I'm trying to look out for structural/organizational lessons that go beyond the basics like avoiding large gatherings, higher decentralization etc. One that struck me is the perils of specialization in healthcare that leads to 1 contact turning into dozens or more.
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I don't have an answer, just flagging the problem. You cannot really run large-scale triage operations in a highly specialized service situation, in emergency mode, and not have such tradeoffs. Assigning a skilled Dr. House level patient advocate to each patient won't scale.
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You need some way to hybridize the cost and operational efficiencies of regular triage and assembly line style functional silo specialization breakdown (a flow or job shop in OR terms) with the greater epistemic coherence and non-blindness of case-flow models.
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Only model I've seen work is a scattering of talented domain-specific systems thinkers with high situation awareness monitoring the flow and picking up on anomalies early. Air traffic control basically. ATC for healthcare, but at a higher skill/knowledge level than triage nurses.
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Still doesn't solve the peculiar path costs here, where each step of handling/mishandling increases contagion risks. When this is over, modeling the "path risks" of a misrouted "case" will make a good PhD thesis in operations research for the right kind of thinker.
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Specific point on the materiality of "seeing like a state" theory applied to pandemics: microbes are *by definition* impossible to see without a microscope. It's literally an org battling microscopic realities that macro-humans present at best via confusing emergence.
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This feature is shared in other orgs that are oriented around microscopic realities. At Xerox it took me a long time to realize that the entire company was oriented around the micro-properties of toner, which isn't obviously the key element when you look at photocopier machines.
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Another example is silicon/microprocessor industry. Takes at least a year to wire your head around the sub-14-nm scale mental models of lithography.
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Seeing Like a State, Microscopy Edition. There's also Seeing Like a State, Telescopy edition, which I encountered during PhD work on NASA's interferometric telescopes program. Wrapping head around lightyears/thousands of kilometers as baselines. But I digress...
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