‘Those who do not learn history are doomed to repeat it’ is advice commonly ascribed to George Santayana, a philosopher and novelist. Yet we often fail to forget this sage or we seem to apply incorrect lessons. We even fail to apply what lessons have been identified because of inertia, cost or complexity.
Take Covid-19 in the historical perspective. We have had four global pandemics in the past century with the time intervals growing ever shorter. A fifth one was widely expected – see Resilience First news item here dated 8 February 2019: the source quoted that ‘Each year there is a 1:13 chance of a significant public health pandemic.’
The topic was certainly high on the risk registers of many governments and the UK commissioned a pandemic exercise (Operation Cygnus) in 2016. The lessons identified – according to open sources on Cygnus, which remains officially classified – appear not to have been implemented in certain key respects such as the requirement for ventilators, stockpiling of equipment and dealing with the excess bodies. The then Chief Medical Officer, Professor Dame Sally Davies, reportedly said after the three-day exercise that ‘a lot of things need improving’, with the exercise showing that the pandemic would cause the country's health system to collapse from a lack of resources. Certain countries in Asia did translate lessons learnt from the SARS outbreak in 2002-03 into tangible actions which have put them in good stead in the current pandemic: Singapore built a designated hospital for infectious disease, for example.
Learning lessons requires a working culture that is ready to learn and ready to adapt. It requires a formal process to establish and record collective or corporate memory. This is all too often absent from organisations, an oversight of top management which cannot easily be recovered. It also requires a historical perspective. While no two events are ever the same, there are frequently common patterns and behaviours. Hence, the potential value of having historians on panels to highlight the commonalities and mark the lessons.
What is clear from the recent pandemic is that it has accelerated history. Actions that were originally planned over several years or trends that were slowly emerging have now taken on a new lease of life and are likely to be completed or cemented sooner than previously envisaged. Amara's classic law about forecasting the effects of technology stated that ‘we tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run’. Post-Covid-19, we can expect an energising adoption of new technologies e.g. remote monitoring, vaccine research, automation, that may surprise us in both the long and short terms. The pandemic is sure to bring forward the benefits (and downsides) of the fourth industrial revolution of AI, robotics, neuroscience, etc. Let’s hope the scientists also have historians by their side: let’s hope and history can rhyme.
Here are some practical steps for recording lessons learnt:
- Organised debriefs should take place as soon as possible after an event. Sometimes, they can be scheduled in advance.
- People should be asked first ‘what didn’t work well?’ Issues should be identified, discussed and – on a structured template – a record made of who said what and their actions on the day. The learning points could include headings such as leadership, training, and policy as well as organisational failures and experiences of others.
- Most importantly, each major point should have a recommendation attached and a person appointed (owner) who should be responsible for taking the action forward, together with a timeline. Without a tight timeline for implementation there is the real danger that inertia will creep in.
- Only then should similar notes be taken of ‘what worked well?’.
- All the details should be circulated around the organisation so that there is transparency and accountability. This can be on an intranet, notice boards or newsletters. Distribution may also be outside the organisation if other parties are involved. The tracking of actions is vital to ensure effective follow up.
- A detailed record or log of events and actions is important to learn lessons. Such a record may also help in subsequent inquiries and form a vital part of any legal actions. Making and maintaining the record requires a deliberate act and a dedicated person.