For want of a ventilator: Covid-19 crisis management

In the early phase of the crisis there seemed little shortage of sceptical criticism that panic overreaction, fuelled by the media, was rampant.

From the taxi driver who took me to Aberdeen airport at the beginning of March to countless vox pops on television, there were a whole host of nonchalant voices dismissing global concerns as exaggerated, including an unworried US President. How quickly we seem to have reached the polar opposite consensus.

Now we appear persuaded that we were underprepared, perhaps even negligently so, and that measures taken have been too little and too late. A decidedly risk-averse British public now appears largely on board with the most draconian arrangements seen in peacetime Britain, a bunker mentality mirrored around the globe.

This volte-face is curiously connected to a perennial conundrum of risk management. If precautions are taken against a risk that does not materialise, such as stockpiling ventilators or having warehouses full of testing kits, questions about efficacy will be raised. Money and efforts might have been better spent on something else. On the other hand, if the risk does become a crisis, we are quick to appreciate that we, almost invariably, might have been better prepared. We might have had more testing capacity, more personal protective equipment, or, ultimately, a better funded NHS. Risk managers are in a perpetual struggle with those ‘at risk’, seeking to defend risk mitigation in the form of back-up plans and contingency arrangements against those happy to ‘cross that bridge when they come to it’, only to be lambasted when theoretical risk turns to real-life hazard.

Is this the right course? We may never know

Of course, there are aspects of the current pandemic crisis that are unprecedented, and one might simply dismiss this turn-around on the grounds that we are now better informed than we were a few weeks ago, perhaps invoking the cliché of hindsight. But that would be to naively underestimate the continuing uncertainty of this societal-level crisis.

We neither know, with any degree of confidence, that we are now taking the best course, nor are we likely to ever know. Much as we might like to believe that there can be some final analysis, with such hugely complex situations it is counterfactual to imagine that we can know what would have happened had the chain of events that has been set in motion been radically different. ‘For want of a nail’ type post-hoc rationalisation makes a good story but cannot, with any certainty, explain how the battle could have been won.

Applying social theory to this problem, situations where ‘nothing to worry about’ reassurances turn into ‘take all possible precautions’ crisis management, are not as exceptional as one might think. The British sociologist, Anthony Giddens, writing some decades ago, describes a similar trajectory in relation to the ‘Mad Cow’ crisis. Back then, eating infected beef had epidemiological modelers grappling with projected fatality rates and worst case scenarios for a frightened population that had already been exposed to the deadly variant Creutzfeldt-Jakob disease. This heightened state of anxiety had come only weeks after the then secretary of state, John Gummer, had fed his young daughter a beef burger in front of assembled media to assure the public of the absolute safety of British meat.   

Global risks require global planning

Giddens identifies how decision makers facing risks of a societal nature are inexorably caught between cover-up and scare mongering. In ‘The Risk Society’, a perspective on the relentless barrage of ‘unprecedented’ risks that assail us moderns, developed along with the German academic Ulrich Beck, Giddens situates the causes of the era defining existential threats in the very nature of modernity.

Clearly viruses predate our post industrial age, but the globalisation of our world cities, the interconnectivity of health services with economic activity, our technological dependencies (demanding ventilators and vaccines as human rights) and the information age that articulates every scintilla of opinion, are features of reflexive modernity that will shape this crisis and the next.

Climate risk teaches us that the nation is not the centre of the world

Ulrich Beck [from review of The Metamorphosis of the World]

Appreciating the complexity, understanding that crises are inherent in the world as it is currently configured and accepting the apparent paradox of risk management doesn’t excuse our leaders or ourselves from facing up to Covid19 as best we can and defending our society. Of course, the government ought to manage ventilator acquisition and other practicalities. And equally it is right that the media scrutinises this level of detail. But managerial competence is the least we ought to expect from our representatives in government.

Our best hopes in dealing most effectively with CV and with the next global crisis that seems inevitably not too far away, rest in our collective ability to see the bigger picture and to put shared values above self-interest. With the global south on the verge of much greater disaster than anything seen in health-rich societies, putting the interests of the many above those of the few must transcend counting ventilators. Crisis management must make space for risk management and global risks require global contingency planning – something no one seems to be talking about.

Featured image: Medical respirator, wikimedia commons, Bird Mark8 

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Further reading

Beck, U. (1992). Risk society: towards a new modernity (M. Ritter, Trans.). London: Sage. [PDF available HERE]

Beck, U. (2016). The metamorphosis of the world. Cambridge: Polity. [reviewed HERE]

Pidgeon, N., Kasperson, R. E., & Slovic, P. (Eds.). (2003). The Social Amplification of Risk (1st ed.). Cambridge: Cambridge University. [online version HERE]