You’re listening to a press conference from the Harvard T.H. Chan School of Public Health with Leonard Marcus, founding co-director of the National Preparedness Leadership Initiative, a joint program of the Harvard T.H. Chan School of Public Health and the Harvard Kennedy School. This call was recorded at 11:30 am Eastern Time on Wednesday, May 27.
Previous press conferences are linked at the bottom of this transcript.
LEONARD MARCUS: Thanks to all of you for the work that you’re doing covering this very, very complex story. We’re now in week 11 of the COVID-19 crisis, and we mark that date from March 13 when the president declared a national crisis and the Stafford Act was implemented. There are two really important stories that are part of this crisis. One of them is the story of the virus itself. And it’s a mysterious, very enigmatic virus. It’s aggressive, it’s smart. It’s figured out how to hop into people and then for them to hop in transportation systems so that the virus in and of itself is an extraordinary story. And there’s still a lot to learn about the virus.
The other story is the leadership story. And when I’m referring to leadership in part, yes, it is the political leadership. And there’s certainly been a lot of attention to the mixed messages that are coming out of political leaders, not only from Washington, but from governors throughout the country, world leaders, how different countries are making decisions and taking actions strategically in this in this crisis. And now that society is opening up its leadership at the level of companies, we’re talking to a lot of corporations, companies about the challenges that they’re facing now. Their leadership in bringing their workforce back into the work environment, redefining what work is, how work is getting done, the mission and strategy that they’re using in trying to reopen. So the the other story besides the virus is the story of the leadership.
And what we are seeing is that in various states, governors handled and approached the COVID-19 crisis in very different ways, and it had direct implications for the cases that were found in that state. And now decisions that are being remade regarding reopening, whether the population is complying with requirements regarding masks and social distancing. What will be the impact on perhaps even an upswing in cases that we’re seeing at this point in about twelve states across the country? So there’s the leadership story. And what we’re doing at the NPLI is studying as best as possible, what leaders are doing, how they’re thinking, their strategies, what’s working and what’s not working as part of the leadership side of the COVID-19 story. And with that, I’m happy to take any of your questions.
MODERATOR: All right. Looks like first question.
Q: How common is it that in response to a a catastrophe like this becomes politicized because it sort of seems that that’s the way we’re trending. At first folks were kind of on the same page and in recent weeks, it seems politics as sort of entered it.
LEONARD MARCUS: So it’s not whether the crisis is politicized. The question is how much the crisis is politicized and then what are the implications? So let’s just compare two crises to long term crises that occurred in the Gulf Coast. First one was Katrina. And I was again, we study leaders by being with them in moments of crisis. So during Katrina, Mike Brown, who is the FEMA administrator at the time, I’d gotten to know him over the years, he had come up to Harvard for one of our NPL meetings when I was in Washington. We would regularly meet. So when when things were very, very difficult. And in New Orleans and Baton Rouge for him, he wrote me an email, said, well, Lenny, you want to study leadership, come on down. So I was there. And of course, Katrina was a highly politicized event. First off, it very much reflected upon President Bush.
And there was a lot of animosity between Mike Brown, FEMA administrator and President Bush. There is also a lot of animosity between the governor of Louisiana, the mayor of New Orleans, and the governors of the other Gulf states that were involved. So Katrina is an example of a politicized event. Another example in a second administration was the Gulf oil spill, the Deepwater Horizon, which happened under President Obama’s watch. And one of the terms that I heard at that time is that President Obama wanted to make sure that that the Deepwater wasn’t his Katrina. So spent time during that event with Admiral Peter Neffenger, who was the deputy administrator, deputy national incident commander, the commandant of the Coast Guard, Admiral Thad Allen.
So that was a very differently politicized event. And one of the problems there is there were four Republican governors of states along the Gulf and a Democratic president. In this particular case, probably history will remember this case as the most politicized of crises. The difference between the White House, their approach to it. Here in Massachusetts, Governor Baker, also a Republican, is taking a very, very different approach to communicating the crisis, to engaging with the public and then gaining compliance with his directives. And one of the ways that Governor Baker is doing that is being a good role model for wearing a mask, for the way he is personally approaching the crisis.
So crises are always politicized. And as my colleague David Gergen at the Kennedy School will say, you know, a crisis can make it or break it up for a political leader. And many political leaders aren’t aware that they will be responsible in their tenure should a crisis occur. No political leader runs for office so that they can be in charge during a crisis. However, it’s absolutely critical for them to be ready when a crisis hits. And here in Massachusetts, we studied the Boston Marathon bombings in depth and certainly had the opportunity to to interview Gov. Deval Patrick and Mayor Tom Menino. And yes, there were political aspects to that crisis. And in that particular case, an example where President Obama, the governor and the mayor were really working together as a team. So every crisis is political. This one has taken its own flavor.
Q: Clearly, leadership matters in crises. But I wonder if you could talk a little bit about to what extent can these considerations at a very top level affect the what eventually happens? I’m wondering because, you know, you have sort of the people on the ground who will probably be the same people crisis to crisis. Do they somehow manage to muddle through regardless of the kind of – do they tune that out and sort of do what they have to do regardless of the machinations at a higher level? Or does that really make a big difference in response effectiveness?
LEONARD MARCUS: So thank you for the question. And I’ll just state for the record that the NPLI, when we were established in 2003, we made a decision that we were going to be non-partizan. So we’ve worked with the Bush White House, the Obama White House and the Trump White House. And so we’re very intentional about not getting caught up in the politics so that we can stick with what our belief is, which is that a crisis by its very nature, at its core, should be as non-political as possible, which is to say, lives are at stake. The responsibility of any politician at that time is do everything possible to save lives, to protect property, to protect the welfare of the population, and then create conditions in which a recovery can take place and that the population is resilient. So whether Democrat or Republican, that is the responsibility of a political leader in a crisis.
Now we teach a model called meta-leadership. So the prefix meta means look at a problem from a very, very wide scope. And so what you’ll often find in a crisis is there will be a FEMA administrator, so subject matter expert. And when we’re talking about meta-leadership, we say you have to lead in multiple directions. You lead down to your subordinates, you lead up to your boss. You lead across to other people within your organization. So for FEMA, that would mean other components of the Department of Homeland Security. And you lead out to the private sector, to other governments, to state governments, local governments. So as a meta-leader, you’re leading in multiple directions. So one important element of that is a subject matter expert. You’re leading up to a political leader. So that’s always a consideration. And the best of these subject matter experts will tell us or we’ll study them. And they’ve led up to a Republican elected official or a Democratic elected official.
And in a case like that, you want to establish a relationship very early on so that you have a good working and personal relationship with the elected official. And it really depends on the priorities of that elected official. For example, I mentioned the Boston Marathon bombings earlier so that Governor Deval Patrick had a lot of experience with crises here in Massachusetts with floods and other crises that faced. He was in his seventh year, so he had good working relationships with the people who were leading up to him. And, you know, one of my favorite lines from from Governor Patrick in that crisis was he said to the operators, to the people who are running the different departments, let me know how I can help you do your job. And so he didn’t interfere with them. But his job as an elected official was to do communication, to make overriding decisions, for example, to close the city of Boston on the Friday when there was a manhunt going on for the younger of the two brothers who committed the terrorist act. So that relationship between subject matter experts and political leaders is a complex one. And in the best case scenario, the political leader is following the advice of the subject matter experts and the subject matter experts are following the priorities of the political leaders. And in the ideal world, they align so that everybody’s working in the same direction. Does that answer your question?
Q: Yes, it does. Thank you.
MODERATOR: Great. Next question.
Q: Hi there. I wanted to just talk to you a little bit at personal and ask you if one of the 12 states you’re studying includes Florida.
LEONARD MARCUS: We’re not specifically studying Florida. I will say that we studied Florida as Hurricane Dorian was coming into your state last September 1. But we’re not specifically studying Florida, but certainly keeping a watch on that as one of the, you know, as one of the states where this has been a question.
Q: Interesting. OK, well, so you watched what happened with Hurricane Dorian. One of the things I wanted to ask you about is as reporters, we are struggling with what appears to be information that’s very managed from the state. We have, you know, the state has pretty broad open records laws, but they’re not presenting us with the records. We need them in a timely way to sort of hold government accountable.
I know this is not unique to Florida. It’s certainly happening in other states and on the federal level. But the question of the amount of trust we should put in data and information about where the state is in terms of its testing as we continue to reopen. The governor has made a really, has really emphasized that they are data driven and even shows up at press conferences with maps, you know, with like Governor Cuomo has with, you know, charts and graphs, but when we ask for the data to define that and ask him to defend it and allow us to challenge it or just verify it, we can’t get to it.
And it raises a question in my mind about what is the calculation for leaders in terms of being open in a crisis and transparent and sort of managing it, too, so that the public can trust you, if that makes sense? Because I think there’s a disconnect in Florida between what they’re telling us and what they’re not telling us. And I wonder if it’s more effective for leaders to say, here’s what we don’t know. So I’m throwing a lot in there. Love your thoughts.
LEONARD MARCUS: Well, that’s a really good question. And we have been watching from a distance that the person who was responsible for reporting, I think, just left her position correct.
Q: Well, that was the dash, yeah, the dashboard creator. Yeah, there’s been a little bit of a dust up about that, but we have observed this and more than just the dashboard when it comes to other data sets and things like that. So.
LEONARD MARCUS: Well, there’ve been many casualties in this crisis. And one of the casualties has been confidence in the validity of the numbers that are being shared by the government. And that is a very significant casualty when we’re talking about a crisis that hits so personally and communities so personally to individuals and families, that the data – there’s not confidence in the numbers that are being presented. There’s a lot of controversy, for example, on what to count as a COVID death and what not to count as a COVID death. Those are the kind of things that you want very, very standardized, so everybody’s operating from the same definition and that we can believe and trust the numbers.
If we can’t believe and trust the numbers, there are several problems. Number one, in a crisis such as this, we, society, we rely on the compliance of individuals to stop the spread of the disease, just like in Florida, when Hurricane Dorian was happening, there was a call for an evacuation and people complied. There was extraordinarily high level of compliance. Not everybody, but there are a lot of people that moved inland fearing that the hurricane was going to hit the shore and that compliance is critical to the management of any kind of a crisis. So truth matters and truth has been a casualty. And so it’s, number one, difficult to get the compliance of the population if they don’t believe what they’re being told or if they’re getting different versions. But the second thing is it’s difficult for policymakers to make sound scientifically based, data driven decisions if there are questions about the validity of the science. And then finally, for researchers who are trying to track this disease and provide data driven answers and theories about what’s going to come next, it’s absolutely critical that we’re all operating from the same data set.
You know, another one of the crises that we studied was the H1N1 in April 2009. And Dr. Rich Besser was the acting director at the CDC. And the first Sunday of that of that crisis, there was a press conference at the White House. Secretary Napolitano spoke to National Security Council. Homeland Security Adviser John Brennan spoke and Dr. Rich Besser spoke. And, you know, one of the things that he did, which was so critical in a public health crisis at the very outset, is to say this is what we know and what we’re doing about it. This is what we don’t know and what we’re doing to learn more. And he talked about the epidemiological investigations that were going on. And the third thing he says, and this is what you should do as the public, you know, cough into your elbows, don’t go out if you’re sick. And about two and a half weeks later, one of our colleagues here at the Harvard School of Public Health did a public opinion survey to find that there is an 83 percent confidence in the federal government in the handling of that public health crisis.
And in part, it was because people believed what the CDC was telling them. The CDC constantly was updating their advisories. So Dr. Besser said, you know, please continue to pay attention, because as we learn more about this H1N1, we’re going to be changing our advisories. And one of the things that they learned in that event was that it was particularly fatal for pregnant women. So as soon as they figured that out came up with that science, they made announcements to clinicians to be vigilant in regards to pregnant women. And they’ve been announcements to the populations that pregnant women would be particularly careful.
And so that kind of here’s what we know, here’s what we don’t know, and here’s what we’re doing to learn more actually instills confidence in the public. But if they hear that there’s discrepancies in the numbers, if they’re controversies about who is a covered fatality and who’s not, that only foments confusion. It makes it more difficult to get the compliance necessary from the population and from a leadership perspective, that’s one of the weaknesses of what we’re seeing going on right now across the country.
Q: Just as a follow up, if I may. Have you found that some leaders or governors are more effective than others in getting compliance and I guess my two, what do you attribute that?
LEONARD MARCUS: I’m not going to speak to a particular governor. In general, though, the answer is yes. And what we are finding is that some of the governors are really paying attention to the data. They’re very data driven. The other thing that they’re paying attention to is the experience of other jurisdictions. So early on, there were governors that had to make decisions about enforcing the stay at home social distancing rules. And there was a correlation between when the governors issued those rulings and the cases per million that were found in those states. So that’s certainly been a significant difference.
I’m looking at the experience of others driven by the data and then the extent to which the governor serves as an example of this is the behavior that we expect of you and these other behaviors that I and my family are doing myself. Role modeling is an important way of influencing the behavior of followers. And so that certainly has also been a very significant difference across the country. I’ll give you one example, just, you know, Governor DeWine in Ohio with Amy Acton as the health commissioner there. And, you know, she was very, very focused on the data. She did an extraordinary job in leading up, subject matter expert to a political figure. He became very engaged in that and made one of the early decisions about restrictions in the state of Ohio. So that’s an example of how it can work in that subject matter to political leader interface.
Q: This is very helpful, I want to mention I have watched and compared Governor DeWine as well. And I think that it has struck me that he has been very willing to kind of go ahead of the CDC, which has that’s been different. I mean, he’s been bolder in many ways. And I watched every governor. But what has happened in Florida is, and this may be a political decision, but our governor never wanted to do anything that wasn’t already CDC guideline, even though, you know, the CDC was much more – it was more voluntary in many ways before it became a requirement. And Florida just would never get ahead of that. I think that is partly because he didn’t want to show Donald Trump, who is a mentor of his, that he was countering him in any way.
LEONARD MARCUS: Right. Well, and when I when I think of Florida these days, what’s most on my mind is putting together what if a Hurricane Dorian were to be headed toward Florida while we’re in the midst of this COVID-19 crisis. And it reminds me, during the Deepwater Horizon, a hurricane was headed toward a New Orleans. And so it’s difficult to handle a hurricane. It’s difficult to handle a big oil spill. The combination of those crises were a real challenge for the White House and for people on the ground. Similarly, COVID-19 will have to rewrite the books on shelters that are established during hurricane assistance and evacuations to vulnerable populations. And I know that in Washington they’re rewriting the books when it comes to preparedness for hurricanes and other disasters. And certainly Florida, with the hurricane season upon us soon is one of the places that has to really be paying attention to the combination of two crises at the same time.
Q: That’s an excellent point. You know, who knows where this is going to head. I do wonder if there, you talked about the the casualty being public confidence and trust. And how does that play out if we’ve got, you know, people having less trust in their government when their government is telling them now to, you know, shelter in place or or evacuate?
LEONARD MARCUS: Well, so that is the question. Which is to say in the Hurricane Dorian example, and, you know, here is an example and there are a lot of parallels to COVID-19, where NOAA, National Oceanographic and Atmospheric Administration, believed that their hurricane was headed straight to Florida. And then the hurricane did something that was unpredictable. It just stood in place. It just got stuck over the Bahamas. And, you know, in talking with people that were looking at that in the moment, one of the things that fascinated the meteorologists is that it was just rare to see a hurricane just get stuck. They’re always moving for a whole set of factors, the rotation of the earth and the jet stream. Hurricanes always move in. Here was one where all of those forces, for an odd reason, came together pushing and pulling so that the hurricane tragically was stuck over the Bahamas and then didn’t go on the path was predicted toward Florida.
So here you’re asking the population to evacuate. It’s difficult. And then the crisis doesn’t present as it was predicted. Similarly, there’s the credibility of leaders saying, look, COVID-19, is coming to our community. You’ve got to shelter in place, wear masks, social distance. So you’re asking the population to comply with those sort of considerations. You know, the problem with two crises coming in at the same time is if there is a hurricane, if people do evacuate, if there are shelters, they don’t social distance. Now, you’ve got the problem of a post-hurricane and you’ve got the problem of COVID-19. The better that leaders plan for, strategically plan, you can pretty much predict that that confluence is going to happen in this hurricane season. So you have to be ready with the contingencies before it happens.
Similarly, when we were back in January, one could have predicted here in the United States that we would need ventilators and masks and personal protective equipment because we could see what was going on in China. And we knew that there were people who were coming from China, including repatriated American citizens. People had already come from China. People were coming from Europe. And that we could predict that we are going to see many cases here in the United States. And in some ways, we were lucky. We got a warning. We could see what it looked like in Wuhan. We could see what it looked like in Italy. And we knew that it was going to one day be here. Now, thinking back then, what were we all thinking in January? Oh, gosh. I can’t imagine what it would be like to live like those poor people in Wuhan or those poor people who were sheltering in place at home in Italy. But it was predictable that it was going to happen.
So the responsibility of the leader is not simply to manage what’s going on today. It’s to say there’s a good chance that we’re going to have this confluence of crises in the future, what can we do today so that the day that we have to reach for the ventilator or reach for the masks, there will be an adequate supply there. So, for example, now it’s going to be critically important working with the Red Cross and other organizations to prepare for what will the establishment of shelters, evacuation shelters look like in Florida while we’re still in the midst of what even could be a rise in COVID-19 cases, as many modelers are forewarning about the fall.
Q: Really good points. As long as I have you, if I could ask one more question about the kinds of messages that people respond to best in a crisis. You know, I’m just wondering what we’ve you know, it just seems to me there’s a lot of people that sort of thought, well, this will never happen to me. Kind of dismissed it. There’s that group of people and then there’s the others that were just so paranoid and frightened that they were sort of immobilized and couldn’t do anything. And there’s then the middle ground of everybody sort of analyzing the risk and people coming to a conclusion about what risk they have.
And I’m I think that happens with every crisis, you kind of, people do the assessment of what’s going to happen, you know, what’s the risk reward equation here? And we had an interesting moment when this crisis was beginning and we had the first cases in Florida, the legislature was in its final days of its two month legislative session, and legislators pretty much ignored it. They just nobody was taking precautions. The word was out that social distancing is what you should do. And they continued to operate as if it really didn’t affect them. So their role modeling was, it doesn’t matter to us, we’re not going to get hit.
And I’ve watched that same sort of approach happen to a lot of leaders in the states. Now different – it wasn’t the case in Miami because Miami got hit so hard that everybody believed it was going to. It was a possibility that that’s something that you could be infected. We even had the mayor of Miami test positive. So I guess I’m wondering, what are the – how do you translate a message in an effective way so that people do the right thing that you want them to do?
LEONARD MARCUS: So that’s a really important question. And there are two sides to the answer. One of them is you’ve got to give them the facts and there’s gonna to be evidence based on the facts. And they’ve got to believe that what you’re telling them is true, which even includes telling them that there’s some things that we don’t know. But if they believe that you’re giving them the facts and the evidence and that it’s data driven, that buys you a lot.
The other thing that leaders do in a crisis is active empathy. So people who are in the middle of the crisis are suffering. And, you know, the best of political leaders and the best of agencies and corporate leaders have empathy for the difficulties that people are experiencing. And they don’t simply say, I really feel sorry for you or they read a script, my condolences to the family. It’s genuine. And, you know, when people are going through a hard time or someone has lost a loved one, there’s nothing that a political leader can do to bring that loved one back.
But if people believe that actions are taking place so that the suffering won’t be extended, so that something is being done. Actions are being taken. Strategies are in play. So that while I might have suffered or I might have lost a loved one, activities are going on so that, yes, you feel sorry for me and you’re doing something to make sure that this doesn’t happen again or you’re taking action so that this crisis will be abated or that it will come to an end or that there won’t be more suffering. So it’s not simply the – people have said, for example, about active shooters, which I know you’ve also had in in in Florida. It’s not you know, we don’t want your prayers. Yes, we want your prayers as long as they’re attached to doing something. And that’s why I call it active empathy. And that active empathy buys a lot of credibility and confidence and compliance from the population. Those are exactly the things that you want in the middle of a crisis. You want that confidence. You want that compliance. And you want people to be resilient. So for a leader to give facts and data and evidence combined with active empathy goes a long way in being able to bring your population along, not only for today.
This is going to be a long tail crisis that we’re experiencing right now. And one day we want our states and our cities and our country to be resilient. The process of resilience doesn’t begin on the day when everybody is vaccinated. The process of resilience really begins today. And if people have confidence in their leaders and in their institutions and in the viability of those institutions, we will be resilient. And if people lose that confidence, that’s going to make being resilient, our economy resilient, our country resilient, our standing in the world, that will make it all the more difficult to build that kind of resilience.
Q: Superb. Thank you. It’s very helpful.
MODERATOR: So, Dr. Marcus, I have a quick question for you. So we’ve been talking about very large things like the Deepwater Horizon, hurricanes hitting, pandemics. Do you have any advice for small business owners and how they can take some of the knowledge that you have, some of the lessons you’ve learned and then apply them to small organizations and smaller groups of people?
LEONARD MARCUS: Oh, so that’s a good question, I just got off the phone talking with someone who was a business owner of multiple businesses, actually. So the question is really how do you build the resilience of the business? Because with few exceptions, businesses have really taken a hit one way or the other. Even if they’re very, very busy, they’ve still taken a hit on their bottom line because leading and operating through a crisis is expensive. I mean, if you think of grocery stores, they’re having to provide personal protective equipment to their workers. They’re having to do a lot more cleaning. It costs money.
So if you want your business to be resilient, step one, be loyal to your workforce. Protect them, inform them. Be honest with them, because the viability of your company really depends on the viability of your workforce. So whether we’re talking about a retail store or a restaurant or a service company, if your workforce feels that you’re going to make them safe, that’s the first step. And especially if you’re a public facing company, like a restaurant or a service organization, that if you want them to convey to your customer base that we’re treating you carefully and we’re concerned about your health and your safety, that they have to make sure that their employer has done the same thing for them. In talking about offices, technology companies or other offices where people are sitting at their desk and working, you know, that comfort to know that your employer is concerned about your health and safety and has done everything possible to to assure that.
I think one of the things that every company has to be concerned about is you don’t want to be that company that was a super-spreader. There is the story of a hair cutting salon in Missouri where one of the hairstylists was sick at work and got another one of the hairstylists sick. And at last count, there are one hundred and ninety one people who tested positive from that one workplace. Well, that that’s a terrible thing to happen morally and ethically. It’s terrible for business. So, number one, ensure that your workforce is healthy. Ensure that they bring that same standard to the people that they’re interacting with. And go step by step slowly, because at the end of the day, you want a resilient business and you’re only going to be resilient if step by step, you’ve been careful in protecting the people who are looking to you and have confidence in you as their leader.
MODERATOR: Thank you. Looks like you are pretty quiet today. Are there any other topics that people have been talking with you about that you’d like to address? If there’s any common themes that you’ve been seeing coming through your inbox,.
LEONARD MARCUS: Oh. that’s a question to me?
LEONARD MARCUS: Well, I mean, I’ll say we study leaders and we teach leaders. And, you know, I think one of the fascinating themes is that, you know, many people who are in leadership positions, for example, in academia, in universities or in schools, in general companies, they were going about the business of running their organization. They never really thought of themselves as a crisis leader. And one of the things that people have talked with us about and one of the surprises that they’ve had as they’ve looked at their experience through this and everybody’s got a story, is that I think there’s just a general recognition in the world of leadership that every leader one day could be a crisis leader and that it’s critical to be ready for that at any time.
As I said in my earlier comments, that when a political leader comes into office, one part of their briefing and their preparation is preparing them for a crisis. So even before President Trump took office, after he was elected, they went through a crisis scenario with him and with his senior team. So just as a president or a governor or a mayor needs to be ready for a crisis on their watch, so to the leader of any organization or any company, a school, a business has to be ready for what if a crisis hits on my watch watch. And I think that that’s turning out to be one of the lessons, because whether anyone likes it or not, this crisis has affected everybody, affected every business and every organization. So the resilience, the ultimate resilience.
And that’s one of the questions right now. What organizations are going to survive through this? And what organizations are not? A crisis is an opportunity. It’s an opportunity to change and to adjust and to become part of the new environment that we’re going to be living in in the future. So this is the time for that adaptation. So in many ways, what COVID-19, the lesson of COVID-19 for people who are leaders is that every leader has to be prepared to be a crisis leader one day.
This concludes the May 27 press conference.
Paul Biddinger, vice chair for emergency preparedness in the Department of Emergency Medicine at Massachusetts General Hospital and medical director for Emergency Preparedness at the Hospital and Partners Health Care (May 26, 2020)
Michael Mina, assistant professor of epidemiology (May 22, 2020)