Leadership lessons

We were unprepared then and we are unprepared now. SARS in 2005 spread from China to nearly 28 countries resulting in more than 800 deaths. No lessons were learnt and here we are 15 years later with a situation that is far worse than anyone can imagine.

After the 9/11 attacks, the US and other countries ran exercises to prepare for attacks and had stringent vigilance processes incorporated in every action. No importance was given to the outbreak and instead of paying heed to this invisible attack, the superpower disbanded the pandemic team just recently, only to make it functional after losing many lives to this virus.

It is essential that once we are out of this Covid-19 situation, a great deal should be learnt and planned in a system-wide response to these ever-emerging pathogens. Leaders should have the foresight and capacity to quickly gather a team of professionals to help address issues within their domains.

One of the most important steps that need to be taken by the leaders is to form an infrastructure to build resilience. This can only be done if relevant teams are educated of urban resilience and rural resilience and work around to absorb the shocks felt by this crisis. Accurate and up to date knowledge of the disease should be actively disseminated to all regions throughout the country regarding precaution, prevention and strict measures to implement them. Mobile teams can be deployed to various villages and towns to meet specific needs. This activity can help control the infection, decrease transmission and avoid prolongation of the outbreak. This can only be achieved with the cooperation of stakeholders.

Disaster situations from infectious disease outbreaks require planning where leaders need to develop practical means to conduct continuous widespread surveillance and screening of the illness especially in the absence of diagnostic testing. Health departments need to develop a team to track and follow potential epidemiological linkages and engage in surveillance for new cases. This team should be facilitated in all aspects to collaborate across wide geographical regions and engage in open discussion to develop surveillance and quarantine strategy that is practical and caters to the dynamics of the country.

In the face of uncertain diagnostic criteria, individuals will be isolated needlessly and some infected asymptomatic individuals will be missed adding to perpetuate the outbreak. It is important that the leader does not seek to assign blame under these circumstances and instead learn from the mistakes and analyze each failed decision to improve the knowledge of the disease transmission and prevention. Constant feedback from the teams is critical for subsequent reliable communication.

In the present era of global travel, it is unlikely that one center or country will be dealing with new emerging diseases in isolation. Disaster planners are challenged to develop a global perspective including accurate communication of events as they unfold. Websites providing the updated information on the outbreak, modes of transmission and required infection control measures can ensure speedy communication to a large number of people. These websites can also teach how important it is to wear protective gear and how to respond to unique situations. Affected patients must be kept informed as much as possible. Family members who had any contact with the patient need to know that they will be kept in quarantine and will not be allowed to visit anyone. Disaster management plans must anticipate isolation and the need for informational, psychological and emotional support for those immediately affected considered as imperative.

The coronavirus has received unprecedented media coverage. Daily headlines generate widespread fear and panic. Leaders should make efforts to decrease sensationalism and portray the real picture. Assigning a relevant team of professionals to inform and update the media would ensure that consistent information is provided and help avoid the confusion, fear and even chaos that can potentially arise from inaccurate information.

Another important role is to provide support to the health workers who have curtailed interactions with their families for fear of transmitting the disease. Their morale should be addressed by encouraging them regularly and congratulating them for their efforts. Particular attention should be given to devise ways to decrease the emotional and psychological burdens of the workers. This could be addressed by providing them protective gear. Special benefits should be provided to them. Benefits such as extra compensation for illness and quarantine should be given. Special insurance coverage packages should be introduced. The presence of people who listen to staff concerns and address them to the best of their ability is another means to provide much-needed support and boost staff morale. Such stressful events lead to post traumatic disorders which need to be addressed by psychiatric support.

No one knows the scope of future outbreaks, but the nation needs to move from an institution based to a system-based thinking. Creating system-based thinking is not an easy task. This requires sharing information and learning from collective experiences that requires open communication and unprecedented collaboration between all levels of government and health care organizations. Political barriers, bickering over responsibilities or consideration of personal professional gain must be overlooked.

System thinking is not easy and will challenge the best of us. The most seasoned and ethical institutions will find it difficult as the number of people involved and the efforts required to get them to collaborate on such a broad scale is not something people have experienced or tried to tackle in the past. Training our staff and our future trainees for such eventualities, through the use of simulators and mock disaster codes, has become necessary to build on our successes and learn from our past to avoid the problems we are currently encountering.

Let’s take this time to reflect on our mistakes and think about how we can prevent and contain such a pandemic so our future generations don’t have to experience such uncertain times.

The writer is an assistant professor in the faculty of ManagementSciences, Szabist.

Email: shehlanajib@szabist.edu.pk