While the history books have yet to be written on the worldwide response to COVID-19, a recent article by Anne Applebaum, Senior Fellow at Johns Hopkins University has provided an interesting take on the response to the coronavirus.
In 1947, Albert Camus, a French philosopher and journalist published a novel called The Plague. Like other novels of its decade, including Orwell’s 1984 and Animal Farm, the novel is allegorical. That is, while it is purportedly about the occupation of France, it really seeks to illuminate the unseen. As the primary character, Dr. Bernard Rieux bears primary responsibility for treating the afflicted in his town of 200,000, while vainly exhorting authorities to take measures to address the spread before it was too late.
In modern Italy, the virus first appeared in the northern provinces of Lombardy and Veneto, a region heavily represented by the Northern League, a far-right political party led by Matteo Salvini. As Daniel Trilling reports in The Guardian, the defining feature of populism, namely the mistrust of elites and widely circulated conspiracy theories find the most fertile ground in times of uncertainty.
[The quarantined town] continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debates?from The Plague, by Albert Camus (1947)
In an article published in the Harvard Business Review, four lessons have been considered that may have helped to mitigate the failure to contain COVID-19 in Lombardy and Veneto:
Skepticism and cognitive bias. Despite warnings that had been weeks in the making, Italian authorities engaged in confirmation bias and viewed with skepticism any position that did not align with their preferred position. This systematic refusal to listen to subject matter experts in the early days of the outbreak (defined from February 21 to March 22) resulted in the region being impacted by an “incessant stream of deaths.” (Pisano, et. al., 2020)
Avoiding partial measures. In response to the initial wave of COVID-19 cases, the Italian government issued decrees concerning lockdown areas (‘red zones’). These red zones were then expanded until they were applied to the whole country. This partial-measure approach backfired for two major reasons. Firstly, the known facts were non-predictive of the situation, so the partial lockdown followed the virus rather than prevented its spread. Secondly, partial lockdowns may have helped to accelerate the spread of the virus as Italians relocated to ‘non-lockdown’ regions, inadvertently spreading the virus to regions it had not been before.
Rapid learning is essential. A feature of ICS is the ability for it to rapidly scale up or down in response to changes in the facts. The Italian health care system is highly decentralized, and newly acquired knowledge was not given the priority it deserved. The article looks at the policy decisions of Lombardy and Veneto officials in depth as the two regions share similar socioeconomic traits, however experienced far different outcomes. Lombardy opted for a more conservative approach, with a strong focus on symptomatic cases whereas Veneto’s strategy was proactive and varied. As of March 26, 2020, the Lombardy region suffered 5,000 deaths in a population of 10 million, whereas Veneto experienced 287 deaths (in a population of 5 million) during the same period.
Collection and distribution of data. As a corollary to the third lesson, the lack of data dissemination and standardization of virus statistics should be a priority. Documenting both macro (state) and micro (hospital) levels would help authorities to allocate available (often limited) resources accordingly.
In the uncertain environment in which we find ourselves, both emergency management professionals and policymakers can benefit from the ‘fast tracked’ lessons being developed in real time.
Perhaps fittingly, the heroes of Camus’ novel remain the doctors and the volunteers who use science to contain and control the disease, without indulging fear-based hysteria. According to Dr. Rieux, “[it] may seem a ridiculous idea, but the only way to fight the plague is with decency.” (Camus, 1947).
As always, I look forward to reading your thoughts and insights.