Cognitive biases, piecemeal approaches and a systematic inability to grapple with complex problems or listen to experts have seen the coronavirus outbreak run rampant in Italy, with important lessons for countries like Australia that are some weeks behind on the epidemiological curve.
This widely-shared piece published in the Harvard Business Review is a must-read on Italy’s response to COVID-19 and why, in contrast to countries like China and South Korea, the outbreak there has been so devastating.
We’ve summarised the main points below, but recommend reading the whole piece. There are certainly similarities to reflect upon with Australia’s reponse to date.
- Cognitive biases: a tendency to seize upon information that confirms our preferred position or initial hypothesis — particularly challenging for problems like pandemics which evolve in an exponential rather than linear fashion. The nature of this threat requires strong action to be taken well before it seems warranted. Instead of listening to experts, the government resorts to instinct or the opinions of their inner sanctum
- Partial solutions: Incremental responses eked out so as not to alarm the public, spook the markets or damage political standing leave authorities *following* the spread of the virus rather than preventing it. Graduated measures rolled out on different timescales by different jurisdictions may also be counter-productive, driving potentially infected people into places they may not otherwise have been. Orchestration between jurisdictions, and of measures across a range of domains (testing, tracing, communicating) are the only guarantee of effectiveness. This also applies to the health care sector, which must think outside the box, moving away from patient-centred institutional models to community-centred approaches that focus on care at home
- Flexibility and learning: With marked differences in rates of infection, fatality and other outcomes both within and across countries, drawing on success stories and adapting responses is a critical element in success. Policies should be considered “experiments” rather than inviolable political imperatives. This involves surfacing not only examples of things done well, but also ventilating failures, and seeing these as a product of systemic shortcomings rather than scapegoated individuals.
- Devil is in the data: Collection and sharing of adequate and precise data must be a priority for resource allocation and interpreting the success of measures. Where possible, data should be standardised, and collected at both the macro (state) and micro (health service) level. Rather than obscuring poorer-performing services and regions, we must be frank and open about these so that allocation of limited resources can be planned accordingly.
- Urgency and coordination: Though the nature of the virus means that there is a considerable lag between action (or inaction) and its consequences, there are two major lessons from the Italian experience. One, there is no time to lose. Two, extreme coordination of human and economic resources, both public and private, is required, in a manner unseen outside of wartime. We must be systemic, prioritise learning and be flexible in our policy experiments, identifying and shutting down those found to be without merit.