Accidents will happen? Lessons from the Covid-19 pandemic.
| Date | 22 September 2020 |
Expect many inquiries into what went wrong in the early stages of the COVID-19 pandemic. Some will 'name the guilty men' and highlight policy-makers who indeed made major mistakes, including the delay in imposing lockdown. Others will present 'arrow indicates defective part' explanations and blame agencies like NHS Supply Chain with its limited reach into the PPE supply chain, or Public Health England, for its anaemic inability to upscale COVID-19 testing. But what were the deeper reasons for such failures? And why did specific failures proliferate into unanticipated and uncontrolled large-scale breakdowns?
The reasons for these proliferating failures are analysed in the Foundational Economy Collective's public interest report, When Systems Fail. (1) We argue that what happened in the early stages of the pandemic was (in the language of science and technology studies) a normal accident, an accident waiting to happen because fragility had been built into the system. The acute hospital system had no buffers because it was running with no spare capacity, and then it cleared beds by discharging untested elderly patients into care homes and freed up staff by suspending other treatments. The public laboratory system lacked back-up because Public Health England (PHE) was over-reliant on its own limited test capacity and could only slowly bring other laboratories online.
The UK acute hospital sector is run as a low-stock, high-flow system. This means that it is inherently vulnerable to disruption by a surge in demand. Other North European countries have more staff and beds in...
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