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Risk Governance Management Specialists

COVID19 - Applications of the Principles

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[Last amended: 22 Dec 20]

 

INTRODUCTION

 

In 2019 the Global Health Index produced by The Economist Intelligence Unit in conjunction with John Hopkins Health School ranked the UK 2nd out of 195 countries for its pandemic preparedness. In late October 2020 the UK ranked 5th highest in the list of countries suffering from COVID19 related deaths. While there may be some debate about the way these numbers were collected, it is still clear that the UK's response to COVID19 was not as effective as had been hoped. As part of our examination of the reasons behind this discrepancy, we will take a look at the preparations made by the UK for handling pandemics. In this case we will be looking at the Department of Health's Pandemic Strategy published in 2011.

 

As with all other work, we will examine this issue using the lens of Disaster Incubation Theory (DIT). Within DIT the strategy setting process is seen as part of Stage 1 as it defines the threats and sets the mitigation norms. In terms of how we understand organisational failure, we are looking to see how the threat is characterised and whether the mitigation norms had been fully addressed in the subsequent strategy. If they do not then the strategy, as written, would fall into the definition of being a fantasy document.

 

So what do we mean by 'strategy'? As ever, this is a much debated subject. This debate has been summarised by Mintzberg, Ahlstrand and Lampel in their books "Strategy Safari" . This suggests that strategy is many things to many people and so it does not help us determine whether this document is strategy rather than doctrine, plan or procedure. In practical terms, I find the definition by Patrick Hoverstadt and Lucy Loh to be more useful.

 

Hoverstadt and Loh define strategy as "the way forces manoeuvre for advantage against an enemy (competition)." In the case of COVID19, the enemy is clearly the virus. They go on to say "strategy as about using the resources (including time) at your disposal to change your position relative to your environment (changing which structural couplings you have, or the nature of them, or both), so that you can thrive there on your own terms."  Therefore, in terms of COVID19, we would expect any pandemic strategy to describe how the organisation intended to use its resources to cope with a future pandemic.

 

As a strategy is intended to cope with the unknown it can only make assumptions about the environment that will be faced. Given those assumptions, the strategy should therefore describe how they will manoeuvre the resource (forces) available to them. There are then two ways that manoeuvring can be described. It can be described in terms of activity or it can be described in terms of the results to be achieved.  Our position [See "then a miracle occurs" for our reasoning] is that it is preferable to couch manoeuvring in terms of the results to be achieved. In any pandemic we would therefore focus on the stated objectives and hope to see how they plan to use those resources to achieve their objectives.

 

For the DH Pandemic Strategy 2011 (which can be found here) the assumptions used and objectives stated are set out in tables below. As part of any "double-loop" learning process, these assumptions and objectives need to be re-examined in light of our COVID19 experience.

 

This analysis will be two parts. The first will discuss the validity of the assumptions in light of the COVID19 pandemic. The second will discuss the utility of the objectives in light of the COVID19 pandemic.

 

ASSUMPTIONS

 

While the assumptions used should not be taken as a prediction of future scenarios, they do set the scope of the problem for which the organisation is planning its response. We will firstly therefore question whether the assumptions were appreciated. That is, did the assumptions identify the nature and scale of the problem in general terms as this will affect the construction of the strategy: this is an examination of how foresight was applied to this problem. We then secondly use the information now available to us to suggest how these assumptions might be adjusted: this is an exercise in hindsight.

 

The table below sets out the assumptions (as stated in pages 15-17) and our comments.

 

Summary of planning assumptions for pandemic preparedness

 

A pandemic is most likely to be caused by a new subtype of the Influenza A virus but the plans could be adapted and deployed for scenarios such as an outbreak of another infectious disease, eg Severe Acute Respiratory Syndrome (SARS) in health care settings, with an altogether different pattern of infectivity.

 

COMMENT: This assumption identifies the threat from unknown infectious diseases and therefore it would embrace COVID19. The question therefore is whether the Government planned to cope with "Pandemic X" or in reality, their thinking was limited to another type of influenza.

 

An influenza pandemic could emerge at anytime, anywhere in the world, including in the UK. It could emerge at any time of the year. Regardless of where or when it emerges, it is likely to reach the UK very quickly.

 

COMMENT: This assumption warns that a pandemic can emerge at any time and would reach the UK very quickly. The question therefore is how long was the envisioned recovery window (that is that time the Government has to prepare for it reaching this country) and what did it foresee it had to do during this time. Did the scope of what had to be done match the time they thought they would have available to them?

 

It will not be possible to stop the spread of, or to eradicate, the pandemic influenza virus, either in the country of origin or in the UK, as it will spread too rapidly and too widely.

 

COMMENT: Here the assumption clearly states that it would not be possible to stop the spread, yet this is what the Government has tried to do. We therefore see great divergence between what was planned and the reality. This is one indication that this may be a fantasy document.

 

From arrival in the UK, it will probably be a further one to two weeks until sporadic cases and small clusters of disease are occurring across the country.

 

COMMENT: This assumption proved to be true. However the implication for how the strategy would be enacted is never made clear.

 

Initially, pandemic influenza activity in the UK may last for three to five months, depending on the season. There may be subsequent substantial activity weeks or months apart, even after the WHO has declared the pandemic to be over.

 

COMMENT: Here the assumption is that each 'wave' will be 3-5months long. If that was the expectation then the system needed to be configured to endure 5 months+ high tempo operations with 2-3 months recovery period before the next wave.  Whether this implication was recognised is not made clear. This is another indication that this may be a fantasy document.

 

Following an influenza pandemic, the new virus is likely to re-emerge as one of a number of  seasonal influenza viruses and based on observations of previous pandemics, subsequent winters are likely to see a different level of seasonal flu activity compared to pre-pandemic winters.

 

COMMENT: Here the assumption is that a second wave might coincide with an outbreak of winter flu. The document is not clear how the department intended to cope with this eventually.

 

Although it is not possible to predict in advance what proportion of the population will become infected with the new virus, previous studies suggest that roughly one half of all people may display symptoms of some kind (ranging from mild to severe).

 

COMMENT: This is a poor assumption. It confuses assumption with prediction and would seem to contradict the assumptions in the next section. This suggests that about 33m people would display symptoms.  This assumption is critical to the resources required and so is a major gap in this document. This is a further indication that this may be a fantasy document.

 

The transmissibility of the pandemic virus and the proportion of people in which severe symptoms are produced will not be known in advance.

 

COMMENT: As this statement is factually correct it might be seen to be a valid assumption. However, the point of assumptions is to help build a valid planning scenarios. All this statement actually (the implication of this statement) does is to reinforce the need to make the assumptions stated in the next section. As the document does not make this link it brings into t question the coherence of the document as  a whole therefore suggesting that it might be a fantasy document.

 

Infectivity and mode of spread

 

Influenza spreads by droplets of infected respiratory secretions which are produced when an infected person talks, coughs or sneezes. It may also be spread by hand-to-face contact after a person or surface contaminated with infectious droplets has been touched.

 

COMMENT: The problem is clear but the implications for the system do not seem to be addressed.

 

Spread of the disease may also be possible via fine particles and aerosols but the contribution to spread is, as yet, still unclear with the latest evidence suggesting this mode of transmission may be more important than previously thought.

 

COMMENT: The problem is clear but the implications for the system do not seem to be addressed.

 

The incubation period will be in the range of one to four days (typically two to three). Adults are infectious for up to five days from the onset of symptoms. Longer periods have been found, particularly in those who are immunosuppressed. Children may be infectious for up to seven days. Some people can be infected, develop immunity, and have minimal or no symptoms but may still be able to pass on the virus.

 

COMMENT: These are key assumptions that should drive the risk mitigation strategy. The only evidence that they have been used as such can be found in paragraph 4.19.

 

Regardless of the nature of the virus, it is likely that members of the population will exhibit a wide spectrum of illness, ranging from minor symptoms to pneumonia and death. Most people will return to normal activity within 7 - 10 days.

 

COMMENT: The problem is clear but the implications for the system do not seem to be addressed.

 

All ages are likely to be affected but those with certain underlying medical conditions, pregnant women, children and otherwise fit younger adults could be at relatively greater risk as older people may have some residual immunity from previous exposure to a similar virus earlier in their lifetime. The exact pattern will only become apparent as the pandemic progresses.

 

COMMENT: While the last sentence puts a large caveat on this assumption, in the reality of COVID19 it proved to be false when it comes to children and younger adults. This raises two points. The first is whether the assumption was used to formulate the initial advice given to the public  and what were the implications of them getting this wrong? The second point concerns how this assumption should be reformulated.

 

Responding to an influenza pandemic

 

The UK will continue to maintain stockpiles and distribution arrangements for antiviral medicines and antibiotics sufficient for a widespread and severe pandemic.

 

COMMENT: In essence this assumption remains valid. However, this is an open book in resource terms. The likelihood is that the initial sufficiency required, if ever met, will become depleted over time and this is more evidence that this may be a fantasy document.

 

Health services should continue to prepare for up to 30% of symptomatic patients requiring assessment and treatment in usual pathways of primary care, assuming the majority of symptomatic cases do not require direct assistance from healthcare professionals.

 

COMMENT: Without numbers of expected infections such percentages are meaningless in terms of this strategy. The question becomes, 30% of what? If we take the previous assumption, the number displaying symptoms could be about 33m and therefore this assumption means that the system need to be prepared to 11m seeking help from the primary care system. The strategy does not cover hope they are intended to cope with this level of demand.

 

Between 1% and 4% of symptomatic patients will require hospital care, depending on how severe the illness caused by the virus is. There is likely to be increased demand for intensive care services.

 

COMMENT: OK …  so how many beds does the NHS require? What does this mean for the resources (such as drugs, ventilators, oxygen etc) the NHS will need to cope with the demands that will be placed upon them?

 

For deaths, the analysis remains that up to 2.5% of those with symptoms would die as a result of influenza if no treatment proved effective. These figures might be expected to be reduced by the impact of countermeasures but the effectiveness of such mitigation is not certain. The combination of particularly high attack rates and a severe disease is also relatively (but unquantifiably) improbable. Taking account of this, and the practicality of different levels of response, when planning for excess deaths, local planners should prepare to extend capacity on a precautionary but reasonably practicable basis, and aim to cope with a population mortality rate of up to 210,000 – 315,000 additional deaths, possibly over as little as a 15 week period and perhaps half of these over three weeks at the height of the outbreak. More extreme circumstances would require the local response to be combined with facilitation or other support at a national level. In a less widespread and lower impact influenza pandemic, the number of additional deaths would be lower.

 

COMMENT: this assumption is confusing. If we take 2.5% of this how are symptomatic will die that is 2.5% of 33 m; that equates to 825,000 people. However this assumption states that it assumes an excess death number of between 210,000 and 315,000. Beside the major discrepancy between this numbers that the document never resolved, these figures are more proof that these are fantasy numbers as far as this strategy is concerned. These numbers have proven to be politically unacceptable and this has driven the way the Government is handling this pandemic.

From a strategic planning point of view it would (in hindsight) seem more practical to divide those affected into four categories.

 

These might be:

  • Mild - infected but not hospitalised

  • Medium - Hospitalised

  • Severe - Intensive care (on ventilator)

  • Deaths (in terms of excess deaths)

 

In order to plan, figures, based on existing hindsight, need to be attached to each category. These figures would then inform the contingency arrangements that can then be adjusted as the true requirement becomes clear during the pandemic.

Without this kind of detail this becomes a fantasy document.

 

Starting from the figure of 315,000 deaths the logic would follow that:

  • If 2.5% of those with symptoms die [that is 315,000 worst case] then 12.6m have symptoms.

  • If 1% require hospital care = 126,000.

  • If 4% require hospital care = 504,000.

  • People return to normal 7-10 days.

  • Assume (unstated) hospital stay would be 2 weeks.

  • Duration of 1st wave pandemic assumed to be 15 weeks.

  • The 504,00 (worst case) needs to be divided by 7 = 72,000 beds would be required.

  • We would also need to make and assumption of IC beds/ respirators required. Say 50% =30,000 {note that this is the number bought!}

 

Staff Absence

 

COMMENT: These figures are clear but our question is 'so what?'; what are the implications for the system.  What arrangements can be put in place to ensure that the system can continue to function in the face of this level of absenteeism?

 

Experience of the pandemic showed that the Department do have a plan to recall recently retired staff but this major detail was not included in the strategy suggesting that the document was not kept up to date with the actual evolving strategy; fantasy document.

 

Up to 50 per cent of the workforce may require time off at some stage over the entire period of the pandemic. In a widespread and severe pandemic, affecting 35-50 per cent of the population, this could be even higher as some with caring responsibilities will need additional time off.

 

COMMENT: These figures are clear but our question is 'so what?'; what are the implications for the system.

 

Staff absence should follow the pandemic profile. In a widespread and severe pandemic, affecting 50 per cent of the population, between 15 per cent and 20 per cent of staff may be absent on any given day. These levels would be expected to remain similar for one to three weeks and then decline.

 

COMMENT: These figures are clear but our question is 'so what?'; what are the implications for the system.

 

Some small organisational units (5 to 15 staff) or small teams within larger organisational units where staff work in close proximity are likely to suffer higher percentages of staff absences. In a widespread and severe pandemic, affecting 50 per cent of the population, 30-35 per cent of staff in small organisations may be absent on any given day.

 

COMMENT: These figures are clear but our question is 'so what?'; what are the implications for the system.

 

Additional staff absences are likely to result from other illnesses, taking time off to provide care for dependants, to look after children in the event of schools and nurseries closing, family bereavement, practical difficulties in getting to work and/or other psychosocial impacts.

 

COMMENT: This is meaningless without a figure. Therefore, the question is 'so what?'; what are the implications for the system?

 

Discussion of Assumptions

 

The above list of assumption articulates the foresight that was available to those producing this strategy. Given that most of the assumptions are reasonably valid if imprecise, the real issue seems to be that their implications for the strategy have not been articulated and addressed. Without these implications being addressed that strategy is unlikely to be successfully implemented and therefore the document becomes a 'fantasy'.

 

While it may be tempting to make some recommendations based on currently available hindsight, we felt that it is too early to do so. This must be set aside for later.

 

STRATEGIC OBJECTIVES

 

The overall objectives are set out in paragraph 3.1 of the Strategy. The document lays out three objectives. These concern minimising the potential health impact of any pandemic, minimising the potential impact of a pandemic on society and the economy and finally, it recognises the need to maintain the trust of all stakeholders. We assumed, because it is not explicit, that this refers to trust in the Government and particularly, the Department of Heath as the author of this document. The document then goes on to suggest ways in which this may be done in general terms.  The text is detailed in the table below.

 

i. Minimise the potential health impact of a future influenza pandemic by:

 

• Supporting international efforts to detect its emergence, and early assessment of the virus by sharing scientific information.

 

COMMENT: While the objective talks about detection, the activities are mainly described as surveillance. The clearest the document gets to stating how this will be done is paragraph 4.7 which states that it "will be based on established seasonal influenza surveillance arrangements". The document indicates that the surveillance covers two distinct subjects. The first concerns the detection of the virus threat and the second is the detection of the spread of inflection. It is not clear how either of these will be achieved.

 

In light of our experience of COVID19, the Government seems to have been successful in quickly identifying the virus and to characterise its nature within a reasonable timeframe given the limitations of the science. In terms of tracking the spread of the inflection, this does not seem to have gone well. While they  may have had the data necessary for their own needs, their public difficulties over their 'track and trace' system have not enhanced public trust in their processes.

 

• Promoting individual responsibility and action to reduce the spread of infection through good hygiene practices and uptake of seasonal influenza vaccination in high-risk groups.

 

COMMENT: The only time the phrase "individual responsibility" is mentioned in this document is in the wording of this objective. Therefore this document does not provide a strategy to achieve this objective.

 

In light of our experience of COVID19, the Government has not succeeded in promoting a public consensus that it is the individual's responsibility to help reduce the spread of the virus. This can most clearly be seen in the debate over the wearing of face masks. It is clear from comments made that the individuals who object couch the debate in terms of their rights rather than in terms of their responsibility to protect others. If practice, the Government’s approach has been based in compliance with rule which is the antithesis of this objective. This objective was a fantasy.

 

• Ensuring the health and social care systems are ready to provide treatment and support for the large numbers likely to suffer from influenza or its complications whilst maintaining other essential care.

 

COMMENT: This document does not provide a systematic description of how the authorities will ensure how the system will be ready for the pandemic. The only preparatory action found is at paragraph 4.16 which talks of the need to stockpile facemasks and respirators and the imposition of a constraint on the way the system worked in the form of an ethical framework (paragraph 3.19). Paragraphs 4.45 & 4.47 talk of the early use of vaccines for first line workers but this could only be seen in terms of preparation if it was available for use as a prophylactic.  

 

Given Pareto’s 80/20 rule, this single objective (c.20% percentage of the objectives) constitutes 80% of the effort required to defeat the pandemic. This suggest a significant imbalance in the construction of this strategy. Having said that, whether the system had been prepared to respond appropriately to COVID19 will require a much deeper examination. What we can say is that if it was, this success cannot be attributed to this document.

 

ii. Minimise the potential impact of a pandemic on society and the economy by:

 

• Supporting the continuity of essential services, including the supply of medicines, and protecting critical national infrastructure as far as possible.

 

COMMENT: Paragraphs 7.5 to 7.10 address the 'maintaining' of essential services. This states that arrangements were in place for the following sectors: (1) Energy and Fuel, (2) Water and Sewerage, (3) Food supply, (4) Transport, (5) Finance, (6) Postal Services, (7) Emergency services, (8) Benefits and pension payments, and (9) Education. The strategy here was to rely on the business continuity planning being carried out by those organisations.

 

With the exception of education, these systems seem to have operated reasonably effectively during the COVID19 pandemic. The main resource required by these organisations was to come from the Treasury. The causes of failure of the education system were complex and need to be the subject of a separate analysis.

 

• Supporting the continuation of everyday activities as far as practicable.

 

COMMENTS: The only time the phrase "individual responsibility" is mentioned in this document is in the wording of this objective. This subject does not appear to have been addressed.

The experience of COVID19 was that this objective was the first causality of the pandemic. We have no idea what was intended by this objective but experience suggest that protecting the NHS was a great priority than learning to live with the virus. This would seem to be further evidence that this is a fantasy document.

 

• Upholding the rule of law and the democratic process.

 

COMMENTS: Paragraph 7.14 to 7.17 covered "maintaining public order". This however made no special arrangement for a pandemic except that it recognised the importance of "Engaging the public in the development of policies, plans and choices, and ensuring that expectations are realistic …"; how this was to be done was not clear.

 

Over the COVID19 period, the authorities have faced challenges in maintaining law and order both on the streets and in the courts (as seen in the developing backlog of cases). Whether the level of public disobedience, disorder and delays are deemed to be acceptable within a democracy need to be the subject of a separate analysis.

 

• Preparing to cope with the possibility of significant numbers of additional deaths.

 

COMMENTS: The document clearly identifies the possibility of excess deaths. A planning assumption was that 2.5% of those with symptoms would die and stated that the system should be prepared "to cope with a population mortality rate of up to 210,000 – 315,000 additional deaths, possibly over as little as a 15 week period". What the document is focusing on is being prepared for that number of deaths, including the communication of death data, but is does not set out a strategy for how the country should cope with this number.

 

From the experience of COVID19 this part of the supposed strategy is clearly a fantasy when it comes to how the Government handled the pandemic. There are two reasons for this assertion. The first is that this document does not provide any ideas in preparing the country to cope with the number of deaths. The second is that it is also now clear that this number of deaths is politically unacceptable.

 

• Promoting a return to normality and the restoration of disrupted services at the earliest opportunity.

 

COMMENTS: This document only asserts the need to return to normality at the end of the pandemic. Not only does it not provide a strategy for doing so, it does not even offer ideas of how this might be done. This is clearly a fantasy objective.

 

iii. Instil and maintain trust and confidence by:

 

• Ensuring that health and other professionals, the public and the media are engaged and well informed in advance of and throughout the pandemic period and that health and other professionals receive information and guidance in a timely way so they can respond to the public appropriately.

 

COMMENTS: We believe that the premise behind this objective is correct however the authorities failed to peruse the course necessary to achieve it. The document (paragraph 5.9) does identify that "People are likely to respond better and are more likely to take effective and appropriate action if they trust both the advice given and the person or organisation offering it." It also recognises the central role of "Openness and transparency".  It also sees that "Consistent, clear public messaging, aligned at national and local level, is critical" (paragraph 5.2). The need for communications is mentioned over 30 times. However, the link between communications and trust are only tangential. The document does not therefore provide a strategy to "instil and maintain trust" in the authorities. It does not link activity to results and therefore contains 'magical thinking'. There is in fact more evidence to support the proposition that the Government actually perused a communications strategy based on “tell” and ‘blame avoidance” rather than one designed to around “trust”. This is more evidence of it being a fantasy document.

 

Discussion of Objectives

 

Our analysis set out to determine whether this document meets our criteria for being a strategic plan. That is to say it states how resources will be used to achieve the set objectives given the assumptions made. Therefore when looking at the objectives we looked for how the available resources will be used. Our detailed comments in each case are set out above.

 

In terms of the COVID19 experience, the three objectives have merit. As a starting point for a strategy they provide a solid foundation. However, in general the document provides nothing in the way of explanation as to how the available resources would be used to achieve them. Instead the document is more of an aid-memoire that points out what needs to be done. It does not therefore provide the basis of agreed and resourced action  as befits a good strategy.

 

During this analysis we have tried to relate this document to the framework provided by DIT. The document does set out four phases for the pandemic response (Paragraph 3.11 to 3.13.)  These phases being Detection, Assessment, Treatment, Escalation and Recovery. In terms of DIT, these phases start during the Recovery Window which is at the end of Stage 2 and go Stage 6 "Full Cultural readjustment". We would have therefore expected to see comment on the resources that are or would be allocated to each phase. However, Paragraph 3.12 goes on to say that "The phases are not numbered as they are not linear, may not follow in strict order, and it is possible to move back and forth or jump phases. It should also be recognised that there may not be a clear delineation between phases, particularly when considering regional variation and comparisons." The document then goes on to provide a list a activities that would be the 'focus' of each of these phases. This raises two issues:

 

  • The first is that we have previously identified the weakness of focusing on activity rather than results.  In brief, the focus on activity often results in a great expenditure of resources without the desired result even being considered.

 

  • The second is that any system that is non-linear is, by  definition, complex. A key part of the strategy should therefore, in our view, be devoted to an explanation of how this complexity should be managed. This is not addressed and so leaves a large hole in this plan once again reducing it to the status of being a fantasy document.

 

We believe that we have now shown that, while the document has stated the strategic objectives, it is not clear how these will be achieved nor is it clear what resources will be needed.

 

Overall Discussion

 

The first point for discussion is whether this text adds up to being a strategy document. Hoverstadt and Loh contrast strategy with plans which they describe as a "detailed description of who needs to be where, when, doing what and with what resources at their disposal." This document is therefore clearly not a plan. To us the document appears to be more of an aide-memoire.

 

As a strategy I would expect to read how the organisation (in this case the UK Government) planned to use the resources available to it to fulfil a set of objectives based on a clear set of assumptions. This would provide a clear 'hypothesis for success" for dealing with a pandemic. What we mean by this is that it would provide a general hypothesis that articulates how they expected success to be achieved with the resources. In business terms this is very similar to Kaplan and Norton's Success Maps or, if stated in more academic terms, a lay theory of success. This is about articulating the interdependencies between the constituent parts of the strategy; while the text recognised the need to do this, that is as far as this was taken. From reading the 2011 strategy document, it is not clear how the organisation even hoped to achieve success. This was shown by the fact that it did not prove possible to draw up an overview of the system even in the form of an outline systems diagram. Instead the text gives us a catalogue of related but uncoordinated activities that might help lead to the result desired.

 

If the text does not constitute a strategy that can be successfully implemented then we have to question whether the effort to produce it was, in practice, a waste of resources.

 

CONCLUSIONS

 

We have great difficulty with this document; to us it is not a strategy (as defined above), rather it is somewhere between a doctrine, a grand strategy and aide-memoire for it describes what needs to be done in general terms rather than describing the use of resources to change the UK's position relative to the pandemic environment. It does not define a clear course of action but rather comes across as a set of ideas randomly committed to paper. As a strategy it should be seen to be a fantasy document that was not followed during the COVID19 pandemic. In terms of Disaster Incubation Theory, we see a failure to take the opportunity to prepare effectively during the incubation period (as defined by Stage two of Turner's Model) for any upcoming pandemic. It therefore now seems less surprising that the country that was 2nd in the GHI ranking should find itself having the fifth highest number of deaths from COVID19.

 

Learning about Learning

 

So, what have we learnt about learning from this analysis? As always, in order to enhance the practical utility of this learning, we couch the learning in terms of some questions that managers might ask themselves if they find themselves in similar circumstances.

 

The first lesson is that those producing the strategy failed to incorporate the work that precedes a pandemic. In terms of DIT, this is Stage 1 and most of Stage 2. There is a clear gap between when the threat was identified and the original mitigation strategy was put in place (DIT Stage 1) and when the Recovery Window opened. It is during this period when contingency plans and capability are put in place and then tested.  As a result of this managers should ask themselves:

 

  • Are we clear about how we reconfigure our routine day-to-day operations to meet our expected needs?

 

  • What additional capabilities will we need and how do we ensure that they are available to us?

 

The second lesson concerns the formulation of strategy. Here we have debated the very nature of a strategy. As a result of this managers should ask themselves:

 

  • Does this document set out how we will deliver the results (objectives) we desire with the resources available to use given the assumptions we have made?

 

The third lesson is that assumptions have implications for the planning of threat mitigation. As a result of this managers should ask themselves:

 

  • Are the implications the assumptions will have on the way the threat is addressed made clear within the document?

 

The fourth lesson is that, once the objectives have been identified, any strategy must make clear how the organisation will achieve those objectives with the resources available. As a result of this managers should ask themselves:

 

  • Is it clear how the organisation will achieve its objectives within the resources available to it?

 

Finally, organisations need to be alert to the dangers and inefficiencies that surround the production of fantasy documents. As a result of this managers should ask themselves.

 

  • What is the likelihood that this plan or strategy will deliver the results required or does the production of the document only symbolise that we care about the issue being addressed?

 

 

Hoverstadt, Patrick; Loh, Lucy. Patterns of Strategy (p. 33). Taylor and Francis. Kindle Edition.

 

UK Pandemic Strategy 2011