Strategy and the COVID-19 pandemic

Residents and workers at U.S. nursing homes and long-term care facilities have accounted for a staggering proportion of COVID-19 deaths. The prognosis is particularly poor for elderly individuals who contract the virus. Around 80 percent of U.S. COVID-19 deaths have been among people 65 and older, according to the Centers for Disease Control and Prevention. These numbers highlight the failure of government officials to think strategically.

The disease is particularly lethal to older adults with underlying health conditions and can spread easily through facilities where many people live in a confined environment and workers move from room to room. Because of residents’ close proximity, these places are alike petri dishes for the coronavirus. At least 50,000 residents and workers have died from the virus at U.S. nursing homes and other long-term care facilities for older adults.

This figure may be understated because states differ in how they report deaths of residents in long-term facilities. For example, some do not include incidents of a resident dying in a hospital.

The lack of a national strategy to ramp up COVID-19 testing in congregate care facilities and to provide protective equipment to staff made it easier for the virus to spread in these densely populated settings. State decisions to transfer recently recovered COVID-19 patients back into long-term care facilities also increased the risk to this population. New York State, for example, mandated that nursing home facilities admit actively ill COVID-19 patients.

Despite early warnings based on fatality rates in China and Italy that people over 65 were the most vulnerable to the novel coronavirus, the national and various state strategies for dealing with the pandemic had major shortcomings.

Successful business people understand that strategy is about making choices, such as who is the target customer they wish to serve. Additionally, they understand that a firm’s resources represent the critical building blocks of a successful strategy. They determine not what an enterprise wants to do but what it can do.

Equally important, they recognize that resources are finite. Resources don’t spring full-blown out of Zeus’ forehead. Put simply, a key responsibility of leadership is to identify, build, and deploy resources in pursuit of business goals to provide value to the target customer and adjust as market conditions change.

Brand-obsessed leaders at every level of government have to be honest about clearly defining at-risk populations and allocating scarce resources to protect those people. In the case of COVID-19, that means the elderly and those with underlying conditions. For example, knowing that nursing home and long-term care residents and workers are most at risk, a targeted strategy would have allocated finite resources such as testing, protective equipment and other medical supplies to this vulnerable population.

Strategy is about making hard choices with imperfect information. Anyone running a successful enterprise understands that trade-offs matter. Leaders have to make choices about what they will do and what they will not do based on facts and the reality of limited resources. This requires them to choose carefully among available resources and sensibly allocate them to the problem at hand.

Another challenge when it comes to developing a successful strategy in a competitive environment is not to confuse means with ends. You can’t have everything at once, so your goals should be realistic and feasible, not pipe dreams. Words to live by.

You would be right to conclude that U.S. political leaders could have done a better job of protecting the seniors who are most vulnerable to the coronavirus. They were left exposed by the failure to develop an intelligent strategy. Americans can only hope those leaders have developed a realistic strategy to protect seniors if a second wave of the virus comes in the fall. It’s better to go too far than not far enough when it comes to protecting the most vulnerable in society.

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