A Centre of Gravity analysis for SARS-CoV-2 (SC2)
“If you know the enemy and know yourself, you need not fear the result of a hundred battles..” Sun Tzu
We need to know our enemy. In order to plan our return to normality, we need to consider the SARS coronavirus’s key attributes, and what makes up its centre of gravity.
COVID-19 is a disease caused by a new infectious agent; the SARS-CoV-2 coronavirus, for the sake of convenience shortened here to SC2. The disease, COVID-19, is the personified version of SC2, which is able to hijack its victims and turn them into coronavirus factories.
CENTRE OF GRAVITY
A key to understanding the connection between SC2, COVID-19 and all its human consequences is its prodigious transmissibility.
The word ‘transmission’ is made up of ‘trans-‘ (across) and ‘-mission’ (purpose, intent, expeditionary group). This combination signifies a dynamic process across space and time boundaries to recruit new individuals, communities, populations and even other species. Addition of ‘-ability’ denotes a notable feature of SC2, resulting in doubling of new cases in as little three days. This is SC2’s centre of gravity, summarised here as TRANS.
Key: CoG, centre of gravity; CCs, critical capabilities; CVs, critical vulnerabilities.
SC2 achieves its centre of gravity through a series of critical capabilities:
- STEALTH. SC2’s capacity for undetected spread by people with asymptomatic infection, such as during the pre-symptomatic, and convalescent periods. Estimates of asymptomatic infection vary between 30 and 60% of SC2 test-positive people. A notable contributor is SC2’s ability to cause mild symptoms that may seem trivial to the index case, cand an interval of several days until more severe symptoms set in.
- PASSENGER. A second key attribute of SC2 is its ability to exploit and target normal human behaviour including close personal contact, prolonged proximity, social aggregation, and easing of hygiene practices in familiar company. SC2 is not self-propelled.
- 3-D. SC2 exposes weaknesses in the organisation of healthcare delivery, including diagnostic, therapeutic, preventive, long term residential and surveillance services. As a consequence, SC2 exploits the slow rhythms of peacetime bureaucracy that place a dead hand on lean thinking. This attribute is highlighted where health services are stretched to their limits by high service demand, at great distance for long duration in our most vulnerable remote communities. These three dimensions of logistics give COVID-19 its freedom of action.
COVID-19 is vulnerable to countermeasures that target these critical capabilities.
- INTELLIGENCE. STEALTH dictates that COVID-19 can be countered by early detection. This demands increased molecular diagnostic tests, a broadening of indications for testing to include people without any symptoms, and deployment of test capability closer to regional and remote communities. Early detection enables better targeting of control and containment efforts through laboratory evidence.
- DISPERSAL. PASSENGER demands an increase in interpersonal distance among social, work and recreational groups. This requires a reduction in people density to individual level for extended periods to achieve a circuit-breaker effect.
- LIGHTBULB. 3-D requires organisational agility, a scything elimination of bureaucratic complexity and adoption of lean thinking. SC’s freedom of action is vulnerable to just-in-time decisions that trigger actions within COVID-19’s three day doubling time. Timely solutions will do much for the most vulnerable remote communities.
In the current reactive stage of the COVID-19 response the current paradigm is largely one of containment. The main effort is about delay, denial, disconnection, disruption and defeat. Accepting that effective treatments and vaccines are at least months away, a comprehensive defeat of SC2 will have to be achieved by other means. The key priorities that come out of COVID-19’s centre of gravity assessment are:
- increased SC2 test availability, throughput, geographic reach and repetition for the duration of the pandemic
- increased interpersonal distance, reduced population density, interposition of multiple layers of personal hygiene and protective physical barriers
- adaptive decision-making, supported by streamlined administrative support and just-in-time operational research
Micrognome, 19th April, 2020.