With reports out this week that China has begun to relax some of its most stringent physical-distancing limitations just as India was enacting a total lockdown for 1.3 billion people and countries including Angola recorded their first cases of Covid-19, it’s clear that governments worldwide find themselves at very different stages of this global crisis.
But at every phase of the response, it is essential that leaders focus on three things. The first is having the right structures in place to be able to enact the necessary measures to fight back. Second, suppression measures such as self-isolation and curfews must move quickly to mass testing so you can protect frontline health workers, isolate infected individuals and start to get people and the economy active again. And third, leaders must work to ensure that technology, medical tests, and equipment production and logistics are scaled and deployed with speed to where they are needed most.
Chapter 1
The following three steps help when reorganising government to focus on crisis response:
Create one crisis-management centre. Governments should have already repositioned themselves towards crisis management. Reliance on traditional frameworks should be set aside to identify each main area where immediate action is required. At the heart of this should be the crisis centre, which should be established immediately and staffed with the most capable people. You should consider people you may not otherwise – from the army or from business logistics. All information and the most up-to-date data should flow into this team. This is the place where all key decisions should be made.
Assemble the best available scientific advice. Every leader needs access to high-quality scientific information while responding to this crisis. Much of this is publicly available but there are also those qualified people who can assist any government, especially in the developing world, if asked to do so.
Set up dedicated response teams within departments. Each segment of government needs its own team organised to respond to the crisis. These responses include making sure the health-care system is ready, business support, enforcing social distancing and policing borders, among others. Critically, communications can save lives and jobs. Government communications need to be both strategic and day to day and be the source of evidence-based information and advice to the public and business. Obviously the specific emergency measures being taken, such as social-distancing policies and border closures, should be announced clearly and reinforced regularly. But this should happen within an overall plan, also announced, about how to bring the disease under control so that people can see light at the end of the tunnel.
Chapter 2
Testing must be a priority. Currently, there are two main tests discussed in relation to Covid-19: a PCR swab test and an antibody test. The swab test lets you know whether you have the virus, while the antibody test will show whether you have had the virus. At the moment the PCR test exists, and in the UK, the NHS is using it to conduct around 6,000 tests a day. The situation on antibody testing is less clear. At the moment antibody tests exist in the private sector but none have yet been approved by Public Health England. The antibody test is critical because it will allow us to see who has at least short- to medium-term immunity and can go back to work. There will need to be a vast ramping up of testing capacity worldwide in the coming days and weeks. Every country should work to obtain as much capacity as it can so that widespread testing can be carried out. This allows social-distancing and lockdown measures slowly to be eased, which in turn will allow people to get back to work and the economy to restart.
Chapter 3
Alongside testing equipment, there is an urgent need to scale up the supply of various pieces of essential equipment: masks, ventilators and PPE in particular. Ramping up production and distribution of this equipment requires various steps to be taken: first, harnessing the capacity of the private sector to organise and deliver large projects of this kind, not just relying on business-as-usual government; working with the vast ecosystem of innovative biotech companies to support and scale all viable avenues to making more key equipment available on the frontline; coordinating efforts nationally and globally to ensure we can effectively work out what is needed and where and match this with the right funding. All of this requires a total retooling of government and much deeper engagement with the private sector.
With the right leadership, countries can fight and defeat Covid-19, save lives and resuscitate their economies. Everyone is mobilising globally – health-care professionals and virology experts, community support networks, tech and industry. But more than any of these, leaders and governments are the ones most challenged and also most able to defeat this epidemic and save lives.
TBI’s mission is to equip political leaders and governments, and this has never been more urgent. Within days of Covid-19's designation as a pandemic by the World Health Organisation, my Institute was responding to requests from government leaders for support – in the form of analysis and practical support on the ground. We have repurposed the entire Institute to meet this urgent need and we have developed a framework to advise countries about how to move from emergency response to eventual recovery. “Supress, Test, Revive”.
First, Suppress the spread of the disease, through stringent social distancing to minimise total rates of infection. Next, Test widely, as this is the pathway to getting people the treatment they need and confidence to go back to work, which in turn restarts the economy. Finally, Revive, which means getting to work now to identify those measures necessary to begin the process of rebuilding the economy from the damage caused.
Much of our work is in Africa. Many have already raised the alarm about what this disease will do if it is allowed to spread widely across Africa, where strained health-care systems and logistics will create additional challenges. Coronavirus is spreading more rapidly on the African continent than anywhere else in the world and could infect millions. The potential for catastrophe is high, and the continent must urgently prepare. I saw at first-hand in 2015 the devastation caused by Ebola in Sierra Leone when I was there, but I also saw the incredible spirit and humanity of those who were on the front lines saving lives. Covid-19 is very different, but its likely impact would be felt more deeply in Africa. That is why I am wholeheartedly committed to putting my Institute behind this effort, and reaching out to our partners.
We have over 100 staff who were embedded in governments prior to this pandemic, and they will stay to help. In 14 countries and rising each day, we have been asked to establish or support emergency response structures in government or assist with the economic response.
Analysis and policy work must be done now to mitigate the long-term economic damage and to prepare for recovery. Most important, there needs to be a globally coordinated response to this unprecedented global challenge. That is why in addition our staff working on the ground in Africa and elsewhere, we have reassigned our technology and public policy experts and our team of economists to start working through the mitigation and recovery options for countries. We will be sharing the tools and guidance we have for governments with the public and our partners. We must work together across national boundaries, and stand ready to help in any way we can.