I need you to read this and decide about Coronavirus

Approaching the pandemic with a systems-thinking lens

This article is aimed at CEOs, people who run organisations, events, conferences, communities, or have any sway over the decision-making at these places. I need you to read these selected articles, or the summaries I provide, and use this as a briefing document to decide about what to do to respond adequately to coronavirus, and the shape of that response.

Situation right now

Currently, in the UK, everything seems calm, and life is going on as “business-as-usual”. No schools have closed, transport and travel is continuing as usual, some people are cancelling their holidays and conferences have started to be postponed. But everyday life feels pretty much exactly the same — there are some amusing jokes about the toilet paper running out (wink wink) and a bit of panic buying here and there — but easily dismissed as overzealous preppers getting ready for an imagined apocalypse.

Don’t panic, take responsible action

The last thing I want to do is panic people. Instead, I want to present some pieces of data, opinion and perspective I have found useful in my sense-making and decision-making around precautions, the attitude I am approaching this situation with, the advice I am giving and the places I can exercise my responsibility and leadership.

The tone and care with which we respond to this, matters

This is when systems thinking gets real and out of the boardroom — when your perception of interdependency in real-time will lead to very different systemic effects, with people’s lives on the line. My friend and fellow systems thinker Nora Bateson writes and speaks about the tone of responding to systems change. This is important now.

Ok, so what do I need to know?

(adapted from Coronavirus: Why You Must Act Now):

This is not the flu #1 — fatality rate

This is not just the flu. Flu has a death rate of 0.1%. The World Health Organisation quotes 3.4% as the fatality rate.

This is not the flu #2 — severity of symptoms

An estimated 15–20% of infected individuals suffer from severe symptoms that require medical attention, including pneumonia with shortness of breath and lowered blood oxygen saturation.

Symptoms take delayed time to show up

Symptoms take roughly 2–14 days to show up. The virus spreads before people show symptoms. It is very difficult to predict how many people are actually infected at any given time, giving skewed statistics. Therefore you could very well have the virus and still feel fine, and therefore still think it’s fine to move around, take public transport, go to crowded places.

This virus is highly contagious

With an estimated R0 between 1.4–6.49 (i.e. the number of people a sick person is likely to infect) and a mean estimate of 3.28, SARS-CoV-2 is much more infectious and spreads much faster than the seasonal flu, which has a median R0 of 1.28.

And the virus seems to be most infectious early on (when no symptoms)

New preliminary research, posted Sunday (March 8) to the preprint database medRxiv shows that people seem to shed large quantities of the virus early in their illness and likely become less infectious as the disease wears on. This may hint at why the new virus spreads so easily: many people may be at their most infectious when exhibiting only mild, cold-like symptoms, or none at all. The research has not yet been peer-reviewed and only has 9 study participants, but corroborates with other observations.

We are underestimating the number of people infected

Given the above, this should make sense. But adding to this, factors of human delay, such as — a country not being equipped for testing, not putting adequate testing/detection measures in place, withholding information for worry of political or economic implications… And you have a situation of ‘systems delay’. The same way as when you view the sun, you are seeing light that is actually from 8 minutes in the past, the information we have at any current moment of coronavirus is most likely arriving from days in the past.

The virus spreads in an exponential fashion

Don’t be fooled by low numbers at the start of the curve. The nature of exponential growth is this:

  • Or would you prefer £1 now but I promise to double it every day for 2 weeks.

The UK is at the beginning of the exponential curve

When referencing Italy, a common response has been “oh but that’s just the worst example”. Currently at the time of writing, there are only 456 confirmed cases of Coronavirus in the UK. Italy, a relatively similar sized country was in the same position just 3 weeks ago.

Graph created by Richard D. Bartlett

Countries that prepare can reduce deaths by ten

From studying existing countries and their responses / death rates, we can see the difference in what the number of cases and deaths looks like in a country that responds quickly and with extreme measures compared to those who don’t. From Coronavirus: Why You Must Act Now:

  • Countries that are overwhelmed will have a fatality rate between ~3%-5%

Social distancing will save our healthcare from collapsing

The final important piece of data is that so far only one measure has been effective against the coronavirus: extreme social distancing.

If you are in a position of power, you can act now

The coronavirus could spread with frightening rapidity, overburdening our health-care system and claiming lives, until we adopt serious forms of social distancing.

As well as social distancing, we will need other measures

Most forms of social distancing will be useless if sick people cannot get treated — or afford to stay away from work when they are sick. Therefore at the same time as large scale closures and cancellations, the government should also take some additional steps to improve public health. It should take on the costs of medical treatment for the coronavirus, grant paid sick leave to stricken workers, promise not to deport undocumented immigrants who seek medical help, and invest in a rapid expansion of intensive care facilities.

In Italy (9 days ahead), doctors are having to decide who is worth saving

In Italy, which is a projected 9 days ahead of us, there are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody .The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in the extraordinary circumstances they are facing.

Taking responsibility: don’t panic, do the right thing

Finally, the most important responsibility falls on each of us. It’s hard to change our own behaviour while the government and the leaders of other important institutions send the social cue that we should go on as normal. But we must change our behaviour anyway. If you feel even a little sick, for the love of your neighbour and everyone’s elderly relatives, do not get on a plane, do not go to work, do not go shopping — if you can avoid it, avoid it.

Looking to lessons from history: the Spanish Flu

The influenza epidemic of 1918 infected a quarter of the U.S. population, killing tens of millions of people. Seemingly small choices made the difference between life and death.

A simulation that helps decide when to shut your office

Tomas Pueyo has created a model (direct link to copy). that you can input your metrics into and define a percentage risk you are wiling to take, and find out whether it’s time to shut your office yet or not. It enables you to assess the likely number of cases in your area, the probability that your employees are already infected, how that evolves over time, and how that should tell you whether to remain open.

Stay at home if you can: The Self-Quarantine Manifesto

Taken directly from the https://staythefuckhome.com/ campaign:

  1. Wash your hands often and practice good cough and sneeze etiquette.
  2. Try to touch your face as little as possible, including your mouth, nose, and eyes.
  3. Practice social distancing, no hugs and kisses, no handshakes, no high fives. If you must, use safer alternatives.
  4. Do not attend concerts, stage plays, sporting events, or any other mass entertainment events.
  5. Refrain from visiting museums, exhibitions, movie theaters, night clubs, and other entertainment venues.
  6. Stay away from social gatherings and events, like club meetings, religious services, and private parties.
  7. Reduce your amount of travel to a minimum. Don’t travel long distances if not absolutely necessary.
  8. Do not use public transportation if not absolutely necessary.
  9. If you can work from home, work from home. Urge your employer to allow remote work if needed.
  10. Replace as many social interactions with remote alternatives like phone calls or video chat.
  11. Do not leave your home if not absolutely necessary.

And don’t forget: this is a time to take care of each other

In a state of panic, it’s easy to get myopic and shutdown. Studies have shown the link between stress, anxiety and egocentrism. How do we stay open enough to read the news, to take in the necessary information, without shutting down in a panic or locking out other people from our consideration?

Do not lose heart. We were made for times like these.

You can decide.

References

Coronavirus (COVID-19): Update and Thorough Guidance

Cares about the common good. Building capacity for deep systems change. Complexity & ecosystems obsessive. Experiments for everything. 10 yrs #systemsthinking.

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