New research shows the UK's COVID-19 management decisions were based on an outdated pandemic modelling structure and suggests a more resilient approach would have been more effective.
In the initial months of the pandemic, regular updates using graphs showing how the R number was behaving was the mainstay of the Government's strategy for tackling COVID-19.
This type of infection transmission is usually mathematically-based on dividing the population into 'compartments'. Such an approach has been criticised for its limited scope and inability to capture critical factors, such as the effects of testing, contact tracing and isolation. In addition, these existing models tend to look back at what the outcomes were, rather than look forward at future outcomes.
Professor Ashraf Labib, Professor of Operations and Decision Analysis in the Faculty of Business and Law at the University of Portsmouth, is the author of a new paper published this month in the journal of Safety Science. He urges Governments to use a more holistic approach, which provides a much richer modelling and in-depth decision analysis that can lead to better decision making.
Professor Labib has developed a hybrid model - a combination of resilience triangle modelling, which, provides a specific time of 'when' to act and the bowtie modelling that deals with the question of 'how' to act. He then added five guiding principles* which together provide an improved model from which lessons for the future can be learnt.
Professor Labib explains: "Resilience-based modelling with the five proposed principles can enhance public policy decisions. The aim of such modelling is to provide a learning environment on how to absorb failure and provides an opportunity to achieve quick recovery.
"Resilience modelling can offer the answer to 'when' to do things, whereas the bowtie modelling deals with causal analysis and can provide information on the 'how' questions. By combining the two, a balance is achieved in terms of dealing with a disaster, such as the Covid-19 pandemic, at both strategic and operational levels respectively.
"At a strategic level, the phases of prevention of the cause, response and mitigation of the consequences are visualised and strategic milestones can be set accordingly. Whereas, through bowtie modelling more operational details of causal factors and barriers analysis are achieved. Such analysis helps to improve knowledge related to assessing existing barriers and the need for new or improved ones. In addition, the bowtie modelling provides insight to visualise and communicate the complexity of risks in a concise form."
The paper also suggests it is vital that public health simulation exercises are extended to include not just policies related to health, but also include different economic scenarios caused by pandemics.
Professor Labib says: "Given the complex nature of a pandemic and the experiences with COVID-19 in terms of multiple waves, emerging variants and the variety of available vaccines, the main lesson learnt from all of this is to embrace uncertainty rather than to confront it or shy away from it. This is the way we will learn and prepare for future pandemics.
"Resilience as a conceptual idea is profound and considered to have a key role in dealing with disasters such as pandemics. However, there is little research on modelling resilience and integrating it with other approaches in order to systematise its operation. This paper aimed to contribute to this gap through the proposed hybrid enriched model of resilience and bowtie approaches."
Professor Labib urges policy makers to shift the way they approach things. Firstly, a shift in focus of decision making from efficiency to resilience and secondly to embrace the unknown and learn from it.
Notes to editors:
*The five principles:
Principle of Continuity: the idea is that ideally suffering should produce perseverance and endurance; these are good ingredients of resilience which constitute learning to cope with future similar incidents.
Principle of Vector Analysis: in terms of the principle of vector analysis, each side of the resilience triangle is a vector; which is defined as 'a quantity having a direction as well as magnitude' (Oxford Dictionary). For example, redundancy in terms of maintaining safety stocks helps firms to gain time during disruption, and hence causes a change in the direction of the vector.
Principle of Curvature Analysis: Here deterioration in performance can also be described as a degree of becoming more vulnerable. For example, on reflection of why the UK has suffered from Covd-19 relatively more than other countries, one can attribute the fragmentation and delay in decision making to response as an outcome of similar fragmentation in the preceding negotiation and decision making related to Brexit.
Principle of Antifragility Analysis: This is the theory that you can benefit from disorder. Your new state is even better than before the incident. In the context of Covid-19 pandemic, it has been observed that one of its remarkable positive impacts has been the accelerated innovations in on-line education and remote working.
Principle of Moving Upstream: The term upstream is preferable to preventive or proactive because the stream metaphor nudges us to extend the resilience modelling approach proposed in this paper into focussing more on earlier prevention and solutions. Upstream also means a systematic approach towards reduction or mitigation of harm caused by those problems. For example, teaching kids to swim is an upstream strategy to prevent drownings. Reflecting on COVID-19, we need to enhance education in schools related to hygiene and coping with the prevention of the spread of viruses.
The upstream concept can also relate to both space and time. Being nearer to the source of risk can also be conceptualised as 'psychological distance', which is the real or perceived distance between a person and the risk. It is now clear that those countries which were both geographically and culturally 'near' to the source of pandemic as a risk in the Far East, easily accepted the wearing of face masks, whereas it took some time to convince Western cultures to follow such a tradition as it was initially perceived as a restriction of personal freedom.