Fiona Godlee, the editor in chief of BMJ asks - How did a country with an international reputation for public health get it so wrong? calling this a wake-up call (1). How did the world, with a world of experience and expertise get it so wrong too? Could complexity thinking have stopped all of this? Is it a wake-up call for complexity thinking?
It’s not the science, or the lack of expertise of advisors or modeling experts, or poor political or policy choices, or history of bad preparation, etc, but all of the above and more, of how these come together in a nonlinear dynamic fashion to produce expected and unexpected outcomes, a complexity thinking (2).
But this is not enough. As the editor in chief says, there needs to be accountability – an open process of sharing the evidence and how decisions are made. This would lead to Feedback, Adaptation and Change with Emergence of better, as we FACE the reality of this pandemic together – a complexity thinking.
We have to be as cautious claiming following complexity science as in following the science, however. It also needs accountability, open discussion and debate, with a misstep made by the UK Govt senior political adviser, according to Taleb and Bar-Yam in The Guardian, weighing in also on science “The UK's coronavirus policy may sound scientific. It isn't.” They say that the UK govt adviser loves to theorise about complexity, claiming “but he’s getting it all wrong,” proceeding to describe errors in modeling and policy making (3).
A New England Complex Systems Institute Research Paper by Norman, Bar-Yam and Taleb in January 26, 2020 suggested that with conventional risk-management approaches considered inadequate in the midst of uncertainty and complex interconnected systems, and with the potential for irreversible catastrophe, a precautionary principle should be used: early intense measures at low cost to avoid very costly later actions, as has now happened (3,4). This was January 2020.
We can go back to the onset of the pandemic and the different actions globally since and ask – could a complexity thinking have made a difference to prevent, stop or reduce this pandemic, an irreversible catastrophe? This is important, to learn how best to manage this pandemic, and how to prevent the next. This is especially so in view of Dr Godlee’s concern of the “Sad litany of past and present decisions that have fragmented, decimated and marginalized public health in the run up to this moment when it is most needed" and her view that “Covid could lead us to do things we have long known needed doing” (1).
The editorial asks “Is this then a wake-up call we have needed to plan a new future?” It may be a wake- up call for complexity to help plan a new future - something we have long known needed doing.
The editorial also advises “…we must seize this crisis to build a healthier and more equal society.”
Complexity, the science for complex dynamic interactions could help with this, described in “Tsunami Chaos Global Heart,” a book subtitled “using complexity science to rethink and make a better world,” which includes health, equity, climate change and complex global issues, like this pandemic, and advocacy for teaching/learning complexity at all levels – to make a better world (2).
Courtesy Staff - Sunnybrook Health Sciences Centre and The Scarborough Network, Toronto Canada. Adjunct Assistant Professor of Medicine, University of Toronto.
Rapid Response:
Covid-19: A wake-up call for complexity thinking.
Dear Editor
Fiona Godlee, the editor in chief of BMJ asks - How did a country with an international reputation for public health get it so wrong? calling this a wake-up call (1). How did the world, with a world of experience and expertise get it so wrong too? Could complexity thinking have stopped all of this? Is it a wake-up call for complexity thinking?
It’s not the science, or the lack of expertise of advisors or modeling experts, or poor political or policy choices, or history of bad preparation, etc, but all of the above and more, of how these come together in a nonlinear dynamic fashion to produce expected and unexpected outcomes, a complexity thinking (2).
But this is not enough. As the editor in chief says, there needs to be accountability – an open process of sharing the evidence and how decisions are made. This would lead to Feedback, Adaptation and Change with Emergence of better, as we FACE the reality of this pandemic together – a complexity thinking.
We have to be as cautious claiming following complexity science as in following the science, however. It also needs accountability, open discussion and debate, with a misstep made by the UK Govt senior political adviser, according to Taleb and Bar-Yam in The Guardian, weighing in also on science “The UK's coronavirus policy may sound scientific. It isn't.” They say that the UK govt adviser loves to theorise about complexity, claiming “but he’s getting it all wrong,” proceeding to describe errors in modeling and policy making (3).
A New England Complex Systems Institute Research Paper by Norman, Bar-Yam and Taleb in January 26, 2020 suggested that with conventional risk-management approaches considered inadequate in the midst of uncertainty and complex interconnected systems, and with the potential for irreversible catastrophe, a precautionary principle should be used: early intense measures at low cost to avoid very costly later actions, as has now happened (3,4). This was January 2020.
We can go back to the onset of the pandemic and the different actions globally since and ask – could a complexity thinking have made a difference to prevent, stop or reduce this pandemic, an irreversible catastrophe? This is important, to learn how best to manage this pandemic, and how to prevent the next. This is especially so in view of Dr Godlee’s concern of the “Sad litany of past and present decisions that have fragmented, decimated and marginalized public health in the run up to this moment when it is most needed" and her view that “Covid could lead us to do things we have long known needed doing” (1).
The editorial asks “Is this then a wake-up call we have needed to plan a new future?” It may be a wake- up call for complexity to help plan a new future - something we have long known needed doing.
The editorial also advises “…we must seize this crisis to build a healthier and more equal society.”
Complexity, the science for complex dynamic interactions could help with this, described in “Tsunami Chaos Global Heart,” a book subtitled “using complexity science to rethink and make a better world,” which includes health, equity, climate change and complex global issues, like this pandemic, and advocacy for teaching/learning complexity at all levels – to make a better world (2).
1 Godlee F. Editorial. BMJ 2020; 369:m2021 (Published 21 May 2020) doi: https://doi.org/10.1136/bmj.m2021
https://www.bmj.com/content/369/bmj.m2021 (accessed May 22, 2020)
2 Rambihar Vivian, Rambihar Vanessa. Complexity: the science for medicine and the human story. Corespondence: Lancet Vol 375, Issue 9721, p 1162, April 03, 2010 DOI:https:/doi.org/10.1016/S0140-6736(10)60512-0 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60512-0/fulltext
(accessed May 20, 2020).
3 Taleb N, Bar-Yam Y. The Guardian Opinion. Wed 25 March 2020. The UK's coronavirus policy may sound scientific. It isn't. https://www.theguardian.com/commentisfree/2020/mar/25/uk-coronavirus-pol... (accessed May 22 2020).
4 Norman J, Bar-Yam Y, Taleb N. Systemic risk of pandemic via novel pathogens – Coronavirus: A note, New England Complex Systems Institute (January 26, 2020) https://necsi.edu/systemic-risk-of-pandemic-via-novel-pathogens-coronavi... (accessed May 22, 2020)
Competing interests: No competing interests