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Winning the (local) COVID-19 war

McKinsey 06 Apr 2020 12:00

Individuals and business leaders understandably want to know when life will return to normal, or at least when economic activity can resume unencumbered. We admit we do not know.

We do know we face an enemy that is poorly understood, potentially adaptive, and has already attacked most of the United States. Most epidemiologists have concluded that there will likely be some degree of contagion across the country for at least 12 to 18 months. With that reality in mind, we offer three suggestions to help state and local leaders navigate the challenging set of choices required to safeguard lives and livelihoods in our communities.

We base our conclusions on analysis of the experience of certain Asian countries most often cited as successfully navigating the crisis; a review of the growing body of relevant literature; direct experience in the healthcare delivery system; and an analysis of previous economic crises.

1. Prepare to fight and win a war: Build a true command center with sufficient resources and authority; find talented people (within and beyond government) with the necessary skills, especially in operations and logistics; and invest in the most relevant data and information, as well as the capability to adapt based on the “facts on the ground.”

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  • Clear governance with agile decision-making processes
  • Useful, accurate, current information across all domains and all theaters
  • Each team/domain has clear, tangible objectives, necessary resources, and authority to act
  • Clear mechanisms to interface and engage with public and private stakeholders
  • Sufficient talent: large group of outcome-oriented leaders with mix of skills—operators, logisticians, strategists, analysts, clinicians, etc.

We conclude that five are most fundamental:

We classify the other public health strategies into three additional categories (Exhibit 2):

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It is important to note that many of the strategies to protect older and higher-risk Americans also could create a myriad of challenges. Therefore, any approach must directly address the practical, social, and behavioral needs of people who may be in relative isolation for a long period of time and have sources of income compromised.

Domain 4: Industry safeguarding

Safeguarding also could be critical to managing the psychological impact of the disease, restoring consumers' confidence, and ensuring that people engage in activities deemed safe. Given the intensity with which leaders are communicating the very real risks of exposure to COVID-19, it may prove challenging to adapt the physical distancing message at the appropriate time, especially if some degree of contagion is present. Leaders will need to consider strategies to bolster what the private sector can do on its own. For example, the government could consider visible certification for environments and/or the creation of clear safeguarding standards to reassure consumers.

We then aggregated each sector into one of five segments primarily based on how critical these activities are typically considered by states and how difficult it would be for each industry to safeguard. According to our analysis, 41 percent of GDP and 19 percent of employment are relatively easier to safeguard with limited changes to existing processes and approaches (Exhibit 7). These limited changes could include, for example, adopting physical distancing practices, maximizing telework, and developing hygiene protocols, as many companies did in China. 14 14. Huang X, Sawaya A, and Zipser D, “How China’s consumer companies managed through the COVID-19 crisis: A virtual roundtable,” March 2020, Mckinsey.com. On the other end of the spectrum, 20 percent of GDP and 37 percent of employment are activities that are quite difficult to safeguard and would require significant changes to “business as usual” to limit contagion.

A more detailed description of each industry is provided below.

Domain 5: Protection of the vulnerable

Domain 6: Economic health

3. Execute well to earn greater flexibility

In addition, leaders would benefit from understanding the scale and degree of potential immunity to COVID-19 developing among the populations in their communities.

To assist leaders in making these choices, we have created an illustrative COVID-19 War Dashboard (Exhibit 10). This dashboard highlights the most critical measures of success in each domain and the key interventions that can be “activated” to achieve these results (for example, adding resources, increasing intensity, improving execution). Leaders could also create and use a “composite index” to empirically measure the epidemiological reality in their communities, domain performance, and the state of the science.


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