It’s time for a thread about Swiss cheese and COVID. Are you ready?
1/n

So, there is a lot (I mean A LOT) of advice out there about preventing spread of COVID, from hand washing & masking, to distancing & glory holes. We are asked to keep small cohorts, order our groceries & stay in touch with loved ones in new & novel ways (masked sex anyone?)
2/n

And I get it - so many things to do HOW CAN WE DO THEM ALL??? I mean, I am a champion multi-tasker, but this involves a new set of behaviours and gear and friends and... fuck it, I’m tired just thinking about it. Give me the one thing that’s going to save us. I’ll do that.
3/n

But here’s the thing about public health approaches - those things that protect a population - they are not just one thing. Oh no, no, no. It’s a bunch of stuff that we do which work together to give us the best chance.
4/n

I worked in patient safety for almost a decade & one thing we talk about a lot is James Reason’s Swiss Cheese model. Yes, it’s debated, but it works for this purpose. Trust me.

You can learn more about it using the Google Machine, but it looks something like this:
5/n

Basically, each layer is a different thing we do to prevent harm from reaching someone. The layers have holes, like delicious Swiss Cheese. None of them provide 100% protection, but the more you stack together, the better chance you have that the holes will never line up.
6/n

And, if the holes never line up, the incident or harm won’t get through. (Ok, my patient safety friends are going to start “well, actually”ing me, so I am going to move on. )
7/n

Let’s get back to COVID. Every recommendation that comes from a public health source, be it the AB @CMOH_Alberta, the Federal @CPHO_Canada or the @WHO, acts like a layer of Swiss cheese.

This is hilarious if you think of the WHO. I’ll give you a moment...
8/n

All of these Swiss cheese layers - hand washing, distancing, masking, cohorting, sanitizing, no-touching-facing & glory holes (yep, there they are again) - are different ways to prevent the spread. In a perfect world, we line them up & no one gets sick.
9/n

But the world isn’t perfect. There are lots of places where we can’t expect that they will all happen. We might have to remove some of the layers if it’s just not possible. However, there are still other ones there and, hopefully, their holes don’t line up.
10/n

(Ok, I can here the glory hole/sex mask joke there, but I AM A PROFESSIONAL!)
/n

In our imperfect world where safety relies on human behaviour, it is hard to hear that there is no silver bullet. It’s hard that there isn’t a single fix to this pandemic. And, with a government like the one in Alberta, it’s easy to be pissed off.
11/n

We can’t expect that every layer will be up every time - please remember that public health aims to tackle problems from various angles so that we never have to rely on only one tool in the tool box.

(Again, I hear the joke here, but I’m going to let someone else make it.)
12/n

The cool thing about self determination is that you (mostly) get to decide which layers work for you. I urge you to do as many as you can WHEN you can, but I’m a socialist.

And I prefer Gouda.

-fin/n