An engineer's wholistic Métis perspective 

He has spent the past two years treading steadfastly into discussions about COVID-19 spreading through aerosol transmission and how to best protect ourselves. His steps into the conversation are guided by his wholistic Métis worldview, his scientific brain, and his people-first perspective. He gives the impression he doesn’t want to point an accusatory finger, but calmly usher differing parties to stand side by side and form a Sharing Circle—an Indigenous tradition.

“The circle is foundationally a flat space in terms of power—no one has a privilege over another, and all people have space to express themselves. Fundamentally, it teaches us to listen to others with our whole selves.” 

Many of the communications surrounding the spread of COVID-19 focus on distancing and wearing masks. These measures, however, while important, are not enough, Oliver says. He directs people to studies showing the virus is airborne (Coleman et al., 2021), meaning it is suspended in the air for a period after being launched from the body via droplets. He says a person with COVID-19 can spread the virus simply by sitting in a room and breathing out aerosols that spread throughout a space like cigarette smoke.

Having studied aerodynamics and how to successfully survive chemical warfare, partially by donning appropriate personal protective equipment, Oliver is surprised most major jurisdictions are not mandating more protection in the form of air filtration and enhanced ventilation, especially in health-care facilities and schools. He implores that N95 masks—or better—should be donned not just by all health-care providers, but universally.

Currently, Alberta Health Services mandates health-care workers wear N95 masks when performing aerosol-generating medical procedures on those with suspected or confirmed acute viral respiratory infections—this includes intubating COVID-19 patients. Schools are using masks and mechanical ventilation to protect students. Oliver thinks we need to do more.

He follows the precautionary principle—take the most effective route to stay safe until new evidence is presented.

He likens it to entering a building suspected to have asbestos particles in the air. The person entering will wear protection until the asbestos is confirmed to be there—or not. “That’s the precautionary principle at work. You put the precautions in place even though you may not fully understand the risk because precautions are going to protect you against further damage.”

Oliver is a trained forensic fire investigator and an electrical forensic engineer, and he spent nine years as a hearing chair on the Appeals Commission for Alberta Workers’ Compensation, learning about the law and performing medical causation assessments. 

“Accident investigation is a very wholistic process, because if you allow yourself to get rabbit-trailed by details, you can very quickly lose the picture of what’s really going on.” He says this is especially common in complex failure modes in which there’s multiple contributing factors that need to be pieced together.

His background in investigation means he has an increased awareness of how a rigid mindset can lead to accidents and flawed decision making. He is especially affected by the cognitive failures in thought he repeatedly recognizes during the management of the COVID-19 spread. He says they mirror the flawed thought processes that caused several significant engineering failures in history, such as the explosion of the space shuttle, Challenger.

When engineers approached management to warn the Challenger’s solid rocket boosters were at high risk of catastrophic failure, their expertise was dismissed. Oliver notes today’s engineers have been disregarded in a similar manner when sharing their expertise in air filtration and ventilation. In lieu of moving forward to find a solution to a problem, the problem brought forth is dismissed, he explains.

“There is other stuff going on in the background leading people to make these very, very flawed decisions not based in reality.”

Oliver explains why randomized, controlled trials—the most respected scientific study according to infection, prevention, and control experts—are not used by engineers. “You don’t need to confirm that gravity exists. We don’t need to build a hundred bridges and let 99 of them fall until we get one that stays up. We understand physics and chemistry well enough and can model reality accurately enough to predict the behaviour of things in the real world, to the extent that buildings don’t collapse, and electrical systems don’t burst into flames.”

He says studies that don’t use randomized, controlled trial methodology are considered low-quality research because evidence-based medicine has its own scale of methodological value. “At the top are randomized control trials, and if you look at where engineering fits on that scale, that hierarchy, we use something called mechanistic studies. Mechanistic studies come second from the bottom of the scale, just above opinion pieces.” 

This means the expertise of specialists, such as ventilation engineers, physicists, aerosol scientists, fluid dynamicists, and aerodynamicists are ignored, solely due to differing methodology. Oliver stresses the same mechanistic studies are used to ensure the wings of the planes we fly in keep us airborne and the buildings we sit in don’t collapse around us.

“There are studies that demonstrate if you give health-care workers N95 masks, the hospital transmission rate drops to zero (MacIntyre & Wang, 2020). These are what I consider really high-quality studies, but infection, prevention, and control specialists are ignoring or downgrading them because they see methodological problems in the way the study was done.” Oliver stresses the adage that science reserves the right to prove itself wrong each day, and in this case, perhaps it is time to circle back and delegate the consideration these studies deserve.

He highlights this gap in deference to specialists in their areas, such as engineers suggesting further ventilation, can be caused by many factors. He cites the likelihood of groups of expertise isolating themselves as a distinct class with distinct ideologies and beliefs as postured by Ludwik Fleck, a 20th century physician, biologist, and philosopher. A profession will build a wall of expertise around itself and surround itself with a secondary wall of people who support it, leaving the public outside—along with other specialists.

“The difference is that engineering is fundamentally interdisciplinary because we very rarely work in groups of one specialization. If you’re working on any project of significance, you will always have people from different professions, different disciplines within the same profession, working alongside you.”

This denial of another perspective or wisdom—what Oliver refers to as the epistemological errors in the way people deal with knowledge—is similar to how colonial systems work. As a proud Métis person, he says it hits him as a proverbial gut-punch. There is a history of trauma in his family tied up in colonial violence that spans more than a century. This is the launchpad of his passion for stepping in to advocate a scientific and person-first perspective in the aerosol-pandemic discussion.

“It’s the same deliberate knowledge blindness that underpins and rationalizes colonial violence. Power always defends power—this is the colonial linkage that I see. There is so much effort now going into doubling down on a dogmatic position.”

Coleman, Kristen K, Douglas Jie Tay, Kai Sen Tan, Sean Wei Ong, The Son Than, Ming Hui Koh, Yi Qing Chin, et al. "Viral Load of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) in Respiratory Aerosols Emitted by Patients with Coronavirus Disease 2019 (Covid-19) While Breathing, Talking, and Singing." Clinical Infectious Diseases, August 6, 2021. https://doi.org/10.1093/cid/ciab691. 

MacIntyre, C Raina and Quanyi Wang. "Physical Distancing, Face Masks, and Eye Protection for Prevention of Covid-19." The Lancet 395, no. 10242 (June 1, 2020): 1950–51. https://doi.org/10.1016/s0140-6736(20)31183-1. 

Links:

• Edmonton Journal: Message shift on airborne transmission of COVID-19 seen as positive—but late
• Alberta Health Services COVID-19 Personal Protective Equipment
• Hierarchy of Evidence Pyramid (Dale Hattis)
• Ludwik Fleck Life and Works