April  2020     Edition 150
Crises : Triage is the easy part! 

There comes a point in time when the management of a crises moves from triage to stability to strategy

The approaches as well as the leadership demands are different.

Here’s an example

, if maybe a bit oversimplified.   If you have a heart attack, the health care workers go into triage mode with a very clear goal of keeping you alive and getting you into a stable state giving you and the health care workers time to figure out the next step.  In the process of triage there are consequences, some predictable, some not. You might have an allergic reaction to some drug used to keep you alive, or your ribs might break in the process of being resuscitated.  So, the tactics to triage a crisis, sometimes yields another crisis that also must be triaged.  While the decisions can be hard to make, there are usually only a few people involved in a triage discussion and often the choices are few and the methods to get there are both limited in scope and time.  The triage leader, who is usually clearly identified, will make the decision.

As one transitions to stability, the goals become more complicated and more people are involved

.  In the above example, one goal is getting you healthy enough to be discharged from the hospital and minimizing the chances you’ll be back the next day.  Another goal might be related to a potential tradeoff between quality of life and longevity of life.   Sometimes these goals might be in conflict, or some people favor one goal over another.   Perhaps one kind of surgery will prolong life, but the quality might be poor, or one kind of treatment will speed the recovery, but the cost might be excessive.  The implementation decisions to reach these goals involves you, the health care folks, maybe your family, perhaps even the insurance company.   The decisions about what to do are dependent upon being clear on what the goals are. 

If the goals are not clear, and clear to everyone, then the tactics to implement the goals will be all over the place.   Someone, perhaps you, or a family member, generally must step in and lead the discussions and ultimately make the decisions on the goals. 
THIS is the hard part,
because the variations are often large, and the complexities are vast.

Once recovered, the goal changes again

, to perhaps minimizing the chances of a recurrence, or maximizing quality of life.  Again, the goals need to be clear in order to create a strategy to implement those goals.  The strategy might be diet, or exercise, or job change, or maybe nothing at all.  Leadership plays the role of guiding those discussions and ultimately, and often collaboratively, make the decisions.  These are generally low stress, highly analyzed decisions that can be substantiated and provide confidence for those to follow.

So where are we with Covid 19 Crises.


the goal was to prevent a crisis and stop the spread.  One can debate the reasons, but nevertheless, the world was simply not prepared to stop a very highly contagious, asymptomatic spread of a disease that is very deadly for some.   It became very clear that the spread of the disease was on an exponential path and the world’s emergency health care systems was not going to be able to handle the load and collapse.    The world went into crises mode and we needed to triage the crises.

The goal in this crisis was simple

; Lower the peak demand on the health care system and buy some time to ramp up these systems as well as find treatments and ultimately a cure.    The triage tactic chosen by the leaders of most countries, was social separation.  If people were not near each other, they couldn’t catch the disease from each other.   This is working.  The balance between the spread of the disease and the emergency and health care system is becoming stable, and the rate of spread has slowed.  The predicted consequence of this triage was another crisis ... the global economic collapse including the loss of tens of millions of jobs.  The triage for this predicted consequential crisis was for world’s government treasuries and to pump trillions of dollars into the system.  While the success of these tactics is a bit uncertain, we are beginning to move from crises triage to stability and what to do next, i.e. how to get society out of the hospital.

The challenge here

, as we saw in the heart attack example, is that there are many more people involved now in this transition stage from crises to stability, and the goals are potentially at odds.  Is the goal to save as many lives as possible?  Is it to prevent the health care system from again being taxed?  Is it to repair the economy as fast as possible and get people back into their jobs?  Is it to figure out the new norm and get there quickly, or to slowly move ahead to determine what that new norm is?.  On top of this, we still need to buy time to find a treatment and cure.  

The variations are enormous, not only on the goals, but different geographies, cultures, and individual vs society trade offs are all in play.  
THIS is the hard part
.  Everyone will not like something.  Some will say it’s too fast, too early, too risky, others will say it’s too slow, too late, too conservative.   When I was a student of mathematics, the “science” of this was called the calculous of variations.  In order to solve that equation, you had to make decisions on what you wanted to maximize and where the trade offs should occur.  This is where the world is currently struggling. 


is when Leadership plays the most important role of any crises

.  Our scientific leaders, country leaders, state, providence and local leaders, our community leaders and our family leaders all play a role here in the decisions that need to be made going forward.  All need to understand the responsibilities of each, understanding that mistakes will be made, and changes will need to occur.    All of these leaders will make decisions based on assumptions regarding the current state of things and the goals they are focused on.  It is the responsibility of Leadership to ensure that the goals are clear, decided, and communicated and the information that is being used to make those goals and decisions is accurate and well understood.

The Takeaway
While a crisis needs the triage step, it’s the planning and implementation of what to do during the transition to and within the stable state that really becomes the challenge.  This stage, if not handled well, will generate a slew of new crises and potentially an out of control situation … and back in triage mode all over again.   While Covid-19 is certainly a unique event in the world, business and families will always be faced with crises.   When that occurs, and a triage is implemented, know that it’s often the managing of the transition to and during the stability stage that is the most difficult and requires the best of leadership to manage.

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