Crisis management strategies during COVID and leadership essentials

In continuation with our COVID series, we share a conversation with Prof Magda Rosenmöller, Senior Lecturer of Production Technology and Operations Management at IESE Business School, who holds extensive experience in health policy. She explains how different companies responded to episodes of the outbreak in their workspaces differently, the benefits of certain testing strategies and crucial leadership essentials for companies.

Transcript

Gopika Sampat: Hello to everyone from DocHQ. I'm Gopika and welcome to our podcast 'Health Tech For Businesses'. Here we will be talking to experts about several interesting topics from AI and Data Privacy to Health Equity, and digital health solutions for businesses. In continuation with our COVID series, our podcast today will focus on the relevance of COVID protocols and risk management for businesses and how companies can prepare themselves amidst the possibility of a second outbreak. Today, I'm really honoured to have this discussion with Professor Magda Rosenmöller. Magda is a senior professor at IESE Business School in Barcelona. She studied medicine at the University of Strasbourg in France, and she also did her MBA from IESE. She holds a PhD in Health Policy from the University of London and has extensive experience in health research issues in Europe. She's a member of several international organizations. Including the European Health Member Association, and has also worked as a health economist in the World Bank's Latin American and Caribbean region. So, welcome to our podcast today, Magda. And thank you so much for joining us in this discussion today. 

Magda Rosenmöller: Thank you. Thanks for having me. It's great to see you again, Gopika. I've interacted with you in the health course at the MBA. And I'm really happy to see IESE Alumni now really moving into this challenge that this pandemic is posing and that are actually contributing to managerial experience and in finding solutions. 

Gopika Sampat: That's great Magda. I'm really excited to get this started. So I'd like to take a quick look at our last podcast, where we had a discussion with Professor Mike Rosenberg from IESE. And we asked him what he thinks of the current situation, how does he see it evolving. And he said that it really depends on where you are in the world, the ability of the country to react, the institutions there and the strength of those institutions. And, of course, the leadership in that country, because no matter how many resources a country has, nothing can be resolved if a country's leadership is ineffective. And we are really seeing examples of that across the globe. So Magda, do you feel that way? What is your opinion on the current situation? And do you think this whole lockdown, relax, repeat strategy that countries and cities are adopting is effective, given the possibility of a second surge? 

Magda Rosenmöller: Well, that's what we need to do. I think so in terms of the countries - well, it's a very serious disease. It's very serious because it's very infectious, and it's infectious before you have signs so that makes it really very complicated to control. And it has serious outcomes. It might not be as bad and serious as Ebola for example, but it still has for the risky part of the population, very serious outcomes. And we do learn that even those that have a rather mild version of the disease can have some very serious sick health afterwards. So we're still learning and that's maybe another important point we are still learning and each day we find maybe new insights and that makes the management of the disease also so difficult because there might be some contradicting new things that we find out and here to your question on which countries do better - I think in Europe as well, the disease moved with the sun. It moved from Asia; from China to Europe and then through the United States. So we have learned from China, even though in the beginning maybe they did not share as much information as we would have liked, but then they were very cooperative and I have been to many meetings where clinicians were sharing details as to how to handle (the crisis). We also in Europe have really benefited from a very early and strong outbreak in Italy so it caught Italy unprepared. But other European countries were more prepared. And the important point here is also that it got the population alerted. So we need the population understanding. Particularly now, we are in the post confinement where we need that the population is understanding of the seriousness of the disease and following the recommendations. We are as you say, now, in well, we call it the hammer and the dance. So the hammer was that we started confinement and we had two months or two months and a half of a complete shutdown. And that's the way of dealing with the first wave. And that worked very well, in most countries. But now it's the dance which means these numbers can go a little bit up, a little bit down and here, we need other ways of dealing with that. And we need this commitment of the population. Interesting those countries that did best -  it looks like female-run countries did best. And we saw this in New Zealand, Taiwan, Germany etc. (These countries have rulers) that would talk with authority. Angela Merkel for eg is a scientist. So she spoke about (the crisis) in a scientific way, but at the same time (these rulers) were compassionate, and were saying, 'Yes, we do understand the problem'. And I think this makes it better than authoritarian rulers. And here we look at Brazil, the US and even the UK, where the virus has been neglected for a long time. And then not real measures have been taken. I think this mix of having a strong message, but also having a good health system might refer to that and having a good health system in place that can follow up that can do the controls. I think that would be for me, the successful countries with testing, with different hygiene measures, with the mask - a very big problem, in the beginning, we did not have the mask. And also then the distance, the respect of the distance and here yes, we need the population collaborating. 

Gopika Sampat: So Magda, you've done a lot of work and research on how different institutions have dealt with this crisis, in the automotive sector and the food sector being some of them. Could you tell us more about what these companies and institutions did right and of course, what they could have done better? 

Magda Rosenmöller: Any country has risk management protocols. For hospitals, for example, if we have a regional outbreak, we should have a crisis team, etc. So we all know about that. We had been warned. I mean, Bill Gates did his famous talk in 2015 on an outbreak. The German government had run a whole kind of simulation on a potential pandemic and given some very clear instructions on what to do. We have the European Commission, which, by the way, let me make this comment, were completely absent at the beginning of the crisis, also have this 'Threats To Health' unit. And they did run simulations of bringing data together, but they failed to act. So I think coming back to your question, those companies that had things in place, but then really acted upon it immediately - those companies were the most successful. And yeah, indeed, we have been looking at Webasto in Germany, a car company close to Munich that has production units, also in China, in Wuhan. At the end of January, they had a visitor - one of their employees from China, coming for a usual visit. And as she went back, she was tested positive. So she immediately alerted them. We are actually looking at how the company reacted. They put in place immediately a crisis team, they got in contact with the local authorities - I think that's very important that you actually work together with the local authorities because the company is not finished at the company borders. There's a whole community around that, where the workers live or the employees live etc. So they had the crisis team, they checked with the local authorities, but then they did together develop a very quick plan so that all those that had been in contact with these Chinese colleagues, and never tested were immediately tested and they found that 14 had been infected. They were isolated in collaboration with the local authorities. There were a total of additionally five family members of those infected but did not react quickly. So in total, it was 19 people and that was it. The outbreak there was contained to 19 infected and there was no spread and I think it's a great example of successful handling. Also in the discussion with them, I learned that they had someone from the board on that crisis team so that they could take very quick decisions and they said that we usually work in projects so we are a very agile company. Our people are trained to very quickly react to different demand from a customer, to a project that goes and comes with problems, or even opportunities, you know, the Chinese word for crisis is (is composed of two characters signifying) challenge and opportunity. So we're a very agile company in that we were prepared to very quickly move into the action and take real action. And I think that has been the success factors for containing that very initial outbreak and at the same time for the rest of Germany, it has been a wake-up call. So that others could be prepared. And actually the manual that Webasto prepared has been shared with the Automotive Association in Germany and has been made available to other companies in the industry. We have another example, also that's from Germany and I have followed it closely. We had a meat-producing and fabricating company that had to be closed because of a massive outbreak - they had over 1000 people get infected and here I think it's the other side. I think it was not COVID as such. It was the problems that were there in the company before. So they work with subcontractors. They have cheap labourers that are living in very difficult housing conditions that are very close to each other. So very easy spread for the virus. To add to this, the company did not even think that there could be an outbreak. And then the outbreak was there, and nothing was done. So here actually the authorities had to step in, close the factory, etc. So, maybe the biggest difference would be being responsible and prepared.  

Gopika Sampat: Let's look at the specific measures that you mentioned earlier that companies are doing to limit the risk in bringing their employees back to the office. They are considering two main strategies. One is using molecular or PCR testing, and/or antibody testing. And the other strategy is deploying electronic tracking of infection through contact tracing apps, asking employees to download applications etc. These strategies hold a lot of promise, but they also have serious limitations. With molecular or PCR tests, for example, it is unclear with what frequency such testing should take place. So given these limitations, do you think there is a possibility for companies to adopt reactive or adaptive testing protocols? Or is this just a price to pay? Something that we just have to deal with? 

Magda Rosenmöller: Well, it is costly, but I think the price of shutting down is higher. So I think whatever investment you want to do in that is worth by doing and maybe just the IESE example. So IESE Business School was completely shut down, we moved all our classes online. And for us, it was important to get back to campus as quickly as possible. So we work very closely with the local authorities and see what needs to be in place in order for us to be allowed to be open. So they developed a very good concept on bringing together the testing on one side like saying that - let's see that we reduce as much as possible the risk of someone entering the campus that is infected. Doing this together with still distance in the classrooms, in the working space, the mask-wearing and then the hygiene. There are a lot of hygiene points across the school for disinfecting and this going together with continuous supervision of the health status. So you have an initial test and here, we had discussed this earlier and I was of the opinion that the only test that is applicable is the PCR test since you know who is infected or not but in hindsight, as we are moving several months into the pandemic, I think that serological testing is probably better because it can show us those that had the infection. And that, at least for the moment, we can assume that they had the antibodies. We don't know how long they will last at least two-three months. So there's a lot to know about the virus. But with the serological testing, we can know those that had the infection and are less likely to be infected. So that's why I think that serologic testing is very good. And then with the IgG and IgM, I can make the difference between an ongoing infection or the IgG which tells me that person had an infection in the past but is protected. So I would say serological testing is probably the best, and then following up and yes, IESE does that with a follow-up questionnaire i.e did you have experience any fever, any signs of sore throat, or loss of all fat and have you been in contact with somebody? So with these questions, they can actually monitor and keep the risk of someone infected coming to the campus as low as possible. This is important, as you know, we have our students come from all over the world. So they go through airports. And so there's a high risk that the infection would be taken to campus. So that's a very good way of diminishing it. Coming to the tracing apps. I know Germany has started with the tracing app that seems to work well is well accepted and took a long time to develop, but it is very much to the decision of those that have been traced on the data he would like to make available on or not. He is told that if he is really infected, then to alert the health authorities, but otherwise, it's not duplicated somewhere else. And I think that's a very good way to do that. For companies. I would say the tracing app is not that important because you know, the workers that work together, inside the company probably doesn't give you much more information than it will at the population level, but you need the buy-in of the population at a large scale. And that's not that easy. So I would say, for these successful companies, I think it's similar as to what we said for the countries - you need authority and a good plan, a plan that has been discussed with the authorities, that is trusted by the workers, that is agreed by the workers or accepted as being the best way to go. But at the same time, a leadership that is compassionate, that is, for example, taking into account if a worker has a risky person at home, In my team, there was one such person. We had a presential meeting with the distance restrictions in place and he said that he would like to visit his in-laws on the weekend and I know that they will be at risk so I'd rather not attend the meeting. So we actually connected with him online or by virtual means. But that's this compassionate way of understanding what are the needs of our workers. 

Gopika Sampat: Magda, what's interesting is that you mentioned that there's a lot of learning going on. And I can also say that there's a lot of unlearning going on. The information that we receive keeps changing on a daily basis. People are being taught the importance of handwashing again. Many people are still refusing to wear masks in certain countries. So let's talk about the role of businesses in this. Do you think businesses have a bigger role or responsibility in educating their employees and, you know, the general public? For example, can then collaborate with specific healthcare partners to educate their workforce and, you know, justify the rationale behind their measures? 

Magda Rosenmöller: I think that's crucial. A new responsible for public health authority was appointed here in Catalonia and the first thing he said is that we need to increase the communication to the population, they need to understand why wearing masks is important. It's like anything preventive in healthcare. As long as nothing happens, people will ask why they should wear a mask especially if they don't have too many cases. Well until you have cases, and then you might have 50 or 100,000, they have so many deaths at the same time. So we need to keep that high level of alertness. And that's very difficult to do. And here, I would say, particularly the public authorities should use more social networks in doing that, to really bring that message. I know some of the VIPs, the singers, actors do participate in that. Keeping up the alertness is very important. And here I think companies play a very important role of continuing to keeping up that alertness in the company and of really repeating this is serious. I mentioned the hammer and the dance earlier. We have to be even more alert. It's much easier to close everything down, stay at home and nothing happened. And that's it, you will feel secure. But in order to allow economic development, in order to decrease the economic impact and social impact of the pandemic, we need to start and have economic activity. But then the alertness is even more important. So I think it's very important for the companies to keep that alertness up and keep that up every day and really saying 'Look, it's important to wear the mask every day and wear it on the metro. And when you are in close contact with people that you don't know'. So keeping up the alertness and the seriousness and an understanding of why do we do that. It's not that we are necessarily doing this for ourselves. We do this for the risk persons in our society, we do this for the elderly generation. And I think we have seen how important that is with the first month here in Europe, the ongoing disease in the US and also in Latin America, numbers from Brazil, of the death toll, I mean, are really, really frightening. So, yes, the role of companies very important in keeping up the alertness, the understanding of this very, very serious disease.  

Gopika Sampat: So let's focus on the positive outcome of this pandemic. It is definitely the heightened digital transformation and the use of technology. And of course, I'm saying this as I communicate with you virtually. So we at DocHQ have developed a tool called Klarity, which combines an AI-based risk assessment methodology that categorizes the company's employees into low, medium and high risk of contracting COVID and recommends a cost-effective COVID testing and monitoring solution for companies and at the same time guaranteeing employee privacy. Do you think such technological solutions will be helpful for companies in this time? How receptive do you think they will be? What is your take on it? 

Magda Rosenmöller: Well, it's fantastic you shared the information on your application earlier with me and I think it's a great tool. What I would really think is very positive is that companies like yours act so quickly. There is a need and there were companies that reacted early on in the pandemic to address these needs. There's a need, let's go, let's do it. I would really hope we can keep up this spirit of responsibility. We do something and we act. The early lack of masks for example, and protective equipment that was usually produced in China and there was no more supply chain. And companies just responded to that very quickly. So I thought this response taking is really great. And I really would compliment you for that. So that's a great thing that you acted quickly and said, 'Well, what can we do now to alleviate the crisis?' And then to the question on the usefulness, in Europe, health and safety at work, started in the 70s. So that would be how to keep the workforce safe, particularly in the nuclear field, in the coal and mining industries. Workers had a lot of respiratory diseases. In the past, companies only made sure that the workers didn't get more ill. But now, companies are asking 'Do you sit correctly on your chair?' even for safe work. Companies are wondering how they can make the workplace safer. In the last 20 years, this has moved from just being a safety at work to making sure that employees don't get ill and looking at how companies can increase the health of our workforce, how they can make the workspace a place where people like to come etc. Companies want to actually contribute to the health and wellness of the workforce and are looking at things like healthy food, gyms, issuing no-smoking recommendations etc. So, I think in that sense, what you're doing and the app that you're developing is really helping. It's helping to support the health messages and making it a joint effort and moving towards a healthier organization, a healthy workforce community, but helping with this spirit of - if I give my contribution, I will help everyone out. And I think that's where probably the app that you developed is helping. Doing that, particularly for those companies that are not so used to to do that, they probably have not been an unhealthy company, but have in the past not made so much effort of caring about the health. They have to do now, if they would like to work on and if they would like to count on their workforce. So what I see is that apps, in general, can help companies in reminding them of what do we need to do and giving reliable information for that. 

Gopika Sampat: That's great Magda. Going to my last question, from what we have seen so far if you had to sum up the key learnings from this crisis for businesses, what would that be? And how should businesses prepare themselves to deal with such trying times amidst you know, the unfortunate possibility of a second outbreak? So if you had to sort of sum that up, what would that be? 

Magda Rosenmöller: It's exactly what you said. I mean, it's not over yet. It's there. And we have to keep vigilant and keep prepared for that, in terms of learning as you said like the positive side, we are in a new normal. In healthcare, we have a rise of telemedicine everywhere. People don't want to go to the hospital because they feel it is a dangerous place. But now we are seeing that hospitals are needed for more urgent and presential treatment like surgery, X-ray treatment or things where we need to have the healthcare provider and the healthcare receiver along with the patient there at the same time. There are so many things I can actually move out of the hospital. We will probably have an increase not only in telemedicine but also all types of surveillance - like an app that helps survey chronic patients. So I think the health workforce sees that now this is possible. And I think that's an important thing that we have learned. Similar to companies, it's possible to work from home, it's maybe not ideal. Particularly we have seen all the downsides for parents that have to look after children, etc. The downside also of the confinement in terms of well, we have an increase in domestic violence, we have increasing loneliness, etc. Hereby the way, there are several apps also that look into that. But what we have learned is that the virtual world is possible. There's so much we can do from a virtual way. I had a meeting with my team last week, and it was just great to see each other so there's a human factor also that it is nice to work together in a team. Probably, we will find some way in between. There's another and we haven't spoken about that, but a very important aspect also is in terms of the relationship between science and decision making, science and political decision making, and that probably will go beyond our talk now. But we definitely have to watch that science is moving much quicker. It's less bureaucratic but less controlled as we had in the past. We can't be sure if the evidence is really the right evidence. So we have articles in The Lancet that are based on the wrong data, that had would not have happened a year ago. So there's a lot of side effects that we have but in general, I think and hopefully, science will advance quickly in terms of a new vaccination and in terms of treatment. We have seen that those countries and those politicians and probably companies also that are not listening to science and are neglecting science have actually done worse. And here, I would have mentioned the US, probably Brazil, unfortunately, UK has to also be counted on not really listening to science. So I think there is a lot to be done in the future - can we move science quicker? And I think apps like yours and other new ways of collecting data will help us to get a better understanding. Maybe one of the major flaws that we had also in the health system was that the data was not correctly available and put together in the correct way. And there's a lot of things to do and I can imagine that you will also contribute to having better data in the future so that we can take better decisions. 

Gopika Sampat: Thank you so much, Professor Magda. Our aim with these podcasts is to share the right kind of information, especially with the information overload that is happening around us, and to contribute to the knowledge sharing so that individuals, businesses, everyone comes out of this pandemic well informed and better prepared. So thank you for sharing your knowledge and your insights, and for being with us here today. Thank you. 

Magda Rosenmöller: Thanks for having me. It's a real pleasure. Thank you Gopika.