It Takes a Big Village: Lessons at the Intersection of Government, Industry and Non-Profits in the Time of Coronavirus

Infectious Diseases blogBy Frank Weil

The novel coronavirus pandemic is, by most accounts, an “all hands on deck” crisis. Indeed, infectious diseases are an area where government has a long history of fostering and mobilizing cooperation and collaboration among private sector businesses, non-profit service and philanthropic organizations, and government agencies at the federal, state, and municipal levels to act in concert in the face of public health emergencies.

In such emergencies, government may be the maestro, conducting a vast orchestra of respondents, but it plays relatively few instruments itself. As the current crisis shows, there are essential roles for pharmaceutical companies, technology companies, health insurers, community health centers and public hospitals, universities, and first responders at all levels.

Infectious diseases are an area where government has a long history of fostering and mobilizing cooperation and collaboration.

There are direct and vital responsibilities each of these participants takes on, a complex web that includes supply chain management, triage and treatment, research and development, and social mitigation tactics. Thought of as a unit, the conglomerate of entities engaged in the current crisis resembles a Fortune 500 company, one that has had to ramp up virtually overnight.

Those challenges notwithstanding, there is no doubt that the Trump Administration badly bungled the initial response. From downplaying the risk to flawed and far-too-few testing kits, our nation missed its best chance to quickly contain the spread of coronavirus in this country. It isn’t a coincidence that in 2018, the President dismantled the National Security Council’s pandemic response unit, leaving the White House without the kind of expertise that could have avoided the early missteps that have left us dangerously exposed. The President has also proposed new cuts to the Centers for Disease Control budget and a reduced contribution to the Infectious Diseases Rapid Response Reserve Fund, which is likely to be depleted by the current crisis.

Whatever the cause, and in light of the consequence, public health experts will use this experience to better understand the nature of pandemics and the weaknesses – structural, economic, and intellectual – that must be addressed to ensure a faster, more effective response to future crises. To that end, the partners in this effort carry vital expertise, historical knowledge, and real-world experience that must be captured and preserved. A full evaluation of the systems of governance that exist during crises is necessary.

Only when the immediate crisis has passed will we be able to undertake a full accounting of what transpired, and what can be learned. A deeper understanding of costs and benefits will help refine future strategies and tactics, putting money and people where they can do the most good the soonest. This isn’t always a “dollars and sense” analysis for the simple reason that we rightly tend to value lives over money. But, certainly, that sensibility is advanced by ensuring we’re not simply throwing money at ineffective responses.

An important component of this work will be rebuilding and reinforcing what we call the “intersector” – the convergence of government, business, and non-profit entities in a common cause. Capacities to develop, test, manufacture and distribute vaccines – for diseases that have not yet emerged – must be maintained, much as the government has ensured domestic ship-building capacity since the Second World War as a component of national security. While there are differences between crises of war and those of a pandemic, both have the ability to shock the fundamentals of our society, and both highlight the necessity of collaboration in crafting a society-wide response.

More work also needs to be done extending response networks down to the local level. FEMA, the Red Cross and others have vast experience reacting to natural disasters that are highly localized, such as earthquakes and hurricanes. The recent vaping crisis and the emergence of coronavirus represent a very different type of disaster, in which resources must be deployed in many places, simultaneously, with new hot spots rapidly emerging until the crisis abates.

In this, as in other national emergencies, it is the process and mechanics of the response that will determine the scale and damage ultimately suffered.

In this, as in other national emergencies, it is the process and mechanics of the response that will determine the scale and damage ultimately suffered. An effective process must draw on the knowledge and resources of a wide variety of public, private and non-profit organizations, putting each to use where they can do the most good at the moment they are most needed. Otherwise, the maestro stands alone, frantically waving their arms on an empty stage while the world burns outside their door.