Skolnik: Leadership In The Age Of COVID-19

Los Alamos

To deal effectively with the COVID-19 health crisis, the US needs exceptional leadership at all levels of government and society.

In the absence of such leadership, many more people will die then would otherwise be the case.

So, what kind of leadership do we so urgently need?

General Stanley McChrystal suggested in a webinar Friday ( that we must have leaders who:

  • Are honest and inspire
  • Understand the directions in which they have to move the country and the world
  • Surround themselves with experts to whom they listen
  • Drive action in a coordinated way
  • Take actions urgently, as we did in World War II

The General further suggested that one of the first principles of battle is to break your enemy into pieces and then take the pieces out one at a time. However, allowing this to happen to your forces, he said, will lead to certain defeat.

With this in mind, I want to suggest that our Governor and her team have exhibited high levels of leadership during this crisis, for which I am very grateful and for which I believe they deserve much more credit nationally than they are getting. The governor has acted swiftly, forcefully, and transparently against COVID-19. We took timely steps to engage in social distancing. We have been at the top of testing per capita for some time. The governor has a superb command of the subject matter, including the second, third, and fourth order effects in our small but socially complicated state.

Nonetheless, she surrounds herself with outstanding public health people, to whom she listens. The governor has taken a coordinated “command and control” approach to organizing the key areas of the state’s response. She communicates clearly, regularly, and honestly with her constituents. She invites constructive criticism and thanks people and journalists for it. She works hard to get what New Mexico needs from the federal government but understands that she cannot count on federal help with any certainty. In many ways, the governor strikes me as a profile in both courage and leadership. In addressing COVID-19, she reminds me of the few national leaders who accepted the reality of HIV in its early days and then dealt with it effectively.

By contrast, if we judge the federal response against the criteria for leadership noted above, there remain a range of serious and potentially lethal gaps. After more than a month of dishonesty, national leaders are beginning to be more honest about what we are facing. They appear to be listening more to the experts then before but continued until recently to promote unproven medical solutions to the virus. Contrary to what almost every health provider in America faces, federal leaders continue to claim that anyone who wants can be tested, doubt the needs governors have expressed for supplies, and implied that healthcare workers might be asking for supplies for nefarious purposes.

The federal government has failed to put in place a coordinated command and control approach to the procurement of needed masks, personal protective equipment, and ventilators. In fact, the procurement “system” is the exact opposite of what general McChrystal recommends, with 50 states competing against the federal government and each other (and our “allies”) for scarce goods. In addition, an important part of this procurement is the responsibility of the President’s son-in-law, a real estate investor with no experience in such complex matters. Rather than act like this is World War II, the President has only belatedly and hesitatingly used the Defense Production Act. Rather than lead the world, we are now receiving supplies from China and Russia. Related to the above, we should expect to see more healthcare workers infected, more deaths, and more physicians engaging in triage than if the federal response were well lead.

We are all in this together and whether we like it or not, we are also in this with states whose actions on COVID-19 look more like criminal negligence than an appropriate public health response. With this in mind, I urge everyone to engage in the social distancing and mask wearing that the governor has asked us to do. I also urge people to communicate urgently and forcefully directly with federal authorities to demand a more coordinated, evidence-based, and forceful response. It is not too late. However, it is moving rapidly in that direction in many parts of the US.

Editor’s note: Richard Skolnik is the former regional director for health for South Asia at the World Bank. He was the director of an AIDS treatment program for Harvard and taught Global Health at the George Washington University and Yale. He is the author of Global Health 101 and the instructor for Yale/Coursera’s Essentials of Global Health.