Leadership, Coronavirus and Exponential Curves: Look Back to See Ahead.

 

 

(Updated, March 23, 2020)

                A vital element of leadership is the ability to see what's coming.  Since the future is inherently uncertain, that means you need to study what’s happening, see where current forces are taking your world, and make appropriate choices.  Across the globe, leaders are failing this test.  They keep waiting until the horses are out of the barn before closing the door.  In responding to the Covid-19 crisis, leaders keep waiting until things get bad before acting aggressively to curb the spread of disease. Leaders wait to act aggressively until cases in their jurisdiction start to explode.  Why wait until things get really bad?  Because exponential curves are very deceptive in the early stages if you only look at what’s happening right now. 

Here’s the curve for growth of Covid-19 cases in Italy, a worst case at the moment:

New Cases in Italy

 Source: https://www.worldometers.info/coronavirus/country/italy/

On January 31, Italy had 1 case.  Two weeks later, they only had 3 cases, not the kind of number that would cause much alarm.  You had to understand the underlying dynamics to realize that things would soon get much worse.  China’s experience taught that this virus was easily spread by asymptomatic people. In China, that led to an exponential growth curve.  The same curve would happen anywhere without containment or mitigation because no one had immunity to a novel virus.  That’s exactly what keeps happening.  The infection curves in the US and just about everywhere in Europe now look very much like Italy’s. 

To see how much leadership matters, let’s compare two countries: South Korea and the United States.  Both saw their first cases of Covid-19 at about the same time.  South Korea’s rate of new infections mushroomed within a few weeks, largely because of a large cluster in a megachurch in the city of Daegu.  But South Korea had infrastructure in place which enabled it to institute a very intensive program of testing and isolation.  About a week ago, South Korea had more total infections than any other country except China.  Now, it has fewer total cases than France, Germany, Iran, Italy, Spain and the U.S.   In new cases/day, South Korea peaked at 813 on February 28.  So far, China and South Korea are the only major countries that have bent the curve of new infections down.   A week ago on March 17, the US had about 6,400 cases, 2,000 fewer than South Korea.  Now we're up to about 42,000, while South Korea is at just under 9,000 total. The US is logging more new cases each day than any other country.  We have to hope that mitigation efforts (social isolation and hygiene) kick in soon, but given divergent approaches across the country, that is going to take a while. 

Here are bar graphs showing new infections in South Korea and the US:

      New Cases South Korea                                           

New Cases US

Source:  https://www.worldometers.info/coronavirus/country/us/

Note that the US got lucky: we didn’t see a real surge until March. But even though any epidemiologist knew that we’d soon be seeing exponential growth, we missed chances to get ahead of the curve.  President Trump's decision on January 31 to close entry to non-residents coming from mainland China probably slowed the spread, but there were already cases in the United States and many other parts of the world.   (We keep hearing stories from friends who came back from Asia or Europe and breezed through immigration with no screening.)  In February, things did not look dire: 8 cases at the beginning of the month, 62 at the end. You would only worry if you realized that we were seeing the very early stages of an exponential curve.  That curve exploded in March.   We're now seeing more total cases and more new cases/day than Korea ever saw Only after the horses were stampeding across the country did we finally wake up and try to develop a coordinated national response.  It’s still a work in progress.

In late January, at a time when South Korea had only four identified cases, health officials convened medical companies in Seoul's train station to tell them the country needed a test fast to cope with a likely pandemic.  A week later they approved one company's test, and another soon followed.  Seven weeks later, South Korea had tested more than 290,000 people, of whom 8,000 tested positive.  https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW

In the US, the president was  late to see the gravity of the threat.  On January 22, President Trump told the nation that the US had the virus “totally under control.”  On February 24, he said “very much under control,” and then, on March 16, even as new cases were exploding, he said we have “tremendous control.”  

South Korea saw what was coming before it happened, and got ahead of the curve.  The US lagged.  In a pandemic, leadership failure costs human lives.The growth of new cases is still accelerating almost everywhere in the United States (though California and Washington may be close to turning the curve down).  Leaders in many places continue to take piecemeal steps.  Florida saw its first case on March 1, and advised residents not to travel to certain international hotspots.  On March 4, the governor assured Floridians that the risk of getting infected was low.  On March 11, with nearly 50 cases, the governor announced limits on visits to nursing homes.  Two days later, he indicated that public schools would stay closed an additional week over spring break.  On March 17, with 261 cases reported, the governor announced the closing of bars and nightclubs.  On March 20, with more than 560 cases, the governor ordered restaurants to go to take-out only. By March 23, in just over three weeks, Florida had increased from one case to more than a thousand--and still growing.  That growth was predictable if you understand how exponential curves work.

No country has yet succeeded in driving new cases to zero.  After reporting no new cases on March 18, China has been reporting around 50/day recently. But many countries in East Asia have been able to keep Covid-19 spread at much lower levels.  Japan recorded its first case abut the same time as the US.  As of today,  Japan is showing 1,128 cases with 42 deaths, compared to just over 42,000 cases and more than 500 deaths in the US.

Experience, as the saying goes, is a great teacher, if we learn from it. As a leader, you need to look back and find the right way to frame or model what's happening before you can think forward.

 

 

 

 

 

 

 

 

 

 

 

 

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