Network analysis is great for getting some clarity and a sense of direction in complex, messy, multi-actor situations, and I guess that is a pretty good description of the situation in Europe’s E. Coli outbreak (just how messy? These CNN and Newsweek articles give some insight). It’s a multi-actor situation, the actors involved include different government departments (e.g. for health, agriculture, trade) of different countries (Germany, where the outbreak happened, other countries that may or may not have produced the vegetable responsible) and at the EU level, everyone in the supply chain, from farmers to traders and food businesses to consumers, research organizations, media outlets etc.
But what makes this really messy, is the fact that these actors are linked by very different kinds of connections. There are the material flows of produce (infected or not) from farm to table. There is the movement of the infection through the system, with the bacteria sometimes connected to the produce, but now, further into the outbreak, more likely a person-to-person connection. As if this wasn’t complex and obtuse enough, the way that countries and the EU as a whole deal with this issue is structured by the administrative networks and hierarchies. And because multiple departments or ministries in multiple countries are involved, this is not just one hierarchical pyramid, where the person in the top position can decide what to do, but a number of (internally hierarchical) organizations, which are linked to each other by non-hierarchical links and somehow have to figure out how to collaborate quickly and effectively once new information becomes apparent.
And this leads us to the fourth kind of link we need to look at, to understand how this outbreak works and that is the information link: Where is new knowledge about sources, spread, effects and treatments produced and how does this knowledge reach those who matter, who tells decision-makers what they need to know to make good decisions, who informs (and doesn’t mis-inform) the media, where does the general public get their information?
Now imagine you sat down with a group of researchers, government and farmer representatives to map out the actors, how the produce flows between them, how the infection has spread so far, how they are connected in terms of hierarchy and coordination and where the information flows through the system. The resulting map might be so big and messy that it first blows your mind. But (even without mapping it) that is the reality that the decision makers on the ground have to deal with; under time pressure and with high stakes.
And as we have seen when mapping out the response to bird flu outbreaks, just putting this map together can help those involve discover crucial oversights and structural problems in the system. In Ghana, we were able to point out how the structure of the compensation schemes created corruption hot spots at the border and where structural holes led to a risk of communication breakdowns.
However, when reading about the outbreak, certain network links are in the forefront of everyone’s attention: The big question everyone is asking is: How does the infection travel through the system (did it ride a cucumber or a bean sprout)? And while this is one crucial question, the questions that will have a greater long term impact are: How ready was the system to deal with the outbreak? How did information flow and how are interventions coordinated? Jack Ewing hints at that in a New York Times article, pointing out that the federal decentralized system of disease reporting led to a crucial delay in understanding the scope of the threat. But to increase readiness for the outbreak of any contagious disease (be it the swine flu or bird flu or a new strain of E. coli) it is crucial to improve the information and intervention systems along with discovering the source of a specific outbreak.