Analysis of anti-epidemic strategies using Chinese original innovation methodology to enhance decision quality

By Ir Dr Lotto K H LAI

Since the outbreak of the Omicron variant in Hong Kong before the Lunar New Year, the number of confirmed cases and deaths has continued rising and reaching a record high.

Some public support exists for the Chinese style "dynamic zero" strategy, that is, "early identification, early isolation, and early treatment". Others support the Western style "coexistence with the virus" that begins to lift epidemic prevention measures after vaccination or infection to achieve herd immunity. The two strategies seem to be contradictory. Using the transformation bridge method in Extenics, which is the Chinese original innovation methodology, the "win-win" solution is proposed. This paper analyses the antithetical problems of anti-epidemic strategies using an extension model and other tools to describe the implicated relation network that finds "extension resources" for resources solution for anti-epidemic measures. The policy cycle diagram of "dynamic zero" and "coexistence with the virus" is proposed as the basis for improving decision quality.

Four key elements for decision quality

In its attempts to control the fifth wave of the pandemic, there have been a lot of discussions over the current anti-epidemic policies. Four key factors that directly affect the decision quality are recommended, which are moral intensity, information quality, group cohesiveness and decision experience (See Figure 1) ¹. Descriptions of these four key factors follow.

• Moral Intensity refers to the severity of ethical behaviour in a given situation. This can be measured by urgency of the situation, certainty of the effect, moral impact of the decision-maker on the event, and availability of alternatives such as social consensus and certainty of the effect.
• Information Quality includes information dissemination, information processing and perceived adequacy of information.
• Group Cohesiveness is defined as the willingness of group members to respond as a team.
• Decision Experience indicates that experts have sufficient experience such as personal relevant experience, participation in past decision-making and relevance to the position. Decisions that require specific skills are made by individuals with these skills.

Figure 1: Four key factors for decision quality

Extenics and transformation bridges

Extenics is a Chinese original innovation methodology for studying the possibility of extending things, as well as rules and methodology, and developing innovation with formalised patterns to resolve a contradictory problem. The contradictory problem (P) is defined as the goals (g) that are unable to be reached under current condition limit (l). The formula is P = g↑1².

The basic element is the logic cells of Extenics including matter element (M), affair element (A) and relation element (R) (See Figure 2). Basic element is an ordered triad composed of the Object (O), the characteristics (c), and its measured values (v), which is denoted by B = (O, c, v).

For matter-element, element name used as Object that M = (O_m, c_m, v_m).

For affair-element, action used as Object that A = (O_a, c_a, v_a).

For relation-element, relation name used as Object that R = (O_r, c_r, v_r).

Many of the above need to take transformation of matters to solve the contradiction problem.

Figure 2: Basic element family - key elements that make up the extenics model

Transformation Bridge method is the solution achieving the best of both goals that "Each acts its own way/Win-Win". The
extension model of the antithetical problem is shown as follows:

Antithetical problems (P) are defined as the inability to achieve both goals (G₁ and G₂) simultaneously under current condition limit (L). The formula is P=(G₁ ⋀ G₂ ) ↑ L .

If the antithetical problem can be solved through the transformation of target, condition limit, domain of discourse, then T is called the solution transformation of the problem T = (T_G1, T_G2, T_L ). The formula is P=(T_G1G₁ ⋀ T_G2 G₂ ) ↓ T_LL .

Transformation Bridge of Extenics is a powerful innovation tools originated from China to solve contradiction problem.

There are two types of transformation bridges, which are connection transformation bridges and separation transformation bridges. Neither is used in isolation. The "connection-separation" type transformation bridge mainly focuses on the connection function, such as the Hong Kong- Zhuhai-Macao Bridge, which connects and separates the two different traffic systems of Hong Kong and Zhuhai. The "separation-connection" type transformation bridge mainly focuses on the separation function. A simple analogy is a Mandarin Duck Hot Pot which separates and connects the
spicy and non-spicy soup bases (See Figure 3) ³.

Figure 3: Two examples of transformation bridge

Extension model and analysis of "dynamic zero" and "coexistence with the virus"
According to Liang Wannian, the head of the National Health Commission's COVID-19 leading task force, the "dynamic zero" strategy includes three aspects:

• Actively discover the source of infection in a timely manner, including patients, asymptomatic infected persons and any animals that may carry the virus;
• Quickly take public health and social intervention measures after discovering any cases;
• Immediately and effectively treat and prevent the progress of the epidemic.

This is the pursuit of maximising social and economic development together with the greatest epidemic prevention and control effect at the least cost.

The Western style strategy of "coexistence with the virus" assumes high vaccination rates and high virus infection to achieve herd immunity. Epidemic prevention measures, including social distancing, mandatory mask wearing, restricted gatherings and closed venues, are no longer enforced.

Implicated Relation Network demonstrates possible cause-effect conditions for better understanding the situation on decision making.

M₀₁ is the matter element of "dynamic zero" and M₀₂ is the matter element of "coexistence with the virus". The value of their characteristics is expressed by the affair element, and the formula is as follows:

The two goals (G₁ and G₂) and the current condition limit (L) are expressed by the extension model of the antithetical problem (P) in the following formulas:

After modelling the anti-epidemic strategies, correlation and implication analysis is used to evaluate the relationship of the two strategies. The implicated relation network of "dynamic zero" and "coexistence with the virus" is shown in Figure 4. Blue ovals, squares and arrows represent "dynamic zero" strategic measures. The green ovals, squares and arrows represent "coexistence with the virus" strategic measures. Their implicated relationship is represented by blue, green and white squares with + or - inside to indicate the increase or decrease of different magnitudes in different strategic measures. Yellow ovals indicate measures for both strategies, such as increasing vaccination rates and effective medicine. Figure 4 graphically demonstrates that the two strategies need to increase resources such as hospital beds, doctors, nurses, medical equipment and logistics personnel. The orange ovals show opposite magnitude due to the influence of the two strategies.

Figure 4: Implicated Relation Network of "dynamic zero" and "coexistence with the virus"

The main condition limit (L) of Hong Kong’s anti-epidemic is listed in Table 1 and then expands different resources under different characteristics. Resources can be divided into "Controllable Resources", which are resources that the Government can control, and "Extensible Resources", which are resources that the Government cannot control ³. The success of anti-epidemic does not depend on the amount of government controllable resources, but the ability of the Government to utilise and mobilise uncontrollable resources. The increase of COVID-19 testing such as the Universal Community Testing Programme means the Government’s controllable resources are far from enough. Thus, the Chinese Central Government (Chinese Government) can be asked to help. For example, the Government's controllable resources are insufficient for the increase of isolation facilities for mildly ill patients, so the Chinese Government has helped to build makeshift hospitals.

Recommendations

Some recommendations provided by extension and conjugate analysis are as follows (see Table 1):

Table 1: Extension analysis of anti-epidemic condition limit (L)

• To increase testing facilities, equipment and personnel. The Chinese Government, for example, has helped by sending sufficient resources to Hong Kong such as the Huo-Yan (Fire Eye) Laboratory.
• In addition to government quarantine centres and makeshift hospitals, isolation facilities could be extended to idle spaces such as movie theatres, schools, cruise ships, playgrounds, hotels, large fitness centres, industrial buildings, homes and correctional institutions.
• To increase medical equipment in government hospitals, private hospitals and universities.
• To increase the number of doctors and nurses including registered Chinese medicine practitioners, medical students, nursing students, Mainland Chinese doctors and nurses.
• To increase the number of logistical staff, volunteers, social workers and social science students as well as engage local domestic helpers to ease any manpower shortage.
• To increase the number of hospital beds, in addition to government hospitals, private hospitals and Chinese medicine clinic of hospitals.
• To increase effective medicines, use of Traditional Chinese Medicines (TCM) or a mixture of TCM and Western medicines. For example, the first batch of 150,000 boxes of anti-epidemic Chinese medicine "Jin Hua Qing Gan Granule" donated by the Chinese Government have arrived in Hong Kong on 20 February 2022.

With the above methodology, some feasible suggestions arise that can change Hong Kong's anti-epidemic condition limit (L). When the two goals (G₁ and G₂) of "dynamic zero" and "coexistence with the virus" cannot be changed, changing the anti-epidemic condition limit (L) is also a way to provide a solution. If condition limit (L) in terms of the matter-element M_L transforms to reach the turning point, the strategic direction becomes T_LM_L as shown below.

The vaccination rate should not only be presented by averaging all age groups with second vaccine taken, but should also take into consideration different age groups with different number of vaccine doses taken that have vaccination rates higher than a certain level. For instance, the age from 12 to 19 years and the age from 70 to 79 years with third dose taken have vaccination rates higher than a certain level (such as 98% or above). Public hospital bed occupancy rates must be below a certain level and other medical resources (doctors, nurses, beds) are sufficient to reflect that the medical system is not collapsing. At this moment, conditions exist to change the direction of anti-epidemic strategy from "dynamic zero" to "coexistence with the virus".

Once the T_LM_L is changed back to the original conditional limit (L) or worse, that is, the inverse transformation  , then the strategy direction is changed back from "coexistence with the virus" to "dynamic zero", and so on. Because the epidemic is dynamic, this forms a cycle, and the strategy direction should be adapted according to the situation. The proposed anti-epidemic policy cycle diagram is illustrated in Figure 5.

Figure 5: Anti-epidemic policy cycle diagram

Anti-epidemic policy cycle diagram give a path to enhance decision quality.

Thus, the decision quality can be effectively improved based on the anti-epidemic policy cycle diagram. The four key factors of decision quality are illustrated as follows:

• Moral Intensity: When applying the Extenics transformation bridge to solve the antithetical problem, it is necessary to set "indispensable indicator" to prevent Hong Kong residents from contracting COVID-19, reduce severe cases and reduce deaths. Under the severity of the pandemic in Hong Kong, saving lives is the most urgent priority to be considered. Many methods of handling special cases can achieve social consensus and understanding.
• Information Quality: The extension model is used to clearly express the characteristic, value and relationship of things that act as a guideline for selecting strategies, especially the infection mortality rate, vaccination rate, public hospital bed utilisation rate, isolation facilities, medical resources (doctors, nurses, hospital beds), and so on. Such information needs to be accurate and real-time to be analysed for big data thinking. Information dissemination must be released uniformly and anti-epidemic strategies must be timely and clear. The public are unable to obtain all information they need for preparation all at once. There is also a lack of preplanning for emergency cases before COVID outbreak in different districts.
• Group Cohesiveness: With a clear anti-epidemic policy, resources can be mobilised. For example, controllable resources include government civil servants and extensible resources such as Chinese Government support and non-governmental voluntary organisations.
• Decision Experience: Expertise is required in infection mortality, vaccination rates, isolation methods, and TCM and Western medicine treatments. In the formulation of anti-epidemic strategies, the support of the Chinese Government and local experts is very important to ensure decisions are made based on professional advice.

Conclusion

The fifth wave of the Omicron coronavirus variant has posed an unprecedented challenge to Hong Kong. The fight against the pandemic should be regarded as a "war", and all forces in Hong Kong should be mobilised to contain the pandemic. Evaluating with the policy cycle diagram of "dynamic zero" and "coexistence with the virus", "dynamic zero" is now the only option until the conditional T_LM_L of changing the policy direction is reached. The "indispensable indicator" must be met which includes reducing infections, reducing severe cases and reducing deaths. Using implication analysis will determine the interaction relationship and bottleneck of policies. Then applying expansion analysis will provide ideas of "Extensible Resources" to reverse Hong Kong’s anti-epidemic condition limit (L) and other deficiencies.

This article aims to use the Chinese original innovation methodology of "Extenics Transformation Bridge" to solve this contradiction problem. It is only for reference, however, due to the limited data and dynamic anti-epidemic situation. The Hong Kong Government should apply big data thinking, to strengthen the construction of Hong Kong as a smart city and unify all data for policy simulation and evaluation. A scientificbased anti-epidemic policy plan and preplan should be established. Only then can decision quality be improved. Finally, according to the anti-epidemic policy cycle diagram, we conclude that "First zero, then coexistence, and then zero, after that coexistence" is the ultimate solution ⁵.

About the author: Ir Dr Lai is the Adjunct Professor in Department of Advanced Design and Systems Engineering (ADSE) in City University of Hong Kong.

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