Prepare for whiplash

Let’s take care of the sick first, yes? They need care. So let’s take care of the care providers, yes? They need material and emotional support to do their jobs – masks for protection, gel for disinfection, respirators for the very ill, beds for the surge of patients, and all the underlying logistics of modern medicine. Let’s double our treatment facilities if the takt time of respiratory patients has halved. Don’t tell me no one knows how to set up field hospitals? (I’ve met ONG people who know very well how to do that). What can we do to solve the problem?

First we need to understand it. Our great leaders sound as definitive, as responsible and as in charge as every general in every debacle in history. They have somehow decided that they can’t fix basic care production and logistics issues so, instead… they’re going to stop society as we know it. Easy: everyone stays home (by force if necessary), fewer people get sick, takt time is back up to something manageable. Problem solved.

Except that caregivers need all the emotional and material support of a functioning society to give care. And when lockdown lifts and the epidemic starts galloping again, they’ll need more and more of that, exhausted as they’ll be. But will we be in shape to provide it?

Whiplash is a rapid back and forth movement that happens when you stop a car too suddenly, and which can badly harm your neck. As supply chains are grinding to a halt for a number of reasons ranging from lockdown on operations, materials shortage or people understandably scared to come to work, we will live through something unprecedented.

Supply chains are not a simple matter of pressing “buy now” on your touchscreen and watching stuff appear magically at the door. They’re complex assemblies of production and logistics that must come together to deliver – and that includes human expectations, plans and decisions.

In The Lean Sensei we sketch the outline of a supply chain system:

There is no debate that supply-chains are fully stocked – no worries there. But as production of key component falters, executives will issue instructions for production or delivery according to their expectations. Our government, for instance, has just asked fuel distributers to restrict delivery to a “strict minimum” whatever that means. This will shape expectations for every delivery outfit, with the normal range of human interpretation – some will continue to serve as normal, some will stop completely.

This, in turn will influence the stock in the system and distort even further expectations, until customer start to panic and create a blip of unusually high demand as everyone wants to top up – as has happened with sanitizing gel, masks, toilet paper and so on.

Expectations will be further distorted by governments’ assumptions that everyone is ill or about to be and so must remain in lockdown. Since we’re only measuring the critically ill against the tested, we have no idea of how lethal the bug really is. And as with the other logistics issues, testing is somehow, off the table.

An article from The Economist gives the following numbers of tested per one million: South Korea 5567; Italy 2514; France 168, Germany stopped updating the numbers; Spain not announced; Britain 3.9.

In France, for instance, one reason for so little testing is that the reactive agents for test come from… China and the production machine is both in lockdown and stockpiling for Chinese and US use. Instructions, production, stocks/backlog.

In simple terms this means that the information driving the instructions to the production and delivery facilities in our graph is completely flawed or absent. Governments are shutting down the entire machinery of supply chains not to swamp ER services going in blind about the expected demand, and with no notion that supply chain are a complex system of capillary value that will break at the weakest link – which we’ll only discover when it happens.

Furthermore, the entire theory is built on slowing down the curve of infections in order to not swamp hospitals and then… waiting for the bug to subside in the summer. The corollary to that is that the moment lockdown is lifted, which it will have to be sooner or later, the epidemic will start raging as ever before and I don’t see how we’re logistically readier, with exhausted healthcare staff and broken logistics.

It ain’t going to be pretty.

I am confident we will get over this. Water follows the cracks in the rocks to reach the river, and humans are smart and resourceful when their livelihoods are at stake – look around you: proto-black markets are already happening, as in any prison camp. But I am overwhelmed (and a bit panicked I have to confess) at the scale of the non thinking displayed by authorities so happy with the “go to your room” playbook that they don’t show us what they are actually doing to solve the problem (if they are indeed working on it) rather than ask the police to stop people from going to work.

We need lean thinking and lean thinkers more than ever. We need people who put customers, here patients and caregivers first. People who understand how supply chains work and have firsthand familiarity with the Forrester effect and how to counter it. We need people who are experienced with flexibility in operations and know how to modify buildings and equipment to make new stuff out of existing operations. And we need people with the coordinating know-how that understand that vast undertakings can’t work with bureaucratic command-and-control systems but need collaboration and teamwork.

Stuck here confined, in a locked down country, I feel guilty that we didn’t do more to train more people to the deep mechanisms of operations and how to work them in a crisis. We failed at making executives care. Now I fear we’ll all pay the price. Watch out for what happens when you bring logistics and productions chains to a sudden stop. Prepare for whiplash.

What can we do? First, we can accept that we’ll not be the same after this crisis as we were going into it. We will be a different society – without knowing what will change or how. Still, lean thinking trains us to change, concretely, by cultivating:

• Clearer minds: what new problems will our customers experience? How can we focus right now on the new problems appearing and what can we do to support our customers even as we go through the same crisis as they do? New problems are symptoms of the deep changes going on that we currently can’t see. Looking into them, building scenarios, thinking of options and refusing to go down the rabit hole of just one possibility is how we can be most useful right now: keep thinking independently!
• Warmer hearts: no matter how serious and calm people sound, we have to accept that we’re all freaking out somehow right now – fear is everywhere. Fear makes people respond differently, either by focusing on too narrow problems they can control, or by flying off the handle unexpectedly, or by hunkering down in denial. It’s okay. We need to help our staff feel safe by strengthening our community – each one of us is a refuge.
• Faster focus: fear makes us want to jump to action instinctively, to commit irrationally to solutions that will look crazy with hindsight. Let us ask ourselves: “what is the first thing we need to learn?” Rather than “what is the first thing we need to do?” The speed of our recovery is directly link to the speed of learning – we need to recognize repeating situations and investigate. They are the shape of things to come.

Yes, I’m ranting. Apologies for that. Like everyone else I feel completely overwhelmed by everything that is going on. But I am also deeply convinced we have the knowledge and experience to face the tsunami – if we activate it. Post mortems of most crises show that people knew what to do, but, overstimulated as they were by the flood of contradictory information and the fear and panic – they did something else, and crashed. I pray we activate our lean thinking and learn-by-doing our way out of this mess.