We Shouldn’t Wait for a Breakthrough in the Covid-19 Pandemic

We Shouldn’t Wait for a Breakthrough in the Covid-19 Pandemic

by Gary P. Pisano - May 06, 2020

In disaster movies, there is usually a make-or-break moment when the hero turns desperation into triumph with one incredible act. As we Americans watch our own real-life disaster movie called “Covid-19” unfold, we too look toward a proverbial Hail Mary solution that will let us return to normal. We are told by expert after expert that things won’t return to normal until we have a fully effective vaccine or drug remedy, and we despair when neither appears imminent. In lieu of a medical miracle, we are told we must wait for extensive testing and tracing capabilities before we can ease draconian restrictions on our economic and social lives.

The all-or-nothing approach to solving problems makes for great theater. It does not, however, bear much resemblance to how actual big problems are solved in society, business, or science. Big problems typically get tackled through a series of small solutions, each of which on its own may not seem particularly important, but that together can have a huge impact.

While the U.S. policy approach to Covid-19 should continue to support big breakthrough initiatives like vaccine and drug development and building massive test and trace capacity, we should not ignore the potential cumulative impact of the many small things we already know how to do or might try that together could make a big dent in the current crisis. Most are things we are already being told to do (like fastidious hand-washing). Each probably just makes a small difference. But when harnessed together in a comprehensive program aimed at implementing them more rigorously, they could potentially make a big enough difference to get our economy and society functioning sooner rather than later. Getting a majority of our population, businesses, and government entities on board with these actions is the key challenge facing our public- and private-sector leaders.

What if we greatly improved the hygiene of public spaces - particularly public transportation, shopping areas, and restrooms - through extensive and vigorous cleaning? New York City just announced that it will clean its subway cars, commuter trains, and buses every night instead of every 72 hours. What if that were every eight hours or every four hours? What if showing up for work when sick was no longer a sign of being a dedicated trouper but was frowned upon? What if workplaces and schools found creative ways to reduce the physical proximity of employees through more telecommuting and staggered shifts, which would also make public transportation less crowded? What if wearing a mask in public became the social norm? What if we improved our testing capacity week by week? What if more people were willing to use apps to identify “hotspots” (even imperfectly)?

I am not suggesting these are the only things we might do, or that this particular set of actions on its own is the right one. Experts in public health can probably identify a dozen other small steps that can chip away at infection rates. My point is that to make a big dent in the Covid-19 crisis, we need to be thinking about a big set of “small” solutions rather just a small set of “big” solutions.

Medical developments, too, are often cast as all-or-nothing propositions. But here, too, reality is more complex. Big improvements in health care outcomes typically come from many incremental improvements. A vaccine doesn’t have to be 100% effective to make a big dent in a disease. (Remember, the flu vaccine typically reduces risks by 40% to 60%, not 100%.) The same is true for drugs. It is hard to think of any drug that is 100% effective for all patients. Many drugs lead to only small marginal improvements in patient outcomes. But if a disease is prevalent enough, such small improvements translate into many lives saved. And let’s remember, many improvements in medical outcomes have nothing to do with technology or drugs; they come from better patient management practices. Figuring out when the best time to intubate a patient or whether to put them on their stomach rather on their back is unlikely to make headlines, but it can lead to better outcomes. You don’t necessarily need game-changing drugs or technology to change the game; you just need a lot learning about what works and doesn’t in practice. Fast learning from experience will be critical.

The big challenge with the “many small solutions” approach is that it requires very broad participation and compliance across society and active engagement across public- and private-sector institutions. For instance, the vast majority of the population must be willing to change its behavior - always wearing masks in public, religiously washing hands, avoiding going out when sick, picking up the phone when called by a contact tracer, agreeing to comply with self-quarantine rules, using apps that help track hotspots, and so forth. Businesses must be willing to adopt new work schedules, new work arrangements, and new ways to protect workers and customers. Schools would need to alter schedules and activities to avoid crowding. Governments would have to invest in extensive cleaning of public spaces and in a test-and-trace infrastructure.

A big advantage of the “many small solutions” approach is that it lends itself to constant updating and continuous improvements as better information becomes available about what is working and what is failing. But to exploit this potential advantage, we need good information. Most importantly, we need leaders capable of responding to new information and convincing broad swaths of society to adapt. Everyone can be and must be an innovator today.

Many of the specific things I have suggested above have been criticized by various experts for not being enough. I would agree that nothing I have mentioned above by itself is going to put much of dent in the Covid-19 pandemic. But if we consider the cumulative impact of such steps, we could see real progress much sooner than anticipated. We can wait for the magic moment to arrive when the hero saves the day, or we can act now in whatever ways we can. I know which real-life movie I want to be in.

Gary P. Pisano is the Harry E. Figgie Jr. Professor of Business Administration and the senior associate dean of faculty development at Harvard Business School. He is the author of Creative Construction: The DNA of Sustained Innovation.