Leaders Lead And They Do So With Inadequate Data

By

Leonard Zwelling

         MD Anderson keeps taking it up another notch. No international business travel. No domestic business travel. Personal travel is to be registered and ought to be limited to the absolutely essential and a car is better than a plane. Meetings will consist of no more than 15 people and visitors to the facility will be held to a minimum. Is this an over-reaction? Who knows? But it is judicious, cautious, as safe as possible, and based on inadequate data. That’s what leaders have to do. They make choices based on inadequate data. If the data were adequate, anyone could make the call. So far, my hat is off to President Pisters. He is putting the faculty, staff and patients of MD Anderson first and the bottom line last. Good for him. Good for MD Anderson which has clearly taken a lead in the country on these matters and that’s what I want to talk about. Why did it have to?

         In general, businesses, schools, universities and sponsors of large public gatherings have had to determine their own courses of action as the federal government continues to bobble the ball on testing, the one place it needs to lead. If a rapid, on-the-spot test for corona virus was widely available, cases could be confirmed, carriers could be identified, appropriate isolation and quarantine could occur, and the disease would be contained to the extent possible. Perhaps most importantly, the federal government could lead local decision-making. So far, the CDC has not done this. It is too late for containment now. The best we can do is mitigate the effects of covid-19.

https://quillette.com/2020/03/03/dealing-with-a-once-in-a-century-pathogen/
https://www.wsj.com/articles/what-we-can-learn-from-the-20th-centurys-deadliest-pandemic-11583510468?mod=searchresults&page=1&pos=5

         In the first superb article sent to me by a blog reader (and in the one below from The Wall Street Journal on March 7), there is a description of how leadership during the Spanish Flu epidemic of 1918 saved countless lives in St. Louis while thoughtless local guidance cost many lives in Philadelphia. Sometimes a leader just has to make the call without all the information he or she would like. Think of Barack Obama going after Osama Bin Laden. It was a risk. He took it. Jimmy Carter did the same trying to rescue the Iranian hostages. It went less well. Leaders take chances, but this time, what to do has been clear to many local and state leaders, and, to their credit, they have acted.

         Once the CDC finally gets the testing kits out to doctors’ offices, the prevalence of the virus in the population and the incidence of covid-19 are likely to rise precipitously. Events will be cancelled. South By Southwest already has been. This is no time to “muscle” through it. The goal is to keep as many people well as possible, to limit the exposure of the well to the sick, to return as many of the sick to health as is humanly possible, and to calm the fraying nerves of a thus far poorly led population at the national level.

         This is what happens when a president like Trump cannot be trusted to fulfill his fiduciary role to the American people because he is too focused on his political standing and his presence on Twitter. He also has lied so much he is like the old man who cried wolf. It is also a problem when the administration in DC sends out politicians to weekend talk shows instead of scientists and the non-government scientists I have heard are as baffled as I am at the comportment of the president and his men. If South Korea can get this right, and it seems that it has, why can’t we?

         The difficult decisions being made all over the country by business, academic and educational leaders require our support. A little bit more support from Washington, DC and Atlanta wouldn’t hurt either. Maybe, it’s coming.

         We have probably not seen the worst of this yet. Testing will lead to more diagnoses and the identification of carriers. The health system could be overwhelmed, but there is hope that the last few weeks have allowed all of American health care to get ready.

         We may have to get used to having limited proximate exposure to one another. The economy may take a hit as more people stay home and the restaurant, travel and hospitality segments take a hit and it is a hit that cannot be recouped with government money to the populace. Business will fall not because of a lack of cash in the hands of customers, but a lack of demand and eventually supply. This could produce a recession from which it may take some time to rebound.

         But rebound it will. Even in 2008, the country came back. It will this time, too, but for the present time, local leaders will have to lead us through. Let’s hope the federal government can catch up.

Leonard Zwelling