Grand Jury Report on Fire Department EMS in Orange County

The recently published document by the Orange County grand jury regarding the deployment and response of resources by Orange County fire departments to emergency medical calls for service is both stunning, and concerning in the inaccuracies, opinions, and falsehoods presented as fact. The determinations made appear to be based on these failures or research, and lead to what may be a pre-ordained belief, without factual support. Because this document rehashes a 2012 effort of a similar matter, I am disturbed by the need for another review that fails to build on the earlier discussion.

Fundamentally, the local fire department deploys resources designed to respond to and to mitigate the unwanted effects of the environment on life, property, and the environment itself. Albert Einstein is quoted as saying that the environment is “everything but me,” referring to himself at the time. Except for specifically law enforcement related matters, unrelated to unwanted fire, this defines the responsibility of fire department emergency response. The two most time sensitive, or emergency responses, include fire suppression and emergency medical/rescue code-three (with lights and siren) response. The fire service is truly a multi-mission operation that serves to address many of the emergency needs of the community. The capability of the local fire department is only limited to the funding and leadership provided by the governing agency decisionmakers.

To fully understand the importance of emergency response it is necessary to carefully consider the concept of time, and the influence of time on the growth of uncontrolled fire and patients in extreme medical conditions i.e., coronary, stroke, blood loss et al. In all these situations the outcome is directly related to timely intervention. The sooner that trained personnel, operating efficiently, arrive at the scene and begin fire suppression or medical treatment the more likely that a desired outcome is probable. There are three components to the total response time of a fire department: call processing time, turnout time, and travel time. The only component that cannot be manipulated to a great extent is travel time as rescue personnel can only travel so fast through the city streets to arrive at the scene of an emergency.

The distribution of fire stations across the land mass of a city like Newport Beach serves to place fire department rescue personnel near potential fires or medical emergencies under static conditions. During times of fire department system stress due to uncontrolled fire i.e., Emerald Bay and Coastal Fire recently, in Orange County and specifically Newport Beach, a rapid and integrated system is employed to shift similar resourced into areas of reduced coverage. This was recently demonstrated and reported to the City Council in a timely fashion by the fire chief regarding the Coastal Fire in Laguna Hills. Rapid intervention serves the people you, and your fire department serve.

Of the two identified time sensitive functions of the fire department, fire suppression and medical/rescue, resource deployment should be considered for the need based on a timely response to the incident, or potential incident. Because the building stock of a community changes slowly over time, the deployment of firefighting resources and staffing at the local firehouse responsible for initial fire suppression efforts should be based on factors related to risk, occupancy type, and travel time to all areas of initial responsibility, or first due for the resources staffed at that firehouse. Earlier intervention of fire should equate a smaller fire that is extinguished faster, requiring fewer total resources from neighboring firehouses. This concept should result in a more efficient operation that has fewer fire stations assigned to a fire and committed to a fire outside the first due area.

Because the community will need the firehouses staffed for fire suppression needs, the use of these same firefighting personnel for emergency medical/rescue response was seen as a wise use of taxpayer funds. The report fails to understand the wisdom of this important concept, and in fact fails to consider this altogether. Fire apparatus, fully equipped to perform all the multi-mission functions, and available 24/7 unless committed to a prior emergency is the gold standard of the business. The idea presented to staff a two-person medic unit in place of a “second” engine at the Laguna Woods firehouse fails to consider the multi-mission functions of a fire station that protects a large hospital, a very busy complex of freeways, and housing with mature residents who will need additional support under emergency circumstances. That Laguna Woods firehouse is staffed in that fashion because it is the busiest firehouse in a densely developed county of over 3 million residents. Drawing broad conclusions based on a limited, and often false understanding, has resulted in a bad recommendation.

I found it unusual that Newport Beach in particular, with a somewhat unique deployment of resources only matched by the City of Orange, was not mentioned in text of this report. This was especially noteworthy as the thesis of the report was focused on resource deployment, city operated ambulance services, and the Orange County Fire Authority (OCFA). The limited investment by the OC grand jury into the research on this important subject only serves to support the idea that the effort was biased from the start and will provide ample information for those intent on diminishing the value of a future OC grand jury report on a similar subject.

Cell Phone Tracking for Dynamic Public Safety Deployment

Based on research, most children will likely have a smart phone by age ten.  Assuming that most people carry their personal phone with them most of the time, this information can be instructive for the purposes of public safety deployment relating to need, surge capacity and deployment of fire, police, emergency medical services (EMS), and lifeguard posting.

The protection of the public is the prime mission of a public safety organization. Therefore, the location of people and the environment in which they live are the focus of the efforts to protect the greater public to the best of its collective ability, with reasonableness and with mindfulness to individual liberty. Recently, advancements in technology and the widespread use of cell phones have proven valuable in the understanding of the daily movement of people. If public safety providers can utilize this technology for the intelligent deployment of limited resources, then greater efficiencies could be realized.

Cellular phone technology is so named because each individual cell phone is linked to the greater system by a series of cellular towers that transmit the data between each other to the destination. These cellular phones are in constant communication with a tower using electromagnetic wavelengths.

Cellular phone providers are tasked with setting up a cellular network to provide coverage for their customers across the country and across the world. Cell phone towers in wide open areas can provide service for up to a 25-mile radius around the tower. However, in congested, dense cities with tall buildings, this requires a large number of cell phone towers that often only cover several city blocks. Large buildings, built from solid materials, unintentionally block cell phone signals, leaving the customer without service. Cell phone providers, therefore, try to cover every block and every direction, to provide smooth cellular coverage to their customers.

Each cell phone tower has a precise location, with latitude and longitude coordinates. A cell phone provider will be able to provide the location of cell phone towers. On top of this, each cell phone tower is comprised of usually three sectors, pointing in different directions, to form a triangle that covers 360 degrees. When a cellular phone connects to a particular cellular tower, the records indicate which sector the cell phone pinged. In other words, if your cell phone pinged off the northeast tower sector, the records will indicate that you were generally in a northeast direction from that cell tower, which narrows down your exact location.

As you move around, and use your phone for various purposes, your movements are creating a record of the usage and your cell phone location. This is captured in what is referred to as a “Call Detail Record” and would be received from the service provider in response to a proper legal subpoena. When your phone attaches and reattaches to different cell towers as you move, it becomes possible to see in which direction your phone is traveling.

In order to more closely pinpoint your location, it is important to understand that a cell tower providing voice and text message service does not also provide data usage. So, if you are receiving text messages throughout your day, and also opening and closing a web browser or a mapping application, you are connected during those times to two different cell towers. Specifically, you are connected to two different sectors on two distinct cell towers. Where those coverage areas overlap, a reasonably good understanding of the city block where you are standing is known.

When you are attempting to use your phone, but there is a lack of signal strength, or you are blocked by a building, your phone remains aware of the closest available cellular tower for the purpose you need service (data or voice/text). The phone will continue to attempt to connect to the closest cell phone tower. The only time your movements and location are not being tracked is when your phone is completely turned off.

Realize that our phones are always operationally on and are constantly using data service to receive our emails, text messages, and calls. Often, we are opening and closing various applications that require data usage. This means that cell phone users are frequently connected to two different cell phone towers. Based on the sectors we connect to, and where those coverage areas overlap, the cell phone company, or a party who has served a subpoena for your call detail records can pinpoint your location closely. This is particularly true in a dense city location, where there are many, low-range cellular towers that cover only a couple of city blocks.

In the middle of a long drive through open and flat terrain, the cell phone towers cover much longer areas, and it is more difficult to pinpoint your location exactly. The call detail record would be able to track, generally, the direction of your travel, and what town you stop in. But, in the city, all of the constantly pinging cell phone towers keep close track of our movements and where we are at any given time.

For the purposes of the dynamic deployment of lifeguard personnel, using anonymized cell phone location data can be utilized in the intelligent understanding of when (time of day) and where (lifeguard tower) to deploy lifeguard rescue personnel. The mobile deployment of water rescue personnel in a patrol vehicle is done during periods of low numbers of beach visitors and few people in the open water, or when posted at a tower when beach occupancy rates dictate more water watchers in a stationary location (tower) to observe and pre-empt trouble.

Consider that available anonymized cellular phone location data technology can reliably be used to determine how many people visited the beaches, and the locations from where they came on any given day of the year. Additionally, using this data, managers can more precisely predict how temperature, holidays, weekends, school activities, economic environments and political influences affect the incidence of beach visitation, water rescues, preemptive actions, etcetera. Previous attempts to understand visitor counts were not scientific, and probably not as accurate as needed to achieve the desired efficiencies.

Utilizing anonymized cellular phone location data, and potentially leveraging artificial intelligence, the authorities having jurisdiction (AHJ) can move from the anecdotal to a reliable predictive operation. This is likely to have multiple levels of benefit in the administrative and operational domain, something that senior managers can use to more precisely devote limited tax resources. Less total staffing hours can lead to reduced personnel staffing dollars, less exposure to ultraviolet sun exposure for the employees, lower workers compensation claims, and most importantly, a potentially greater save rate for water rescue victims.

For the fire service, the situation is both static and dynamic. Fire protection, by nature, involves maintaining a capability to suppress fire in the developed and undeveloped environment based on a reasonable standard as determined by the AHJ. Understanding how fire may threaten life in a specific AHJ environment is instructive on where (distribution) and how many (concentration) of statically deployed (fire station) resources are staffed over the geographical landscape. Travel time is the uncontrollable metric in the total response time (TRT) three-part standard of call processing time, turnout time, travel time. Remember that while many calls for service may originate from the local fire station, the fire company is available nearly 24/7/365 and when the alarm is sounded all assigned units are obligated to respond without delay. So, travel time from the fire station matters and operationally indicate that the location of the facility should be in the middle of the initial service area, or first due. Cellular location data in this metric may not provide as much assistance beyond long range planning for the location of future fixed facilities like a fire station.

For the dynamic location of EMS companies, the anonymized cellular phone location data could be exceptionally valuable for the efficient deployment of ambulances and paramedic units. During a normally functioning economy, most people move during daylight hours toward their employment site in the morning (0600-0900) and back to their home at night (1600-1900). The traffic patterns of vehicles, subway systems and other modes of transportation reflect the dramatic movement of people during the normal workday. By analyzing these figures, EMS managers can forward deploy prehospital care resources to a location that will provide optimal travel time access to a patient. This could include staging an ambulance near a freeway on-ramp in the morning and late afternoon hours, and near any event that could expect large gatherings of people for commercial events and a civic rally.

Police protection is a much more complicated component in the discussion of dynamic deployment of resources. Because of the myriad of differing state and federal laws involving law enforcement access to anonymized cellular phone location data, it is important to limit data to that which does not involve personally identifiable information. Law enforcement is a closely scrutinized service that involves significant regulation and oversight by local, state and federal authorities. Much of the business of police work involves observation, response, intervention and investigation. The ability to enhance the efficiency and performance of law enforcement officers by police managers may include the use of anonymized cellular phone location data for the deployment of patrol, foot beat and special assignment personnel.

The deployment of law enforcement resources and personnel is dynamic, as deployed police officers are usually on patrol in a marked/unmarked vehicle or on foot/horseback. By understanding what motivates non-residents to travel into a community, the police managers can utilize the information provided in the anonymized cellular phone location data for predictive solutions to crime suppression, traffic control and management challenges.



Modifications to the Medical Priority Dispatch System in the age of COVID-19

The Medical Priority Dispatch System (MPDS), sometimes referred to as the Advanced Medical Priority Dispatch System (AMPDS) is a call taking system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and pre-arrival instructions. Priority Dispatch Corporation is licensed to design and publish MPDS and its various products, with research supported by the International Academy of Emergency Medical Dispatch (IAEMD). Priority Dispatch Corporation, in conjunction with the International Academies of Emergency Dispatch, have also produced similar systems for Police (Police Priority Dispatch System, PPDS) and Fire (Fire Priority Dispatch System, FPDS).

MPDS was developed by Jeff Clawson from 1976 to 1979 prior to his medical school training. Clawson designed a set of standardized protocols to triage patients via phone and reduce call processing time and create efficiencies in the emergency medical system (EMS) response. Protocols were first alphabetized by chief complaint that included key questions to be asked the call taker, give pre-arrival instructions to the reporting party, and to assign the proper resources to the request for EMS assistance.  

MPDS begins with a call-taker dispatcher asking the reporting party key questions. These questions allow the EMS dispatchers to categorize the call by chief complaint and to establish a determinant level ranging from “A” (minor) to “E” (immediately life-threatening) relating to the severity of the patient’s suspected condition. The phone information is used to accurately assign resources to the incident scene and the proper code of response i.e., red lights and siren. The MPDS also uses the determinant O which may be a referral to another service or other situation that may not actually require an ambulance response.

In 2020 the spread and concern of COVID-19 had caused a dramatic change in the procedures used by pre-hospital personnel in an effort to minimize risk following known, and unknown exposure to a patient with COVID-19. In an effort to minimize exposure on all EMS pre-hospital care patients many delivery systems are limiting the previously standard number of personnel arriving at the scene that physically interact with the patient. Further techniques including moving the patient from a confined space environment to the outdoors, and greater use of a higher level of PPE are practiced in an effort to minimize exposure. 

Each of these efforts, including additional questioning may benefit the hopeful outcome of reduced exposure. However, I believe that technology can provide additional benefit utilizing anonymized cell phone location data (“pings”) based on occupancy types that speak to the number of people per square foot, amount of linger time, and pathway crowding. This data could be used to better understand where people congregate and what methods could be used to leverage this data in an effort to minimize exposure to COVID-19.  

Information on person per square foot, time spent on location, activity during linger time i.e., sweating at a gym, seated at a church, could be used to more clearly identify potential location dangers of biological hazardous previously not well understood. This information will provide dividends in a healthy work environment, potentially higher morale, and overall healthy workforce, potentially saving resource dollars for other preventative needs.  

Locations and occupancies of potential “super-spreader” environments learned prior to arrival at the scene may reduce call to patient contact time as EMS response personnel can be fully and appropriately dressed in personal protective equipment (PPE) upon arrival at the scene. This data could lead to other modifications to EMS response not able to be understood today due to the lack of available data. 

Due to the heavy burden of workers’ compensation claims for federal, state and local government related to COVID-19, and the likelihood of additional biological challenges in the future, the potential benefit of leveraging anonymized cellular phone location data into the MPDS for responder safety and public health is highly valuable. 

My COVID-19 Antibody Testing Experience

The Novel Coronavirus disease has impacted the country at all levels of society, influencing and perhaps exacerbating beliefs about the value of science, importance of government, and the public’s appetite for risk. Because so much of everyday people’s understanding of the science of disease progression, and COVID-19 in particular, is not well understood by the population at large, each day new information is learned that shapes and/or fortifies earlier held feelings. And because of the availability of information that has not been vetted is written and published on an hourly basis, it may be difficult for the everyday American to carefully consider all of the important nuances in each article or news segment.

Like many others I was interested in learning if I had been exposed to COVID-19 earlier this year. I had been sick with a significant respiratory illness about the time of when the virus is reported to have first arrived in California. Because I regularly provide assistance to elderly relatives, I felt motivated to understand what my potential was for contracting and transmitting the disease. Early information indicated that the availability of testing was limited and that available COVID-19 tests would be reserved for those workers whose employment regularly interfaced with infected individuals.

With the passage of time I learned of a number of locations around Orange County, California that had COVID-19 testing capabilities. It was important that I establish baseline to learn if I had been exposed to COVID-19 to an extent that I had developed antibodies. During one of my limited trips to the supermarket I saw a sign that advertised “Instant COVID-19 antibody testing now available.” I made an appointment for the next day at 0800 when the emergency care facility opened for business that day.

When scheduling an appointment, I was pre-screened online by answering questions about why I wanted the COVID-19 test and if I believed I had been exposed. I was able to obtain the first appointment for the following morning, and upon arrival was surprised to find that I was the only customer at the facility. Because of the prominent sign advertising the availability of such a test, and the limited availability of testing, I had expected greater interest. I walked into the local emergency care facility, followed the written instructions pertaining to disease spread, and made contact with the medical receptionist. The process was efficient and involved a very limited amount of contact. I had worn an N95 face mask that I’ve had for months and the only other potential for transmission was the paper I handed to the receptionist. All of the billing questions and associated HIPPA questions were managed previously via online.

After about ten minutes, I was invited into a treatment room where I was met by a lab technician. The room looked exceptionally clean and the technician was professional. He looked for a site to draw blood and choose to use my left antecubital vein. Using and alcohol swab, proper site preparation and a small needle the technician drew a small sample of blood rapidly. When I asked about the anecdotal figures for those COVID-19 tests he noted that many of the tests were negative, specifically for Orange County. Without elaboration he seemed to indicate that the outcomes were different in other areas.

The testing that was performed was an immunoassay for suspected disease caused by the 2019 novel coronavirus, rapid SARS CoV 2 IgG + IgM Ab, QL IA serum or plasma. To the best of my understanding, this testing process attempts to determine if I have the antibodies following exposure to COVID-19. The test is designed to find antibodies for both near term, such as the last two weeks from the time of the blood draw (IgM), to long term (IgG). The sensitivity and specificity of the assay were not presented.

After about 15 minutes, I was given my result: my test was negative for COVID-19 antibodies, meaning that I was not exposed to the virus if this test proves accurate. The cost was $70.00.

This benefit of this exercise is that it forms a baseline for my exposure moving forward. Assuming I use the same cellular phone I would be able to track my movements and find when/where I am exposed in the future, if that happens. Other technological values that I do not fully understand may be used to follow my movements that could be used in the future to determine a when/where/who of a possible/suspected exposure. My experience illustrates the value of public testing and how this can be used to manage the risk regarding COVID-19 and the reopening timeline specific to state and local government.

On Communication: Words Have Meaning

A standard by which we as a society communicate and function is through a common understanding of language. This is especially important when operating at an emergency scene, in the expenditures of public funds, in matters of employment, and legal issues. How senior managers prepare themselves and their organizations for all of these challenges prior to expected and unexpected events will likely factor into a desireable outcome. 

The words we choose to use in oral and written communication can be used by others when evaluating our inner thoughts, beliefs, and feelings. The effective use of language is important when trying to convey understanding and attempting to influence others. This is illustrated by many of the historic speeches and writings of Prime Minister Winston Churchill, Activist Mahatma Gandhi, President John F. Kennedy, et al during times of crisis. When language is used properly to advance a noble cause good people will follow the leader, whether for an instant emergency incident, a crisis event or a chronic challenge that can only be managed to mitigate damage. 

The media by which modern society gathers, records, and documents our individual communication has changed rapidly in the 21st century and this has proven to be somewhat of a double-edged sword.  Because of the advancement of recording technology, the concept of private communication is no longer assured.  Images and edited recordings of audio and video can be manipulated so as to advance an idea without complete context. The use of advanced monitoring devices such as laser microphones, directional microphones, and highly advanced camera systems can capture information without the knowledge of the subject. This not only eliminates private conversations and actions but leaves out the context of prior understandings between communicators. 

In the business environment individuals should be aware of their communication styles and make every effort to be as effective and respectful as possible while still maintaining fidelity to the mission.  Common words specific to a discipline can sometimes shortened into an acronym, and are commonly seen in military, public safety, and healthcare applications.  Any acronym that may be construed to have an unintended negative meaning should be avoided, as the unintended consequences may prove to be a distraction from the organizational mission. 

Recognizing that people have individual personalities, and that these characteristics may surface in a comfortable work environment is critical for the supervisor or manager of any business. The workplace can be a controlled environment, to some degree, and the people who are authorized to manage that environment are responsible that to the extent possible the workplace is free from many forms of discrimination.  How those in charge care for the individual freedoms, limitations, and corrective actions employed will have significant influence on the morale and productive behavior of the workforce.  

Individual business disciplines involve varying levels of education, and the level of education can influence the size of the commonly used vocabulary. If the intent is to effectively communicate information in a workplace environment, it will be important to use words in the language that will be understood by the receiver. The objective is to achieve a desired result, and when multiple minds develop a common understanding the likely of success is enhanced. 

To add emphasis, foul language may be used in oral communication, most notably in military and public safety environments. This may be due to the inherent nature of timeliness of a needed action so as to prevent injury or death commonly found in those professions. While this may be uncomfortable for someone reviewing a body camera recording involving a subject and a police officer, it can be argued that it is used to achieve a successful outcome in critical use-of-force activities.  The Los Angeles Police Department (LAPD) argues for the use of “tactical language” when dealing with potentially violent subjects as a method to emphasize the seriousness of the officer during critical situations. 

Law enforcement officers operate in an environment where, at virtually anytime, a potential need to report critical information via radio for officer safety exists at virtually all times when on patrol. This speaks to the need to be exceptionally brief when possible.  The use of ten-code radio communication, intended to add brevity and covertness to the verbal communication, is not universal nationwide and can lead to a misunderstanding

Fire departments also routinely operate in in an uncontrolled workplace environment and under stressful conditions. Because most emergency calls for service for a fire service organization are “consequence mitigation/management” in nature a timely, efficient and competent response is mandatory. Much of this involves oral communication on the incident scene is between the individual(s) performing scene management, supervision, tasks and resource dispatchers.  Because this communication can be over portable radio only the most important information is spoken via radio during the emergency phase of an incident. 

In degrees of ascending importance, radio traffic can be described as routine, priority, and emergency, and it is necessary to recognize how to properly and efficiently communicate on the channel/frequency.  “Emergency traffic” via tactical radio channel is reserved for communication limited to information involving the immediate life safety of a firefighter; “priority traffic” is radio communication reserved for important information about the direction of critical tactical activity on the incident scene; and all other radio traffic is designated as “routine traffic.” 

When writing in the business environment on a work computer or device, it is important to limit the communication to that which is accurate, proper, fair and fact based.  Any electronic communications involving specific subject matter may be open to discovery in a claim and the employee/supervisor/manager will want to be seen as professional as possible.  Interpersonal communication between employees and the proper supervision of the healthiness of the workplace communication is a supervisory and management priority. How the supervisor handles her/his subordinates and understanding when to engage and at what level to engage will determine the success of those charged with this duty.  The volume and tenor of your voice, the environment chosen to have a discussion, and the perceived fairness and adherence to stated policy are important factors in these critical discussions. Modeling proper communication techniques is very important, as the standard is established by the supervisor. Giving license to subordinates by behaving contrary to the established organizational policy can lead to failure

Public Safety Officer Response Best Practices in The Age of COVID-19

Due to the highly contagious nature and potentially deadly outcome of exposure to COVID-19, and the need for first responders to adequately serve the public, modifications to the standard emergency response practices need to be designed and implemented by those charged with public protection. The purpose of a streamlined procedure is to ensure that all task and tactical operations achieve the intended benefits of a competent emergency response agency and provide adequate protection for the employees as well as those they serve.  

Because the public safety community has not experienced such a catastrophic event as the COVID-19 pandemic, a model of best practices does not currently exist on the numerous issues relating to the specifics of this disease including contagion, protection and prevention.  Further issues related to the management of labor contracts, treatment guidelines, and psychological issues outside of the normal business of daily emergency management serve to add to the complexity of a workable solution.  

For the purposes of this article I refer to first responders as those whose employment is designated as a safety member by the State of California. Specifically, I will speak to peace officers, police officers, firefighters and ocean lifeguards. These employees constitute the lion’s share of those public safety members who respond to emergencies for service via 911 call or other notification avenue. Privately employed security, emergency medical service (EMS) or other initial emergency responder may benefit from this information as well.  

The understanding and nature of Novel COVID-19 virus is developing rapidly on a daily basis. Each new understanding serves to challenge previously known information and can influence the belief of the public and first response personnel that officials charged with public safety are sufficiently able to meet the demand. The larger legal, economic, and policy issues will be determined over a spectrum of time but the procedures related to emergency response and protection of the public should be focused on all of the safety related components. This includes call taking at the public safety answering point (PSAP), resource assignment, and tactical operations when arriving at the scene as well as patient treatment and transport to a hospital or other care facility.

Time, Distance, Shielding 

The primary consideration of public safety operations is force protection. This is consistent with the need to have a functional force capable of performing their sworn duty to protect the public. It does not suggest that first responders will not enter into harm’s way to take a calculated risk to protect a victim from harm. There is a tenet in the hazardous materials response discipline that applies to virtually all aspects of emergency response management. Time, distance, and shielding speaks to the three components of protection to be employed when dealing with a substance, or situation of known/unknown nature that could pose a health hazard to the public or responders. 

The concept of time seeks to address the influence of time of exposure to activities that are, or could be, hazardous to human health. The more time a first responder is exposed to the hazard the greater the chances of harm to that rescuer.  

For firefighters the concept of time is intended to limit how long of an exposure to toxic hazardous chemical substances, or poisonous biological agents in the immediately dangerous to life & health (IDLH) environment. For a lifeguard it could include operating a water rescue in open water at night, subsurface activities, or high surf rescue operations. In law enforcement it may include a felony car stop, high risk felony search warrant, or domestic violence response for service.  

Distance refers to the distance between the hazard and the rescuer. A firefighter may increase the distance from a hazardous chemical fire liberating toxic smoke, or simply increase the distance from the radiant heat from a structure fire to limit injury. A lifeguard may modify open water rescue tactics away from the surf line and choose to place a victim into a rescue boat off-shore to avoid the challenge of dragging a victim through heavy surf.  A police officer, when faced with overwhelming human force may add distance between criminal subjects to buy time to consider alternative solutions.  

Shielding speaks to the personal protective equipment (PPE) used and provided by an employer for the purpose of protecting the wearer from the damaging effects of a specific insult. This can be as simple as a helmet to provide some form of protection to the head, gloves providing protecting to the hand(s), boots to protect the feet, etc… Firefighters wear structural protective coats and pants for thermal protection from fire, law enforcement officers don ballistic vests to provide protection from bullets projectiles, and knife attacks, and lifeguards use a personal flotation device (PFD) to help them stay afloat in open water. 

Whatever the discipline it is likely that all first responders will come into contact with people during the course and scope of their work. It is also believed that some degree of these people will be carriers of COVID-19, and some will be symptomatic and others asymptomatic. Because we believe this disease to be highly contagious significant procedures, behaviors, and policies will need to be trained, practiced, and enforced for the safety of the public and first responders. 

Recent information indicates that a significant number of people are silent carriers of COVID-19 and because of this all patients will need to be treated as a potential carrier. Further, awareness on how to disinfect the protein involved in the virus should be understood by all first responders so that efficient and effective measures are developed and learned properly by those who are expected to have public contact. Additionally, the life expectancy of the virus in all mediums that first responders are expected to operate should be known and understood so that the confidence of the health & safety of the force is well established. 

Standard behaviors when operating in a confined space should recognize that the COVID-19 virus can stay atomized in an unventilated environment for hours.  Because of this EMS care providers should take measures that would either minimize exposure time in that environment or remove the patient to a more controlled environment such as the outdoors or inside an ambulance where the air is constantly changed. 

The treatment of a patient often involves intimate contact that enhances the potential for human-to-human transmission. Because of this distance becomes impossible for the patient woman/man. However, other EMS care providers can support the person providing treatment and still maintain six feet of distance. The use of a single EMS care provider entering a home so that the entire pre-hospital medical crew is not potentially exposed may hold promise, but fails to account for the realities of where all emergency medical calls occur and a stair-step approach should be considered so as to ensure adequate scene safety for responders.  

Providing proper PPE, and the consistent use of adequate protective equipment on each EMS call will be necessary to prevent the transfer of the COVID-19 virus from a known, or unknown patient. This is the only shield that we currently have to prevent human-to-human transfer via personal contact. Because the protection of the force of first responders is paramount to the safety employee these measures are necessary in the near term until effective anti-viral, vaccines, and other solutions are developed for common use.  

Why Marine Fire Fighting in California Matters

Historically, the incidence of fires aboard vessels near the coastline in California has been low, comparatively, to the total call for service volume of local fire service delivery. The irregular level of activity may have contributed to this false sense of security for firefighters charged with marine firefighting responsibility. Many local jurisdictions outside of California in the US have taken significant action to develop sophisticated program for the training of land-based firefighters in marine firefighting following the withdrawal of active mission support by the US Coast Guard in the 1980s. The failure of State Fire Training (SFT) to design and develop a modern curriculum for land-based firefighters to properly fight fires in the marine environment, and the implications of such following the seminal event involving the Santa Cruz/Conception dive boat fire suggest this can no longer be tolerated.

The fire service has historically accepted many duties involving disciplines outside of firefighting, perhaps due to the geographical distribution of fire stations across the landscape. This distribution permits a reduces travel time of trained people to the scene of an emergency following notification. Some of these duties are more recognizable such as emergency medical service (EMS), hazardous materials response (Haz-Mat) and perhaps Urban Search & Rescue (US&R). Other response activities are less known to the public, such as rope rescue, ice rescue, et al. Other duties such as Search & Rescue are a primary duty of law enforcement. Each of these common emergency activities are often accomplished by the fire service but are sometimes done by agencies, both public and private, outside of the fire service. This is understandable given that when a member of the public makes a request for emergency service a timely response from the authority having jurisdiction (AHJ) is expected.

The development of firefighting training in California is the express duty of SFT, a division of the Office of the State Fire Marshal. Nature abhors a vacuum, and due to the failure of SFT to develop a comprehensive program for firefighting in the marine environment other disciplines have filled the gap with a marine firefighting program not approved by SFT and not developed by firefighters in what is one of the most dangerous of firefighting activities.

The US Constitution provides the states police power that enables each state the authority to provide for the health and safety of the public. In California the AHJ is given the explicit control of how this is accomplished in emergency situations under the Emergency Services Act. Further, each jurisdiction along the coastline in California extends a three mile boundary beyond the mean high tide line into the ocean or other open water such as a bay. This authority cannot be abdicated unless expressly done so by the AHJ. The duty and responsibility of a fire service agency along the California coast extends into the open water for three miles from the shore.

California law under the Harbors & Navigations code mandates that the local sheriff’s department maintain capability to provide aid and assistance to persons in the coastal waters, but does not provide for firefighting. This suggests that each local government agency along the coastline in California has a responsibility to the public to maintain some plan for marine firefighting within the three mile coastal zone.

California Occupational Health and Safety (Cal OSHA) stipulates that, in the workplace, workers must be provided with proper training and protective equipment for dangerous duties. The marine environment and vessel firefighting are unique as compared to land structural firefighting activities as there are numerous challenges found in the marine environment not found on land, i.e., confined space, redundant electrical systems, rotating mass below the waterline, large quantities of fuel, limited fire prevention regulations, et al. Taken in total is it clear that firefighting fire on a vessel away from the shore provides many challenges not found on land. Because land-based firefighters will provide the workers to fight a fire in the marine environment, and the lack of a SFT approved plan to train these firefighters currently exists, it is foreseeable that a Santa Cruz/Conception dive boat incident proximal to the coast would be devastating for the fire service as well as any victims.

I have been championing the idea that SFT develop a curriculum for firefighting in the marine environment for land-based firefighters for ten years. I ask that you schedule this idea for discussion at the Statewide Training Education and Advisory Committee (STEAC) as soon as reasonably possible so as to properly address this gap in the training of firefighters in the protection of the public.

A Need For Better Marine Fire Training

Although the Santa Cruz/Conception boat fire event likely progressed more rapidly than could have been mitigated due to a host of facts, this tragedy serves as a clarion call to governmental leaders for enhancements to the fire defensive posture by local/state government in California and State Fire Training/State Fire Marshal to develop a modern training curriculum for marine firefighting. This could be used as a platform for agencies tasked with legitimate jurisdictional authority for marine firefighting duties to begin to deploy adequate and capable resources needed for vessel fires so as to properly protect human life.

There are many governmental agencies that may hold authority regarding the design and standards of fire prevention relative to vessel construction. Any enhancements to the fire prevention leg of the protection of human life on the water is not likely to be realized in the near term. Recognize that a vessel inherently contains many of the firefighting challenges found on land, but all in the same space. A combustible building construction, confined space hazards, redundant electrical systems and filled with combustible and flammable liquids further complicate the firefighting operations challenge. When combined with high occupancy, limited routes of egress and no early warning audible alert the potential for disaster increases. 

The development of a standardized curriculum for marine firefighting in California is another critical leg in any plan to protect the public from the negative consequences of fire in a vessel on the water. The problem is that currently there is no curriculum developed or approved by California State Fire Training (SFT) for marine firefighting. However, a substandard curriculum was developed for marine firefighting by the California Department of Boating & Waterways, since relegated to a division of a parks agency, for this mission. The issue is that the aforementioned curriculum was designed by non-firefighters and is taught by persons unlikely to have experience in the subject.  Finally, under the Injury, Illness & Prevention program regarding training for employees involved in dangerous aspects of job tasks, there is a gap in what training is available in marine firefighting for any employee involved in such a practice.

Throughout the State of California there are a number of natural and man-made environments where large bodies of water meet the land and provide an opportunity for the harboring of a vessel on the water. This water environment becomes a more challenging firefighting activity when the structure is a vessel in water and not accessible to land based firefighters. This challenge is further complicated by the confluence of hazards contained in a vessel as well as boarding and the movement of waterborne craft in open water.  Other issues involve certifications from agencies outside of the fire service in the operation of a vessel, authority, jurisdiction and radio/communication issues.  The lack of a combined arms approach of law, fire, lifeguard add to the challenge.

The recent Santa Cruz/Conception dive boat fire/mass casualty incident speaks to the potential for known hazards found on board a vessel on the water. While this disaster was likely beyond what even a nearby fireboat could have mitigated a similar situation could be predicted near shore where an aggressive interior fire attack would be necessary for a favorable outcome.