Covid-19: An Unnatural Disaster; Focusing On Human Factors In Emergency Management!

By Deshai Botheju –MAY 20, 2020

Dr. Deshai Botheju

“The term ‘natural disasters’ has become an increasingly anachronistic misnomer. In reality, it is human behavior that transforms natural hazards into what should be called unnatural disasters” ~  Kofi Annan, 1999

The global pandemic of COVID-19 caused by the SARS-CoV-2 virus is instigating a mass disruption of the normal societal functioning and costing billions of worth of economic harm across the continents. This is a large scale biological hazard, that we need to go back almost 100 years in history to find anything matching the level of havoc it is causing now. The nearest historical example is 1918 Spanish flue influenza caused by the avian origin virus H1N1 which is estimated to have caused a death toll of more than 17 million across the globe. 

A widespread biohazard is one of the many types of large scale catastrophic events that can trigger a global scale societal breakdown. Responding to large scale catastrophic events is always challenging. Managing such events involves a complex mix of socio-economical and technological dimensions. Understanding various human limitations and behavioral characteristics early in the process can often give an advantageous head start. This article presents several Human Factors associated aspects that should be given attention when managing large scale societal safety emergencies such as COVID-19 outbreak. 

Human factors in emergency management  

Within the societal safety domain, emergency management (or disaster management) can be defined as the managerial process addressing the aspects of i) Preparedness ii) Prevention, iii) Response, and iv) Recovery against large scale disasters. Based on the above four (4) key objectives, it is indicated here as 2P2R approach. 

Human factors should be important considerations in societal safety and emergency management. The same concepts are broadly applied in industrial safety management and associated emergency preparedness activities. During last few decades, industrial safety management field gained noteworthy advantages by applying human factors as a part of engineering and designing the products, systems, and procedures in order to prevent large scale industrial accidents as well as for enhancing occupational safety. The wider application of the same concepts in societal safety management will obviously produce substantial rewards. 

Human factors can be introduced as an aggregate of knowledge on human behaviors, human capabilities, human limitations, and human errors with respect to the safe and efficient management of a certain system. The concerned system could be a technological system such as a large production plant, or it could very well be a procedural system aimed at achieving a particular target, such as preventing or responding to a large scale disaster. 

Inclusion of human factor aspects in emergency management can significantly increase the eventual success rate of the exercises. Lack of such insight often lead to poor management inputs and failures in achieving desired outcomes. The higher the needs of human involvements in large scale disaster response activities such as COVID-19 mitigation, the more important is the use of human factors knowledge in managing such processes. Let us discuss some of the applicable human factor concerns regarding the current pandemic situation, with primary attention placed on the Sri Lankan context. Figure 1 presents a summarized view on several associated factors separated into three (3) categories; including 2 skill categories (cognitive and social skills) and one resource category.

Patient behavior 

Understanding human behavior should be a big focus when responding to disasters. Within the context of COVID-19, one key error that must not happen is to victimize the patients. Threats, media abuse, and subjugation will all lead to the patients being forced to go underground. Such practices found in historical contexts all teach us one lesson. That is, for mitigating pandemic spread of diseases, the society has to be open and welcoming to the patients where they can freely seek medical care without the fears of reprimand, refusal, and punishments. Forceful actions will always be met with counterproductive responses from the society that will eventually lead to failure in containing the disease. Based on a human factor perspective, it is important to understand that behaviors such as being afraid, not seeking medical attention, or being reluctant to quarantine are all natural human behaviors under stress, or when traumatized by the negative societal response. Emergency management must address this aspect and create an environment where patients can become visible freely and voluntarily. In a global context, this is the exact approach used in Scandinavian region countries (where the author is currently residing) at this juncture, and they are well on their course to successfully countering the outbreak.

Team dynamics

Human factors play a major role in team dynamics during crisis management activities. Managing large disasters needs extended teams working at various levels. Many of these teams are comprised of individuals with diverse backgrounds and expertise. Not necessarily all of them speak the same language even though they use the same language. This means, not everybody understands each other due to various technical specialties and also due to different professional cultures within different professional groups. Often, these teams are put together in an ad-hoc manner due to the urgency of the situation. The familiarity and the trust within team members can be minimum or non-existent. Under such situation, certain team members may not feel enough “psychological safety” to open up and be communicative. In contrast, some team members can be dominant over others. The cooperation and coordination within such teams can be extremely challenging and chaotic. This is a particular area where the emergency management leadership should pay attention. The leadership skill itself is a vital human factor concern in emergency management. Sometimes, it is best to use a few generalists who are skillful in human management to enhance the team dynamics and improve interplay and assist translating each other. Such resource personal must be able to ensure the psychological safety of the group members and adequately moderate overacting members. This situation found in societal disaster management is quite different from industrial safety management. In safety critical industries, crisis management teams are often pre-defined well in advance. They also undergo regular training sessions, sometimes including simulated crisis situations. Such teams know each other, understand each other, and also expects what emergencies to happen. This is one area that societal safety management field can learn from industrial safety management professionals. Predefined crisis management teams based on different disaster scenarios recognized during national level risk assessments can help rapid deployment of them in an actual emergency situation, and also will lead to formulate better teams that can work coherently and efficiently.  

Communication and risk perception

Communication is another major area needing human factor based aproach during emergency management. We have briefly discussed potential inter (or intra) team communication difficulties in the previous section. Here we put more attention to the public communication aspects during emergencies. It is crucial to have a transparent and open communication strategy from the early phases of crisis management. If the management team is exposed to have delivered incorrect or misleading information, thereafter the public trust on the whole emergency management process will become lower. Such broken trust is hard to regain. The concept of risk perception comes into the picture here. The risk perception is the “risk feeling” that public receives via various communication channels or via their own observations (or experiences). This risk feeling can be very different from the actual or statistical risk that the subject experts have estimated. For example, due to the information they are receiving, public could overestimate the danger of a biohazard such as COVID-19. Similarly, in another society, the public might underestimate the same risk. Both types of risk perceptions are not good. While the underestimation could lead to weaker compliance to safety precautions, the overestimation is equally bad. Overestimation can easily lead to panic, societal chaos, subjugation and discrimination, violence against patients or suspected persons, total shutdown of the economy, and such great harm. Therefore, it is extremely important to deliver correct risk perception to the society with the correct dose of emphasis. Formulation of public information, warning messages and their structure, clarity of the guidance with attention to any contradictions, as well as the personnel entrusted to present such information must be chosen with great care. It is recommended to seek opinion from multi-discipline teams in such matters, without resorting to a single group of professionals who could often have certain tunnel vision towards the disaster in progress. 

Read More