Pandemic Resiliency - in Action

I've been studying & facilitating pandemic mitigation, and the human response to it, since 2005. I'd like to share some things that might be useful to you, your family, your business and your financial security.

It is clear. COVID-19 is going to be with us for quite a while. The health and economic consequences could be worse or better than predicted. Either way, we're in this together, as a planet, nation, economy and in our households.

The only variable fully in any of our control is how resilient we will be. How well, wisely and rapidly to we adapt to a rapidly changing reality - no matter what direction it changes.

In an early discussion that I was privy to about how and when best to warn people of the potential that the SARS-CoV-2 virus might cause a pandemic, Ian Makay, a virologist from Australia said “You’re damned if you do, damned if you don’t.” What he was referring to is the emotional recoil of adjustment reaction, from listeners, as you share information with people that they would prefer not be true. They’ll often attack you as a fear monger. But if you don’t share what you know, and a pandemic begins, you’ll damn yourself -and others - for saying nothing.

No one wants there to be a pandemic, but some people, families and organizations are more flexibly resilient in adjusting to new realities than others.

There are unpleasant social consequences for those who share warnings about things not everyone can fully (and easily) comprehend. Some folks, for reasons I will describe shortly, will attack the messenger. Makay, the virologist, was sharing (from experience) that he had felt the fear of being damned by people numerous times in his career. Like Makay, as someone versed in reading the tea leaves of sociocultural response to disease spread, I’ve occasionally experienced this emotional backlash from those I share insights and warnings with.

As many have heard me say, over the years: "There are two mistakes I can make. Either #1 , not warning you about a disaster I see coming, and it comes; or #2, warning you about a disaster I see coming, and it does not. Which mistake would you rather me make?"

If it is #1, then by all means, stop reading.

Lately, however, I've been widely sought out and appreciated for the "heads-up" that I've been giving people since late December, 2019. This is one of those "head's up." 

Some messengers withdraw from the emotionally fraught task of helping others adapt to a new reality and adjust their behaviors to decrease risk. It’s emotionally hard work, and you’ll be damned also, if you know something but don’t say something.

The trick is finding a way to do "risk communication" that causes the right behavioral change. The respected risk communication guru, Peter Sandman, responded to Makay’s statement with “No, you’re darned if your warning does not pan out, your only damned if it happens and you said nothing.”

Something is likely to happen that I need to warn you about. And I want to show you how to wisely prepare - even if I turn out to be wrong.

I'm cool with the idea that I'll be darned by others if I'm wrong. I'm not at all okay with saying nothing, as I'll damn myself if I'm right and don't share my insights and things pan out as I believe they will.

First, though, how am I qualified to see these patterns?

• My first role in a public health crisis was as the Director of Drug Abuse services in a rural northeastern region of New York State. My warning then? “There is more drug use and addiction in our area than you know. Your community/school/church has that going on, and something can be done about it.” There was a lot of “Not my town, not my school, not my family”, when the evidence was obviously contradictory to that denial. Working creatively, I found patterns of communication that could affect change.

My Insight? We tend to want to deny realities that are painful to imagine, and it takes tenacious finesse to get societies to change behavior

• My second public health role was at the New York State level, warning of a crisis at the nexus of drug use (especially cocaine and heroin), general social pressure to hide ‘gayness’ and HIV. It was a mess of emotional adjustment reaction in every population I worked with, and it took longer to get the HIV crisis in control because of the incredible degree of social discomfort we have with talking about sex, drugs, and sexual orientation. But I helped poke at this beast, and grew in my effectiveness.

My Insight? Social activism can change norms of behavior and enlist vulnerable populations in preventing a problem.

• My third role was incredibly fulfilling, and netted me the unique learning available when public policy and cooperative efforts are immediately and measurably successful. My previous responsibility was in chronic health issues. This one was acute. I got to be part of a global success in preventing a public crisis that would have had devastating impact on everything from power & water transmission to health care to nuclear environmental disaster. It was the Y2K computer code issue in 1999, and I facilitated risk mitigation strategy sessions all over the world as a way of preserving supply chain for one of the world’s largest health-care companies.

My Insight? When you are successful, people will deny the problem was ever going to happen, and darn you for “over-reacting”.

Few people outside of the IT and military worlds know just how vulnerable that Y2K moment was for our planet, because of incredibly smart global crisis mitigation efforts. (Even so, nuclear reactors had to be scrammed because of missed fixes in Japan, gasoline prices spiked because of inattention to preparation at major refineries in Venezuela, and control tower local radars failed in numerous airport locations around the US and elsewhere.)

 I want to keep you and your loved ones safe…

…and in so doing, keep myself and my loved ones safe too. I want to speed the economic recovery. I want to increase the likelihood that we can all get back to work.

So, I’m going to request that you to do 4 very specific things to make a difference for the world - and I'm going to invite as many as possible into the 5th.

Since these early experiences, and as I improved my ability to facilitate good strategic thinking, I’ve had the opportunity to take a crack at things from speeding the development of life saving therapies, improving the trust in and use of electronic medical records, improving the post-Katrina health care delivery system in New Orleans, and yes, facilitating pandemic risk mitigation strategy development.

It is sobering to see what we have prepared for actually happening, but gratifying to see plans being utilized I did my part to being into existence. (Albeit not as elegantly or quickly as our planning imagined it would be).

I need to say something so that it can be well heard, even by those who would rather not hear it, and I hope to enlist your help in the messaging.

The activism I am inviting you into will be activism in both word and deed. It will serve your family and finances as well as the greater good.

Pandemics end in two ways:

1. Transmission prevention: For instance, HIV/AIDS was managed with safer sex practices, needle exchanges, and chemical dependency treatment / prevention. Ebola spread is regularly halted with surveillance and quarantine.
2. Herd immunity: There are two pathways to herd immunity: widespread infection and/or effective vaccination. The herd immunity in 1918 was achieved the hard way. In the year or so that it raged through homo sapiens, 500 million people became infected, and 20-50 million died. A better way is through vaccination, as was the case with polio, and generally the case with measles, mumps and rubella until self-serving research fraud caused a false doubt of the vaccines safety.

Darn me if I’m wrong, but we are unlikely to achieve a widely available, safe and effective vaccine in any less than 6 months of this writing (a miracle in development terms) and, if experience in the past is an indicator, it will likely be sometime in mid-2021. Getting to herd immunity without vaccination will be deadly for many humans. Perhaps not as bad as 1918, as we’ve advanced treatment, but it will be costly in lives no matter what. Unless we prevent transmission. And that’s where your help is needed. Nay, required.

You’ll damn me if I know a truth and I do not find an effective way to communicate what you and I can do – and more people die with economic disruption lasting longer.

• Here the first truth: As we struggle economically, and make the decisions that we must to move back to a more active economic pattern, there will be at least one more wave of epidemic-level COVID-19 in every area of the world. We cannot avoid it, but we can make it less devastating. And you can have a part in that.
• The second truth: We can make it worse, or less so, based upon what kind of prevention efforts we undertake, even if we do go back to “normal”.
• Third truth: Our prevention efforts will only work if they are widely adopted, and if those who refuse to adopt them are ostracized by the bulk of society until they get in line behaviorally.

So here are our social policy options:

• Achieve a 1918 type herd immunity by just letting it run its course. They seem to be trying this in Sweden and we already see a higher infection and mortality rate because of it as compared to their immediate neighbors. (At this writing, already almost 2x that of their neighbor in Norway) I don’t find Sweden’s approach acceptable for the vulnerable populations. We can do better.
• Keep intensive social isolation and physical distancing through economic restriction policies until a vaccine is developed. I find this unrealistic and unacceptable as well. We’ll create a number of secondary problems that may outpace the benefit of lower infection transmission.
• Get really good at not transmitting the SARS-CoV-2 virus, while sensibly resuming economic, educational, social and religious activity. I choose this pathway. It’s one we can all contribute to. But it will still be hard. This is where I’d like to invite your help.

To transmit, or not to transmit, that is the question. -with apologies to William Shakespeare

You already know four things you can do. They are all a bit inconvenient, and two are socially awkward. I'll share a 5th.

• Hand Hygiene. Wash frequently, use hand sanitizer that you always carry in your purse or pocket. Learn to touch your face less. This is easy stuff. Just new habits.
• Clean and sanitize high touch surfaces that you can take responsibility for more frequently. Also easy
• Keep more physically distant outside of your household. More than you might naturally. 6’-10’ is the goal. This too is relatively easy. Keep thinking about ways to make it easier. Yes, it’s a bit socially awkward.
• Wear a mask whenever you are in public. Until we are vaccinated or achieve herd immunity the more painful and sad way. I know that mask wearing for that long seems like an extreme thing to do. This is going to be the larger challenge. And the one I want to enlist your help in normalizing.
• Build a resiliency strategy for your organization and family. The folks at New & Improved feel so strongly about this that we're going to offer the course that guides to do that for 75% off to the first 8 organizations that register. Go here, and apply the code COVID19BE to get that discount for your teams.

My brother, Tim Eckert, did not have to die the way he did.

No regrets: I lost a younger brother due to his own drunk driving and alcoholism. This occurred when I was working full-time in the chemical dependency field. It’s a terrible thing, still to this day. In my family, there were a lot of after-the-fact-feelings of guilt. Each of us wondering if we could have been just a little more effective in preventing his alcoholic behavior.

I had the easiest go of the guilt resolution, because I had been calmly and lovingly challenging him about his addiction and his PTSD from his time in the Navy. I was lovingly and effectively coaxing him into treatment. He was making early inroads at the VA with counselling, but it was too little - too late.

I learned an important lesson watching my family members after Tim’s death. There were lots of regrets about things that could have been said and done, but weren’t. Ask yourself this: If someone close to you has to die the lonely death that is a death from COVID-19, will you wish you had done more to prevent it?

My Insight? find ways to help people, even if they don't want to hear it. Live a no-regrets life pattern.

Uncomfortable actions: On my last flight, before we were even calling COVID-19 as a pandemic, I saw just two people in all of the Chicago airport wearing a mask. I always carry one in my computer pack, and knew, from my work, that there was COVID-19 “in the wild” yet undiagnosed. But it would have been very awkward as an American, in our social culture, to put one on. It’s not macho. It shows fear and weakness. In fact, it was my own fear of being ostracized that kept me from putting it on. Until...

As I took my seat on my flight to Salt Lake City, I heard coughing and nose blowing in the seat right behind mine. Still, not enough for me so overcome my social fear. But then, a young girl of maybe 10-11 entered the plane, making her way to the back. She was wearing a mask. My guess is that she was immune compromised. I’m sure there was a feeling of awkwardness on her part. I finally had the motivation I needed. I put on the mask I carry, in part, so she could see me and would not feel alone. To deal with the unmasked man behind me, I pulled my brim down over my glasses, made sure the vent was blowing down on my head, and kept my hands off of my face. He hacked and coughed and blew his nose for the entire flight. I did not get sick.

We will all have to take some uncomfortable actions if we want a no-regrets outcome.

Normalizing mask-wearing is going to go well or poorly depending on herd behavior. Let’s make it go well. It’s the one action all of us can take.

My Insight? If I let my "social awkwardness" define my behavior, I'm not being all I am capable of. And I am capable of helping others with the right behavior on my part.

Get creative: What might be all of the things you can do, besides just wearing one yourself when out in public, to make it a social expectation that masks are worn by everyone until it no longer makes sense to do so? Do as many things as you can, but chief among them is to lead by example. It’s what leaders do, and if you’ve chosen to read this, you are a leader.

Get manipulative: Humans seek pleasure and avoid pain. We want to be part of a clan. Leverage that. What might be subtle and clever ways to craft messaging so that we leverage human motivators to move toward mask wearing? I plan to pull out every creative technique I can utilize to get mask wearing to be part of the new norm in my culture and community. You can do that too.

Grab your power: Utilize the Creative Problem Solving process that is instinctually available to all human beings, and build a kick-butt resiliency strategy for your organization and family. It will never be easier to do than it is now, and the pricing we are offering is from our heart, not from sane business continuity planning. It is economically unsustainable for us, but we have to do it in order to live our "no regrets" rule. So we're only doing 8 of these.

Finally, this: In the words of Margaret Mead:

“Never doubt that a small group of thoughtful, committed citizens can change the world: indeed, it’s the only thing that ever has.”

So, dammit, wear a mask.

Bob Eckert is the Healthcare Practices Lead at New & Improved. He has been teaching and facilitating creative problem solving for over 30 years, and has been utilizing CPS to facilitate disaster planning, strategic planning and pandemic mitigation for his entire career.