Insights from the COVID-19 Pandemic for Systemic Risk Assessment and Management

The COVID-19 pandemic has activated hundreds of interdependent long-lasting risks across all sectors of society. Zoonotic diseases are on the rise, fuelled by climatic change, by encroachment and destruction of habitats, and by unsustainable practices. Risk assessment and management must be greatly improved to prevent even worse consequences than COVID-19 if the next pandemic is caused by an agent with higher infectiousness and lethality. Insights from a project on systemic pandemic risk management reveal that the interdependency of risks creates cascading effects mediated by millions of vicious cycles which must be addressed to gain control over a pandemic. We propose a method for systemic, cross-sectoral risk assessment that detects the myriad of causal influences resulting from the risks, allowing to identify and mitigate the most potent risks, i.e., those participating in the highest numbers of vicious loops. © 2022, IFIP International Federation for Information Processing.

Elicitation, analysis and mitigation of systemic pandemic risks

The Covid-19 pandemic has disrupted the health care system and affected all sectors of society, including critical infrastructures. In turn, the impact on society's infrastructures has impacted back on the health care sector. These interactions have created a system of associated risks and outcomes, where the outcomes of risks are risks themselves and where the resulting consequences are complex vicious cycles. Traditional risks assessment methods cannot cope with interdependent risks. This paper describes a novel risk systemicity approach to elicit and mitigate the systemic risks of a major pandemic. The approach employed the internet-based software strategyfinder™ in workshops to elicit relevant risk information from sixteen appropriately selected experts from the health care sector and major sectors impacted by and impacting back on the health care sector. The risk information was processed with powerful analytical tools of strategyfinder to allow the experts to prioritise portfolios of strategies attacking the vicious cycles. © 2021 Information Systems for Crisis Response and Management, ISCRAM. All rights reserved.

Robotic surgery during COVID 19 pandemic – experience from a high-volume cancer centre in UK

Introduction & Objectives: We present our experience on managing our robotic cancer service during the lock down period of COVID 19 pandemic to ensure safety of both staff and patients, reducing waiting list times and re-initiating robotic training. Materials & Methods: In keeping with government guidance all non-emergent operations were suspended in the Royal Surrey County Hospital (RSCH), Guildford, UK on the 9th April till the 29th July. In collaboration between RSCH and the Nuffield Private Hospital, innovative solutions were proposed and implemented to set up a robotic hub for cancer surgeries in a “clean” area. This included risk assessment, team allocations, moving of equipment, correspondence with various teams, reinstating logistics using remote access, screening and training of staff and patients along with setting a protocol for procedures and emergencies based on national and international guidelines. Results: 76 Robot Assisted Radical Prostatectomy (RARP) and 13 (Robot Assisted Radical Cystectomy (RARC) were performed between 21st April and 29th July at RSCH. After a month of service, when all procedures were conducted by expert surgeons, robotic training was initiated in a phased manner. None of the patients or staff members developed COVID 19 infection or were off sick during this time. Our waiting list at the end of this period was down to single figures for both RARPs and RARCs. Conclusions: With adequate planning, robotic surgery can be safely carried out to confront the barriers for return to pre-pandemic practice, preventing a ripple effect on waiting list times for cancer surgeries. Good patient and trainee satisfaction can also be achieved using this approach.