Article | July 17, 2020
The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future?
Before we get into analysis and solution design, summarizing the C19 quirks:
While a large section of the affected population is asymptomatic, for some it can be lethal
There isn’t clarity on all the ways C19 spreads
It’s known to affect the lungs, heart, and kidneys in patients with weak immunity
It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are:
With no vaccine in sight, the end of this epidemic looks months or years away
Health care personnel in hospitals need additional protection to treat patients
Lockdowns lead to severe economic hardship and its repeated application can be damaging
Quarantining people has an economic cost, especially in the weaker sections of society
If one takes a step back to re-think about this, we are primarily solving 2 problems:
Minimise deaths: Minimise the death of C19 and non-C19 patients in this period
Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels
One needs to achieve the 2 goals in an environment of rising number of C19 cases.
An approach that can be applied to achieve this is:
Data driven health care capacity planning
Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes
This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed
The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly
Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations
Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence
The diagram below explains the process
Mechanism to increase hospital capacity without cost escalation
Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing.
To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management.
Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red.
**Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established
Better enforcement of social factors
The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc.
Maximise economic growth
The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are:
One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts
Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact
The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed.
An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow)
Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector
The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc.
In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.
Article | July 17, 2020
© 2019 American Cranes & Transport Magazine.
Moving over-sized, over-dimensional loads during the day is no easy task. Adding darkness and poor visibility to your trip adds numerous hazards that must be thoroughly identified and mitigated.
When planning a specialized transportation project, there are three primary objectives:
Ensure the safety of the transport crew and the general public.
Protect the integrity of the cargo and transport equipment.
Protection of Infrastructure – roads, bridges, traffic control devices, utilities and the like.
For the most part, specialized carriers perform night transports to reduce the impact on day-time commuter traffic. Route challenges – construction, road closures, lane crossovers, bridges and other obstacles – are often better solved at night. Police and utility support are often more readily available at night.
Night transport hazards include employee fatigue, slowed reaction time and poor visibility for both the transport crew and motorists. Decreased visibility increases potential for trips, falls, runovers, back overs and equipment strikes.
It can’t be emphasized enough how critically important it is to ensure that all transport crew members have had adequate rest for these projects. Workers need complete rest before the transport takes place. A fatigued worker is a danger to himself as well as his fellow crew members. And while impaired drivers can be out on the streets during the day, there is often an increased number of these drivers on roadways at night.
Limited visibility is a given when it comes to night-time transports. Limited visibility increases the chance of going off route and striking objects, and the transport driver’s maneuverability and reaction time maybe be reduced. Road conditions can abruptly change during a night-time transport. Therefore, it is critically important to know the route and to have drivers run it in advance. Statistically speaking, accident frequency increases when the transporter goes off route and attempts to correct itself. While providing the necessary lighting to make night transport is important, artificial lighting can pose visibility hazards, especially to the drivers. Other hazards may include bright work lighting that produces glare.
OSHA has identified the “Focus Four” accident events that make up the most serious injuries and fatalities in the construction business. They are also known as the “Fatal Four.” Many carriers have had employees injured in the past as a result of one of these four incidents.
Caught-in-between hazards are injuries resulting from a person being squeezed, caught, crushed, pinched or compressed between two or more objects or between parts of an object. This is also referred to as “pinch points or entrapment.” As the transporter navigates its designated route the landscape is continuously changing. It is imperative that all ground crew members maintain situational awareness and not place themselves between the moving transporter and fixed objects such as guardrails, parked vehicles, buildings, etc.
Struck-by hazards are injuries produced by forcible contact or impact between the injured person and an object or piece of equipment. There are many potential struck-by hazards. Guide wires that must be raised can snap and strike workers on the ground. Tag lines should be used to control loads. The primary purpose of using tag lines is to control the load but more importantly give the worker a safe buffer distance away from suspended and the uncontrolled movement of these loads.
Fall hazards are anything that could cause an unintended loss of balance or bodily support and result in a fall. To prevent fall hazards all workers should have either fall prevention or a means of fall protection in place. As a rule, 100 percent tie off is required when using a fall arrest system (FAS). FAS’s should be thoroughly inspected before each use.
Electrocution hazards result when a person is exposed to a lethal amount of electrical energy. Maintaining minimum approach distances (MAD) is a critical safety practice. As everyone knows, equipment does not have to physically make contact with energized equipment or lines to cause serious injuries and even death. Electrical energy can “jump” from lines into equipment that has encroached the Minimum Approach Distance based on its voltage.
As noted above, it is critically important to ensure that crew members have had adequate rest and are not fatigued. Night transports are difficult enough, and the last thing you want to introduce are tired and fatigued workers. Being fatigued creates a risk for anyone who undertakes an activity that requires concentration and a quick response.
All companies should have an “Hours Worked Policy” that clearly spells out the number of hours allowed to work before a mandatory rest period. This policy should ensure that the transport crew has had adequate rest during day, that a fatigue assessment is conducted on all team members, that crews are never allowed to work double shifts and that employees are prohibited from driving long distances to return home.
Dealing with darkness
Visibility and slowed reaction times should be a part of the project planning. A limited amount of ambient light that only projects upward and outward impedes vision and increases blind spots for drivers. Lights cast shadows, increasing the potential for slips, trips and falls.
All transport moves should establish pre-planned Emergency Action Plans. When an emergency occurs, time is of the essence and can mean the difference between life and death. If it is a long-distance move the emergency numbers and first responder information can change. Crews should know when it’s time to seek emergency “safe harbor.”
When approaching overhead obstructions such as guide wires, electrical lines, communication lines and overpasses, travel speed is of utmost importance. Again, pre-route surveys provide advance knowledge of obstructions. At night, visual identification of roadway obstructions is reduced and delayed and last second reactions to oncoming hazards can lead to accidents. Support personnel in bucket trucks also have the challenge of reduced visibility.
In darkness, overhead hazards often require more utility support for height clearances, which means the need for raising energized lines, lifting traffic control devices, trimming tree limbs, releasing tension on guide wires, removing highway signs, repositioning street lights and raising railroad crossing arms.
Traffic control can also create hazards. The general public may ignore pilot car lights at night, so it’s often advisable to also use police escorts. All support vehicles and trucks should be properly marked and equipped with strobe lights.
The configuration of the transport system can also be a hazard. Navigating sharp turns or crossovers is greatly reduced based on the length of transporter. Snake-like maneuvers of trailers pose an increased risk.
It’s important to never allow personnel to take shortcuts by walking through or under transporter while it’s in motion. Stop or have the worker go around.
The transport crew must always maintain “situational awareness” to prevent being in line of fire or entrapped between moving and fixed objects.
All the equipment used in the transport must be deemed safe. You should have procedures to conduct thorough assessment of all new equipment.
Ensure machine guard devices are in place especially around moving components.
Provide secured areas using catwalks/railing system.
All steps should be designed with slip resistant material.
Ensure that all deck openings are properly protected and covered.
Components that hydraulically extend and retract should be clearly posted with DANGER signs.
Roadway conditions are always a bigger concern at night. Assess weather conditions prior to start of the project and don’t take chances. A “Go – No Go” criteria should be developed for each project. Once the decision is made to transport the load there is no turning back. Changing weather can cause the transporter to lose traction. Underpasses that are shaded during the day will likely freeze up more quickly. If the temperatures drop significantly during the move, equipment performance may be affected – especially those with hydraulics.
Because the reaction time of the transport crew is reduced, speeds are often reduced, causing potential for curfew violations. Boarding and deboarding the transporter increases risk for slips and falls. Other potential road condition hazards include grade of road, width of road, shoulder surfaces, railroad crossing clearances and bottoming out, overpasses, tight and narrow turning lanes, parked vehicles and frequent grade changes.
Crew prep is essential and should be a part of the job plan and job training. The team should be briefed each day to identify the responsibilities of all crew members. The crew should know it is empowered; everyone has the authority to stop the transport if something looks unsafe or when someone is unsure. In the event of a complication, crews should be informed of how to regroup and formulata mitigation plan. There should be an established means of communication that is limited only to transport issues. Most importantly, crew should embrace these words: When in doubt, call time out!
A Task Hazard Analysis (THA) should address all scope of work activities, identify hazards and have a mitigation plan for each, clear channels of communication, the traffic control plan and an “Emergency Preparedness Plan.” And finally: Know the route; ride the route and expect the unexpected.
Edwards Moving performs a night move using it’s Goldhofer Faktor-5 transport system.
Keys to a successful night transport
Early planning and attention to detail. Anticipate roadway hazards such as guardrails, poles & hydrants that pose obstruction with travel path or turning radius.
Preparing a detailed traffic control plan.
Thorough due diligence throughout scope of work.
Established contingency plan for equipment.
Article | July 17, 2020
Software automation accelerates processes and makes them more cost-effective, accurate, scalable, and measurable. But it also lets organizations coordinate and manage a collection of disparate systems according to business rules. These benefits offer enough value that automation is becoming an indispensable part of the enterprise toolkit. A 2019 Deloitte survey of 523 executives across industries found that 58% of organizations were already using Robotic Process Automation (RPA) and artificial intelligence (AI) combined. The top four objectives of this intelligent automation: increased productivity, cost savings, accuracy, and customer experience. How will this trend affect the healthcare job market? In the healthcare industry, examples include scheduling appointments, physician order entry, checking for allergies, ordering electronic prescriptions, validating a spreadsheet’s entries against data on a website, and manually transferring data from one system to another. Healthcare office workers tend to hate these tasks, which typically require very little decision-making, judgment, or creativity.
Article | July 17, 2020
Health marketers who want to deliver personalized experiences across all channels must evolve the use of the person-level ID to balance differentiated offerings with privacy. Following Apple’s lead, Google recently announced that Chrome will start blocking third-party cookie tracking within the next two years. Marketers are wondering, what’s left? The ad industry will now begin to replace third-party cookies with new person-level identifiers versus relying on anonymous ID’s. For all media channels in the omni-channel world that have logged in, PII based matching will be even more critical. This will result in greater media efficiencies and more relevant experiences with fewer wasted impressions. Identity management will also become a more critical need as person-level data replaces third-party cookies.