How the lack of margins of safety in our systems has made the COVID-19 crisis worse.

with all types of infrastructure, including the medical infrastructure system, efficiency and resilience are in conflict. The most efficient system is one that is carefully optimized to use the fewest possible resources to meet current conditions.
But when the situation does change—and especially if the change is anomalous, high-impact, and rapid, allowing little time for adaptation—such a system will be very fragile, since the conditions to which it has been adapted no longer prevail.