinations. You know, and to your point, we are doing emergency training to train people to be these emergency vaccinators.
00:48:31
Speaker
And I know the person who I've had, I've been lucky enough to have one vaccine so far a few weeks ago, and it was at a pharmacy. And the person who gave me my shot, I said, so are you here as a contractor working with a pharmacy or is this your regular job?
00:48:53
Speaker
And she said, this is where I've always worked. I've worked at this pharmacy for seven years. She said, but I'm a pharmacy tech. And I've never given a shop before until I agreed to have this training to do it. And I said, well, how many do you think you've given? And she said, I think I've probably done 500 so far.
00:49:14
Speaker
And then I said, tell me about your training. Cause you know, I'm, this is my job, right, Eric? So I'm asking questions. And so she tells me about the training she has. And then I don't tell her what my background is at all. And I have, you know, cause I'm like, oh, first of all, you don't do that when you're in the safety field when somebody's about to stick a needle and you feel nervous. Right. And, um, and I said, and, and she said, and I have bloodborne pathogen training. I'm like, okay. Okay. Well that's, you know, that's a data point of good news.
00:49:44
Speaker
And then yesterday in my life, I volunteered at a mass vaccination site for my county. And I wasn't doing anything medical related. I was helping, you know, like shuffle people through the system. And they're doing them car side. And I was just watching all those vaccinators in all that unpredictable environment.
00:50:11
Speaker
right, you know, cars of every shape and size with numbers of different kinds of people coming through, where people are putting their, you know, the vaccinators are putting their bodies in different positions to be able to reach people.
00:50:25
Speaker
And, you know, you have an unpredictable, like I saw so many people bringing their dogs with them, you know, like the dog is in the back of the car. And all I'm thinking is like, gosh, you know, this is an unpredictable hazard where a dog might decide to jump, you know, and you've got a needle in your hand. And I absolutely see just from the sheer volume that this is a risk.
00:50:47
Speaker
But then this unpredictable environment that makes it even a greater risk. And I'm wondering, you know, like, what are all these organizations doing to protect people from needle sticks? And do they even have exposure control programs in place, post exposure control programs in place when somebody does get a stick? Yeah. And I think regardless of how robust
Advocacy for Safety and Leadership in Public Health
00:51:13
Speaker
a workplace health and safety program may be. Workers will still get injured if the policies lead to those hazardous conditions, right? And if we want to, I think, achieve safer conditions, one thing we can use and one thing we do in our paper that we address or call to action is to emphasize the hierarchy of controls.
00:51:44
Speaker
And as you know, the hierarchy controls start off with, this sounds like a test right now, I'm saying it out loud, but eliminating and substituting the injury, I mean, excuse me, the hazard to begin with. And for COVID-19, we can't exactly substitute COVID-19 out, right? It's there. It's part of the situation in the site, other than eliminating it through vaccines itself. But to protect the worker,
00:52:10
Speaker
you know we want these engineer controls we want these administrative controls more focused and relying on people the person protective equipment has been such an emphasis on i want the right mask rather than i shouldn't be in the situation where the mask is my last line of defense and what we've done is to emphasize something we call institutional controls an institutional controls
00:52:41
Speaker
we believe sit on top of the hierarchy and controls and it is a way of having full faculty engagement. You know, getting that leadership and management together as well as the staff workers or even the union representation and having everyone share a responsibility rather than focus on placing accountability. And I believe a full fledged effort of everyone working together can allow
00:53:12
Speaker
those in positions that can make the working conditions safe, aware of unsafe conditions. Of course, not every employer listens and not every employer agrees. I remember a couple of days ago, I was getting my hair cut and the barber was telling me about, yeah, yeah, I've opened up a pharmacy with my wife. And I was like, oh, that's great. What?
00:53:41
Speaker
And I was like, that's wonderful. And he was like, yeah, but you know, we're given these vaccinations and the government just wants to take advantage. I don't even think this stuff is real. The virus? Yeah, the virus, the pharmacy owners were telling me that they don't even think it's real. If they're not aware of the issue, or they lacking the empathy to protect the workers and employers,
00:54:11
Speaker
employees. How can we know that those employees and those workers are going to be safe? And at a time right now where our country was seeing such a decline in unionization, one lasting mechanism that I know can really work is getting unions back, getting workers organized, collectively bargaining so that
00:54:39
Speaker
We aren't hit with another disaster and we're wondering, will people do the right thing? We know that the right thing will be done because workers have organized together for the safety and the standards that they deserve. Or we could hope for that emergency standard from OSHA, fingers crossed.
00:55:02
Speaker
Oh, my gosh, right. I don't think my eyes have ever been glued to a website as hard as they have been since March waiting for that emergency temporary standard to come out. And I hope we're not waiting too much longer because we need it. You know, we need it. I've talked to health and safety professionals from around the country who, as, you know, mask mandates are being lifted.
00:55:27
Speaker
by governors, it was there, it was there as their profession, the only hope that they had to leverage for safety and health in some work settings. I mean, many, many employers are doing their best, they're trying their hardest with the information that they have, and they have, you know, their people in mind, and they come from a place of, of caring, and then there are some that don't.
00:55:52
Speaker
And the ones that don't, those health and safety professionals really need that law. And all of us, frankly, could use a roadmap, right? And gosh, I hope that emergency temporary standard provides that. We get it. Yeah, I think it's important to have leadership. That's right. We've had a couple of years where scientific and worker health leadership
00:56:17
Speaker
was either non-existent in some vacuums or so beaten down and attacked that it gave us a watered down version of what it truly should be. And I hope going forward that all the situations that we described in this hour or so highlight to people just how important it is that we move forward
00:56:47
Speaker
in a safer way, because it's not just for, you know, the polar bear in Alaska, or wherever polar bears are, I don't know, Coca Cola bodies. But for, for the future of the way we live and work, it's important. It's important that public health not get attacked, but supported.
Empathy in Public Health Discussions
00:57:14
Speaker
The paper that, or the article rather, that you authored for this journal is titled Needle stick injuries among healthcare workers administering COVID-19 vaccinations in the United States. And Eric, if you'd like, we can include it in the show notes. That'd be great. So people can, people can access it. Yeah. Okay. We'll do that. We'll make sure that it's included in the show notes for people who are listening today, if they want to read about that as well. Yeah.
00:57:43
Speaker
Well, I have really enjoyed talking with you this past hour. Are there other things that you'd like to leave our audience with? Other thoughts before we close out our time today? I would just want to say that you're going to hear, and you've been hearing, so many statistics, so many numbers on paper. Every day on your TV screen, you see
00:58:12
Speaker
whatever it may be, how many people got vaccinated today, how many people have unfortunately passed away or tested positive. You may hear about, you know, so and so many people have unfortunately succumbed to an overdose. You may hear, you know, as we go forward, different kind of issues arise, needle sticks, etc. And I hope that
00:58:36
Speaker
Less and less people view those as numbers, as statistics, and remember that those are people. That those are people who, for every single one of them, is a story. For every single one of them, it's their lives. And it's not just a number, it's a person. And I hope we can continue to think about the way we look at public health in that vein.
00:59:03
Speaker
Beautifully said, Eric. Beautifully said. Thank you. Thank you so much. Soon to be.
00:59:10
Speaker
Dr. Eric Prasad, good luck with your dissertation. Thank you, thank you. Fingers crossed. And thank you all for spending your time listening today. And more importantly, thank you for your contribution toward the common good. Making sure your workers, including your temporary workers, make it home safe every day. If you'd like to join the conversation about this episode or any of our previous episodes, you can follow our page and join the Accidental Safety Pro Community Group on Facebook. If you aren't subscribed yet and want to hear past
00:59:39
Speaker
future episodes, you can subscribe in iTunes, the Apple Podcast app, or any other podcast player you'd like. We'd love it if you could leave a rating and review us on iTunes. It really helps us connect the show with more and more professionals like Eric and Mike. Special thanks to Will Moss, our podcast producer. Until next time, I'll see you soon.