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

 

 

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