Followup: I absolutely agree that it is not right to load all the adaptive capacity onto frontline workers. We need to see resilience as a system property, not just an issue of indiviuals and teams.

How do you think the experiences of getting through COVID-19 and Whakaari will shape future perspectives on risk management?

Safety-II is sometimes portrayed as only "learning from what goes well". This really sells it short as it is a way of understanding that safety is something we have to create, it isn't the natural state to be defended.

You definitely see different things from different models. We initially saw that both were required but now we probably have a Safety-II worldview that informs all the tools we use and the way we think about issues. We still have checklists, procedures, investigations but they are focussed in a different way. It has changed everything but it is definitely not a battle between Safety-I and Safety-II.

In some ways, disasters represent a fundamental challenge to our understanding of risk. We have focussed on managing small risks but taken for granted the bigger risks that can arise. This has been seen in the oil industry, military history etc and also in healthcare in past. I think we fell into the trap of thinking our modern society was immune to these risks but it has been clear we are not.

The next stage will be one of how we frame these disasters? What lessons will we learn? How much will we question our previous assumptions? Will we choose blame or learning? Will we value adaptation or see these events as aberrant?

Carl, many thanks for taking part in this Q&A session and for providing such thoughtful and thought-provoking responses! Now we'd better let you go so you can prepare for another day in ICU, which surely must be the most exciting/alarming work environment of all: you never know what is going to come through your door, and the stakes could not be higher. Thanks for your work - and be sure to pass on our appreciation to all of your team. Good work!

For those of you interested in understanding more about our experience, this is a chapter we wrote about it (a later version was published in "Delivering Resilient Healthcare" by Hollnagel et al)

Thanks Peter, it's been an interesting session.

Thanks for all the great questions and I look forward to more conversations in the future!