Pandemic Lessons from a Health Solutions Company

By Christopher A. LeGrand, CEO, BroadReach Group

 BroadReach (www.broadreachcorporation.com) has been preparing for this moment in time since our founding. Applying our 17 years of learning and investments, we defined and implemented a COVID-19 pandemic response around two dimensions: demand (screening, testing, contact tracing, and treatment) and supply (the health system, including facilities, workforce, and supply chains).

From my own 30+ year journey in global health combined now with BroadReach’s learning, I’ll frame out below some pandemic lessons I think worth sharing. Individuals, organizations, and society progress when we apply the learning of the past to change the trajectory of the future. The lessons below are not unique to BroadReach or me. But I share them so we can all grow and progress.

Lesson 1: Data Matters

The HIV/AIDS pandemic we have fought for 20+ years has taught us many things, including the power of data. When the global HIV fight began, researchers, epidemiologists, policymakers, managers, and citizens had little access to real data. Over time, the volume and fidelity of data, and the intensity around data-driven decision making, have dramatically expanded.

We have also developed an entire generation of ‘data aware’ health professionals, policymakers, and even politicians. Capturing, cleaning, aggregating, and interpreting data are now the norm. For instance, the current US-funded PEPFAR program has 30 standard reporting indicators. Reaching the finish line to an AIDS-free generation will be costly and time consuming, but would be impossible without sophisticated use of data. We now have a rich body of learning across research, implementation science, and policymaking that will teach us for generations to come.

Data matters in the response to COVID-19 as well. With early data from China and Italy, even countries with limited resources were able to make aggressive, informed, early decisions that may have saved the pandemic from growing to even more dire proportions.

The exceptional modeling done by the University of Washington’s Institute for Health Metrics and Evaluation (IHME) and others is evidence of a new data culture. Also, BroadReach’s own Vantage technology platform is ingesting a range of pandemic data to inform local and national decision making.    

So, first pandemic lesson: data matters.

Lesson 2 – Velocity matters

In 2003 when SARS began hitting US shores, I was working for a public health organization that supported the US Centers for Disease Control and Prevention (CDC). Late one evening, we got an urgent call from a CDC official who asked for help in reopening up CDC’s quarantine centers in numerous US ports of entry. These centers had once been a major line of defense for the US from infectious disease but had been mostly defunded and moth-balled.

The request was to find, train, hire and obtain airport security clearances for 80 qualified public health professionals, stock and modernize the quarantine stations, and get the facilities up and fully functional in 45 days.

CDC is the preeminent public health institution in the world and has trained and mentored most of the government public health agencies worldwide. Yet, CDC knew its internal operations could not move as fast as necessary, so they turned to a nimble partner they trusted.

I saw first-hand how critical velocity was in containing SARS. CDC was racing against the clock, and its quickest path to contain the virus was through the quarantine centers. Even a few days of delay could have resulted in dramatic spread. CDC accelerated its procurement processes, and my organization then jumped in with everything we had, finding and hiring those 80 people. We played our part to help contain SARS. 

Similarly, velocity matters in COVID-19. Nations and organizations that have moved with great velocity have battled more successfully to avoid the exponential rise or flatten that curve earlier. My home country, the United States, was slow to react. Analyzing daily testing volumes from the US, it is clear that we lost two precious weeks before we dramatically escalated testing and began restricting movement. In these two weeks, the virus was already spreading across major urban areas.

A positive demonstration of velocity is the race for a COVID-19 vaccine. The speed and intensity with which literally hundreds of institutions around the world are moving to find a vaccine is breath taking.

So, second pandemic lesson: velocity matters.        

Lesson 3 – Agility Matters

The 2014-2016 Ebola crisis in West Africa seems like a distant memory now, with minor lasting impact on the broader global community compared to HIV or COVID-19. However, its deadliness, with a 50% case fatality rate, called for dramatic action in 2014. Though documented outbreaks of Ebola had been occurring since 1976, the global community was again surprised when Ebola re-emerged in 2014.

Even with the best trained and committed public health emergency responders from CDC and elsewhere, the early stages of the outbreak threatened to overwhelm the response. Response teams got on the ground and had to adapt quickly. Lack of a vaccine, insufficient equipment, poor public awareness, and inadequate numbers and training of local health workers required agility.  

Agility is the ability to pivot, go around or over obstacles, and creatively find solutions to seemingly intractable problems. In an infectious disease outbreak, this ability is essential.

When faced with obstacles, Ebola responders found ways around. Countless acts of creativity and heroism began to turn the tide.For example, local and international institutions adapted quickly on the ground, creating innovations in personal protective equipment, more efficient decontamination units, and numerous other improvised clinical and operational tools. When health workers were inadequately trained or not reachable in rural areas, NGOs like IntraHealth International and Last Mile Health invented new mobile ways of keeping in touch with health workers. When a physician in Lagos, Nigeria, suspected one of her patients of having Ebola, she immediately locked down the patient and refused to let him leave even though she came under intense pressure to release him. Unfortunately she contracted Ebola and lost her life, but she prevented what could have been a catastrophic outbreak in a bustling city of 20 million.

So, third pandemic lesson: agility matters.

Lesson 4: Collaboration Matters

Founded in 1948 as part of launching the United Nations, the World Health Organization is the embodiment of collaboration in global health. In particular, WHO was central to coordinating the multi-decade, global effort to finally eradicate Smallpox, achieved in 1980.

If velocity and agility are the engine pistons and spark plugs in a pandemic response, collaboration is the oil that allows everything to move in sync. No single individual, organization, or nation has all the answers. Governments don’t have all the solutions and neither does the private sector. From Smallpox, HIV, SARS and Ebola, to COVID-19, when effective collaboration is present, the impact of pandemics is minimized and recovery is quicker.

After a slow, uncoordinated start in the 2014 Ebola crisis, actors from across the global health community built collaborative working relationships that had a major impact on minimizing the effect of the disease. For example, the United States’ own Department of Defense overcame initial local government hesitancy, built trust, and became a critical component of the response.

Fundamentally, effective collaboration requires trust and alignment to a common cause larger than any one individual, organization, or nation.

From my own vantage point in public health preparedness and response, I have seen numerous positive examples of collaboration, including close coordination between CDC and WHO, joint private sector and government biomedical research, and robust data sharing and analysis among epidemiologists across various national government public health agencies.  

With COVID-19, we are seeing a mixed bag of collaboration globally so far. But within the African context, collaboration has been strong and focused. Africans are not waiting for more ‘developed’ countries to lead the way. In fact, recently launched organizations like Africa CDC are becoming central bodies for information sharing, convening, and coordination across Africa.

So, fourth pandemic lesson: collaboration matters.

Lesson 5: Leadership Matters

As I stated in my 2019 published book,The Complete Business Leader,  leaders cause things to happen that were not going to just happen anyway. All the data, velocity, agility, and collaboration comes to life only when leadership shows up to cause it.

In every pandemic I have studied or been involved in, a set of leaders ultimately infused an unwaivering will to succeed. These pandemic leaders came from government, NGOs, multilateral organizations, and the private sector. These leaders rallied other leaders from across the globe; helped the public understand what was at stake; worked together to marshal financial and human resources; inspired the brightest and most creative individuals to help; reached out to previous adversaries in common cause; created the sense of urgency and call to action; and modeled the persistence to keep going and never give up.

US President George W. Bush saw the scourge of HIV/AIDS and stood up to lead. He personally drove the launch of and set in motion the PEPFAR program. Subsequent PEPFAR leaders, including Ambassadors Mark Dybul, Eric Goosby, and Deborah Birx have all led the program with that same persistence.

In COVID-19 days, we are seeing the consequences of missing leadership, both in individual countries and globally. There has been no unified global voice to lead. Yet, I have seen decisive, data-driven leadership from S. African President Ramaphosa. He has made the hard decisions with the data he had available, and worked tirelessly to convince the public to support those decisions. And he did what great leaders do – led by example – when he donned a facemask on live TV.

So, fifth pandemic lesson: leadership matters.

How BroadReach is Applying these Lessons

At BroadReach, we are applying these lessons from the past to change the trajectory of the future. Our Vantage platform is built on the principle of data-driven insights. Our teams have moved with great velocity to develop and roll out our COVID-19 solutions at scale when lives were on the line.  Our teams showed agility reconfiguring our Vantage platform to address the demand and supply side pandemic response and connect our data pipeline to the South African national COVID-19 command centre. We are collaborating closely with departments of health leaders, local government health workers, US Government partners, tech partners, and others. And our leadership commitment includes investing our own resources to build, launch, and scale a whole new suite of pandemic management tech-enabled solutions.   

In under four weeks, we developed and launched seven targeted COVID-19 technology solutions at scale. At last count, BroadReach had trained more than 9,000 frontline healthcare workers, screened nearly 2 million households, and assessed over 300 facilities. We are currently processing up to 323 new screening surveys per minute.

We are clear that BroadReach does not have all the answers and solutions. We are clear that it takes a network of passionate individuals and institutions working in common cause. This brings out the best in us and all who work together for global good.