The value of planning
From the June 2020 print edition
The impact of the pandemic could have been better mitigated had senior governments engaged
in proper emergency readiness and leveraged strategic procurement planning. This article proposes
a three-point plan for containing the impact of the next pandemic.
The failure to plan became an emergency
Seeing long-term care homes spiral into death zones, shutting down schools and regular healthcare services, driving countless businesses into bankruptcy, leaving millions out of work, and forcing an unprecedented mass quarantine was not a strategy. It was a reaction, arguably even a necessary reaction in the circumstances, to a foreseeable crisis that mutated into an emergency due to a failure to plan. While some might defend this failure by arguing that governments worldwide were caught off guard, this collective inaction did not produce herd immunity. Rather, it produced catastrophic global consequences. Next time, we need to do better.
Senior governments need to prepare national pandemic readiness plans and put aside their jurisdictional squabbling since pandemics are, by definition, matters of national importance. Ironically, New York State, and Canada’s two largest provinces, Ontario and Quebec, were quick to declare states of emergency and call on their national governments after failing to manage the crisis themselves. While a US Navy hospital ship sailing into New York City and deploying soldiers in long-term care homes in Canada became our reality, it is far from a well-planned strategy. Our governments should develop a real strategy to contain the next pandemic to mitigate another mass shutdown.
Raising the bar through strategic procurement
To avoid overwhelming our healthcare system, our governments imposed a mass lockdown to contain infections and flatten the curve. Curiously, many jurisdictions mobilized field hospitals to deal with the surge, only to see those temporary facilities shut down due to underuse while still imposing mass lockdowns. Why did this happen? It was a failure in timing. Had that surge capacity been ready when needed, we could have avoided shutting down our regular health system and imposing mass quarantine. We need to raise the bar. In the future, we need a plan to quarantine the quarantines through a three-part national response strategy:
Establish rapid action field hospitals
Field hospitals and related supplies should be procured well in advance to enable real-time mobilization. This would allow us to contain the spread and treat the sick without exposing our regular health system to contagion or imposing mass lockdowns. Existing local military reserves should be trained to quickly mobilize these facilities. Like military reserves, we should also train an army of medical reserves who are ready to be redeployed from our regular health system to those emergency facilities to contain the spread. These operations should be subject to regular training exercises to test system readiness.
Build self-sufficiency in critical supplies
We need to identify mission-critical supplies in advance and ensure that our domestic supply chains are ready to deliver those supplies during the next pandemic. This means establishing a national plan to fund the sourcing of mission critical supplies domestically. During normal times, those supplies can be supplemented with globally sourced supplies for our regular health system. However, pandemic readiness supplies need to be produced domestically by domestically owned companies so that in the next pandemic we are not dependent on precarious global supply chains.
Mobilizing mass testing
Governments are scrambling to conduct proper widescale testing. Without that testing, there is little reliable real-time data on actual infection rates, no way to quickly calculate actual fatality rates among those infected, and no proactive means of preventing asymptomatic infections from contribut-
ing to community spread. This compromises the ability of governments to assess actual risk and react proportionally. Forcing everyone to shelter in place may have been the reaction to this problem, but it was not a strategy and it is not a long-term solution.
As with elections, senior governments should be ready to mobilize our local community infrastructure to enable the timely mass local testing needed to contain the spread. A proactive and co-ordinated strategy would be necessary to procure testing supplies in advance to enable that type of rapid local testing.
While implementing this national strategy would be expensive, we already have an idea of the far higher costs associated with the failure to plan – we are currently living it and will be paying that bill for years. With the 20/20 vision of hindsight, we can plan better for the future.