First Responders On The Front Line Measuring The Effect: Fill & Download for Free

Well, I was a CEO of a £5bn turnover, 25,000 person quoted company for 10 years. As with every new job, I kept a timesheet for the first year to check that my activities matched my priorities.In summary, I spent about one quarter of my time on strategy — thinking, researching, consulting, defining and communicating the future for the company. The structures I used for this were unremarkable — where to compete, how to compete and what strengths to develop (particularly people and culture) — because I felt our effectiveness in implementing all that stuff was much more important than any particular framework or methodology.I spent a quarter of my time supervising performance and risks - normal and regular business reviews, major project reviews and dealing with the inevitable crises and unexpected events. Over time, this proportion fell, because after 18 months or so I'd established a wonderful team of people who did this stuff much better than me.I spent another quarter dealing with building the strength of our people - evangelising (and hopefully personally demonstrating) our culture, recruiting, taking the temperature of the mood of the people, consulting with my HR Director (my closest executive team member), succession planning, presenting to groups at every level on development programmes, and thinking and researching what made people in our business effective and successful (most important conclusion; be clear what you expect of people, equip them, and then bugger off out of their way - very important message for policy loving central functions). This time proportion grew, justifiably.The remaining quarter was split more or less evenly between dealing with important stakeholders - mainly shareholders, but also government, key suppliers etc - and non-productive guff . Clearly, any person at work wants to avoid time wasters, but CEOs are probably afflicted by more than most by people who want to come and sell their latest idea, from investment bankers to industry lobbying groups.I did OK as a CEO, and I'm sure there are many, many better than me, but here's a few reflections (also informed by my working directly for, and networking amongst CEOs for the last 25 years):I didn't want to be a CEO. The people who have a burning ambition to get there, excluding founders, are probably not suited to the role. This is the tragical paradox of the agency management model;Yes, it's true - it's lonely and everything is your fault;If you do your job properly you will work every waking hour, and need to be disciplined about keeping your body and mind healthy;You should aim to have a clear desk - seriously. You are the only person in the organisation with the heavy responsibility to ensure the long term survival of the enterprise. You can't think about that with a full email inbox and a desk covered with papers. I was obsessive about clearing my inbox to zero each night, mainly by ignoring or giving one word answers to people who were seeking cover (people learn and it stops after a while). As CEO, if you don't respond instantaneously, you can actually stop the organisation getting on and doing things. On the other hand;Be very, very accessible. Wander around purposefully. You'll pick up what's really going on, what people are really worried about, and then you can add value to the decisions your people are grappling with;Sack high performers who are a pain in the arse - again, seriously. The profits they make is usually dwarfed by the profits foregone by the waste of energy of everyone else being disrupted and demoralised by their bad behaviours;Look outward. The prison of an email inbox forces attention in an internal direction. Take your team on study tours. Look at parallel sectors. Talk to innovators in colleges. Read, read and read again (hooray for the iPad);Be very sensitive of your symbolic behaviour, because people notice and ape your behaviour. Be nice, Smile. Say hello to people (they are making the money to pay your wages). Show people that the front line is the most important, not the head offices or support centres or whatever name you give them. If your office environment isn't egalitarian, you're in the wrong century.Remember that on a daily basis you are probably the least important person in the organisation (most CEOs get this wrong). The person serving a customer is the most important. Believe me, it takes constant concentration to remain humble when everyone is laughing at your jokes, and;Even though your jokes probably aren't that funny, it is your absolute priority to make working life rewarding for everyone that works in the organisation. Make it a happy, vibrant place. When your CFO delivers you an excellent piece of analysis, go to the whole FP&A team after you've appreciated it and thank them;Your success will be measured by growth and development after you've gone. If it tails off after you leave, you have been a terrible CEO. That's why you have to think about your own succession from the first day you were appointed;You are not defined by your job. You will go, and be forgotten, and seeking a legacy is a fool's errand

As a medical professional, what is your biggest concern about the COVID-19 coronavirus?I am not a medical professional. I have a scientific background, I am in public health. And what terrifies me the most was the utterance of the words “The cure can’t be worse than the problem”, and the potential for this particular point of view to start gaining traction.Listen, there is no way that this pandemic can be anything less than hugely disruptive. It is going to take the lives of many of our loved ones, it is going to impact the economy, lots of people are going to lose their jobs and face economic uncertainty. We HAVE to acknowledge this. There is no single scenario in which this is going to get going back to normal in two months. None. So just stop it already. Don’t give in to the allure of the words of people who have shown a clear disregard for their fellow human beings before. And all for what? so that capital markets and wealth can be protected?FUCK THAT. #NotDying4WallStreetIf we ease off on social distancing and revert to even a half of current measures, we will be undoing hard-won gains and face a runaway epidemic that will clearly overwhelm the medical system of every nation. We know this. We are ill-equipped in terms of testing capacity, ICU capacity, ventilators, PPE, medical professionals. And now, the investor class is trial-ballooning the concept that we should ease off on the only measures that have shown any evidence of effectiveness hoping to capitalize on the rightful unease that fills your heart with dread as you see thousands upon thousands losing their jobs.But consider the alternative.One in which easing off on measures scarcely instituted a week ago (and not even adhered to by a large proportion of entitled individuals that have been engaging in non-essential travel and non-essential socializing) inevitably leads to a huge spike in the number of infected individuals requiring medical assistance. Sure, maybe the initial estimates of 20% complication rate are much too high since the denominator, the number of infected, is still an unknown. We are primarily testing those with a travel history, a contact history and with symptoms.We simply do not know who else could be infected.And maybe the case fatality rate is equally inflated for similar reasons. Even so, the numbers are going to be sobering. In the USA, even if the rate of complications isn’t 20% but rather 5%, even if the case fatality rate isn’t 2.5% but rather 0.5%. And even if the denominator only rises to 50% of the population being infected over the next year, even then, that’s a lot of people: over 8 million with respiratory distress and requiring medical care — including nearly 1 million requiring an ICU bed and ventilation; over 800,000 dying of COVID-19 complications. The medical system has nowhere near the capacity for that. We know this. This means that many people requiring other forms of emergency medical treatment because life, may be at greater risk when every single ICU bed is already occupied by a person infected with this novel coronavirus.Oh, most of the people who die are “elderly-types” with several co-morbidities? Sure, those are the people who die. And certainly age is a huge, maybe the largest, risk-factor for death:Courtesy of ATAndyBiotech on twitterBut.The people who end-up recovering still require weeks and weeks of supportive treatment. A surprisingly large proportion. It varies by country and region so I won’t even pretend to know the number. Early numbers in NYC were in the 35% range. Recent CDC estimates for the 20-44 age cohort are 14.3 percent hospitalized, 2 percent in the ICU, and 0.1 percent fatality rate. As you move up the age pyramid the risk for each of these things (hospitalization, ICU, fatality) keep rising. But the point is that nobody is infallible and the entire age pyramid will be cramming into overstretched medical facilities.Meanwhile, as we overwhelm the medical system, we will be putting the entire membership of medical professionals (nurses, doctors, first responders, respiratory therapists, etc.) at increasing odds of personal danger by sending them to fight a fight that we are unwilling to support wholeheartedly by what is a rather insignificant amount of personal sacrifice. That shows a callous disregard for their commitment to doing the right thing. It’s amazing to see these folks, many of whom entered their profession out of a sense of public good, give it their all on our behalf, retired doctors and nurses rushing back to get recertified so that they can lend a helping hand to their brothers and sisters in arms even as they discover that we don’t have their back, that the federal government is too slow to react to their increasing need for supplies.Our callous disregard for their safety is not what they deserve.Scarcely less than two decades ago, we sent young men and women to die in foreign lands without the necessary body and vehicle armor to at least provide them a modicum of safety. In the age before GoFundMe, their loved ones were already deep into crowd-sourcing in order to raise funds to buy needed equipment so that their loved ones would be better protected. The worst? Sure, you may not recall Donald Rumsfeld’s infamous words: “You go to war with the army you have, not the army you might want or wish to have at a later time.”. Those words would be true, were it not for the fact that it was a war of choice. A war that we entered at a time of our own choosing. That was a fucking shocking abdication of responsibility and a grotesque disregard for common decency. It was only last summer that the James Zadroga 9/11 Health and Compensation Act passed congress. You know the one. The one that ensured proper funding to provide for the medical needs of the brave first responders who rushed to help on 9/11 at great personal sacrifice. Sure, James Zadroga only passed away from his 9/11-related ailments 15 years ago but who’s counting anyway?A less than responsible response to this pandemic threatens to do the very same. How shameful that some in the highest echelons of power are contemplating a similar course of action. We have had months to prepare for this pandemic as the situation deteriorated in Hubei and signs of a chain of international transmission trickled out of China with increasing intensity. We are seeing Italy, Iran, Spain, France toppling under the crushing weight of an unrelenting wave of infection. We even got an early trial by fire in Kirkland. And here we are, weeks later, still unable to assure our front line responders that we can provide timely access to PPE, to testing kits, to ventilators. That we are contemplating running headfirst into an incomprehensible number of casualties, one which will certainly include many of the medical professionals that are trying to save us and our loved ones, by relaxing social distancing efforts is beneath us.For me? All I have to do is look to history to see that when humanity is presented with a fork on the road, generally, we split into two tribes sure in the knowledge that we are choosing the correct course. Sometimes, it’s like in The Poseidon Adventure, and neither group really knows what’s going on and who is going to be right in the end. But at the very least, ask yourself this question. The last time that the shit hit the fan and we were at the edge of disaster, were the people leading your group the ones responsible for the debacle? Are you being led by a gang of sociopaths looking out for number one and seeking your tacit approval as means of empowerment? The same people floating out this particular trial balloon of insanity and grotesquerie are the very same people that barely more than a decade ago were “the smartest guys in the room”, fucking the world over through their sheer hubris, incompetence, and greed. They’re the same sociopaths that sold garbage dressed up as AAA-rated financial instruments and then also made money when these instruments, which were designed to fail, began to fail.People make mistakes, all of the time. But making the same critical mistake twice in a lifetime? Why should we seek guidance from them in a time of crisis?Stay sane, stay safe, #StayHome. Don’t be a #COVIDIOT.And remember, #NotDying4WallStreet. #LloydBlankfeinWasBadAtIvestmentBankingAndIsAnEvenWorseEpidemiologistPost-Script added on 2020–03–25:I had a thoughtful exchange with Dan Rosenberg, in which he made some valid arguments about the economy, ones that I wholeheartedly agree with. I do not mean to give the impression that there is no merit to the saying that the cure cannot be worse than the problem. Far from it. The health and welfare of people is intricately linked to their economic situation and I know this. As Dan correctly pointed out as well, this isn’t just about Wall Street. The economy isn’t an abstract thing; it employs people, provides their livelihood, it contributes to their welfare. I may be a bleeding heart liberal, but I don’t mind capitalism and enjoy its trappings. I just don’t think that we need to kneel at its altar and I don’t think that we need to bow to its high-priests. And I certainly think that we have to be extremely skeptical about a bunch of investment bankers telling us that the economy “must go back to normal” in two weeks, or that it would be ruinous for the Federal government to borrow too much money in order to protect the American worker. And we sure should be skeptical of a president who is involved in the hotel and hospitality business wanting for things to get back to “normal” as soon as possible.I don’t want my embracing of the #NotDying4WallStreet hashtag to distract from my main argument, which is that we cannot possibly be considering that the economy gets to go “back to normal” in two weeks, while we are going to be in the middle of an exponential rise in infected patients and fatalities, with hospitals being overrun and our medical professionals struggling to cope with the horror. The heroes in our medical and first response system are running out of PPE, out of ventilators, out of ICU beds in NYC right now.And this is still the relative calm before the storm.In two weeks' time, there may be between 10 and 30 times the number of people seeking medical attention, requiring ventilators; this is how exponential growth works. Over the weekend, I had a discussion with a Quoran who will remain unnamed. They were touting America’s response to the pandemic because of the apparent rate of growth in case fatalities, which at the time looked to be smaller than that observed at a similar point in time in Italy. The flaw in their reasoning? they were using “time since first fatality” as an arbitrary marker to perform the comparison. The projections were based on looking at the quasi-linear part of the graph that we call the “lag-phase”, right before shit gets real and rates skyrocket at an exponential rate. Moreover, the key point is that although you can move the curve around and it may delay or hasten the time of arrival at the crisis point it does not make the crisis point go away.In terms of an epidemic, the number of casualties always lags behind the number of confirmed infections and the number of confirmed infections always lags behind the number of actual infections. Why? because of the incubation period, the number of asymptomatically infected, and the lack of comprehensive testing. The numbers we are seeing today are a reflection of people that were being infected one to two weeks ago. Now I dare you to think about Mardi Gras and the current explosion of rates in the New Orleans region (the highest rate of new cases in the world) and then all those kids that spent spring break asses to elbows in Florida beaches and then flew home. We are sitting on a goddamn time bomb.Do you think it brings me joy to point out that in four days we have overtaken that person’s rosy projections? At the time, we were sitting at just over 400 fatalities. They thought we would be at 700 deaths by the end of April. Tonight we surpassed 900 deaths, 5 days later. Let me reiterate: the casualties more than doubled in 5 days. Exponential growth.Some of you doubt my motives. That I’m some socialist or communist that hates the free market or, ironically, that I’m arguing for the shutdown of the economy because “fuck the poors”. I mean, it’s fairly rich (pardon the pun) for defenders of capitalism to all of a sudden show so much compassion towards the poor or working poor now, in the midst of a pandemic. But I digress. My solution to this whole thing, such as it is, is for the government to borrow huge amounts of money and to invest it in the safety and welfare of its people. This will wipe out a generation’s worth of wealth. Sorry to be a realist. But this buys us the time to come up with an action plan for the eventual resuming of economic activity. It buys us the time to keep infection rates manageable until we reach herd immunity through natural infections or a vaccine without overwhelming the medical system. In time, those that were infected with this virus and live to tell the tale get to go back to work and resume normal activities.I will share with you something that I wrote to Dan:“I would be happy to regale you with my thoughts on how to get out of this mess in the least disruptive way possible. Note that I say “least disruptive way possible” because I am a realist. Something that I hope you share with me. This is a war that we are fighting. We may lose more people than we have lost in previous conflicts that qualify as war. And the president himself wants to be considered a wartime president. I cannot imagine that I’m about to quote Liz Cheney, who at times has shown herself to be a monstrous individual:"There will be no normally functioning economy if our hospitals are overwhelmed and thousands of Americans of all ages, including our doctors and nurses, lay dying because we have failed to do what's necessary to stop the virus".She’s right.p.p.s. I want to again, turn the focus on the heroic healthcare workers that are currently having to go to work in the face of scarcities in personal protective equipment and the gear that they need to treat their patients. If America “goes back to normal” in two weeks' time, how about if they refuse to go to work and treat you and your loved ones until we can assure them that we are sending them into battle with everything they need?

What was the American firepower like versus the Germans in World War 2?Like what many of the authors here have pointed out in Quora, American firepower simply "dwarfed" the German's. Let's take a look at an example - Operation COBRA.Following D-Day, as the Allies began to push inland into Normandy, they quickly found that the dominating terrain feature in the Norman countryside were bocage hedgerows — mostly impenetrable to Allied armor. The base of the hedgerows consisted of a large earth mound, several feet in thickness and three to twelve feet in height. As a result, the Allies were largely unable to effectively use their armor. Infantry units had to painstakingly clear one field at a time and the Germans were certainly excellent defenders with the skillful use of their MGs and Mortars, making the Allies pay for every inches.(Germans with their fame MG34/42 defending behind hedgerows. Photo credit: Imperial War Museums.)Soon, the initial excitement of D-Day quickly died down for the Allies, when advances would be measured in yards instead of miles. Late June and early July of 1944 were beginning to turn into the slow attritional style of warfare that looked very much like WWI. The Normandy campaign was fast grounding to a near halt. By 2 Jul 1944, Allied advances had stagnated. The Allies desperately needed a breakthrough.Use of strategic bombing to support tactical operationsAt the American sector, General Bradley launched what would be known as Operator COBRA, the use of strategic air power in a combined-arms role that would directly support a ground offensive. Superior air power would be used to create a "hole" in the front-line for the ground forces to quickly punch through the weakened hole. The 7 thousand-yard narrow front-line just south of St Lo-Periers road would be chosen for the breakout.At 0614 the morning of 25 July, the aircraft of 8th Air Force began to rendezvous in English skies. By 0930 hours all the aircraft were over the designated zone in Normandy. At 1100, the bombers began to pulverize the German line, just south of the St Lo-Periers road.Flying in formations of twelve, 1,500 B-17 ‘Flying Fortresses’ and B-24 ‘Liberators’ dropped 3,300 tons of bombs in preparation for COBRA. 380 medium bombers and 550 fighter-bombers also supported the initial COBRA bombardment, dropping 650 and 220 tons, respectively. In all, 50,000 bombs were dropped along the 7 thousand-yard front in a spectacular display of American firepower. This worked out to be about 7 bombs per yard front.On the ground, the Germans received virtually the full brunt of the American saturation bombing.(The devastating bomb load released by B17s.)Crying and shouting for helpGerman medical sergeant Walter Klein who was deployed at the St Lo front would later recall:"It was 1100 hours. According to orders I had to report back to the company command post, but on the sunken road I found five wounded parachute gunners of the 5th Para Division, injured by a splinter bomb.What happened during the following hours was terrific. By our calculation, 1,000 to 1,200 bombers took part in the attack. The effect was devastating; all our anti-aircraft guns and artillery were destroyed. Tanks that tried to get away were destroyed by pursuit planes.When a wave of planes had passed, one could hear the crying of the wounded and shouting for help of medical personnel. I had just the time to carry one of my comrades, who had been wounded badly in the thigh, into the dugout when a second wave started bombing.It was impossible to give help as long as the air raid lasted. Several companies of the 5th Para Division who tried to withdraw to the north in the direction of Marigny were entirely destroyed by Lightnings, pursuit planes and bombers. On that day my company lost one officer, and 34 non-commissioned officers and enlisted men. The attack lasted approximately three hours.At 1930 I brought the last wounded to the dressing station. The unit had moved to another position. The general opinion of my comrades and even the officers was that, if the enemy made another attack, it would be our end. Only one heavy weapon was left and it only had six rounds of ammunition. Of our heavy trench mortars only two were left.The St Lo front had suffered very much from this attack. Worse than the loss of weapons was the effect that the attack had made on our morale."Survivors were like madmenThe Panzer Lehr Division, the elite German armor division, was completely ravaged by the COBRA saturation bombing. General Fritz Bayerlin, commander of Panzer Lehr Division, was ordered by his superior, Field Marshall Gunther von Kluge, to hold steady. Bayerlin angrily responded to his superior, "Out in front everyone is holding out. Everyone. My grenadiers and my engineers, and my tank crews — they’re holding their ground. Not a single one is leaving his post. They are lying silent in their foxholes for they are dead!"He would later remarked about the aftershock of COBRA, "The whole place looked like a moon landscape; everything was burned and blasted." And added, "It was impossible to bring up vehicles or recover the ones that were damaged. The survivors were like madmen and could not be used for anything. I don’t believe hell could be as bad as what we experienced."The shock effect cannot be doubted. An American doctor noted in his diary that "many of [the prisoners taken] were actually babbling, knocked silly".An American infantry officer, advancing through the target area, observed, "At the end of this great bombing action the earth was as if it had been plowed. Within an area of many square miles, scarcely a human being or an animal was alive and all kinds of trucks, guns and machines of every type were in twisted disorder over the deeply-scarred soil." In some cases, Panther tanks had been flipped over on to their backs like turtles.(General Fritz Bayerlin, commander of Panzer Lehr Division)As Bayerlin remarked, the COBRA saturation bombing did have a significant impact on front-line German defenders. Many experienced severe psychological trauma. It shocked and disorganized the Germans. Not only the bombing affected the German troops, it severed important German communication channels as well as destroyed the already critically low German supplies — namely munitions for the versatile 88s. Many of the German artillery depots went up in smoke along the German front. The saturation bombing contributed much to the success of the ground offensive, as the severed communication links between the German front and rear inhibited any serious counterattack. The importance of cut lines of communication cannot be overstated in their contribution to the overall success of COBRA. In many places, the Germans had no idea that an Allied breakthrough was even occurring.The breakthrough itself occurred the day after the commencement of COBRA, on 26 July 1944. Following the saturation bombing and the onset of the COBRA offensive, combat continued through the night into 26 July. By the afternoon of 26 July, American forces had created a gap in German lines. Yet, as American forces began flowing deeper through the gap, simultaneously widening it, joint air-ground operations continued to play a critical role in successfully exploiting the breakthrough. Key to the post-breakout air-ground operations were tactical air operations supported by fighter-bombers, the infamous "Jabos", like P47 Thunderbolts and Typhoons.Friendly fireDespite the success of COBRA on 25 July, unfortunately, 111 American soldiers also perished in the COBRA bombing due to the fog of war. The dust and smoke threw up by the bombs from the first wave of bombers had obscured the aiming points for subsequent waves of bombers, resulting in accidental bombing of friendly units. Some 500 men were also wounded in the friendly fire.The dead included Bradley's friend and fellow West Pointer Lieutenant General Lesley McNair — the highest-ranking U.S. soldier to be killed in action in the European Theater of Operations. He had come from England to watch the operation. Even though he was well behind the intended bombing area, McNair was found blown 60 yards from his foxhole, identifiable only by the three stars festooned to his collar.(American troops digging out men buried after COBRA bombing - AP Photo)Ref:https://www.washingtonpost.com/news/checkpoint/wp/2016/06/06/the-little-known-d-day-operation-that-accidentally-killed-more-than-100-u-s-troops/Amazon.com: 9781101148723: BooksTrailing Edge of Airpower: Operation COBRA's Legacy in the Development of AirLand Battle DoctrineUS bombers prepare the ground for Operation Cobra