What follows is a guest posting from Mr. Ian McLean, a retired public official in NZ. Comments from readers are invited.
A significant strategic issue emerging from the pandemic seems to me to be this: In almost every country, the Covid pandemic required management skills and capacity beyond those available in ‘business as usual’ within the government structure.
Existing structures were severely challenged in most countries, but skills and capacity were developed to deal with the pandemic. These skills will decay in time, with an expected half life significantly less than the expected return period of another pandemic based on historical events. Unless deliberate action is taken, in the next pandemic governments will again have to again re-invent structures to manage it.
Despite many skills required by the pandemic being substantially technical in nature and related to the disease and its impact, substantial management and administrative skills are not health-specific. These include decisive decision making, rapid expansion of organizational capacity, fast development of new logistics systems, and mobilization of assistance from external agencies both within government and in civil society.
These skills are available to a considerable extent in government agencies including the military, first responder emergency services, and civil defence/emergency management. But they are not otherwise required or available as core skills in government agencies in NZ and many other countries, – especially in those agencies whose focus is planning and administration. Where the prime task of a government entity is planning or monitoring other entities, the ability to take action taken quickly and effectively is not a key attribute in recruitment of staff. Good planners, even superb planners, are not necessarily effective managers.
In NZ, both the military and police are playing a vital role in assisting the management of the Covid pandemic. But neither is equipped by culture and training for the core role of managing the government response. The military are neither trained nor skilled in the breadth and depth of interaction with civil society and the population that is required with a pandemic like Covid (although they have done very well during Covid, as in major natural disasters). The police do not have the logistics capacity and skills for a major operation of this kind, nor the required linkages with the cooperating agencies in civil society.
An important aspect is the coordination of the various government agencies involved in managing a pandemic. In NZ the National Emergency Management Agency (NEMA) is the obvious candidate to undertake logistics and similar non-technical functions during a pandemic. It would need to be strengthened and redirected towards operational rather than planning priorities in order to do this.
The advantages of such an an arrangement are threefold:
- Learnings from the management of the pandemic would be preserved and kept fresh in an agency focused on emergencies
- The management of other emergencies would learn from the experience of managing the pandemic
- Strengthening NEMA’s role in pandemics would make it stronger to deal with other emergencies.
Similar integration of non-technical aspects of the pandemic management with emergency management may well be worth considering in other countries.
I certainly agree with McLean’s thesis, but find it ironic that he DOESN’T mention the one management skill that to me is most important: communication with the public. It is also the area that has been the most badly botched, at least in the developing world.
• Fauci’s flip-flops. Especially early on, every pronouncement was made as if it were revealed wisdom. And then the next pronouncement made contradicted the earlier one, but was made with the same confidence (arrogance?). No need to mask transitioned to double masking, the use of models to predict viral spread, the mode of virus dispersion, the efficacy of vaccines (95% success rate means 1 in 20 are still likely to get sick), the current focus on cases when omicron cases are often asymptomatic… a little more humility would have paid huge dividends (e.g., “when you’re attacking me you’re attacking Science” – no, we’re attacking someone who has been a bureaucrat since the ’70’s, and acts like one!).
• Lack of information on mitigation. We’ve known almost since the beginning that the immuno-compromised were most at risk. I have never heard any guidance about strengthening our immune systems – e.g., taking vitamin D, importance of exercise (would our lockdown regimens have been the same if the importance of exercise and sunlight were acknowledged?). Knowing that it was the elderly most at risk, no guidance on how best to protect them. Wouldn’t proper guidance have prevented hundreds of nursing home deaths?
• Lack of information on treatment. I will admit I don’t have a clue whether any of the supposed treatments bruited about on the web are worth a flip. However, one of the reasons that there was so much (probably) bad “information” out there is because the CDC never told us anything else. Simple things like “We know that rest – allowing your body to heal itself, drinking plenty of liquids – to prevent dehydration, are important to being cured. We have anecdotal evidence that X, Y and Z seem to work, but don’t really know for sure. The best current information we have is that A, B and C don’t work.”
• Rumor management. An effective communications strategy for any kind of disaster needs to consider how the agency will use traditional and social media AND how those media will respond to the agency’s communications. Rumors abound when no information is communicated.
• Targeting. The elderly and the immuno-compromised were the ones most at risk. There didn’t seem to be any communications targeted specifically to them.
FEMA has begun to institutionalize at least some of these for natural disasters. The public health community and especially the CDC needs to do an honest review of their communications failures and work to redress them for public health disasters. While pain is inevitable, good communications can minimize suffering – and needless deaths.