Process Triaging COVID-19

Note: This 3/10/2020 post was last updated on 3/13/2020 to reflect my latest thinking.

How we think about caronoviruses is important. They are a deadly threat to the immunologically compromised. This post applies the ProcessTriage® Protocol to the COVID-19 virus epidemic. Here’s my triaging narrative so far:

The COVID-19 epidemic is a Process Pain Point. In no particular order, it inhibits business and community performance. It is a repeating event that disrupts our business by delaying supply chains, suppressing retail customer traffic, increasing employee absences, overwhelms medical ICU capabilities and is fatal to a specific demographic at rates quite higher than seasonal influenza (.1%), to perhaps +10x that, perhaps 2%, about half of what the 1918 Spanish Flu recorded.

Panic? Absolutely not. Pay attention? Absolutely. At this writing, it has an exponential growth rate about 1.15 (meaning each subsequent day’s infections will be 1.15 times the previous day’s) with an unknown inflection point date in sight (where the growth rate is 1.0, after which it will decline exponentially). Here is the latest data from Johns Hopkins University. A most sobering analysis of COVID-19 is Joe Rogan’s interview with infectious disease expert Michael Osterholm (March 10), Dr. Osterholm asserts “This will not be a flu blizzard, but a flu winter with potentially 480,000 deaths.” This is NOT the flu, although both are respiratory infections. There will not be a vaccine anytime soon. Unfortunately, forty percent of the US population have mitigating risk factors of obesity and high blood pressure, that increase their risk of complication, with an amplified risk to the elderly and those with weaker immune systems. The CDC’s Dr. Anne Schuchat gives a good summary as well (3/12/2020), from Senator Bill Frisk’s podcast (See episode #42).

Do we know the most likely cause? Yes, enough. COVID-19 is highly contagious and lasts from a few hours to perhaps ten days on surfaces. It originated in Wuhan, China, likely from a wet market.

Do we have a best practice that, if followed, addresses the pain point? Yes. During the epidemic’s expansion phase: SLOW IT DOWN until enough people recover from exposure until is stops spreading. It’s all about reducing the R0 ratio — the number of adjacent individuals a contagious carrier infects, thereby flattening the curve. Establish and maintain social distance. Avoid crowds. Practice good hygiene, diet, and exercise. Strengthen one’s immune system. Focus locally. Since the virus is spread by breathing, an R-95 grade breathing masks is required to prevent breathing it. One can be infected and contagious for typically four days before showing symptoms. If one is appears symptomatic, self-isolate and get tested if possible. Be especially aware of the immunologically compromised such as the elderly.

At some point, the strictness of this social separation can collapse the economy. Most hourly workers in all industries that serve gatherings of people will be unemployed. Schools, in-person entertainment, in-person sports, restaurants — the entire social services sector will collapse.

(Do not panic. Neurobiologically, keep your consciousness parked in your prefrontal cortex, where it’s emotionally safe. Focus on watching the empirical data — your local city and neighborhood numbers (not the numbers of places you’re not not going to visit, other than the trend lines). By focusing on the facts, we avoid the amygdala’s fight-flight-freeze lizard-brain panic; we suppress that nasty cortisol.)

Does this best practice need training or learning? YES. We need to TRAIN and ENFORCE this best practice with an effort and focus proportionate to the virus exposure rates within our neighborhoods and public places we frequent.

Is this triaged solution a Small (task size) or Big (project size) effort? Small for us individually, from a pre-infection viewpoint. Dealing with a serious COVID-19 infection individually or within one’s family will be a Big (project).

Let’s follow our best practice and lead by example, but be patient. This will take months to resolve. It will take a national strategy to stockpile the supplies needed for infectious disease outbreaks.

The above triage result focused on our individual-level solution. A similar triage from a national perspective yields a different solution: It’s a BIG DESIGN (and IMPLEMENT) a capability to detect and manage COVID-19 virus infected individuals. We must be patient and recognize our response will be clumsy and mistake-prone until a learning curve is completed enough. Since COVID-19 has a 10x+ morbidity rate than seasonal flu and it there is no vaccine, we will have to design and establish COVID-19 intake facilities based on the volume of serious infections. The best case is we size and deploy these facilities and staff in a flexible, scalable manner. Establishing dedicated facilities will answer itself depending upon severe infection frequency. Some things will never be the same, such as nursing home access; every visitor and staff member will have to cleared to enter. Obviously, we must decouple the medical supply chain from China and return all manufacturing of essential medicine and medical supplies to domestic manufacturers as a matter of national security.

How Business Can Be the Highest Expression of Righteousness

I have often closed my Process Triaging for Executives talk and exercise with a reflection on my father’s (OBM) commentary on the Declaration of Independence. Because business processes are constantly stressed and break as the company succeeds and grows, continuous process improvement is a pursuit, not an objective one satisfies. As dad admonished, the pursuit of happiness is a miserable existence that implies one is not happy in the moment, only chasing what one doesn’t have. Instead, find pleasure in the toil and hard work of life — find happiness in every moment; in every item on the to-do list. And occasionally everything comes together for truly superlative, joyful celebrations — like icing on an otherwise very good cake.

This happiness of pursuit is an excellent anchor, psychologically and emotionally. As a habit, it builds resiliency and courage. However, it must rest on a foundation of purposefulness. Pursuing anything with the intensity it takes to lead a business requires transcendence. Might this be charity?

The medieval Jewish sage Moses ben Maimon (a.k.a. Maimonedes) — the Rambam unpacked the concept of tzadaka, often translated as charity. But charity doesn’t do it justice; a more nuanced word is righteousness that expresses an alignment with purposeful virtue. With our Divine raison d’être — why we are here. The Rambam offered a list of righteous actions ranked by degree — all good but some more equal than others. The highest form of tzadaka is all why we devoted to this business of business:

  1. The least expression of righteousness if to give unwillingly. The giving is good, nevertheless.
  2. A better expression is to give gladly, but inadequately. The giving is good, nevertheless.
  3. A better expression is to give to a poor person after being asked. The giving is good, nevertheless.
  4. A better expression is to give to a poor person directly to his or her hand before being asked.
  5. A better expression is to give, but not know who receives it, so the receiver is not shamed.
  6. A better expression is to give, knowing the receiver but the receiver does not know the benefactor.
  7. A better expression is to give in a manner the benefactor and receiver do not know each other — such as giving to an anonymous fund. There is a necessary obligation to be satisfied with the fund’s administration.
  8. The greatest expression of righteousness is to endow someone with a gift or loan or entering into partnerships that finds them employment or a livelihood.

There is no greater expression of tzadaka — of charitable righteousness than creating and sustaining a business that provides someone employment and a livelihood. This is beyond teaching someone to fish — it is to help and enable them become a professional fisherman.

So in our happiness of pursuit, let’s pursue that which is most purposeful.

Will We Find the Balance Between Justice and Mercy?

Here follows some random thoughts about the current state of affairs, this Juneteenth. I have just recently had an implanted cardioverter defibrillator (ICD) discharge that seized my undivided attention. Thirty-five joules of joy! I am undergoing a treatment plan for myocarditis (heart inflamation) that has made me reflective. Please indulge me.

From antiquity we learn that, in terms of social justice, thriving communities find the right balance between enforcing a strict justice and fostering a forgiving mercy. The art of good government enforces an order that instills a proper respect for the government, lest we devour each other, complemented by a lenient, gracious empathy that binds a community together in compassionate interdependence. It is the balance between the classical assertive masculine and the receptive feminine. We remember that those who show mercy to the cruel will live to see the cruel devour the merciful. We are questioning this balance today; the empathetic are crying for mercy and less police assertion, while the just demand the enforcement of law and order to protect the merciful. Every generation must sort this out. Our Constitution and Bill of Rights are the perfect framework to do so.

I weep for my country. The media-instigated social frenzy and gas lighting about a systemic racism is appalling. It simply does not exist in America at large. It appears to be thriving in urban one-party Democrat urban centers and academia, fueled by click-bait obsessed fake news propagandists. The reality is most Americans live in integrated harmony. That is my lived experience for decades. I agree that black lives matter within the greater and more empathetic virtue that all lives matter. If you study the data on violence, black lives matter except between poor young single urban men, usually black.

If you believe you are surrounded by systemic racism, leave. Move someplace else. At least half of America is living Dr. Rev. M. L. King’s dream where only character matters. Join us.

Regarding our national past racism, our ancestors — that minority who are guilty of it are not alive to ask forgiveness. And only they can ask for such. And those who would forgive them are long dead. It will always be unfinished business between them. There is nothing for us to forgive; their sins are not ours. My own ancestors fought for the Union-side of the Civil War (1861-1865), risking their lives to end antebellum slavery. That Republican virtue is my inheritance and I reject all assertions that diminish it. I cherish the moral privilege I inherited. If we apply this transference of past guilt fairly, then I am owed a measure of equally transferred gratitude for supporting slavery’s end. I’m not holding my breath about it.

The idea of equality of outcome is preposterous in a community where individuals are rewarded by industrious work, innovative creativity, and protected private property in which to gather and invest hard work’s fruit. The solution to such inevitable wealth disparity is a moral problem first and an economic one afterwards. The strong must not prey upon the weak; the smart not take advantage of the ignorant, and private property in all its forms must be respected and protected. Those are moral matters. For without such protection, capital will not accumulate and investing will not thrive, and jobs will not be created. Wealth disparity places a burden on the wealthy to put their wealth to moral use; to attempt the highest level of righteousness and virtue: to create jobs and livelihoods for others, above and including benevolent charity. Concomitantly, one should not covet. It is okay to want that beautiful — whatever, as long as it is not a specific thing belonging to a specific person. In this regard, our pillars of virtue are those to create jobs — the entrepreneurs.

Immorality begets poverty. The immorality of stealing destroys wealth and collapses marketplaces. Burning down and looting a grocery store as a form of protest against hyper-rare police brutality is beyond foolish. The protesters on these occasions were entirely capable of stopping the looting by force of numbers. They could have stopped it and gone back to exercising their right to assemble freely and peaceably. Shame on them.

In America, police interact with citizens hundreds of thousands of times a day, generally providing help and assistance. A minority of interactions involve arrests. Of those, the vast majority are non-violent. An astonishingly small percentage of arrests are resisted, and therefor likely to involve violence. In fact, it is practically impossible to experience police violence without resisting arrest. The probability of being shot by the police is higher for whites than blacks, however, seven percent of the population is most likely to resist arrest and encounter violence — urban young poor black men. There are anecdotal and statistical outliers of police misconduct that should be addressed, of course. Burning down the entire edifice of public safety because of occasional police misconduct is just stupid.

The world of young poor urban men, often black, is a tragedy. The reasons for their violence are complicated, but fundamentally, it is a cultural and moral failure. I am glad our attention is focused on it. We can solve it. We have to vector these young males toward productive lives.

One’s poverty is no excuse for avoiding the predictors of social failure: not graduating from high school, single parenthood, absent fathers in the home, and affordable good food and accessible health care. In other words; conventional successful White, Hispanic, and Asian American cultural values — the values that earn a privilege of generational social success. Blacks who have lived this are generally and equally successful, for virtue is color blind.

The sages of old observed the strict justice that served one generation may suffocate a subsequent generation that lacked their moral virtue and self-restraint. I grew up in a world of unlocked doors and keys left in the car’s ignition. Of varmint rifles on pick-up gun racks. Of “Yes, ma’am”, and “No, sir.” When a teacher’s note home brought a sound trashing if appropriate. A less virtuous generation will cast off the laws they cannot keep and descended into lawlessness. Eventually, a excessively merciful generation will cry out for justice until leaders rise to enforce that necessary justice. Often, those leaders will become dictators. We are grappling with this question now, especially in excessively empathetic urban centers.

Thomas Jefferson captured the greatest vision statement in the history of human civilization in “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty, and the pursuit of happiness.” It is the nature of vision statements to reach for the stars; to aspire to ideals that are not yet lived. Certainly Jefferson and many of our founder’s generation did not live it, in respect to slave ownership specifically. The Civil War settled that constitutionally. 130 years after Jefferson planted this flag, women were given the right to vote. The civil rights act of 1965 sought to improve on it. And so this week’s Title IX decision broadening the definition of sex to beyond biology to personal belief follows this aspiration. So to tear down Jefferson’s monument is a sacrilege. We ride on his shoulders.

This coming generation has experienced so little violence compared to the previous century that now, mere words and silence are thought violent. They would trample on the right of free speech that many generations of Americans have given their full measure to preserve. This ANTIFA generation has learned nothing from the genocides of Stalin and Mao that enshrined a rabid political correctness, other than to emulate it.

The recipe for civilization is over 4,000 years old. The oldest, continuous and most resilient civilization on the earth are the Jews. They are kept by the Torah more than they keep it. It teaches we need only seven essential laws — the Laws of Noah. Know and respect our Creator who gives us purpose. Do not murder or kidnap. Do not steal. Treasure and preserve the family (no illicit sexual relations). Be compassionate in our stewardship of the earth (do not eat the limb of an animal while it is alive). Establish just courts to enforce these six. Two traditional practices are encouraged; to give charity and honor one’s elders (parents and teachers). That’s it. Every social failure can be traced to a violation of one of these laws. We are surely without excuse.

I hope we find that new balance.

I pray my heart does not fail me, as I have unfinished business and hope to be a part of this solution.

Will We Be the Next Greatest Generation?

Friedrich Nietzsche opined, “That which does not kill us makes us stronger.” I suspect he said this when was a young man, when he likely thought himself immortal. Older men, as I now am, understand quite clearly that many things can actually kill you! Anyway, as I post this blog, the United States recorded 558 COVID-19 virus deaths today (March 30, 2020). There is every indication this daily rate may continue for this month of April, on the way to over 200,000 cumulative deaths in this contagion’s wave, perhaps tailing off in May sometime (the wave seems to be about six weeks long). Let’s put this horrific number in perspective.

The WWII Battle of the Bulge was American’s most deadly battle of that war in terms of total casualties*. Historians generally bracket the battle between December 16 to January 25, give or take — about 40 days. The Americans recorded 20,876 killed-in-action (89,500 killed, wounded, or missing). That’s an average of about 520 battle deaths per day. If the COVID-19 casualty rates keep this 500+ run rate up during this month (April) — and there’s no evidence the curve has flattened nationwide, we will experience a heartbreaking sadness and trial that forged America’s Greatest Generation.

The Battle of the Bulge (Dec 16 – Jan 25, 1944)

I am a late boomer kid, a son of card carrying members of this Greatest Generation. My parents grew up the during the Great Depression (1930’s) and fought World War II (1941-45). They designed and built The Arsenal of Democracy. They invented the transistor and the integrated chip, Teflon® and Tupperware®. They pioneered heart transplants, discovered DNA, landed astronauts on the moon, and desegregated the South. Granting Nietzsche his point, the Great Depression raised them tough, no doubt. But WWII bound their generation together and forged this greatest generation. They personally or as a community faced and grieved over death at an uncommon scale. And many, many of them made their lives count during and after the war.

The President’s 2016 campaign slogan was Make America Great Again. Not in anyone’s wildest dreams except, perhaps, a small coven of virologists, foresaw this COVID-19 virus pandemic. While the virus watchers in the CDC raised their alarming suspicions in early January, our leadership class was immersed in hyper-partisan impeachment proceeding. Granting it is pointless to criticize that any good thing could have been attempted sooner, we found ourselves ill prepared for a pandemic of this magnitude. As usual. America has never been ready for the next new war; we always scramble to catch up and figure out the fight. Our learning curve is full FUBAR and fog-of-war missteps, luck, second-guessing and tragic (and often fatal) incompetence. Then heroic leaders step forward and fight and scramble and inspire and solve and win. We figure it out. In WWII, we were getting the shit kicked out of us in North Africa during our first real engagement with the German army. It was General George Patton who showed the Army how to fight, eventually defeating his tactical mentor, General Erwin Rommel. While General Patton could be exasperatingly obnoxious (not unlike Mr. Trump at his worst), he had the necessary temperament (most of the time) for war. He made bold decisions and quick course corrections. To get a sense of his focus, read all of his “America Loves a Winner” speech before the 3rd Army the day before D-Day.

All that to say, let’s gather ourselves and recognize the profound opportunity our nation faces in these coming months. It may very well be as intense as the Battle of the Bulge — in real numbers of casualties and heroic sacrifices of our front line medical professionals. If we rise to this occasion, we will indeed win. And it will forge us into the next America’s Greatest Generation. Indeed, let us rise to this occasion.

*The deadliest battle in US history was the WWI battle of the Argonne Forrest during September, 1918; 26,277 KIA and 95,786 total killed and wounded.

The Post-COVID-19 New Normal — The Arsenal of Virology Excellence

JUNE 20 UPDATES:

This post is a follow up to Process Triaging COVID-19 this past March 11. This post is a living document.

Our national response to the COVID-19 pandemic is sufficiently along to start making Lessons Learned notes. Here are mine, subject to better data:

  • MOSTLY CORRECT: A coronavirus epidemic is like a weather event, similar to a lingering cold front. It lasts about three to six weeks depending upon the factors favoring contagious respiratory infection transmission: population density, social distance, humidity, sunlight, virus type, and human immune system vulnerability.
  • MOSTLY CORRECT: The COVID-19 coronavirus is a nasty bastard. Contagious days before showing symptoms make it a silent spreader. Persistent on non-porous surfaces for days in favorable room characteristics (low humidity, no sunlight, sufficient virus quantity). It has an exponential infection growth rate of about 1.5 and doubles in about four days with an RO factor above 2. The most vulnerable are the elderly over 60 years old with the 80+ age group the most susceptible and those with compromised immune systems. The fatality rate has not been concluded as the ratio’s denominator is not known; we don’t know how many people have been infected because a large proportion of the infected (enough to make antibodies) do not develop symptoms. We know about one in four hospital admissions die, recognizing they are pretty sick by the time they are admitted based on current stay-at-home guidelines. MOST CASUALTIES WERE OVER 60 AND/OR COMPROMISED IMMUNE SYSTEMS
  • INCORRECT: Immune system compromised patients escalate to ARDS — acute respiratory distress syndrome and pneumonia very quickly (in a couple of days) and requires ventilator breathing assistance (an ICU bed). It’s debilitatingly painful, as well. VENTILATORS LIKELY KILLED MORE THAN SAVED. IT IS AN OXYGEN ABSORPTION PREVENTING DISEASE SIMILAR TO HIGH ALTITUDE COMPROMISES.
  • CORRECT BUT DISPUTED: Anecdotal trials indicate certain anti-malarial and rheumatoid arthritis drugs are therapeutic. Trials with COVID-19 antibody plasma show promise but the benefits are short term.
  • CORRECT: The exponential rise of the contagion wave is flattened by reducing the RO factor by social distancing, personal hygiene, and non-porous surface antiseptic cleaning. Regional or national scale enforcement of social distancing collapses an economy if sustained too long. At some point, the cure becomes more harmful than the disease, recognizing what that point is is more art than science.
  • CORRECT BUT TESTING HAS BEEN INCONSISTENT: The essential public health strategy is to (1) reduce the infection transmission rate, (2) minimize healthcare worker infections specifically, (3) size the ICU/ventilator equipped hospital room and support staff inventory to meet peak patient volume, (4) medicate prophylactically and therapeutically, and (5) test enough of the population to understand the virus’s pathology enough to design management strategies. The leading indicator of the wave is the daily number of virus-positive tested persons in the population and their infection profile.
  • NOT CONFIRMED: It takes about three virus storm cycles or waves in a population to establish sufficient immunity in a population.

COVID-19-grade viruses are the new normal. The world has never had a coronovirus pandemic of this scale pile on top of a typical seasonal influenza (a very different rhinovirus). While virologists have forecasted such pandemics (including a wet market source like that of COVID-19), no pandemic planning has anticipated this magnitude. We were not ready and no one is to blame. This pandemic has exhausted our inadequate emergency stocks.

Process improvement design begins with The Ball, Not The Player. We do not care about the who or the how. We start with an overall strategic objective, often called The Big Number. Then we look at each supporting process and define its physical capability in one or more of four dimensions: Quality (of output), Speed (from process trigger to final product or state), Volume (how many final products or states), and Cost (the unit revenue or expense).

A Big Number might be something like, “Contain X number of coronavirus outbreaks within a population of X size within 6 weeks with no more than X% deaths with less than % economic depression.”

This might require the following Process Capability Goals:

  • Virus Outbreak Prevention A community must practice virus awareness behaviors. These best practices must become habits and integrated into cultural expressions and educational curricula. For example, people wearing anti-viral masks are visually common.
  • Virus Outbreak Detection A community must be capable of detecting a virus contagion outbreak and assessing its public health risk within X days of suspicion with 95% accuracy, anticipating two per year, on a budget of $X.XX per member of the population.
  • Virus Outbreak Response (Local) The community must be capable of sustaining standard virus abatement practices within 24 hours of a public health declaration and maintain this posture for up to 15 days. Community health care infrastructure must be capable of treating X% of ICU/ventilator necessary infected patience with on-hand facilities, technologies, supplies, and staff.
  • Virus Outbreak Response (State and Federal) Supporting health care infrastructure (State and Federal) must be able to deploy supporting treatment infrastructure, staff, and supplies within X days of request, state or federally funded, up to X times per year per state and X times per year federally.
  • Virus Life-Cycle Management The nation must be capable of developing and deploying prophylactic and therapeutic medications and vaccines for high-probability viruses in a timely manner within the budgets allocated to the nation and internationally as afforded.
  • Brand and Cultural Considerations The design and implementation of these virus management processes shall support and deliver the nation’s national brand promise of being the world’s Arsenal of Virology Excellence. The United States is the World’s brain trust and preferred anti-virus technology and best practice source.

That’s The Ball. Obviously it needs a lot of refining. Now we need to find the Players to make it happen.

Judge Crisis Leaders By Their Course Corrections

This is a post as much to myself as to my readers (Thank you!).

I have spent most of my professional life facilitating teams from good to great business process improvement to dumpster fire-interventions. Regarding these crises events, there are two kinds of work: first, solve the immediate problem and stabilize the situation, then secondly, after an after-action analysis, design and implement better practices that prevent a recurrence.

It is pointless to criticize leaders for not doing something good sooner. We simply don’t live with a real-time awareness of the events that trigger a crisis. Hindsight points out what was missed or not appreciated at the time. What matters is what one does with what one is focused.

We judge leaders in crisis management moments by the quality of their course corrections. Meaning, how fast can they cycle their OODA Loop. How fast do they Observe-Orient-Decide-Act. When two combat aircraft meet in arial combat (the perspective John Boyd applied to develop OODA Loop theory), the combatant that cycled the best OODA loop won. If the opponents are otherwise equal, the faster OODA loop won the day. Save the “What and why things went wrong?” questions for later — after the crisis is managed and when it is time to do so. Bugging crisis managers with whining and complaining about how and why things are FUBAR is a distraction to be rebuffed.

I have watched President Trump’s cycling through this COVID-19 crisis OODA Loop with no small interest. (My own company’s primary service is on pause because it requires teams to meet in person.) The simplest tasks are ridiculously complicated at very high frequency. Diagnose, isolate and treat a few COVID-19 virus-infected patients with a ventilator in a sealed room is not that difficult (respecting it is technical work). To treat hundreds of such patients in hundreds of locations, ramping up a capability from a near standing start within a few weeks is a massively complex undertaking with potentially catastrophic unintended consequences, like collapsing our economy. Our expectations from our government at all levels is at a wartime high.

I’m pretty impressed with the President so far. To be clear, I find his communication style a bit obnoxious, especially his use of conversation-leading and framing on Twitter. It is a very effective persuasion and negotiation entry technique. It includes exaggeration and hyperbole and setting expectations well above the actual satisfactory agreement positions. Mr. Trump’s fake news counter-punching has destroyed the media’s monopoly on setting the terms of public debate.

Setting that aside, is the president’s OODA Loop spun up? I think so. For example, his appointment of Ambassador Deborah Bisx, MD for the White House Coronavirous Response Coordinator is spot on. She is a fabulously informed and articulate expert on infectious diseases having managed the nation’s work on HIV/AIDS reductions. He has made a number of startling decisions that appear to be based on the advice of our very best scientists. He’s has not delegated the one thing he must absolutely accomplish — project the right attitude and demonstrate the right core values. We will beat this virus, no matter what, for the right reasons, using every resource available, including winning the national narrative.

After the dust clears and this crisis is in our rear view mirror, it will be time to assess Mr. Trump’s performance. Will he have set us on a course for new policies and practices based on the lessons learned?

In the mean time, how am I executing my OODA Loop? For my business. And my life.

P.S. The leader I am most impressed with is New York Governor Andrew Cuomo. His articulate, straight-talking briefings are simply superb.

What will the post-COVID-19 New Normal Be?

This is a follow-up “WHAT IF?” post to my COVID-19 epidemic Process Triage analysis.

The COVID-19 Virus pandemic may be a generational calamity if the morbidity forecasts prove true. It will pivot our national narrative to a new normal. Again — IF the morbidity forecasts prove true over the next few months.

If so — and we see 480,000 deaths in three to seven months, it will impact this generation, with comparisons to WWII in the 1940’s, the 9/11 attack and responses, and the investment derivatives-driven financial collapse in 2008. It will leave a very long shadow if it takes three to six months to work its way through the population, as Mr. Trump admitted (agreeing with Dr. Michael Osterholm’s “COVID-19 Winter” analogy.

Alfred Eisenstaedt and Gretta Zimmer Friedman’s V-J Day Kiss, August 14, 1945

We will pivot. Do not doubt it. Again, IF these dire forecasts materialize. The entire nation has paused a suspended animation of social distancing, made necessary by the virus’s nasty pathology, where the non-symptomatic are contagious. We have neither immunity nor vaccine. The only way to slow the contagion is stay away from each other enough to traumatize our economy if it lasts too long. The longer it drags on, the more catastrophic it will be. Hourly workers in our heavily service economy will be slaughtered absent direct replacement cash payments by some yet to be designed method. If we do not suppress this virus by eventual public immunity or vaccination, it will reset how we work and live as groups — if we can live as groups. (So we must establish an immunity from it).

The pandemic presents us with a rare, generational, finest-hour opportunity if we will seize it. The history of this, when written, will mimic the pattern of previously heroic or tragic (both conclusions are possible) narratives:

A few farsighted but powerless experts try to warn the powerful, as Dr. Osterholm forecast in 2017 in Deadliest Enemy. He described a coronavirus spreading from a Chinese wet market precisely as COVID-19 launched.

The required national-level response will be a stumbling, bumbling, fog-of-war ramp up with many and often appalling oversights, missteps and mistakes. There will be weeping and gnashing of teeth. The public square, both physical and virtual will be rife with rumor (this is a Chinese bioweapon), mob hysterias and overreactions (toilet paper hording). A heroically entrepreneurial optimism (Mr. Trump’s default settig) will drag well-reasoned skepticism (the mainstream media’s hyena howling) across the finish line kicking and screaming if our American Character has its way.

As the learning curve settles in, the incompetent will be replaced as meritocracy enforces its will, such as the unflappable Colonel (Ret.) Dr. Deborah Birx (please run for President!), the administrations COVID-19 Response Coordinator. In WWII, the US Army’s hapless North Africa Campaign exposed incompetence at every level until Major General George Patton, a maniacal tank warfare enthusiast demonstrated the style of fighting the war would require. His tactics and attitude set the new normal for what would characterize the fight. We have never been prepared for a new war and figuring out how to fight it always stumbles through a life-squandering learning curve. Fortunately, our geographical distance from nations infected before us accelerates our learning curve. But we’re only at the beginning of this contagion at this post’s date.

The charismatic solution implementers will become the public face of leadership as the less articulate step aside (yes, expect to see less Mr. Trump and more of the point team members) . Partisan politics will give lip service to cooperation while the long-game politicians will lay the foundations for the post-epidemic opportunities (such as Speaker Nancy Pelosi inserting language into an emergency spending bill to eviscerate the Hyde Amendment).

New products and services will launch along with businesses to monetize them. Homeland Security and TSA was the new normal after 9/11. COVID-19 drive-up testing may be the new normal now. They may become a permanent fixture on the landscape like TSA airport screening (because this virus may not go away and a vaccine is years away).

Will these disruptive changes and adjustments to daily life be normalized? A think a complete reset to the pre-epidemic status quo will not happen unless our most optimistic scenarios prevail. The frightening question will be the long-term impact of large gathering events and the business models of industries that depend upon such venues. Will we become more physically isolated and segregated as work-from-home becomes more necessary? Will the impact to commercial property be catastrophic until such spaces are repurposed? Will this scenario be a seismic shift in the economy for white collar work? Will the travel and tourism industry ever completely recover?

While we hope for the best, that being a non-disruptive level of deaths, the more likely outcome will be a generational reset on the way we live and work.

Will our better angels prevail? Will we bind together and find the best new normal?

At the date of this writing, the President is leading a private-public charge at flank speed. Let’s hope for the best.

I wish us all God’s speed.

Hat Tip to an Amazing Vistage Chair

Not long after I hung the ProcessTriage® company shingle, an early successful client introduced me to Vistage International chairperson Jeff Hutsell. We outlined a talk and practical exercise in Business Process Triaging for Executives and tested it with one of his peer advisory groups. This promising start in 2013 led a satisfying presence on the Vistage speakers program. I’ve given 85+ executive presentations with good review scores and followed on to work with well over a hundred Vistage member teams in all sorts of enterprises.

I’m reminded that we ride on the shoulders of our parents and mentors. My company’s customers would not have benefited from my company’s contributions, however small or big, without the Jeff Hutsell’s and the Vistage chairs who have offered sage advice. Here’s to a great organization!

With the amazing and gracious Vistage Chair Jeff Hutsell

Beginning 2020 with Thankfulness

The beginning of a new year is a fitting occasion to pause, facing forwards with an optimistic anticipation, out feet grounded in rational calculation. We expect to succeed. We will focus on the important, sweat the details and live our core values.

One of these values includes “Make every touch a referable experience.” So hat tip to our EOS® Implementer family and many Vistage International chairpersons — we are humbled by your kind referrals.

We are in business to add to the community around us by improving our clients’ core process teams’ ability to accomplish their organization’s vision and purpose. We do this by improving their situational awareness and emotional empathy and accountability to each other. To identify and present issues accurately and in a mentally safe way that fosters collaboration and enables all of them to be smarter than any one of them. To enable them to focus their leaders on the right next improvements constantly. To be amazing process triagers.

We are thankful for 2019’s best-year-yet successes and what makes ProcessTriage® and our triaging workshop experience possible: Each client’s success supported by our certified triage facilitators. Thank you for the opportunity to make a contribution, however slight or significant. Here are some of our new (2019) and what we hope are friends for life (logo’s link to home pages).

We wish our ProcessTriage® community a prosperous 2020. Remember, cosmetic updates to your process maps are free (PDF’s) with a modest reprint and shipping fee.

A CEO’s Perspective: The Most Critical Thing I learned From Process Triaging

One of our Core Values at ProcessTriage® is to measure ourselves by our customer’s successes. Their celebrations drive our celebrations.

Merideth Shay, CEO of InCord®, a custom safety netting manufacturer and Vistage® International member sponsored a Process Triage session last spring. We triaged their core Lead-to-Cash process. Merideth reports the following outstanding results:

The team was able to complete every single issue that arose! I had to remind them to celebrate as the were just focused on working the next set of issues. It was a huge accomplishment and it brought together people from different departments in ways that they didn’t necessarily have the language or understanding of how to connect, or how they affected each other, before the process triage. [The triaging workshop] trained our team on the art of discussion, listening and negotiating priorities and concerns with each other. Now we have a way to prioritize the concerns related to a project and mitigate risks — everyone is heard.

We have positive growth with sales without changing the number of employees.

Most importantly, we have a company excited about sales, knowledgeable about the process from Sales to Cash, and empowered to make decision now that they know what considerations they need to make for the other departments / parts of the process.

The most critical piece of knowledge I learned from ProcessTriage® is that it is okay and natural, that as you grow the process will break at some point in it and need to be fixed. It’s given me the language and the confidence to assure our employees that the heart of InCord — our culture, doesn’t have to change, but our process will continually change as we grow.

Meredith’s insights and observations are almost point-for-point what we — ProcessTraige® represent in our marketing and messaging. We strengthen team collaboration, accountability, and emotional intelligence around their shared processes.

The InCord Triage Team (Courtesy InCord, Inc.)

P.S. A special shout-out to Will Henrickson, Merideth’s Vistage Chair for introducing us.