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Archive for noviembre 2021

The headline comes from a recent webinar intervention by Annabel Seebohm[i]. We are negatively experiencing in our everyday lives how the very much praised and extended “just in time” inventory management method has turned our lives upside down. Car factories are on hold, electronic gadgets are missing from the shelves, ports are blocked and unable to process incoming   goods. And, last but not least, the health system is stressed to the limits, because it was designed for “normal times”. “Normal times” does not take into account out-of-the-norm factors like a pandemic, like “just in time” does not take into account disruptions caused by lockouts due to a pandemic.

When Covid-19 struck, the health system designed for “normal times” was absolutely unprepared to cope with an unexpected inflow of patients: there was a need to build new hospitals, a need to recruit more health professionals, a need to explore new treatments, a need to design new care processes, a need for extra masks, medical aprons and other medical goods. And all of that had to be done in the shortest possible period of time, since people were dying by the millions (17.3 million so far according to The Economist)[ii].

Suddenly, we realized that “just in time” was not the panacea that everybody thought it was. Suppliers should move back to the point of need. That trend is obvious in the chip market, with the USA and the EU putting forward state subsidies to build chip factories in their territories, avoiding the actual dependence on the far east manufacturers.

The health sector is suffering from a similar malaise, even if the causes are different. There was an initial dependence on China for some medical products, but the two big restrictions came from inside the system: 1) lack of infrastructures such as ICU’s and hospital wards; and 2) lack of health professionals.

The first restriction has an easy solution since it can be solved with political will and money. The second restriction has a more difficult solution, it requires a great degree of advance planning. It is necessary that the design of the health system incorporates human resources for “abnormal times”. That leads to a degree of over dimensioning of human resources during normal times, contrary to “just in time” management system, incorporating the “just in case” management proposal. I am aware that this means increased budgets during “normal times”, but the rewards will be collected during “abnormal times”. It is our choice, the same kind of choice we make when buying insurance, in the hope that “abnormal times” will never come.


[i] linkedin.com/in/annabel-seebohm-ll-m-380b0392

[ii] https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates?fsrc=core-app-economist

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It is a fact that in most cases, those living in a risk area know that they live in a dangerous place but that they assume that it will never materialize. Accordingly, they do not plan to move out. Be it near a volcano, – almost 2 million people live within the range of the Vesuvius, – or by the banks of German rivers that regularly overflow, most people don’t lose sleep over these risks.

It does not matter that authorities draft very detailed risk maps. People refuse to move for various reasons: sentimental, lack of alternatives, indifference to the risks, not believing in science, conspiracy theories, etc.

How to overcome that resistance to move to safer quarters? I think that the most important step is to bring science to civil society. Indifference, science negation, conspiracy theories and such, are bred in misinformation and lack of information. If risk maps were drawn together with representatives of the people living in the affected areas, then the scientific backing for designing an area as dangerous would be transmitted to the population. The will of the people will be always the driving factor for deciding to remain in a risky area or to leave. But at least, those remaining in dangerous places will take their decision based on the latest scientific findings.

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