Managing a Pandemic in a VUCA Environment

"Management success requires learning as fast as the world is changing".-Warren Bennis-

A global natural catastrophe derived from the Greek word "pan-demos," meaning "All People," a pandemic, is deemed one of the worst natural disasters attributed to human history. The impact is much more severe than other natural calamities about the number of casualties, the affected spectrum, and the timeframe. A pandemic can spread through continents and affect millions of humans. When it comes to pandemics' management aspect, it is incredibly complex due to multi-regional and multi-cultural environments. Besides, a VUCA environment, where volatility, uncertainty, complexity, and ambiguity make pandemic management more challenging.

• VUCA and pandemic management

Volatility plays a vital role despite the historical statistics available. Frequent changes on a micro or macro level will be unpredictable, leading to more dramatic scenarios in a much faster developing environment of a pandemic event. Events unfold in a completely unexpected way in an environment of a rapid spread, and it will be more challenging to determine cause and effect. Managing the volatility must be carried out from multiple fronts such as the economic volatility due to disruption in the global & local supply chain, social volatility on the breakdown of regular day to day activities, and from a biotechnical front, specific volatility related to pathogen mutations, spreading patterns and discovery and testing of cures. By focusing on quick solutions to sustain the economy, safeguard the production lines, and establish prudent business continuity plans to keep the business afloat with a minimum capacity, establish adequate and robust health systems, public awareness, and personal safety guidelines. Investing in expertise, education and research for obtaining quick breakthroughs such as decoding the pathogen genome and expediting the discovery of cures will minimize the volatility-related risk during a pandemic.                      

Uncertainty is an important aspect to focus on when it comes to managing a pandemic. During a pandemic, it is challenging to anticipate events or predict an outcome. Historical forecasts and past experiences may not significantly impact predicting the pandemic's future status due to differences in geographical, social, and cultural aspects and other attributes such as mutation and evolving resistance of the pathogen. The change will constitute an extensive burden in planning the next move to contain the pandemic, whereby it will be a moving pendulum. Mitigating the uncertainty can be carried by using sophisticated projective and predictive methodologies and techniques such as artificial intelligence and big data to plot the future changes and manage them.     

Complexity poses a fundamental challenge when it comes to pandemic management. When a disease is spreading across the globe, the impact will be in a broader spectrum of political, social, economic, and cultural avenues. Since these aspects are multi-layered and interconnected, the problems, complexities, and repercussions will be multi-layered and hard to handle complicated scenarios if there is a collective impact. It will be highly challenging to maintain equilibrium on multiple fronts and minimize a global pandemic's impact. Managing complexity requires a competent team and leadership and a competent structure with diverse skill sets and expertise. A well-synchronized team can achieve the said equilibrium point and manage the infections' spread while keeping the other key pillars intact, avoiding a system collapse.

The final factor of a VUCA environment is ambiguity. Ambiguity plays a decisive role as a challenge in managing a pandemic, especially during a new pandemic where there are many grey areas. Decision-making will be complicated when the outcome does not give the intended results. Ambiguity occurs when there is more than one intended result of an occurrence or an action. Ambiguity is not limited to one area but multiple areas of management. If the issue or outcome is a 'catch 22' scenario, pinpointing the solution may challenge. For example, a particular drug or a treatment intended to fight the pathogen might be useful on some patients, and some may not respond to the same drug. This response causes the researchers and health services to spend more time and money to conduct further studies to understand the root cause of such an outcome. More time could mean an increase in the number of infected persons, and more money will be an additional burden on a stressed economy. .There should be competent expertise and an intense research and development apparatus, which will minimize the dubiety.        

Flattening the curve

The basic pandemic management concept is flattening the curve or planking the curve. When we talk about the curve, it illustrates the number of people getting sick over a certain period, collecting daily statistics of the number of people who tested positive for the infection. When many people get sick over a short period, the curve rises faster and more likely will surpass the threshold of the healthcare system's capacity. Irrespective of how sophisticated or useful the health system is, it can accommodate a certain number of patients where the number of doctors' nurses and health care personnel can work. The ceiling is known as the healthcare threshold. Once the curve surpasses this threshold, the excess patients will not get the healthcare facilities required to combat the infection, resulting in many fatalities. Flattening the curve is to push down the number of individuals getting infected below the health care threshold. The minimization can be achieved successfully by prudently managing the VUCA factors about a pandemic. Increasing the healthcare system's capacity can push the threshold upwards by investing more in critical gear, ICU units, and employing more professionals in the system. Although such arrangements may take a certain period, several infected maintained under the threshold line without crossing it and keeping the existing healthcare system, research and development intact and introducing preventive measures such as establishing well-equipped quarantine centres and guidelines to the public such as self-quarantine, personal hygiene, and social distancing during a pandemic.    

Source: www.leader.com, 2020

Major outbreaks and their management through ages

The world has witnessed many pandemics and outbreaks throughout its history. The earliest recorded incident was 5000 years ago; a prehistoric pandemic can also be coined as an epidemic since there were fewer contacts between regions. In 3000 BC in China, the incident took place, a known circa epidemic with mass burned burial sites. The spread was managed by burning all the infected bodies in isolated locations. Archaeological and anthropological study indicates that the spread was so quick that the inhabitants could not manage it with primitive technology and did not have time to carry out proper burial rites for the dead. The areas were abandoned and uninhabited for an extended period.

There were significant recorded pandemics in the ancient world. When civilizations emerged, trade routes and conquests connected more communities and human interactions, prone to the spread of diseases. In 105, smallpox or measles was spread through the Roman Empire, its height due to its expansion. The pandemic was known as the Antonian Plague. It was carried to Rome by returning the Roman army from Parthia, which later spread through the region, killing around five million inhabitants. Rome, unable to manage the pandemic, ended the Pax Romana, which led to instability, which led to civil war and barbarian invasion, paving the road to the empire's decline. In 541 AD, the ancient world was ravaged by the bubonic plague known as the Justinian plague, estimated to kill 30-50 million, almost one-tenth of the world population. This plague struck at the Byzantine empire's height and marked the decline and the subsequent collapse of the empire. Managing pandemics in the ancient world may have been next to impossible where people believed the plague was due to divine wrath and applied superstitious methods to combat the same and meanwhile overpopulated cities with poor sanitation and absence of scientific knowledge of clinical pathology would have contributed to the fast spread and considerable casualties.

After the collapse of the classical empires, Europe fell into a dark era known as the middle ages. The Middle ages saw notable pandemics. The black death, the bubonic plague ravaged Europe in 1347 AD. It was spread from Asia to Europe via merchant ships through trade routes. The estimates suggest that the plague had wiped out nearly half of the population of Europe, around 200 million casualties. Although there was limited knowledge of hygiene and personal protection, it was not sufficient to manage or curtail the pandemic. The loss of many people reduced human resources, which subsequently became valuable. The serf of the feudal system of Europe collapsed and paved the way to the age of renaissance and exploration.

One of the evident pandemics of the age of exploration was smallpox. The new world's pandemic was introduced by the European explorers in 1520 AD, ravaged and brought the Aztec and the Inca civilizations towards their destruction. They were not able to manage the spreading of the disease due to limited knowledge and superstition. They attributed this to their deities by offering sacrifices while the disease spread at a geometrical rate wiping out more than 90% indigenous population. Approximately 56 million people lost their lives during this pandemic. The disease spread through maritime trade and colonial expansion. The germ was used as a weapon to weaken the natives and subjugate them, giving early evidence of biological weapons usage. Subsequently, the colonial masters could not escape when outbreaks such as the Great Plague of London in 1665, the Italian plague of 1629, and the Cholera outbreak of 1817 had a combined fatality number of around 2.1 Million. Although the Industrial Revolution started in 1970, disease control management was still abysmal due to the absence of detection and cure processes. However, Dr Edward Jenner's significant breakthrough paved the way for eradicating deadly smallpox and discovering Pasteurization by Lois Pasture in 1862 to remove bacterium and other organisms from food and discovery antiseptics by Joseph Lister in 1867, which helped to eradicate surface germs. Notable crisis management for controlling disease was carried out by Catherine the Great during the Russian plague in 1770, who ordered to move all the factories out of Moscow while quarantining the population. The death toll from the plague reached 100,000, but she had to face a post insurrection that killed thousands.   

The beginning of the 20th century saw a significant pandemic outbreak after world war I. The Spanish flu pandemic, which began in 1918, contributes to an estimated half a billion people had fell victim to the disease leaving around 100 million dead. The pandemic's spread intensified due to poor wartime management and conditions at the home and battlefront and nutrition scarcity. The 20th century also saw a significant development in the health care sector, where notable inventions and discoveries took place. The discovery of Penicillin by Alexander Fleming revolutionized the medical world. It brought the number of deaths due to bacterial infection significantly down, and the polio vaccine's discovery by Dr Jonas Salk in 1955. Other inventions such as radiology, CT, Ultrasound, and MRI, and significant surgical developments, the discovery of medications and anaesthetics boosted the healthcare sector. The measures made the disease spread control and management much more comfortable than in the previous eras. Although the world had developed modernized counteroffensive for diseases, in parallel new strains of viruses such as AIDS, Ebola, and SARS and drug resistance bacterium, have come into existence in the modern era leaving continuous strain on the pandemic/epidemic management.

Nevertheless, humans have the technology and resources to curtail the same. The governments are well aware of the economic and political impact in the wake of a disaster and have built-in strategies to counter the same. Globalization increased the risk of spreading a pandemic through trade routes, tourism, and the travel industry. Since the countries and their systems are interlinked at various levels, and the rate of a disease spread will be much faster than the previous pandemics.            

After the SARS-related zoonotic flu pandemics, which made headlines, ravaged the world during the previous decade, the most significant virus, COVID19, which emerged from the Wuhan province of China 2019 and at present has spread to all countries across the globe. The initial waves and the mutated subsequent waves still threaten the globe. World Health Organization declared COVID19 as a pandemic, one which humans can control to an extent with the latest technology. However, the outbreak's outcome will depend on the data once the pandemic has come to a complete standstill. Governments and institutions are investing millions of funds for the research and development of vaccines and therapeutic medication. The pandemic management in the millennium saw the most significant breakthrough in pandemic management where innovations such as Artificial Intelligence, Robotics, and Big Data have contributed significantly to prudent pandemic management. The new technology has made it possible to track patients and their movements, use big data to project the pandemic's spread, and provide accurate and faster statistics for the authorities to take proactive measures. Artificial Intelligence has helped decode the genome of the pathogen faster to produce the appropriate vaccine, and AI is being used to create complex formulas to create breakthrough medications. The usage of robots to carry out complex tasks and operations and support nursing highly contagious patients. The pandemic has also seen significant disruptions in political, economic, and social aspects and a significant impact on supply chains, global markets, finance, employment, global travel, manufacturing, energy industry, imports, and exports. The world's people face a new reality of isolation, self-quarantine, social distancing, and remote working mechanisms.

This 21st-century pandemic will teach us significant lessons and subsequently allow us to make more strategic management decisions to face such challenges in the future.