QUESTIONS FOR Vivek Goel
The innovation expert and founder of Public Health Ontario talks about leading the way through a global crisis.
It’s been quite a year for the public sector. What has impressed you the most about the Canadian government’s response to this pandemic —and what has disappointed you?
In the first wave last March and April, the response to the pandemic itself as well as the rapid rollout of support programs was very well-coordinated across the federal and provincial governments. It was very much a ‘whole society response’ and incredible things got put together in a very short period of time.
The disappointing part for me is that in my mind, the things we did last March, April and May of 2020— when drastic measures were put in place — were meant to ensure that we would be ready for a potential second wave. That included building up testing capacity and contact tracing, as well as ensuring that we could isolate people as they got sick, if they didn’t have options at their own place of work or at home. Unfortunately, none of this was put in place over the summer when we had a bit of breathing room.
It is also disappointing that there is no longer a sense that all levels of government are working together. We’ve seen increasing dissension between the federal and provincial governments, with Premiers constantly asking for things and the federal government blaming the provinces for poor results. It is a reality of the Canadian Constitution that the provinces have responsibility for health, but we’ve gone from crisis-response mode back to our traditional ways of doing things in Canada. That, quite frankly, led to the second wave ravaging the country.
In terms of all of the various restrictions placed on people since last March, many feel that the ‘cure’ has been worse than the disease. Do you agree?
Rotman Professor Kevin Bryan and I wrote an article for the Globe and Mail last October about some of the health consequences of the economic consequences of COVID-19. People have had a significant focus on the virus itself — case numbers, hospitalization rates, numbers of deaths, and so on. Much less attention has been paid to the consequences of the public health measures. You don’t have to look far to see that there has been a significant impact for many people in racialized communities, Indigenous communities, low-income populations, essential workers, and the intersections that exist between all of these groups.
Another important consequence is that lots of people haven’t been able to get non-urgent medical and surgical procedures done. We’ve seen a huge decline in visits to emergency rooms, including for acute conditions, and we will see consequences from that. We are going to see increased cancers, for instance.
On the education front, there have been significant challenges for children. Educators are estimating that some kids may be behind in their schooling by more than a year by the time we’re out of this. And just as importantly, they’re not developing their social skills. Last but certainly not least, there has been a big increase in domestic violence, abuse, poor nutrition, and foodbank use; and mental health issues have skyrocketed.
All of this is hard to convey to the public because it’s not part of the daily news cycle. I do believe that when we start to enumerate everything, we will have some significant damage over a very long period of time. In the early weeks of the pandemic, public health measures were unquestionably, absolutely necessary. What is frustrating is that we didn’t lay the groundwork to avoid it the second time around.
It’s not all bad news, though. One of the silver linings in all of this is how rapidly we’ve implemented so many different innovations that would otherwise have taken years or decades — for instance, embracing virtual technology in healthcare and education.
Vaccines are now rolling out across Canada. Do you feel like this effort is being well-managed?
The things we did last March, April and May were meant to ensure we would be ready for the second wave.
There is no doubt that it is an extremely complex task, and you can’t run a complex program without hiccups. My biggest concern is how the media, public and politicians are going to respond when the hiccups occur. Statistically speaking, there will be people who have adverse reactions to the vaccine, and there will be some who get the vaccine and have a heart attack a few hours later. It won’t be caused by the vaccine, but it will end up on the front pages and on social media. How we react to that will be very important.
There will also be people who have to stand in line for hours, and they will complain; and there will be some who get the vaccine and still get COVID-19, because even the vaccines with 95 per cent efficacy will not work for one in 20 people. It’s simple math. I do worry that as a society, we’re not ready for all the things that are going to play out as this unfolds.
Based on your frontline experience throughout the pandemic, what are some key characteristics of the best crisis leadership?
The most important thing in any crisis is always the same: communication. A good leader has to know what to communicate, as well as who should communicate it. Starting at the most senior levels, a Prime Minister has to be there to motivate people, to assure them, and to show confidence in the expertise around him or her. They need to know when to defer to the experts.
Second, leaders need to know what they don’t know and be up front about it. Our leaders decided to get some ex-military generals in to take on the logistics of the vaccine rollout, because they do that sort of thing really well. The leader has to be able to identify what needs to be done, who can best do it, support those people — and quite honestly, just get out of the way.
The third thing is being adaptable. To paraphrase Dwight D. Eisenhower, ‘a good battle plan can be thrown away in the first moments of the battle’. You need to do the planning and be ready for a wide range of contingencies, but, you also have to accept that nothing is going to go according to your plan. You will have to adapt constantly. I think where leaders fail in a crisis is when they look for a recipe book and stick to it, even as circumstances change around them.
The last thing I’ll say is that COVID-19 has really stressed our country’s crisis response system. Most people are used to crises being very defined in time — like an earthquake or forest fire that might extend for a week or two. Our systems are set up for these acute types of events. But this crisis has been unlike anything we have seen in recent decades, and as a result, it has really stressed the ability of people to continue to maintain themselves and contribute consistently. As a result, leaders have to help people step away, take time for themselves and recharge. You can’t maintain a strong crisis response with people working 24/7 for months on end. And by the way, leaders need to model this behaviour themselves, as well.
The innovation/entrepreneurship corridor between Toronto and Waterloo truly has an opportunity to shine on the global stage.
In July you will take on a new challenge as President of the University of Waterloo. What drew you to this role?
I wasn’t looking for a career change, but they laid out a vision where this role would “help define what a post-pandemic university will look like”. That really drew me in, given my background in Public Health and innovation. There are post-pandemic implications for so many things: how we teach, how research is conducted, and how we interact with our communities. One of my priorities will be to focus on the intersection of health, technology and society. I saw an amazing opportunity to bring so many of the things that I’ve worked on over the years together.
Theresa Tam has talked about the ‘boom-bust cycle in Public Health’. When there’s a bad event like SARS or H1N1, people pay close attention to Public Health. Significant investments are made, and then people forget about it and there is a ‘bust’ a few years later. We need to figure out a way to get Public Health out of that cycle — and I think that requires education and scholarship across a range of disciplines and across institutions. I hope to work on that with partners across the country.
There have been conversations for many years about the ‘innovation/entrepreneurship corridor’ between Toronto and Waterloo — and more broadly, including London and Hamilton. This region truly does have an opportunity to shine on the global stage. The Creative Destruction Lab has already helped to increase Canada’s and Ontario’s profile globally, and I look forward to continuing to work with colleagues at the University of Toronto, at Mars Discovery District and CDL to help take it to the next level. As we start to think about building a more resilient world, we have significant opportunities in entrepreneurship, manufacturing, and across the board to take this region — and our country — to new heights in terms of innovation.