An appreciation of Coronavirus: The Swiss Cheese Strategy by Tomas Pueyo.
This is the first of a series of reviews of thought leadership.
The COVID-19 pandemic crisis how ideas have real-world consequences. For instance, the “warp speed” approach to vaccine research and development didn’t come from out of nowhere. It echoes the concept of agile software development (also known as “sprint and scrum,”) which in turn hearkens back to the “challenge-driven leadership” concept in place at MIT. You could probably trace it back to the U.S. Navy during World War II (as recalled by Admiral Hyman Rickover), or for that matter to the Gordian Knot.
At heart, the concept is not really about speed. It’s about focus. When you have a serious problem to solve, put an intensely focused team of driven people in place, and let them work without distraction on it, instead of relying on an established, formal, waterfall-style innovation process. Without that concept in place, and its proven history of success, it’s unlikely that so many pharma researchers and enterprises, working within their highly structured system, would have had the confidence to act so quickly.
Demonstrating the “How” of “Why”
Some very high-quality thought leadership has come out of the pandemic. (Thought leadership is clear, influential narrative work that helps show the link between concepts and practical results.) There are, in my view, four criteria for great work of this kind: timely originality (the writer sees what needs to be seen now, that others have mostly missed), conceptual clarity (the writer makes sense of a complex situation), explanatory power (the reader learns not just what’s going on, but why) and a natural constituency (people are ready to hear what the writer has to say).
Explanatory power is Tomás Pueyo’s strength. His recent Medium article, “Coronavirus: the Swiss Cheese Strategy,” is a great demonstration of the “how” of “why:” how to marshall a stream of logic to make a rationale clear, so people feel confident acting on it.
Pueyo is a vice president for growth at the learning platform Course Hero. His Medium article “The Hammer and the Dance,” published March 19, received more than 20 million hits. That article described a road not taken still by most countries: lock down fast and dramatically (the hammer) and then learn enough, through testing, research and analysis, to apply good judgment in social distancing and preventative care measures (the dance).
“The Swiss Cheese Strategy” takes this idea one step further. It explains why imperfection in a risk management practice is OK. In other words, masks are imperfect barriers. Sure. But that’s no reason to avoid them.
The concept of the swiss cheese strategy, like warp speed management, has a long history. It dates back to the 1980s, when psychologists were trying to figure out how to avoid the kind of human error that led to Bhopal, Chernobyl, the Challenger, Three Mile Island, and the fire in London’s King Cross underground station. In all these cases (and many others since then— you could add Fukushima to the list), seemingly small problems compounded each other and led to disaster.
James Reason, a cognitive psychologist at the University of Manchester, argued that any single defense against a problem could never be absolute. Risk management meant piling up a series of preventative measures, so that even though every one was like a slice of swiss cheese, full of holes, the apertures would not line up, the problem could not pass through, and the crisis would be averted.
That basic concept provides a starting point for considering masks, social distancing, shutdowns, travel bans, medicines, and every other pandemic-related measure. None of them are fool-proof. Several together will do more good than one alone. But putting several measures together, without thinking through the relationships among them, will not suffice. You want to be smart about it, making sure the holes don’t align.
Pueyo is trying to build that type of on-the-ground judgment among his readers. So he doesn’t open with the swiss cheese analogy. Instead, he assumes that most readers are skeptical — after months of conflicting guidance, who wouldn’t be? He sets out to convince readers of his credibility through a diagram of the pandemic’s spread in three regions: the U.S. (surge, level off, mini-surge, level again, and then terrible surge), the European Union (crisis, nearly controlled, and then really bad crisis), and Asia-Pacific, including but not limited to China (low and level). He uses one specific comparative measure, the number of cases over 14 days per 100 inhabitants, and tells us why he chose it. “This is a myth-busting graph,” he adds, and he addresses the myth that many of us in the US are inclined to believe: that authoritarian governments can control the spread of the disease better than messier, more democratic societies.
In fact, he says, the countries that stopped the virus most successfully included “all types of countries: democratic, authoritarian, continental, islandic, freedom-loving, Anglo-Saxon, developing, developed… They prove any country can succeed.” The problem, says Pueyo, is that most Western countries didn’t learn to “dance:” to align the holes of Swiss Cheese, as it were, to hold back the pandemic. But we still could learn. And then he takes us clearly to the core theme: the sequence of principles at the heart of his message:
1. Stop as many infections from coming in as possible
2. For infected people who make it in, minimize the people they meet
3. When they meet people, minimize the likelihood that they will infect somebody else
4. When they infect somebody else, identify that infection quickly and neutralize it
There’s a lot packed into those four principles. They make no mention of masks, contact tracing, vaccines or particular treatments. But they give you a way of thinking about all four of them, and more. If you can follow these four precepts, then you’re safe to make all other decisions, regardless of your political orientation. You can have churches, parties, restaurants, air travel, Spring Break, elementary schools, ceremonies, within the limits of good judgment. This piece went viral, I think, because the author shows that he trusts his readers to act for themselves — and shows what responsible action would feel like.
This piece went viral, I think, because the author shows that he trusts his readers to act for themselves.
Then Pueyo goes on to explain each of the precepts in detail, with references to quarantines, social distancing, ventilation — all the appropriate details. If you mapped out the logic flow that follows, you’d see that each element is chosen to make you a bit more capable in designing your own approach.
The antidote to Fake News — to confusion about which facts are correct — is to do what Pueyo has done here. You create a transparent and simple framework, substantiate it so that even your critics would agree it’s substantiated, and then show how other concepts fit.
By the time he gets to the last section — the discussions of sewage testing, dog-sniffing, and Slovakia’s regime of daily tests for the entire population — it’s clear that he’s a little bit tired. The latter part of the piece needs another round of editing. And some readers will undoubtedly drop out at that time. But he’s already done his job. The material is so consistent with what we know and see that it has face credibility. It’s so well-supported with plain-spoken detail from a variety of different sources, that we know it is well-researched.
And then, at the very end, he does two things that thought leaders don’t do enough of. He says, “You can do it too.” And he acknowledges the people who advised him.
Thank you to: Faith Florer, Bill Isaacs, Elizabeth Kleiner, Nina Kruschwitz, Cheri Lovre, Wallace Mohlenbrok, Suvarchala Narayanan, Juliette Powell, Martijn Sjoorda, and Tom Stewart.
Side note: Among the voices I’ve appreciated relative to the coronavirus are Danielle Allen, director of Harvard’s Edmond J. Safra Center for Ethics. Her (and their) work “Three Key Ideas at Stake for a Post CoronaVirus Future,” summarized in the Washington Post, laid out a conceptual framework that put all the danger in perspective. Humanity has to find contagious people before they infect others (therefore, reliable and frequent testing); stop the spread (therefore, masks and smart social distancing, informed by lots of testing); and focus on treatments that reduce the danger, even more than vaccines. Having read this back in April, despite not knowing much about epidemiology, I understood what would happen. This theory turned out to be prescient; it has been proven correct as events played out. Most of all, Allen didn’t just explain what to do; she articulated why. Again, in thought leadership, that makes all the difference.