The false hope of silver bullets

Have you wondered: am I infected without symptoms? Am I contaminating others unknowingly? Years of gemba walks in hospitals have left this typically hypochondriac author with memories of irrationally leaving shoes on the doormat, carefully stripping, putting all clothes in the wash and taking a long shower on my return from walking the wards. My caregiver friends, exposed daily to invisible bugs and contagion risks tended to take a more cavalier attitude to catching something – in most cases, they told me, contagion requires prolonged contact, so we’re all fairly safe. COVID19 is certainly changing that.

A foundational part of lean training is learning Toyota’s Business Practices:

Clarify the problem Break down the problem Set a target Analyze the root cause See countermeasures through Evaluate both results and processes Standardize successful processes

These practices (practices as something you deliberately do, it won’t happen on its own) are accompanied in Toyota lore by key “drive and dedication”’ attitudes to orient one’s thinking: customer first; always confirm the purpose of your work; ownership and responsibility; visualization; judgment based on facts; think and act persistently; speedy action in a timely manner; follow each process with sincerity and commitment; thorough communication; involve all stakeholders.

It’s true that this thinking process usually applies to isolating defective parts and identifying the cause of defects. These defects are rarely contagious – or autonomous. But there is one thing long experience with problem solving teaches you: there is rarely one solution. Problems are solved by pushing back on the issue with every idea you have – until finally, you understand how all the different things you’ve tried can come together more effectively.

Intuitively we think of problems as:

problem -> figure out the cause -> find a solution -> apply the solution

But the correct structure of real-life problems is well known in cognitive research, and it looks like that:

source: https://pdfs.semanticscholar.org/fc8d/23bb289c1acfd56e1188740e1ff61cc4ea0b.pdf

The king wants to attack the fortress (solve the problem) but defenders have mined each road. Since they need to be supplied, each road can let pass a small number of men, but will blow up if under a massive attack, so the walls can’t be stormed. On the other hand, defenders can rain arrows on any small group of attackers and stop them all.

The fortress will fall if the king succeeds in getting small groups of men to attack simultaneously on all roads, and then converge all troops on the weakest point of the walls where they start to crack.

Contagion is a jidoka-like issue issue: don’t accept the bug, don’t pass on the bug. We clearly need to break the chain of contagion. The difficulty is we don’t see the virus in the air or on our hands, so we can only imagine it’s there. So if we breakdown the problem we get to a chain of risks: breathe it in à catch it on your hands à bring it to your face à detect whether you’ve caught it à breathing on people if you have à touching other people’s surfaces is you have

Each of these problem steps has pretty basic countermeasures:

Breathe it in: Stay at a safe distance (still unclear) from people coughing or sneezing, wear a mask if you are exposed to many people

Touch it in: Wash or sanitize your hands after picking up something someone else has handled

Bring it to eyes or mouth: Don’t touch your face while interacted with people or materials possibly contaminated

Know whether you’re contaminated: Test yourself if you fear you’ve been touched

Breathe it on: Wear a mask if you start sneezing or coughing (it’s probably only hay fever, but we need to stay on the safe side)

Contaminate the environment: Self-isolate if you feel you’ve caught the coronavirus.

Because we’re still discovering how this virus interacts with us, contagion appears magical in many cases – and quite scary. Ultimately, just as tricky quality problems in production, this means that there is not one solution but a range of countermeasures which, applied together, allow us to fight back on the conditions of the problem – and progressively help us narrow down the real root cause.

Governments has reacted in very different ways. Some have confined everyone to their homes. Others have quickly set up systematic testing. Time will tell which factor has the greatest impact – but what we can already see is that those who implement multi-countermeasures as opposed to focusing on just one are clearly more successful in slowing down the epidemic.

Coronavirus’ progresss is horrifying – and the news media keep concentrating the terror of it across billions of people in their front pages. Clearly there is no easy way out until a cure and vaccine are found: we’re going to take hits and suffer heartbreaking losses. It’s tempting to lose oneself in overwhelming emotions of distress and dread, and have no patience with reasoning. On the other hand, I’d argue that this is precisely the time to buckle up think it through – while our hearts bleed.

What lean’s problem solving experience brings to the party is that there is no silver bullet – there never is. Blanket solutions are the knee jerk responses on dominant people in over their head – as we know well when we’re dealing with quality crises. The fortress will only fall if we explore all routes that lead to it to find the right balance of countermeasures and progressively learn which ones are the most effective.

No silver bullets also means we’re all in this together for the duration, and so we need to involve all others we need to maintain these countermeasures for some time. The COVID19 outbreak has started a second clock: the clock to the point that we can’t work with each other anymore. Because these countermeasures need to be applied over time, we need to bring everyone in on the problem solving, and when we hit roadblocks, seek substitution solutions together.

Lean thinking is vital right now, because of its long experience of intractable problems. We know we need to try multiple countermeasures as long as we’re in the dark. We know that each of these countermeasures requires its own supply chain and logistics. We know that as elements of the chain fall down, we can find substitution solutions. More importantly we know we need to keep people engaged and motivated in looking for solutions together until the problem is finally well understood and we can all focus on sensible policies. This is no time to stubbornly hold to initial plans, no matter what. What we need right now is to keep talking and trying and helping people who call for help – until we can figure out the set of countermeasures with the greatest impact. And keep all other underlying systems working as we do. If you want to go fast, go alone; if you want to go far, go together.