March 24, 2020

How COVID-19 Might Kill People in Ways You Didn’t Expect


By now, pretty much the whole world is focusing on COVID-19. Most European countries have put in place some drastic measures flatten the curve. That is to make sure that the virus spreads slower so our healthcare system does not get overwhelmed. The most widely used strategy is ‘social distancing’, a term most of us had never heard of 2 weeks ago?

This includes shutting down shops, closing factories, confining people as much as possible to their homes. Every day, we are surprised about how quickly things are happening and how we are quickly adapting to the new normal. For example: when the outbreak started in China, I remember seeing footage of a drone telling people on the street to keep their distance and go home. That would never happen over here… now would it? Just this weekend the police sent out drones in Brussels to do the exact same thing!

On top of the social distancing measures, governments are increasing the capacity of healthcare. In China, they built a new hospital in 2 weeks time. The Belgian government is proud of its ‘Chinese effort’ to have increased the countries’ intensive care bedding capacity by about 40% within the space of a couple of weeks. Other countries are doing different, but just as impressive things.

So… a lot of great things are happening in the face of this crisis.

But Aren’t We Missing Something?

  • What if our attention to COVID-19 makes us miss information that we would otherwise notice immediately?
  • What if we ignore risks that we would typically capture under normal circumstances?
  • What if some of those measures create new risks that we fail to see?

First things first. How important is the question that I’m asking? Should we really be afraid that we are missing something? Isn’t the COVID-19 the real issue here, and am I actively missing the point that all of our governments are trying to make?

So let me start by saying that I do not – I do NOT – intend to question all the measures that we are putting in place. What I am trying to do is prevent you from falling into the Availability Bias trap: our tendency to focus more on information that is readily available – there is news on COVID-19 every single day, even every single minute – than on information that is not so available – when is the last time you read an article of a worker getting killed at work?

Let’s Look at Some Numbers

Up to today (March 24th), COVID-19 has caused 16,748 fatalities*. In a world population of 7.7 billion, that equates to about 1 fatality per half a million. That number of course will increase and it will increase a lot.

Suppose you are a leader in an organization with 10,000 employees, and you experience on average one fatality per year, on top of several other serious injuries. That means the risk for an employee to experience a fatality in 2020 is 1 in 10,000. The number of COVID-19 fatalities needs to go up to 770,000 within the next year to create a similar fatality risk.

I realize I am using global COVID-19 numbers. The rates for each country will be vastly different, and in some regions the current risk to die from COVID-19 is probably higher than the fatality risk of a work-related event. I am also discarding the unevenly distributed risk among age groups which would make the risk for a typical workforce smaller. But the numbers do show that – whichever way you look at it – the existing SIF-risks within your organization are still at a level that deserves your attention.

Let me provide you with an example of a risk we might miss. A regional HSE manager that I had reached out to a couple of days ago, asking him how they were coping with COVID-19, told me the following: “One thing I’m really concerned about is that measures we take to prevent corona virus exposure might trigger some serious incidents, for example by break down of safety critical communication due to social distancing measures.”

Beware: Biases at Play

One of the elements at play is what is called Selective Attention: when people focus on one thing – COVID-19 – other information gets filtered. One great example is the Cocktail Party Effect: although many people are talking at the same time, we are still able to focus on the conversation with the person in front of us: we focus on that conversation, and actively filter out the other conversations.

But Selective Attention can bring us into problems. One consequence of Selective Attention is Inattention Blindness: the failure to notice even very obvious events while focusing on something else. One of the best-known examples is the basketball video. In this video, two small groups are each passing a basketball between their respective members. One group dressed in white t-shirts, another in black. Observers are tasked with counting how many times the group in white passes their basketball. Most people are able to count the number of passes correctly, using Selective Attention to discard the passes from the other group. But at the same time, most people fail to observe that a big black gorilla passes by at the same time although it is very obvious. That is Inattention Blindness.

It doesn’t take much creativity to see how Selective Attention and Inattention Blindness impact our ability to judge and react to existing, non COVID-19 related risks. That is why organizations need to put in place some measures or strategies that tackle those biases.

A Couple of Suggestions

A first potential strategy is to use the knowledge of your existing SIF (Serious Injury and Fatality) strategy. Through this strategy, you have analyzed existing and potential SIF events and identified precursors for those events. While COVID-19 in itself is likely not captured anywhere in your SIF database, you can review which precursors are more likely to happen with the implementation of the COVID-19 measures. In the example of the regional HSE manager above, one might review where or when a failure in critical safety communication was part of existing precursors and question how social distancing has an impact on the occurrence of those precursors.

Alternatively, you can assign a group that looks at all of the measures through a ‘normal work’ lens: ask them to ignore the fact that there is something like COVID-19 and judge the measures on their soundness and viability. In other words, we are using Selective Attention to help them judge our own decisions. I am certain that this will create multiple discussions with the COVID-19 crisis team… but that’s exactly the point!

So let’s not dismiss the risks of COVID-19. At the same time, let’s not dismiss existing or newly created risks, and put in place measures and strategies that provide equal attention to both.

*source: at 11.15 hours Central European Time.

How COVID-19 Might Kill People in Ways You Didn’t Expect

March 24, 2020


Posted in:

Search for articles