Can “Appreciation for a System” Support the Taming of COVID?

Guest Post by Dr. Doug Stilwell, Drake University

Until managers take into account the systemic nature of their organizations, most of their efforts to improve their performance are doomed to failure.

Dr. Russell Ackoff

The COVID vaccine is clearly one of the most charged and divisive issues in our country today. Relative to the vaccine itself, proponents speak to its medical efficacy in relation to one’s own health and the health of those with whom one may come into contact. On the opposite side are those with concerns about its efficacy, side effects, and overall risks. Beyond the issuesof the efficacy and safety of the vaccine, there is also the issue of personal freedoms, and it is here that the issue appears to be the most politically charged.

In the April 30, 2020 Deming Blog, I penned an article entitled, “Systemically Non-Systemic: COVID-19 Through the Deming Lens.” Written before the vaccine was available, I offered that battling the spread of COVID would require us to behave “systemically non-systemic,” meaning that until there was a vaccine, we would need to collectively separate from one another, physically and/or by wearing masks.  In other words, we would collectively “break” our physical connections (our physical “systemness”) in order to mitigate the contagiousness of the virus. A dramatic increase in daily reported COVID cases in the United States, beginning in February 2020 to its high point on January 10 of 2021 (208,296 cases), confirmed the dire need to seriously address COVID from a systems perspective.

In December of 2020, the COVID vaccine was first made available to the general public. The number of Americans who are vaccinated has risen from 1,342,086 on January 14, 2021 to its current rate of nearly 173,000,000 as of August 26, 2021. As a result, the number of newly reported COVID cases dropped from its high of 208,296 in January, 2021 to a low of 4,063 on June 20, 2021. Unfortunately, following June 20, the number of reported new cases began to spike, reaching 192,720 on August 27, 2021. During this time, the political vitriol around COVID vaccinations had spiked as well, fueled not only by concerns about the safety and efficacy of the vaccine, but even more so by the perceived attack on personal liberty, a sentiment seemingly driven to greater heights by politics and social media.

For now, let’s put politics aside and examine COVID and vaccinations from a systems perspective. Dr. Deming tells us that every system must have an aim and that each of the interdependent “parts” of the system must work together in order to achieve that aim. In the United States, we do have a system at work – the U.S. Public Health Service Commissioned Corps, whose mission, or aim, is to protect, promote, and advance the health and safety of our Nation. COVID vaccinations appear to be the system’s main approach to address the ongoing COVID crisis. However, individuals in this system (American citizens), have singular decision-making rights that can impact, even sub optimize, the entire system based on the decisions they make.

There is no better example of individuals impacting the larger system than the simulation known as Fishbanks.  In Fishbanks, a simulation designed by Dennis Meadows, John Sterman, and Andrew King to inform people about using natural resources effectively and prudently, small teams are formed and make up imaginary fishing companies. In one version of the game, the aim, as laid out, is for each fishing company to “maximize its assets.” Assets consist of cash that is earned by fishing and the salvage value of each company’s fleet. There are three areas where companies can put their ships:  the deep sea, the coast, and the harbor. Placing ships in the deep sea has the potential for the greatest number of fish to be caught, followed by the coast. Placing ships in the harbor will not yield any catch, but rather serves as a place for ships to “rest.” Each of the companies in the simulation share the same natural resources:  the three areas as described above and the fish that live in them. As in the natural world, the fish are capable of reproducing at a rate determined by the simulation. The simulation is played in rounds during which each company makes the following decisions:

  • How many ships to send out
  • Location to send each ship
  • Size of the fleet
    • Teams can add to the size of their fleets by building new ships, buying ships from other companies, or bidding for ships in intermittent auctions.
    • Teams can reduce the size of their fleets by selling ships to other companies.

Once these decisions have been made, the information is shared with the simulations “operator” who enters data into the simulation’s computer program. Once all data has been entered, results are returned, and each company learns how many fish were caught and how much money was earned. Between each round, each company shares its data publicly, posted for all to see and analyze.

As the simulation progresses, an interesting phenomenon begins to occur. As companies see each other’s results, competition (which was never officially shared as part of the simulation) develops; and with each passing round, companies do their best to not only maximize their own assets, but to also outperform the other companies in the process. Given that all of the companies fish the same waters where fish can only repopulate at a certain rate, and because a competitive fervor has set in, over time the number of fish decreases to the point where, in the vast majority of simulations I have facilitated, no fish remain because the system is overfished. In short, the system is destroyed.

The phenomenon described here is known as “sub optimization of the whole.” In other words, when those who live/work in the same system, and share the same resources, seek individual optimization without a concern for the larger system, a sub optimization of the entire system inevitably follows, sometimes to the point where the entire system fails. In the case of Fishbanks, when the larger systems fails – i.e. no fish remain – the results cascade throughout the entire system causing each of the fishing companies to suffer the consequences and fail. Even if a few of the companies recognize what is happening to the larger system (this does happen regularly) and adjust their actions accordingly, if others do not follow suit, while it may take longer, the system still eventually fails.

“Fishbanks” is being played out in our efforts to combat COVID. Large numbers of individuals, whatever their reasons may be, are behaving in what they believe to be their individual best interests and are exercising their rights by choosing not to become vaccinated. As a result, the country is not able to reach what is known as “herd immunity.” The American Lung Society tells us that “Herd immunity is achieved when large percentages of a population (70-90%) become immune to a disease and therefore indirectly protect those who do not have immunity.” The American Lung Society goes on to state that “In most cases, herd immunity is not achieved without an effective vaccine.” However, because individual choices not to vaccinate are being made in our “system” (our country), we are once again seeing COVID numbers rise to levels that place a significant burden on our country’s health systems – and for thousands, results in death.

The question at its simplest is whether, as individuals living in a free country, we will make decisions that support the health of the system at large (our country) or whether we will make decisions that may ultimately sub optimize the health of our entire country.

Simply because someone may think he or she is not part of a larger system does not make it so. Individual decisions and actions ripple across the many and complex interrelated systems of our society, a public health dynamic that is unfolding right now across our country. Perhaps our country’s founders had this concept in mind when they penned the words, “We the people” in the preamble of the Constitution, rather than “Each of us individually.” With the goal to “form a more perfect union” – meaning being joined together – it could be argued that our nation’s founders understood the need to think of our country as an interdependent system, a concept penned and reinforced in 1892 by Francis Bellamy in which his original version of the “Pledge of Allegiance” referred to our country as “… one nation, indivisible…”.

Systems scientist Dr. Russell Ackoff once said that “Until managers take into account the systemic nature of their organizations, most of their efforts to improve their performance are doomed to failure.” If Dr. Ackoff is correct, unless a majority (70-90%) of the individuals in our country are willing to take a systems approach to ending COVID-19, most, if not all, of our efforts to eradicate COVID-19 may likely be doomed to fail.

In closing, through this writing I have attempted to apply my understanding of some of Dr. Deming’s ideas (appreciation for a system and sub optimization of a system) in order to analyze and better understand a current and alarming event in our world:  the COVID-19 pandemic, for it is not an issue confined to the United States, but rather the entire planet (hence the word “pandemic”), a true demonstration of the “systemness” and interdependence of the world in which we live. With this “Deming lens” as a foundation, I offer a final question for consideration, crafted in a format similar to Dr. Deming’s own style of inquiry: “By what method” might we as a nation, and entire world, approach the pandemic in order to achieve the best results for all who are a part of this system we call humanity?

References

 

American Lung Society. (2020, July 27). From the Frontlines: Understanding Herd Immunity.  Retrieved from: https://www.lung.org/blog/understanding-covid-herd-immunity

Brant, S. (2010, October 23). If Russ Ackoff had Given a TED Talk. [Video]. YouTube. https://www.youtube.com/watch?v=OqEeIG8aPPk

Health and Human Services Office of the Surgeon General. (2019, March 18). U.S. Public Health Service Commissioned Corps.  Retrieved from https://www.hhs.gov/surgeongeneral/corps/index.html

Historic Documents. The Pledge of Allegiance.  Retrieved from https://www.ushistory.org/documents/pledge.htm

New York Times (2021, August 27). Coronavirus in the U.S.: Latest Map and Case Count. Retrieved from https://www.nytimes.com/interactive/2021/us/covid-cases.html

Our World in Data. (2021, August 26). Coronavirus (COVID-19) Vaccinations. Retrieved from https://www.google.com/search?q=covid+vaccination+rates+united+states&oq=covid+vaccination+rates+uni&aqs=chrome.0.0i512l2j69i57j0i22i30l2j0i390l2.13351j0j9&sourceid=chrome&ie=UTF-8

United States Courts. (n.d.). The US Constitution Preamble.  Retrieved from: https://www.uscourts.gov/about-federal-courts/educational-resources/about-educational-outreach/activity-resources/us

Whelen J. (2001, October). Building the Fish Banks Model and Renewable Resource Depletion.  Retrieved from http://www.uvm.edu/~lpolya/ENVS%20295/Readings/Building%20the%20Fish%20Banks%20%20Model.pdf

 

 

19 thoughts on “Can “Appreciation for a System” Support the Taming of COVID?”

  1. A push for quick adoption of the vaccine may be a short-term solution. Frustration over the seemingly delayed end to the pandemic may simply be impatience regarding a slow, but methodical solution. If the vaccination is the answer to this pandemic, perhaps patience is required to see the long-term impact.

  2. This article was a fascinating read. I appreciated the opportunity to help me process what has been happening in this country. When we think systems thinking, my mind goes to how can/will my actions affect others in my community and beyond. I often fall into a systems mindset whenever tragedy or tough times are thrown upon us as a nation or in this case, as the world. I think back to other tough times in my life and how it has brought us together as a country, one system, one nation, for example, 9/11 and its impact on our country. I always hoped that THIS nation would follow that trend. I enjoyed the wrap-up question, I wish I knew the answer, but I hope someone is thinking about this before our subsequent hardship we take on as a nation or the world.

  3. Upon reading this, two things came to mind from Senge’s “The Fifth Discipline”: 1) “the harder you push, the harder the system pushes back” and “faster is slower.” The FDA and U.S. Public Health Service Commissioned Corps approach towards the vaccine is to push it out aggressively and as quickly as possible. The aggressive approach invites resistance; people do not like being told what to do, especially in the U.S. where individual success is prioritized over the community (the system). Therefore it is unsurprising to me that so many citizens refuse the vaccine; they feel their individual freedom is at stake so they push back even if the logic or science proves that the solution will benefit all of us in the long term. In the U.S. the cultural norm is to operate from an inward mindset, making it that much more difficult to convince “70-90%” of citizens to get on board with a vaccine that is designed out of an outward mindset. The approach to get the vaccine out as quickly as possible is well-intended, but as we know, trying to accomplish such an enormous feat, such as 90% vaccination, in a matter of months is tricky when it’s proven that system improvements happen slowly over time. On another note, the vast number of citizens opting not to receive the vaccine reflects certain mental models about our individual safety and choice. These mental models shape how we act, so if I believe that government decisions about the vaccine are attempting to take away some of my liberties, and I am unaware of this mental model I hold, then I will continue to fight against the vaccine no matter what the benefits might be to myself and others around me.

  4. While I don’t want to live in China for many reasons, I feel they have done one of the best jobs at mitigation of COVID as a country. Yes, I realize it is through dictatorship of protocols. Has it kept their Covid numbers down? Yes. Has it helped stop the spread, again yes. During shutdown they had to report temps. When my friend returned to China from the United States he had to quarantine. There was red tape on his door and a sign that said he was to be arrested if he left his home. I think this is one of the reasons in a city like Beijing they are able to keep covid numbers down. Your choice is: if you don’t get vaccinated then don’t go out in public. Sometimes taking away the individual decisions keep the system safe.

  5. I appreciate the thoughtfulness and examples provided in this post. We must recognize that we are indeed all part of the same system. Our ability to succeed as a human race is highly dependent on one another. Moving forward with an outward mindset to see how our decisions impact others will be critical for all involved. The systems perspective provides great learning around the possibilities moving forward.

  6. Human beings are so very complicated. Fear of the unknown leads some to make decisions based on what they feel is best for themselves at that time, and not about the system or impact they have on the whole.

  7. After reading the article, all politics aside, I see there is a “wholesome” point of view that could possibly allow all to see the true issue at hand. The longer we continue to make individual decisions based on choice, beliefs, and ego the longer we will be stuck mid-pandemic (or any large systematic barrier/challenge). And sadly, that means, herd immunity will not be achieved for this illness and we will continue to battle it and see people suffer, become hospitalized and even die from it.

  8. This article is a great example of how systems thinking can benefit the largest system–our whole world. If everyone’s individual actions ripple and take effect on others, how can we spread the idea of systems thinking and making decisions that support the wellbeing of all?

  9. Samantha Finneseth

    I pose that the idea of personal liberties (i.e. vaccination opposition) is not people believing they are not part of a system, but their participation in a longer-established system: capitalism. I believe this is more of a failure to see the additional system of public health. The idea of winners and losers is deeply embedded and taken as individualism within many cold-climate cultures (Lanier, 2010). The combination focus on individual success and personal rights is well -established and could easily predict the resistance in the public-health system.

    Lanier, S. A. (2010). Foreign to familiar: A guide to understanding hot- and cold-climate cultures. McDougal Publishing.

  10. After comparing the mask mandate/vaccination push for Covid 19 and the Fishbanks Game, I highly doubt that there is enough appreciation for the system with its current mitigation strategies to reach heard immunity. The problem lies within the diverse groups of people that have differing opinions and beliefs. There is a good percentage of the human population that do not believe herd immunity is real or can be reached, therefore hindering the mitigation efforts of the system that is in place.

  11. As stated above, “simply because someone may think he or she is not part of a larger system does not make it so.”
    I think there are many people in the world who do not want to be part of a system, for various reasons. People might believe that the system is rigged against them, they do not fit into a system that is binary, or that they are better at being individuals.
    However, even when someone goes against the system (or are wanting to be part of a more impactful or positive system), they are still part of a system. Therefore, systems are in place even when people do not want to be part of one.

  12. Dr. Stilwell,

    The question you pose at the end of this article is an excellent thought that we all need to reflect on. Our country has given us the freedom to make our own choices but I don’t believe we often realize how our decisions impact the entire system. This pandemic unities us all and requires each individual to be a part of the solution, whether it is through vaccination or mitigation efforts like face coverings and social distancing.

  13. I believe that this article is enlightening because it reinforces what the greater good is. There are two viruses at this moment: the political virus and the Covid-19 Virus. In order to defeat the enemy we need ONE common goal that everyone can rally behind and not two. Very well written article!

  14. Dr. Deming tells us that every system must have an aim and that individual parts must work together towards that aim. I believe a challenge that is faced could be assuming that each individual part of the system has equal access, opportunity and knowledge to affect change. If the system is public health and the vaccine is the change agent, the system is doomed to fail from the outset. We the people doesn’t apply to every person within the system as a whole. When people are excluded from the process, the system fails.

  15. Thank you for looking at the pandemic through a different lens: systems. It also makes me wonder when, and therefore why, did our system (country) develop such an inward mindset. If we want to shift the current system so that everyone understands that they are part of a larger, complex system, shouldn’t we determine why our fellow countrymen don’t know or understand this? Maybe in identifying this cause, it then can become the cure?

  16. Great article, Dr. Stilwell. You posed the question, “By what method” might we as a nation, and entire world, approach the pandemic in order to achieve the best results for all who are a part of this system we call humanity?” and I wish I had an answer that would suffice. Our divided nation/people need to help and I know that mandates or the talk of mandates have further fueled the fire and spread people further apart. I have watched politicians and celebrities on both sides of the aisle make attempts by showing themselves get vaccinated but yet we still have a greater divide. Fortunately, I do know of those who were apprehensive about the vaccine and eventually made the realization that the positives of getting the vaccine outweighed the potential negatives. We know that change takes time and I am hopeful that overtime we will educate those to the point they feel compelled to get vaccinated.

  17. I appreciate the connection that was made here among our current reality as a country and planet to the work of Dr. Deming. This real world connection aided my understanding of Dr. Deming’s work and the impact of an individual and the affect it can have on the system as a whole.

  18. What is the root cause of this system failure? Distrust in our governing officials, distrust in the scientific community, or stubbornness in the individual that only they know what is best for themself? I akin this problem to one of faith, or refusal of it. One’s belief in a higher power does no more to make a non-believer agree that there is one, then the non-believers argument that there is no ‘God’ will make a believer change his mind. So as a system do we look to fix the ‘politics’ as a possible root cause, (if that could even be possible) or do we better educate the average participant in the system the scientific process?

  19. “Simply because someone may think he or she is not part of a larger system does not make it so.” This rings true as personal decisions are made on whether or not to receive the vaccine. When one thinks only of themselves, they may not see the larger impact at play.

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