The COVID-19 pandemic’s impact was pervasive, persistent, and personal, with broad-ranging effects on both collective- and individual-lived experience. It was first and foremost a challenge to our public health systems, but quickly became a test of our economic and social systems as well. With two calendar years of the pandemic behind us and possibly more ahead, it’s a critical moment to ask: How well did we do in preparing for and managing this crisis and what do we need to do differently next time we face a challenge of this magnitude?
Variation in observed pandemic preparations, responses, and outcomes provides a ready lens to assess which approaches were successful, which failed, and why. It is clear that the way leaders prepare for and manage crises matters to the social, economic, and overall health of the communities they lead. We believe leaders in business and civil society can and should manage differently, applying learnings from COVID to better prepare for and respond to future crises, whether those be future pandemics, climate change, cyber-security threats, or other unknown threats.
Because we believe complex problems must be met with multi-disciplinary solutions, we assembled a dozen experts from different fields in science and business to discuss the management of crises. This article is a summary of the discussion. The group sought to answer three critical questions about the pandemic:
- What happened: Looking across the heterogeneous responses, where did we succeed and where did we fail? Where did actions converge or diverge, and why?
- What did we learn: What lessons can we take from this pandemic that would stand us in better stead to prepare for and respond better to future crises?
- What actions should we take: Based on what we learned, what are the types of immediate actions we can take to prepare for the next crisis?
The topics discussed by the group were wide-ranging, but coalesced around three domains: Public Health, Economic, and Social Systems. Additionally, the discussion returned time and time again to the intersection of the three domains and the idea that successful solutions were those which were balanced across domains.
The participants were:
- Sir Roy Anderson, FRS, FMedSci, Professor of Infectious Disease Epidemiology at Imperial College London, Chairman of Oriole Global Health Ltd, and former Chief Scientist at the UK Ministry of Defense
- Stuart Feldman, Chief Scientist at Schmidt Futures
- Stephanie Forrest, Professor of Computer Science and Director of the BioDesign Center for Computation, Security, and Society at Arizona State University
- John Geanakoplos, James Tobin Professor of Economics at Yale University
- Simon Levin, James S. McDonnell Distinguished University Professor in Ecology and Evolutionary Biology, and Director of the Center for BioComplexity in the High Meadows Environmental Institute at Princeton University
- Joshua Cooper Ramo, Co-CEO and Vice Chairman of Kissinger Associates and Member of the Board of Directors at Starbucks and FedEx
- Martin Reeves, Managing Director and Senior Partner at Boston Consulting Group and Chairman of the BCG Henderson Institute
- Daniel Schrag, Sturgis Hooper Professor of Geology and Professor of Environmental Science and Engineering at Harvard University; Director of the Harvard University Center for the Environment and Director of the Science, Technology, and Public Policy Program at the Harvard Kennedy School of Government
- Mildred Z. Solomon, EdD, President, The Hastings Center and Professor (part-time) of Global Health and Social Medicine, Harvard Medical School
- Gillian Tett, Moral Money Co-Founder; Chair of the Editorial Board and Editor-at-Large, US, for the Financial Times
- Peter Turchin, Complexity Scientist and Professor in the Departments of Ecology and Evolutionary Biology, Anthropology, and Mathematics at the University of Connecticut
- Elke Weber, Gerhard R. Andlinger Professor in Energy and the Environment and Professor of Psychology and Public Affairs at Princeton University
- Fareed Zakaria, host of Fareed Zakaria GPS for CNN Worldwide, columnist for The Washington Post, contributing editor for The Atlantic, and bestselling author
Public health systems
When COVID-19 emerged, there were many open questions about the ability of public and private healthcare systems to withstand the initial surge of the virus, define and communicate public health policies, and deploy effective solutions for testing, prevention, and treatment.
While COVID-19 was novel, public health communities had experience dealing with similar threats, including Influenza, Ebola, and SARS, as well as other coronaviruses that circulate broadly today. They had tools such as open platforms and protocols for dealing with such threats.
Withstanding the surge: Turning to national stockpiles in the early days of the pandemic, many countries found them poorly maintained with inadequate PPE for healthcare workers and medical equipment to care for severe COVID patients. Furthermore, many nations struggled to address shortages through procurement or production, resulting in damaging delays. More successful were actions to adapt and expand healthcare system capacity to prevent system collapse. Repurposed facilities and pop-up parking-lot hospitals rapidly expanded care capacity and telehealth was adopted at previously unseen levels to serve COVID and non-COVID healthcare needs at diminished risk.
Defining and communicating policy: Epidemiological models were widely leveraged as effective tools to understand and communicate the trajectory of the epidemic and the value of different interventions. These models, while imperfect, informed public health policy design and motivated individual behavior change by making the science understandable to a lay audience. However, public health policies such as masking and social distancing varied significantly between and within countries. A patchwork of policies emerged as towns, cities, states and countries implemented different policies to different degrees and for different durations. Into this shifting policy landscape, early and consistent messaging drove more unified public action, whereas inconsistent messaging often resulted in lower policy adoption and behavior change.
Deploying effective solutions: Spurred by the pandemic, the scientific community mobilized and advanced critical technologies in vaccine-development, mRNA technologies, and at-home testing technologies, which enabled the rapid development of multiple effective vaccines and cheap, convenient testing solutions.
However, the value from these technologies was limited by our ability to take advantage of them. Diagnostic and vaccine manufacturing lacked the scale required to meet global demand. Manufacturing capacity was added in North America, Europe, and India, but insufficient capacity persists in Africa and Southeast Asia. Manufacturing capabilities remain a fraction of what is required to vaccinate the world in a timely fashion and slow viral mutation.
Furthermore, there was high variance in the competence and agility of public health systems to deploy these solutions. Certain countries, like South Korea, Taiwan, and Singapore showed both nimbleness and competence in rolling out key solutions: ubiquitous and free testing, contact tracing, strict quarantining policies, etc. On the other hand, many countries, including the US and UK, deployed less thorough and consistent solutions with significant delays and some errors. Insufficient and inaccurate testing and surveillance infrastructure persist today, hampering ongoing efforts to contain the virus.
Finally, certain public health measures, such as the use of personal movement data to enforce quarantine or enable contract tracing, were only realistically tenable in a subset of societies based on cultural values concerning privacy, data security, and the balance of personal liberty vs collective health. Mandatory enforcement of such measures was achieved only in highly collectivist cultures, while opt-in programs either run by governments or technology companies saw much lower adoption and impact in more individualistic cultures.
The public health crisis quickly evolved to become an economic crisis. Reducing mortality and preventing the collapse of the tertiary-care system during the exponential growth of an infectious, respiratory epidemic could not be achieved with the economy functioning as normal. To varying degrees, countries effectively closed down the supply side of the economy.
Economic prioritization: Countries facing similar tradeoffs between public health and economic system impacts made differing choices based on each nation’s values. Transportation, energy, food production, and public health systems were uniformly prioritized, but variation abounded in the treatment of sectors such as education, retail and hospitality. Many countries (e.g. China, Germany) kept open schools, daycare, and other enabling services while closing restaurants and retail shops. On the other hand, countries like the U.S. prioritized the commercial sector (e.g. restaurants, gyms, and retail) while closing schools. The longer-term impacts for this virtually-schooled generation and caregivers forced to leave the workforce as a result are unknown but likely significant.
Organizational adaptability: Global supply chains were disrupted, impairing the ability of companies to produce and deliver goods in a timely manner. Organizational models overly optimized for cost efficiency lacked the resilience required for buffering and rapid adaptation. This led to product shortages and delays of both essential and non-essential products, from masks and toilet paper to ventilators and cars.
Businesses, schools, and other organizations were forced to adapt their business models, talent models, safety and legal practices, and their day-to-day operations through an ever-shifting set of circumstances and restrictions (from full shutdowns to fully-remote and partial capacity).
Some organizations made these changes defensively and austerely, often undertaking crisis-driven transformations involving hiring freezes and layoffs to reduce cost and increase asset efficiency. These defensive moves sought to ameliorate the negative impact of the crisis, rather than take advantage of new opportunities such as new patterns of demand, the accelerated diffusion of digital business models, and a fluid talent market.
Financial policy: In the face of these economic pressures, policy-makers responded with overwhelming stimulus (in the form of reduced interest rates, individual stimulus checks, business loans, and bond buybacks) to contain systemic risk and soften the economic shock caused by the pandemic. This proved effective in shortening the resulting recession and spurring rapid economic recovery once economic restrictions were lifted.
The crisis similarly tested our social fabric, requiring individuals to make personal sacrifices and changes to their daily lives for the benefit of the community.
Trust: Crises present an opportunity for authorities (governments, organizations, or individuals) to demonstrate trustworthiness and legitimacy and thereby further reinforce public trust. In the COVID-19 pandemic, governments that entered the crisis with low levels of public trust found greater public resistance and lower adherence to pandemic-related policies. Furthermore, governments that responded incompetently, inconsistently, or opaquely eroded public trust. More broadly, an individual’s perception of risk, reliability of information, and behavior were heavily influenced by the sources of information they deemed trustworthy — with wide variation in the perceived trustworthiness of government, news media, social media, scientific communities, and peers. This manifested most acutely in the backlash toward pandemic response policies, such as protests against economic shutdowns, vaccine hesitancy and anti-vaccination advocacy, and resistance to masking or social distancing policies.
Xenophobia: Political rhetoric and policy enacted during the pandemic reflected an increase in xenophobia, as political actors overestimated or overemphasized risk from outside as opposed to within countries. This led to the passage of scientifically unsupported policies such as travel bans after the window for effectiveness had closed, or travel bans that inconsistently allowed the free passage of citizens but barred non-citizens. This had the knock-on effect of diluting focus on meaningful domestic actions such as driving personal behavior change (e.g., mask-wearing, vaccination and isolation) or building effective infrastructure (e.g., testing and surveillance).
Inequality: Economic shutdowns, widescale layoffs, hiring freezes, and wage freezes had the effect of decreasing the well-being of the majority. By contrast, for the minority in an advantaged position, the pandemic provided the chance to capitalize on new business and investment opportunities, enabling rapid increases in the wealth of top earners. The overall result was a dramatic further increase in economic inequality. The differential burden of the pandemic is likely a factor undermining the acceptance of pandemic policies.
Many of the challenges the world faced during the COVID-19 pandemic were compounded by the intersections between public health, social, and economic domains.
Individual nations often approached these intersections as conflicting tradeoffs between achieving public health, on the one hand, and attaining economic and other social goals, on the other. Leading up to the pandemic, societies were unwilling to pay the economic costs of preparedness, including buffer stocks, buffer capacity, and the funding of anticipatory measures and crisis infrastructure. During the pandemic, lockdowns, mask-wearing, or social distancing policies were implemented to different degrees or for different durations based on the societal willingness to bear the associated political, economic, and social costs.
Taking an international lens to the pandemic, success metrics must be based on the world’s outcomes rather than that of any individual nation. Ineffective international cooperation and primacy of national interests led to the misallocation of resources and inefficient decisions that impacted all nations. Successful vaccine deployment globally has the potential to slow viral evolution to the benefit of all nations. Yet, vaccine nationalism has resulted in differential vaccination rates based on economic status (e.g. US 60% vaccinated vs. Africa 6% vaccinated). This allows pockets of viral spread and unabated mutation to increase the risk of new variant development. Furthermore, our unwillingness to fund global virus surveillance and sequencing infrastructure hinders the ability to identify these new variants in time to contain them. International agencies failed to play a fully effective leadership role in coordinating action to overcome these nationalistic interests.
What did we learn? 11 key lessons from the pandemic
Public health learnings
1. We must invest in and sustain funding for multiple layers of crisis defense. The costs of prevention and preparation are minor compared to the cost of exacerbated crisis management but are born on different time horizons. Viewing these investments on too short a timescale leads to insufficient preparedness in the form of stockpiles and excess operational, manufacturing, and distribution capacity that proved critically lacking when the crisis hit. We must consider economic tradeoffs based on a longer-term horizon to maintain our investment in preparedness both nationally and internationally, especially as the memory of this pandemic fades. Such preparation should create multiple layers of resilience, including generalized, adaptive, and proactive layers:
- Generalized: Improved funding for crisis preparedness planning, supplies (e.g., PPE stockpiles and medical equipment), and infrastructure (e.g., healthcare system surge capacity)
- Adaptive: Improved and distributed surveillance, information sharing, scalable manufacturing capacity, etc., to enable adaptive responses
- Proactive: Development of innovative new models to better predict and design solutions for uncertain, high-impact futures
2. Policies are only effective when adopted. Individual behaviors conflicting with government directives had a profound impact on countries’ ability to control the pandemic. Public health policy design and communication must be informed by a multi-disciplinary perspective that marries medical and social sciences to recognize the societal realities that impact policy adoption and effectiveness. Policies that work in theory but fail to account for cultural or political complexities either in their design or communication will likely have limited impact. Furthermore, communications should be adapted to the target audience reflecting the cultural context and delivered by a trusted messenger to drive maximal acceptance and behavior change.
3. National and international public health organizations must be able to execute rapidly and at scale. The ability to deploy solutions rapidly and at scale proved vital to an effective response. Certain interventions were only effective before viral spread (e.g., travel bans) or below a certain population infection rate (e.g., contact tracing). Additionally, delays in the deployment of rapid testing and sequencing at scale hindered information gathering about the rate of infection, types of variants, and progression of the virus, thereby hindering efforts to contain the virus and make informed policy decisions. Such ineffective execution has been attributed to insufficient funding, overly siloed and bureaucratic organizations, and insufficient mechanisms of accountability. Therefore, public-health entities must be properly funded and undergo substantial transformation to become nimbler and more competent to scale and execute rapidly and effectively in a crisis.
4. Effective financial policy can reduce the duration and intensity of economic crisis and maintain stability, providing a bridge to recovery. Financial policymakers were able to apply effectively lessons learned from the 2008 recession. Regulatory measures put in place following the 2008 financial crisis reduced systemic risk, preventing spillover effects and system failure. Additionally, the economic austerity seen in 2008 was replaced with overwhelming fiscal stimulus that was successful in containing the economic impact of the pandemic and providing societal stability. When restrictions were lifted, the economy was positioned to rebound, making this the shortest recession in a century. In our increasingly volatile world, exogenous crises may become more frequent, but need not become more economically deleterious.
5. Leaders must rebalance organizational efficiency and resiliency. Analysis of crises over the past 100 years shows that they impacted 10% of fiscal quarters but accounted for 30% of the long-term performance differences between companies. Leaders looking to maximize long-term performance should prepare for crisis by building resiliency into their organizations. This involves a degree of redundancy, modularity, and adaptability in operations, supply chains, and other critical components of business models which may come at a cost to short-term efficiency. Prior to the pandemic, many companies had effectively made a choice to value short-run efficiency over resilience, with moves like spending down cash buffers on shareholder buybacks and removing operational slack or supply chain redundancy. These decisions compromised the ability of both individual companies and economies to cushion shock and adapt to an abruptly changed environment. Leaders who find the proper balance between resilience and efficiency will be able to achieve higher performance over a longer time horizon — leveraging periods of crisis to differentiate their performance and competitive positions that far outstrip any efficiency losses.
6. Leaders should manage crises with a long-term view and an eye toward opportunity. Crises impose a set of constraints, time pressures, and competing demands that necessarily involve difficult tradeoffs. Such tradeoffs reveal leaders’ purpose, guiding philosophies, and priorities in ways often invisible and untested during times of stability. How leaders prioritize these tradeoffs and manage performance during crises are an important driver of long-term performance and ability to deliver on the organization’s mission. Crisis responses that are defensive and reactive can often lead to worse long-term performance and decrease the ability to respond to future crises by making corporations or societies less resilient. Conversely, crises can be used as opportunities to create competitive advantage for organizations (and nations) willing to embrace market shifts rapidly. Thus, interventions during a crisis should be guided by principles put in place in advance that consider the impacts on organizational performance and resilience on multiple timescales.
7. Leaders must mobilize organizations around common purpose. The pandemic revealed that organizations can be much more adaptive than might be supposed in stable times. Organizations united around a common purpose were able to rapidly adopt digital business models, shift their day-to-day operations from in-person to virtual, and establish effective task forces to handle issues from worker safety to new product development at astonishing speeds. Such extraordinary alignment can also be used by companies during stable times to address commercial opportunities, shared societal issues (such as climate change) or preparations for future crises.
8. Crisis responses depends on and must reinforce social health. The rate of technological innovation and globalization has outstripped our ability to adapt our social, regulatory, and political systems to new realities. With these systems struggling to respond, social ills of various kinds have been on the rise, including economic inequality, social polarization, xenophobia, and nationalism. The pandemic accelerated these social ills, undermining effective information dissemination, policy adoption, and overall crisis response. “Social Health” — measured through the level of economic equality, trust in public institutions, and ability to forge agreement on issues such as science and policy — has a direct effect on how well societies respond to exogenous crises such as epidemics. Crises can also play out in ways which further deteriorate social health by exacerbating systemic issues and disproportionately effecting vulnerable populations — as observed during the COVID epidemic. Crisis preparations must therefore build social health as a generalized crisis defense and crisis responses must reinforce rather than undermine social health.
9. Leaders must reinforce interdependency, mutualism, and shared purpose to enable collective action. Countries that responded most successfully to the pandemic were those that embraced collective action effectively. This tended to occur in countries with collectivist cultures and strong social cohesion (such as Korea, China, and Singapore). Such countries saw higher adoption of individual behavior change and adherence to public policies. This can be most readily seen in the development of pro-mask-cultures as compared to the anti-masking subcultures in some Western countries. Recognizing and building elements of collectivism within individualist nations can improve crisis response and enable critical collective action. Such tenets as interdependence, mutualism, and shared purpose have been effectively used even in individualist cultures to great effect during other periods– from the World Wars to the Space Race. Such examples indicate that these can become core tenets in all human societies and can be built with focused effort.
10. Meet complex problems with systemic solutions. The pandemic revealed our systems to be ill-equipped to handle the increasingly complex challenges of a highly globalized, rapidly technologically advancing world. Evolving our systems to better handle large-scale, multi-faceted change and reduce the risk and cost of future crises is a tough challenge. Simplistic narratives and solutions to such complex problems must be avoided in favor of those that are multi-disciplinary, systemic, and integrated in nature.
11. Large-scale, rapid behavior change is possible. In the interest of personal safety or the collective good, people around the world demonstrated their ability to change their behavior rapidly, making economic and social sacrifices on an unimaginable scale. With the knowledge that such rapid behavior change at a global level is possible, leaders should approach our most pressing problems, such as climate change, with imagination and boldness, asking: what would it take to secure a similar level popular mobilization?
What actions can we take?
We cannot wait until the next crisis to improve our capacity for crisis response. We must take advantage of the immediacy of this crisis and lessons learned to reform our public health, economic, and social systems in ways that make us better equipped to handle future known and unknown crises. From these learnings, our experts recommended a set of critical and actionable steps.
- Use advanced modeling approaches to predict and plan for uncertain, high-impact futures as well as help us identify the right interventions, and communicate these to drive behavior change before these futures occur
- Make a substantial and sustained investment in crisis preparation and prevention as well as make widescale reform to our crisis response capabilities, involving building generalized, adaptive, and proactive defenses
- Cement international cooperation now, to be in place for the next crisis. This requires establishing new or improved international protocols, guidelines, tools, and networks for coordinated action for known needs like data-sharing, vaccine passports, vaccine distribution, and expedited pathways for unknown needs as they arise
- Undertake new infrastructure builds and reforms with the anticipation of future crises — considering resilience, effectiveness, and efficiency in in our physical, technological, informational, and social infrastructure. In particular, many of our successes in this pandemic depended upon a reliable IT infrastructure, which ironically may constitute vulnerability in a future crisis if not addressed now
- Introduce forward-looking long-term measures of success and create a common language and measurement around resilience for businesses and nations to enable management across multiple timescales
- Establish clear principles and guidelines for leaders to manage short-term financial difficulty to apply to during future crises. Principles should include: Spread short-term losses over the long-term. Look long-term, avoiding cuts to the core mission at all costs. Any permanent cuts should be made thoughtfully and with consultation with stakeholders
- Build a sense of mutualism, solidarity, and common purpose both within countries and between nations. This must begin locally with actions such as: 1) Create new structures for citizens to engage with each other, 2) Emphasize justice and address socioeconomic circumstances (wealth gaps, financial precarity, systemic racism) that create distrust and reduce social cohesion, and 3) Revitalize public education’s role in creating a responsible and active citizenship. This includes (re)creating the practices and values of civic learning — focused on complex problems, debating solutions, and approaching decisions for the common good. This also includes equipping students with the skills to discern opinion from fact and to weigh scientific information on a diversity of topics — from vaccine safety to climate science.
More detailed perspectives on lessons from the COVID crisis
Participants prepared written provocations related to their unique expertise in advance of the Meeting of Minds discussion. These were used to seed the conversation and enable focus on points of intersection, commonality, and debate across fields. The provocations can be read here.
About the Meeting of Minds
The Meeting of Minds is a multi-disciplinary meeting of leaders in business and science discussing major issues in society and business, hosted by the BCG Henderson Institute. Previous meetings discussed strategizing and managing on multiple timescales, commitment and flexibility in strategy, learning and forgetting in the age of AI, collective imagination and innovation, and the “meta-problem” of climate change.
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