Risky Thinking https://www.riskythinking.com/ 2021-06-23T00:00:00Z https://www.riskythinking.com/assets/risky/favicon32x32-d78fce088a2848616bf81daeebb779bfc340892ce260f78f3f10fb25598fe797.png © Risky Thinking (Albion Research Ltd.) Michael Z. Bell Why Covid and efficiency makes for long queues https://www.riskythinking.com/articles/covid-efficiency-and-queues 2021-06-23T00:00:00Z 2021-06-23T00:00:00Z You've probably spent too much of your life in a queue. Covid-19 has made things worse. Could it be because the system is too efficient? Weird people waiting in a queue

An anecdote told to me by a university lecturer has frequently proved useful in anticipating events.

In the days when these things were still new and incredibly expensive, a large utility company bought a highly specialized laser printer to print their bills. This printer was truly impressive, not only printing five million invoices each month, but folding each invoice and placing it in an envelope. This process was much, much faster than any other system available. But it was expensive, so they could only afford one. It could print an invoice for each of the company's five million customers each month with a day to spare.

Things went well for a while.  A whole room of clerks and mail sorters used by the previous system was no longer necessary. 

But one day it failed. A part broke. It took a week for the replacement part to arrive and the mailing system to start working again. 

The question the lecturer asked was this: how long did it take for the system to return to issuing bills on time, and as a result of the delays, how much did the outage cost?

Your arithmetic here will obviously depend upon your assumptions about the size of the average bill and commercial interest rates, but one thing should stand out: it will take years not months for the system to return to billing customers on time. 

This is a common problem when systems evolve (or are designed) which operate at or near capacity: a disruption leads to queue growth, and if the system is "too efficient" , the backlog will never be cleared. The disruptions may be caused by random fluctuations in the rate of new jobs arriving in the queue (think cashiers in a bank, public transit, and hospital waiting lists), or they may be caused by major unexpected events. 

Covid-19 is one such major event. There are a lot of queues in the world, and many of them have been disrupted. A few examples spring to mind:

  • Non-urgent medical treatment. Italian authorities warned early on about the risks of shutting down non-essential treatments following their own experiences. It didn't seem to help: the cry everywhere was to prioritize Covid-19 treatment and shut down non-essential services, leaving extended delays and people who will die waiting for diagnosis and treatment.
  • Driving license road tests. These are labor intensive (one examiner per student). Nobody likes the idea of driving test examiners having much spare time during normal operations: a consequence is that when there is a disruption, new examiners will need to be hired and trained. There's not a pool of unemployed driving examiners just waiting for the call. 
  • Semiconductor manufacture. The car industry has had to shut down production lines or stockpile partly-finished vehicles. This appears to have been a result of not placing regular orders due to an expected downturn, combined with a rapid increase in queue length due to competition from other industries needing semiconductors. (Note that this isn't just due to Covid. There have been fires affecting production as well as major power outages too.)
  • Container transport. There are major delays in shipping containers into some US ports due to congestion, containers are not where they are needed, and shipping rates and times have increased as a result. There are also serious delays on exports from China due to Covid disruptions, and even a suggestion of increased US inflation due to the problems.

All these long disrupted queues interact with each other. The pandemic hasn't finished, but even when it does, expect the effects to linger for a long time afterwards.

There are two key lessons here:

  • Just because something urgent and important is happening doesn't mean that everything else should be halted or ignored. (In a business continuity plan we often add a senior management team whose job is to continue running day to day activities to emphasize this point). It may be difficult or impossible to catch up afterwards.

  • If you design a system (or a system has evolved) where equipment or facilities are being used near 100% capacity, anticipate that any disruption will produce delays for extended periods. Remember that the system may not be your own, but that of a supplier, a logistics company, or some other part of your supply chain.

It's efficient to have resources operating at 100% capacity. But when time is of the essence, it's pretty risky too.

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The Great SSL Certificate Expiry of 2020 (and how I fixed my email) https://www.riskythinking.com/articles/great-ssl-certificate-expiry-of-2020 2020-06-01T00:00:00Z 2020-06-01T00:00:00Z Did you experience any internet connectivity problems on 30 May 2020? Perhaps you, like me, were hit by the Great SSL Certificate Expiry of 2020...

On 30th May 2020, shortly after 10:38 UTC, the email app on my phone stopped working, with a cryptic warning that the SSL certificate being used had expired.

Naturally I contacted my email service provider. How could they let such a terrible thing happen?

They checked, assured me their SSL certificate was in good order, but had it re-issued just in case.

I waited. It still didn't work. So I phoned them again. They promised to escalate the problem to the next level of support, and after a while the error message on my phone changed. Instead of an expired certificate it was reporting an untrusted root. I cursed their incompetence, but then I discovered that the email client on another machine was now working. So this was something specific to my Android phone.

Finally I lucked upon this article Fixing the Breakage from the AddTrust External CA Root Expiration which explained what had gone wrong.

The SSL certificate used by my email provider was signed by a certificate provider whose certificates were in turn signed by the root certificate authority "AddTrust AB", whose certificate was recognized as a trusted root by my phone. Unfortunately this trusted root's certificate expired on 30 May 10:30:48 UTC. My email app detected this, and reported (in a confusing manner) that the mail provider's certificate had expired.

The idea in SSL is that critical things get signed by a certificate to show that they have not been tampered with. This certificate in turn gets signed by another certificate (to show it is genuine), and this repeats until you arrive at a certificate which you implicitly trust. In practice, there are hundreds of certificate signing authorities you need to implicitly trust (each country has several), and your phone or other device has a built in list of which certificates it trusts.

The problem now was that after the email provider's fix, it still didn't work. My Android phone is quite old, and hasn't had any updates for a couple of years. As a consequence, my email app didn't know about the new-ish root certificate which my email provider was now using, and therefore the secure connection still failed. I was worried at this point that I might need to buy a new phone.

But fortunately that was not the case.

I used the Comodo SSL checker tool, giving the tool the hostname and port which my email program connected to. (e.g. mail.example.com:465) This showed the certificate chain from my email provider, and showed that the email SSL certificate was now signed by COMODO RSA Domain Validation Secure Server CA. After more searching, I found a place where Comodo certificates could be downloaded buried deeply in the support section of Comodo's website.

This gave me a number of certificates to choose from, many or which were already pre-expired!

So finally (skipping a lot of paths which led nowhere):

  1. I downloaded the ".crt" file for COMODO RSA Domain Validation Secure Server CA (which expires on 11 February 2029) onto my Android device.
  2. I also added the".crt" file for Comodo RSA Certification Authority certificate.
  3. I dismissed the warning on my phone that somebody could intercept my communications because I had manually added trusted certificates.

And my email started working again… or at least start working until 2029, when the new certificate expires.

On my phone I had the opportunity to manually installl additional trusted certificates. But what about all the poor orphaned IoT devices out there?

Judging by the number of certificates expiring in 2038, everything then will fall apart then.

If we all get that far.

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Covid-19: The Mask Dilemma https://www.riskythinking.com/articles/covid-19-mask-dilemma 2020-04-28T00:00:00Z 2020-04-28T00:00:00Z Should everybody be advised to wear masks to prevent the transmission of Covid-19? It's not just a matter of whether masks work. There is something else you need to consider.

What are the types of mask?

First of all, lets recognize that when people talk about masks to prevent the transmission of Covid-19 they are not all talking about the same thing. There are two main types of mask:

  1. N95 masks. These were originally designed for industrial use, but were later adopted for medical use. These are tight-fitting masks designed to stop the inhalation of most particles. (Depending upon the national standard used, these may also be referred to as KN95 or FFP2 masks). There is a saying about wearing them: if it's comfortable, you are wearing it wrong.
  2. Surgical masks. These are the loose-fitting type you typically see in TV hospital dramas when the surgeon is performing a life-saving operation. These have two functions: (a) to reduce the chance of the surgeon infecting the patient by breathing out infectious particles, (b) to protect the surgeon from blood or other bodily fluids spurting into their nose or mouth.

There are also Surgical N95 masks (which pass both the approval tests for N95 and for surgical masks), and industrial N95 masks with relief valves where the user breathes out through an unfiltered valve for easier breathing — not something that's a good idea for preventing infection. (3M has a useful information sheet on their range of masks and their intended use.)

So if you see someone wearing a surgical mask you should thank them for doing something which primarily protects you from infection, if they are wearing an N95 mask it should help you both, but if they are wearing the industrial type N95-type mask with a relief valve on the side they are only thinking of themselves.

Concerns with masks

Masks obviously do something, but there are some concerns:

  • Masks are only designed to stop larger droplets. The virus responsible for Covid-`9 is small enough that it could penetrate a mask, although most transmission is believed to be by respiratory droplets >5µm. (The 95 refers to the percentage of particles of size 0.3 µm that will be filtered.)
  • Medical tests on mask efficacy have typically been performed on influenza viruses, a different pathogen with a different size.
  • It's easy to wear masks wrongly, or take them off in a way that will infect the wearer. (Yes, medical staff actually get trained how to put then on and how to take them off correctly).
  • When used for protection against a biological hazard, the mask must be discarded or sterilized after use.
  • Covid-19 can stay on face masks for up to a week.
  • Initially it was thought likely that if someone was asymptomatic, they were not infectious, although there was no evidence for or against this.

So it's entirely legitimate to point out that masks aren't perfect, are of unknown efficacy, and may give mask users a false sense of security. In addition at the time advice was being given they weren't definitely known to be necessary unless you had symptoms of Covid-19, or were likely to come into contact with people who have symptoms of Covid-19.

But if the objective is to just reduce the Effective Reproduction Rate (R) of the virus — to flatten the curve, not to reduce transmission to zero, surely if everybody wears a mask it will help? Even if some people will wear their masks incorrectly and get infected as a result, that doesn't mean all people will or that those who wear a mask incorrectly will be worse off than if they hadn't worn a mask at all.

Where's the dilemma?

So why not just apply the precautionary principal and advise everybody to wear masks?

To understand the ambiguous and changeable advice governments have been giving, I think you have to look not just at whether wearing masks reduces virus transmission (they clearly do), but also look at the possible effects of the advice itself.

If the government advises everybody to wear a mask, what happens?

  • First, everybody rushes out to buy masks.
  • Normally only health care professionals and people in hazardous workplaces buy masks. The mask industry is sized for this level of demand.
  • Initially there won't be enough masks around, so prices will go up.
  • In a market economy, masks go to those willing to pay the most for them. This isn't (unfortunately) health care providers, workers in hazardous workplaces, workers in care homes, and other people who clearly have the greatest need. It is the countries and people with the most money, and those trying to speculate on the rise in the price of masks.
  • Eventually, production will increase. New companies will start making masks, and, in a competitive market, prices will fall to a level representing the cost of production plus a reasonable profit.

The key word here is eventually. How long will this be?

In 2016, the South China Morning Post estimated world production of masks (type not specified) as 25 million masks per day.

If we assume 20% off the people in the work need on average just one mask a day, then production needs to increase to about 1.4 billion masks / day. That's a fifty fold increase in world production. That's a big increase in production.

If you are not familiar with production and logistics, imagine the difference between inviting six friends to dinner and inviting 300 friends to dinner: you can't just increase the amount of groceries you buy and spend a bit longer in the kitchen. You will need to build a temporary kitchen, bulk order foods from butchers and bakers, arrange transport, hire extra chefs, install extra toilets, and so on.

It's the same with scaling up manufacturing.

You can't just ask a few people to work longer. It's setting up and training people to work on new production lines, sourcing new equipment, sourcing new suppliers, and so on. One of the key materials in masks is a melt-blown non-woven fabric. There's a limited number of suppliers, with limited capacity. It needs custom equipment for production. So once all the existing production lines are running full out, and it will take some time before capacity can be increased.

By February 2020, China had managed to increase production by a factor of twelve to 116 million masks per day, but that was still insufficient to meet world demand. In March, they exported almost 4 billion masks. At the same time the price on the open market for melt-blown non-woven fabric went from US$2,825 / tonne to US$70,000 / tonne.

So issuing advice for the general population to wear masks::

  • reduces the effective reproduction rate by an unknown amount (assuming a significant number of masks are available),
  • creates shortages of masks where are they are most needed,
  • increases the price of masks significantly, making them less affordable for those who need them to look after patients,
  • creates panic among those who cannot afford or cannot get masks,
  • and may raise questions about the recommendation due to a lack of scientific evidence.

So what is the solution?

It's a tricky dilemma. Advising general mask wearing makes things better for some, but much worse for others.

I think concern about the consequences described above explains the official recommendations that masks were only needed by people in high risk of coming into contact with Covid-19 patients and the patients themselves. As production of masks increased, and as more people wore masks tanyway, the downside of advising against their general use began to disappear.

I cannot say if concern about the unintended consequences of a sudden demand for masks was the reason behind the suggestions that masks were unnecessary and would not help. However, I can say that this is the only rational reason I can think of not to recommendation that everybody should wear masks, and that the reasons offered for not recommending mask wearing did little for anyone's future credibility.

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How to Watch a Pandemic https://www.riskythinking.com/articles/how-to-watch-a-pandemic 2020-03-26T00:00:00Z 2020-03-26T00:00:00Z Covid-19 is now a pandemic. How can you assess what is going on, what it means for you, and update your own business continuity and pandemic plans as a result?

Why Watch a Pandemic

Before we look at how to watch a pandemic, let's look at the why. Why should you watch a pandemic?

There are two major reasons:

  1. To predict what things are likely to happen and how and when they will impact your business.
  2. To determine what measures it may make sense for your business to take and when it will make sense to take them.

Remember, it's always best to learn from other people's ideas and mistakes, so we need to watch what happens elsewhere and try to learn from it.

First let's remind ourselves of some basic terminology:

  • An epidemic is the rapid spread of infectious disease to a large number of people in a given population in a period of time. Control measures may confine a disease outbreak to a limited area.
  • A pandemic is the rapid spread of an infectious disease to a large number of people in multiple areas (e.g. many continents). The 1918 influenza virus, which is thought have originated in the USA and spread throughout almost every part of the world, is a classic example of a major pandemic.
  • A disease becomes endemic if it reaches a steady state. That is, it stays within a population and the number of cases remains stable from year to year. Chickenpox and seasonal flu are both endemic diseases: cases occur from year to year, but the number of cases remains stable.

So when we hear the first reports of an infectious disease somewhere in the world, initially we will always hear about an outbreak or an epidemic. If the disease begins to spread worldwide, it will turn into a pandemic. Unless the disease is totally eliminated, it will end up as endemic in the population.

What impact an infectious disease will have on you, and what governments will do to try and control the spread of the disease, depends on the disease itself. So what do you need to know about the disease?

Watching The Disease…

Even if we are not epidemiologists, we can get some idea of how easy it will be to contain a disease and the likely steps authorities will take by looking at the answers to some simple questions about the disease. Although the questions may be simple, the initial answers will be very uncertain, so it's important to recognize that answers will change over time.

Is it a Virus or a Bacteria?

Bacteria are relatively large and complex, single cell organisms, which can reproduce on their own. Some bacteria are "good" bacteria (they supply essential nutrients or perform other functions for their host), but others can cause serious illnesses. Because of their complexity, bacteria are often susceptible to antibiotics.

Viruses are much smaller, and consist of a protein coating and a core of genetic material. Viruses can only survive and reproduce by attaching themselves to cells in a host organism. There is no equivalent to antibiotic for viruses. The main means of defense are vaccines, which stimulate the host to create defenses against a weakened or inert form of the virus. But vaccines take a long time to develop, and it's not possible to develop an effective vaccine against a virus that hasn't been seen yet. For a novel virus, expect a delay of at least a year before a vaccine becomes available. Vaccines also require extensive safety testing, since they are given to otherwise healthy people. A further problem in some countries is that manufacturers are reluctant to produce vaccines: if people get sick after receiving a vaccine they often believe the vaccine caused the sickness. This in turn leads to lawsuits, and the risk of juries awarding large amounts of damages based on dubious evidence can make producing a vaccine a loss-making proposition.

How is the Disease Transmitted?

The diseases which travel most quickly through society are typically passed through aerosol droplets when you breathe, speak, sneeze, or cough. Depending upon their size, the droplets can hang in still air for a considerable period of time, and depending upon the nature of the disease, the droplets may remain infectious on hard surfaces for hours or days. (More absorbent surfaces may dry out and damage the bacteria or virus in a slightly shorter period). Other easier-to-disrupt mechanisms include contact or exchange with body fluids, the oral-fecal route, and so on.

How easily is it transmitted?

The number used to measure this number in epidemiology is known as the Basic Reproduction Number (or R0 or R nought or R zero) which is the expected number of cases generated in a population which has no immunity to the disease by one infected person. The higher the number, the more rapid the spread in a vulnerable population. Some estimated numbers for well known diseases gives an idea of how a new outbreak compares. These numbers are taken from Wikipedia:

Disease Transmission Mechanism R0
Measles Airborne Droplets 12
Smallpox Airborne Droplets 3.5 - 6
Whooping Cough (Pertussis) Airborne Droplets 5.5
HIV/AIDS Body Fluids 2
SARS Airborne Droplets 2 - 5
Covid-19 Airborne Droplets 1.4 - 3.9
Influenza (Seasonal) Airborne Droplets 0.9 - 2
Ebola (2014) Body fluids 1.5 - 2.5

If the R0 number is below 1, then the disease can be expected to die out on its own. The higher the number the quicker it will spread through a population until most members of the population become immune. Without a vaccine, the only way of controlling the spread of a disease is by changing peoples' behavior so that they come into less contact with each other. The higher the basic reproduction rate, the more drastic behavior changes that may be required. When these measures are taken, the number becomes the Effective Reproduction Number (R). If this can be reduced to one or near one, the epidemic will progress slowly without overwhelming health services.

What are the symptoms and when do they appear?

People won't normally seek medical help until symptoms appear. If the symptoms can be confused with a cold or seasonal flu, people may simply stay at home in bed and (in the West) watch Netflix or read a book. The people who will be recognized as having the disease early on will only be those who had symptoms serious and distinct enough to seek medical attention.

The key terms to watch for in reports are:

  • the incubation period — the delay between a person being infected and showing symptoms,
  • the latent period — the delay between a person being infected and being able to infect others,
  • the infectious period — the length of time an infected person is infectious to others.

With SARS, the incubation period and the latent period were similar, making it easier to quarantine those infected.

With Covid-19 the latent period is four to five days shorter than the incubation period (and some infectious people never show symptoms). This makes the virus much harder to control because you need to ask people to change their behavior or introduce quarantine measures even if there is no evidence that they are sick.

How Serious is the disease?

Much emphasis is often placed on the Case Fatality Rate (CFR). This is the proportion of people who are diagnosed with a disease who subsequently die from it. Death is obviously not a great outcome, so it's worth comparing diseases to get an idea of where a new disease fits. Remember that this number is based upon available treatments, not what happens if the disease is left untreated.

Once again, Wikipedia can provide some good comparisons:

Disease Treated? CFR
Ebola No 83 - 90%
AIDS / HIV No 80 - 90%
Smallpox Unvaccinated 30%
SARS Yes 11%
Covid-19 Yes 4.1%
Influenza (1918) Yes 2.5%
Influenza (Typical) Yes <0.1%

But the Case Fatality Rate does not tell the full story. It only measures death, and does not take account of the resources required to keep people alive.

With a serious disease we also need to look at:

  • What percentage of cases require hospitalization? [Covid-19: 20%] How long for? [Covid-19: weeks]
  • What percentage of cases require an intensive care unit bed? [Covid-19: 4%]
  • What percentage of cases (for a disease with respiratory effects) require a ventilator?

These determine whether a health system is going to have sufficient resources to treat all cases. If the trained staff, hospital beds, or specialized equipment aren't available, then a proportion of cases are not going to be treated, and the Case Fatality Rate will rise as available resources become overwhelmed. The epidemic may also cause deaths of other patients who cannot be treated because medical resources are not available.

There are also two questions to ask about recovered patients:

  1. Are there any lasting effects of the disease?
    Some disease cause permanent damage to a proportion of patients (e.g. reduced lung capacity, disability). Significant lung damage was still found in recovered SARS patients 15 years later.
  2. Can patients be infected twice?
    Most diseases offer some degree of immunity to future infection, but some diseases mutate rapidly and an infection offers very limited future immunity. If having a disease does not give long term immunity, then an epidemic may recur in the future.

Where to Find Current Information

When an epidemic breaks out, it's important to use reliable sources of information. New diseases lead to rumor and fear-mongering. The best English language places to look for reliable information are:

The WHO site is generally the best starting point. Organizations reporting to a single government can unfortunately be tainted by political motives.

Watching the Disease — Summary

Looking at the Basic Reproduction Rate, the method of transmission, the symptoms, the Case Fatality Rate, and the treatment requirements for a new infectious disease will give us some indication of how likely a disease is to be contained, how serious the disease is, what methods can be used to control an outbreak, and the likelihood of an outbreak becoming an epidemic or a pandemic.

Watching The Official Figures…

Testing for exposure to an infectious disease can be expensive, both economically and politically. Early questions to ask are:

  • Is there a reliable test to determine if people have the disease?
  • Is there a reliable test to determine if people have been exposed to the disease? (An antibody test)
  • Are the tests available?
  • Are the tests expensive?
  • Do the tests take a long period of time to perform?

With the Covid-19 outbreak, the genome of the virus was sequenced quickly, and tests for the presence of the virus followed soon after. These tests required complex equipment to perform, took several hours to complete, and in most places testing facilities were in limited supply. These tests only tells if someone is infectious, and are thus helpful in determining treatment options. Rather too much emphasis has been placed on these tests in the absence of any others.

Antibody tests determine if a person had been exposed to the disease and is now immune. These tests make it possible to track the disease's progress, determine the percentage of the population still vulnerable to the virus, and identify those immune to the virus who can return safely to work. Antibody tests also work from a small blood sample, and can typically be completed cheaply in minutes rather than in batch operations which take several hours.

Without both types of testing readily available, political agendas will often affect what is measured, how it is measured, and how the results are presented. Health organizations suffering from resource constraints will also restrict testing to certain groups of the population, resulting in highly skewed figures. So we need to be very wary when interpreting figures such as confirmed cases (which will be zero if a country does not do any tests), and deaths (which may only be being counted if the patient was actually tested).

For example, during the first months of the Covid-19 outbreak our local government only tested people with symptoms who had traveled abroad, or had been in contact with people who had already been diagnosed as having the Covid-19 virus. This made sense. But they then happily announced that there was no evidence of community transmission, even though their testing policy effectively eliminated gathering of any evidence of community transmission. Subsequently they changed their story to report that there might already be dozens, hundreds, or even a thousand cases they didn't know about.

When looking at official figures, also be very aware of the delays involved. Known cases depend upon transmission days earlier, deaths and recovery rates may be based upon patients diagnosed weeks earlier. If you want to be your own epidemiologist, make sure you know how to allow for testing practices, delays, growth rates, and uncertain figures in your calculations.

Watching Governments…

Responsible governments will, if they are able, take measures to mitigate the effects of an infectious disease on their citizens. However, the actions they take will be restricted by both economic and political cost.

If we look at what other governments do, we can get an idea of what our own government may do. We will also get an idea of what will happen at various points in the supply chains we are part of and which may therefore affect our business, even if the disease never affects us directly. It's also very revealing looking at what governments have tried with previous infectious disease outbreaks, and any plans they may have published for SARS and pandemic influenza in previous years.

Government actions can be divided into two phases:

  • Containment. In this phase actions are taken intended to eliminate the disease or to keep it confine it to a small number of people.
  • Delay. In this phase actions are taken to limit the peak effects of the outbreak. If everybody is sick at the same time, this will overwhelm health services, close down industries, and have a major impact on the availability of essential goods and services. However, if the impact of the disease is spread out, health services may not be as overwhelmed and essential goods and services can continue to be provided. This is currently being referred to as flattening the curve.

When looking at other government actions, try to determine what phase they believe they are in, and try to identify any novel actions they are trying that could be tried elsewhere. Successful ideas and strategies are likely to be copied if they are believed to be feasible.

Containment Phase

During this phase efforts are made to limit the disease to a particular area in the hope of eventually eliminating it. Actions often taken at this time include:

  • Tracing possible contacts of an infected person, and placing them in quarantine.
  • Testing of travelers from affected areas.
  • Preventing travel to and from infected areas. (Note that this is often done even though it's not a World Health Organization recommendation; travelers just choose alternative routes and are harder check when entering or leaving an area).
  • Education campaigns to encourage healthy behavior (e.g. hand washing)
  • Local shutdown of events and places where large numbers of people gather.

Delay Phase

If containment is unsuccessful, then the government's concern is to limit the ability of the disease to overwhelm health services and shut down essential services. Actions at this time typically include:

  • Close larger places where people will be near each other and may pass the disease. This includes sporting events, concerts, conferences, cinemas, theatres, pubs, restaurants, etc.
  • Restrict all international travel for non-residents.
  • Close smaller places where people might meet unless they are deemed essential.
  • Require anyone who has symptoms of the disease to stay home.
  • Encourage people to stay away from each other. (Most airborne droplets travel about 6 feet or 2 metres, further with coughing and sneezing).
  • Ask or require people to stay home if possible.

Or a government could try something else entirely…

The UK government's initial response to the Covid-19 virus was to try to develop "herd immunity" by allowing over 60% of the population (35 million) to become infected by the virus and therefore become immune. This, the public were assured, would prevent future annual outbreaks. Fotunately researchers at Imperial College in London calculated that this approach also meant that the health system would be overwhelmed and might result in 510,000 deaths. Shortly afterwards, the response was changed to the "delay" approach adopted by most other countries…

At the time of writing, the Trump administration is arguing that the number of suicides produced by an economic slowdown caused by the government attempting to slow the disease's progress is worse than the number of deaths caused by Covid-19 overloading the health system, and that therefore lifting most restrictions is justified. The lieutenant governor of Texas, Dan Patrick, has also argued that old people would be happy to die miserably for the good of the United States economy. It remains to be seen whether US policy will change from a "delay" response based on these arguments. Juhana Leinonen (@JuhanaIF) tweet cleverly illustrates this American version of the Trolley Problem.

Watching Businesses…

If you watch what businesses are trying in affected areas, their ideas can help in your own pandemic planning. Things we've observed businesses doing include:

  • Communicating with staff, and reminding them of basic hygiene measures (hand-washing, etc.)
  • Banning staff international travel
  • Restricting or eliminating outside visitors
  • Banning in-person meetings
  • Special procedures for staff returning from affected areas, or just returning from abroad.
  • Changing sick-pay policies to encourage sick hourly-paid staff to stay home.
  • Increased cleaning of shared areas and common surfaces to try and limit at work spread of the disease.
  • Reminders to staff of the importance of hand-washing, covering your mouth with your elbow if you cough or sneeze, etc.
  • Making hand sanitizers readily available in the workplace.
  • Supplying protective gear or using protective barriers for staff at higher risk of infection.
  • Visibly cleaning surfaces used by customers between each use (e.g. supermarket trolleys)
  • Communicating with customers to reassure them about the company's continued operations.
  • Introducing practices which minimize in-person customer contact.
  • Tooling up production for alternative products.
  • Switching to delivery only and shutting down retail locations.
  • Shutting down non-essential operations to protect staff.
  • Shutting down operations because of lack of demand.
  • Expanding operations or setting up new production lines due to increased demand.

Watching People…

It's easy to assume that it's just governments and businesses making all the decisions. But people react according to what they hear and know too. What are people doing in other countries, and will they do similar things in other places? Although there may be major cultural differences, people share the basic needs to protect their families and themselves, and to preserve their own livelihood. People in different societies may, however, be more or less interested in acting for the common good.

  • Are people complying with government requests or ignoring them? If they are ignoring requests, what types of request are they ignoring?
  • What are people buying or not buying? Are they panic buying and hoarding? Are they stopping buying other goods and services. Their behavior may not be entirely rational: why do people stock up on certain items like toilet paper? Why do they stop buying Corona beer?
  • What are people doing and not doing? Even without government regulation, fear of infection results in changes in where people go and what they do.
  • Are people still reporting for work, or are staff refusing to work if a colleague is sick?
  • What is being done to raise people's morale? Is it working?
  • Is the additional stress on the population lead to xenophobia? Racism? Discrimination against segments of society?
  • Are people being laid off in large numbers? How will this affect demand for your goods and services?

Watching Your Supply Chain…

Very few businesses are truly independent: they either depend upon a supply chain or are part of another businesses's supply chain. It's important, therefore, to understand not just what the effects may be on your own business, but what effects it might have on your suppliers and customers.

To watch your supply chain, you need to know:

  • Who are your suppliers, and where are they? What about your supplier's suppliers?
  • Who are your purchasers and where are they? Who do they sell to?
  • What effects are government restrictions and market changes likely to have on the supply chains you are part of?
  • Will suppliers shut down?
  • Will buyers continue buying?

Watching Market Consequences…

Government, business, and personal actions may have severe economic consequences:

  • Companies forced to shut down by government restrictions or by rapidly falling demand may lay off staff or go bankrupt.
  • Employees who are laid off may have difficulty finding alternative employment, and stop buying non-essential items.
  • Laid off employees may be unable to meet debt obligations, and go bankrupt.
  • Companies that supply other companies will in turn shut down.
  • Companies that sold non-essential items to the laid-off employees will in turn shut down.
  • Lenders may become reluctant to lend because of the higher risk of default.

The effect may be a major economic collapse. This is one of the reasons governments may be reluctant or late reacting to a possible pandemic, and may introduce economic measures to prop up individuals or selected industries.

Update Your Pandemic Plan

You do have a plan by now, don't you? You didn't just ignore H1N1 Flu (2009), SARS (2002), and Ebola (2013), did you? If not, you have some strategic thinking to do about how you monitor emerging threats.

With what you have seen going on elsewhere, you should now be constantly reviewing and updating your plan with what you have learned.

Some basic questions you might want to ask about your plan include:

  • Which parts of the plan ever been tested or are testable, even with a desktop exercise?
  • Have any technical assumptions been tested? Is it really possible for part of the workforce to work from home using the existing technical infrastructure?
  • Does the plan define what is going to be done and under what conditions actions are going to be taken?
  • Does the plan prioritize the safety of workers and customers?
  • Does the plan relax or change sickness policies so that sick workers do not have an incentive to work while sick?
  • Do actions in the the plan have appropriate approvals and budgets so that they can it be put into action with minimal delay?
  • Does the plan address any effects on production if some workers become sick? (These may be particularly onerous for sterile production facilities.)
  • Does the address likely economic effects? If not, who is responsible for addressing these?
  • Does the plan define any end points when temporary measures will be stopped?
  • When a new normal is established, how will the plan be updated with any lessons learned?

And Finally…

The future is always uncertain. We can never know exactly what will happen. There are limits to what we can plan for and the budgets we have available. But, even within those limits, we can improve our planning and response if we watch carefully and intelligently what is going on elsewhere.

Please don't trust any numbers I've given here. By the time you have read this, numbers related to Covid-19 will be out of date, and numbers for other diseases may have been updated. Refer to Wikipedia for older disease information, and the World Health Organization for the current Covid-19 outbreak.

Stay safe and good luck.

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Don't Panic - Plan! The 2019 Novel Coronavirus (2019-nCoV) Outbreak https://www.riskythinking.com/articles/2019-ncov-novel-coronavirus-bcp 2020-02-02T00:00:00Z 2020-02-02T00:00:00Z I'm not going to say much about the coronavirus outbreak: it's just too early to guess what will happen. Will China's lockdown be effective? Will this virus mutate and die out like SARS? Or will it cause havoc everywhere? We can't answer these questions yet. But we can do one thing... Getting Reliable Information

Beware of press reports which are often more interested in getting you to watch the news than presenting balanced reporting. I suggest the following sources of information:

  • For some up to date (30 January 2020) scientific background on the current outbreak, the "Science Vs." podcast Coronavirus Outbreak: How Scared Should You Be? provides good science-based information, with useful comparisons to other infectious diseases for transmissibility and mortality.
  • For background on pandemics and a good description of the SARS outbreak, the Netflix series "Explained" season 2 episode "The Next Pandemic" published in November 2019 is a prescient look at the risks of pandemics. This explains the origins of new viruses, and outlines what could happen without excessive sensationalism.
  • The Centers for Disease Control has information for the general public and health care professionals alike. It is well worth a visit.
  • The World Health Organization section on 2019-nCoV gives the latest advice for governments, health care institutions, health care professionals, and the general public.


Will politicians play up or play down the risks for their own agendas? Definitely.

Will television journalists report the most sensational story with the best pictures or the story which reflects reality? What do you expect?

To keep everything in perspective, it's worth comparing this with the influenza pandemics which spread across the world each year. Each year there are 3-5 million serious cases of influenza and up to 650,000 respiratory deaths associated with them.

Coronaviruses are very common — you've probably had at least one in the past year — and a lot is still unknown about this one. At the time of writing it looks like 2019-nCoV (it's working name) is currently a little bit more likely to be transmitted than influenza (one person is likely to infect about 1.5 others, versus 1.4 for influenza), and the mortality is 2-5% of those people with serious enough symptoms to seek medical help. For comparison, seasonal flu has an estimated mortality rate of 0.1%, and the 1918 flu pandemic had an estimated mortality rate of 2-3%.

SARS (another coronavirus) had a very high mortality rate initially, but this reduced rapidly as the virus mutated, so it's too early to know whether any comparison to a previous major epidemic is valid. (Studies of current mutations suggest the virus originated in November 2019 — so compared to past pandemics this one was identified and countermeasures were taken to limit its spread very quickly).

What Next?

As I noted earlier, at the time of writing it's too early to tell how the virus will mutate and how effective the steps being taken to prevent transmission will be. An effective vaccination (f needed) is at least a year away, so expect quarantine measures rather than mass vaccinations.

But now is a good opportunity to review your emergency planning for pandemics, and consider such questions as:

  • What would the effects of a local outbreak be on staff?
  • Will staff travel restrictions have any major effects?
  • Could you continue operation if staff needed to be quarantined?
  • Could some work be conducted at home?
  • Can the chances of transmission in the workplace be reduced? Can key staff be isolated? Can cleaning be improved?
  • How will suppliers be affected? Will they still be able to supply?
  • How will customers be affected? Will they want less (or more) of what you produce?

Remember that your plan may not need a major pandemic to trigger it: just a bad year for seasonal flu.

Further Resources

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