CEt article a été publié avec l’accord de ses auteurs en version traduite en français, en voici la version anglaise proposée par eux, avec nos remerciements.
The Covid-19 epidemic and its management in Europe and in the world raise, among others, the issue of the anticipation of crises, independently if they are of natural origin or bound to human activities, and especially of the preparation of appropriate countermeasures.
On this theme, the nuclear sector, since the beginning of its development, established and used some appropriate safety principles. The authors mention three among them, which have shown to be particularly effective to establish a nuclear safety culture in France, which made it possible to overcome what the Prof. Yves-Frédéric Livian calls the « risk of incompetence » in his article « Les Organisations productrices d’incompétence » (Organizations as producers of incompetence, 2010).
These three main principles are the following.
First, the fundamental principle of « Defence In Depth ». It comes from the ancient military practices: the Roman army already used it to defend its walled camps. It consists in taking a set of measures to prevent the occurrence of a feared situation occurs, supervising the status of these measures and their capacities to fulfil their functions, then, in spite of that, assuming that these measures are inefficient, thus ensuring that, whatever happens, the consequences remain controllable. It is a principle of ramped-up defence that, contrary to what one could believe, not only aims at avoiding accidents but also at making the hypothesis that the decided measures can be defective, without having necessarily identified the reasons for these failings. Thus, it pushes us to think about the consequences of disasters before they occur, rather than to make such thinking-action during a state of emergency. This is one of the aspects of the present Covid-19 crisis, isn’t it?
In nuclear safety, this principle leads for example to specific training of all concerned teams, inside and outside of facilities, by facing accident scenarios even if they are very hypothetical. This principle can be very well extended to other industrial sectors and in the managing of natural risks, epidemics or other causes, which are difficult to foresee because of their characteristics.
A second principle drawn from the nuclear sector, complementary to the principle of Defence In Depth, is the « As Low As Reasonably Achievable » approach. This principle, more difficult to handle, consists in comparing all the risks in order to reach a level of safety which, in terms of prevention and management of feared situations, is both the most homogeneous possible and suited to the available resources. This principle aims a) to carry the technological, financial and human efforts, which are necessarily limited, to the points where they will be the most efficient and b) to avoid wasting them at points where their application is only the easiest or the most spectacular (elevated media effect but weak efficiency).
Finally, a last key principle is the institution of a control by experts, independent and coercive, that defines and verifies the setting up of the necessary resources to assure the safety of nuclear facilities: in France, the nuclear safety Authority. The Chernobyl accident, where the soviet state was both judge and judged, demonstrated the importance of this principle.
The application of these principles to Covid-19 epidemic would have allowed us to better prepare for the crisis and to better manage it.
First, the risk of an epidemic of this type was foreseeable, on the basis of several reports and white papers, French[*] and international ones, from 2004 to 2019. As an example, it can be noted that, in 2019, the John Hopkins University concluded in its « Preparedness for High-Impact Respiratory Pathogen Pandemic » study that «Were a high-impact respiratory pathogen to emerge, […] it would likely have significant public health, economic, social, and political consequences».
Long before the infections appeared, or even when they were detected and confirmed, first in China then by the WHO in January, the possibility of a strong epidemic could have been taken into account in a better way by following the Defence-In-Depth principle. A large panel of experts in health, virology, crisis management, etc., would still have had the time to evaluate the different scenarios of pandemic development, until the most serious ones, and to define the different measures to be considered most efficient, then to be applied, taking into account their real cases of application. As an example, although the authors are not experts and on the basis of press information only, the following approach can be drafted.
|Level of Defence In Depth|
|Define foreseeable scenarios of propagation and consequences of the epidemic (virus propagation, morbidity…), then, for these scenarios, identify what we need to minimize the number of victims.||Actions to set up if a part of contemplated measures is not enough or cannot be put in place.||Last actions to engage if problems are not solved, yet.|
|Examples of related actions|
|Identification (measures): fast tests by poll and measure of temperature at the entry in the territory (borders)define the optimal solutions according to the needs and the available resources, as well anticipate their possible developments||Reinforce the measures of detection: take measurements more systematically with more in-depth tests (sampling representative of the population, by following the epidemic evolution)||Think about a systematic reinforced lockdown|
|Prevention (protection) define the measures of hygiene and communicate the orders and the correct gestures (by following the increase of knowledge on epidemic):how to limit the propagation, by explaining how the virus spreadswhat to do since the first symptomsstrategy on the use of safety-masks||Reinforce prevention measures: generalize the use of safety-masks with a well-adapted strategy for procuring them (purchase and manufacture with possible reorientation of the national industrial production)appropriate measures of lockdown: strategy on positive casesreduction in mobility (smart working, stop of activities…)measures to avoid the infection of workers conscripted in priority sectors|
|Care for contaminated people: respiratory devices, intensive care, medicineshospitals:strategy for the distribution of all ill peopleisolate the sectors with Covid‑19-ill peopleorientate other ill people||Increase the capacities of reception and care: increase the availability of resources and of nursing staff by an appropriate strategy of procurement (purchase and manufacture with possible reorientation of the national industrial production)if necessary, create specific hospitals, use other structures and those of the army||Manage the crisis: – choice of priority care – international help|
|Search for, develop and use therapies, medicines and adequate vaccines|
Search for, develop and use therapies, medicines and adequate vaccines
For each level of Defence In Depth, the choice of the actions to be taken and their implementation can be done by applying the principle of « As much As Reasonably Achievable », in terms of available resources (human, technical, financial, timeframes).
These approaches can be applied to economic life, regarding both the position and responsibilities of the State and those of the companies: what do we need to maintain most productive capacity (agriculture, industry, trade, services…)? What do we have to do for that? What can we do for the sectors where that is not possible? At what price?
In the same way, the application of these principles would be useful after the period of crisis management, namely for quitting the confinement and the possibility of a resurgence of the epidemic. That should begin with the analysis of past similar epidemics and with that of the management of crises in countries where epidemics appeared earlier.
Among the possible learned lessons from current management of the epidemic, the authors noted three on the positive contribution of previous principles:
- it’s possible to improve the prior management of risks (namely those for public health) by taking into account the hypothesis that some of the applied measures would be ineffective. This analysis can only be done by experts who will give decision-makers and officials the best information and options. The consequences of these crises are far too serious to leave the public debate to only people with an ideological vision, even though this vision is respectable (as an example, people who opposed immediately closing borders at the very first cases of Covid-19, in the name of traveling freedom, without any consideration of consequences on health),
- thus, an Agency for health control, with the right expertise and which is as independent and coercive as the nuclear safety Authority , would best prepare the medical world and the human society for the possibility of new crises,
- it is necessary to revise the resources that are dedicated to such vital questions for human society. It will be necessary, ‘the day after’, to revise where the budgets are spent and to put effectiveness back in pole position. If, as many fear, the next vital crisis for Humanity is that of climate change, it is urgent to use rational tools and top expertise to prepare ourselves. A climate change could have such huge consequences that it is necessary to stop listening to the ideologues (even though, as written above, their concerns and aims are respectable) and especially those declaring themselves as experts, e.g. like those who pushed Germans to spend huge quantities of money to produce electricity by wind turbines and solar panels, although without reducing their electricity carbon footprint, which remains one of the highest in the world for greenhouse-effect gas emitted per produced kilowatt·hour.
Angelo Beati, nuclear engineer expert in innovation and collective creativity, France
Bernard Carluec, engineer expert in nuclear safety, France
April 26th, 2020
[*] The authors take as reference their country, France, but their analysis and their proposals have general relevance and application.