Lessons learned from managing COVID-19 (Week 2)
Practical lessons learned during the second week of managing the COVID-19 epidemic in South Korea.
Phew. What a week.
To recap, I’m a crisis management specialist, embedded in a large organisation in South Korea. My role here is to help my client to structure their response to the COVID-19 epidemic. I’m working with a great team, and we’re making good progress.
In my last article I covered some of the issues we faced during my first week on the ground in Seoul. This included tracking public cases, mitigation, contact tracing, addressing employee fears and concerns, home quarantine, incident briefings, playbooks, and benchmarking. We learned a lot in that first week as we orientated to the epidemic and pulled together playbooks and templates for mitigation and response.
The work continued this week as we were hit by a flurry of suspected cases. We had multiple near misses, and I’ll be the first to admit I was sitting on the edge of my seat as test results came in to our team. It’s easy to say “so far so good”, but in our minds the reality is that it’s not a matter of if, but when, we receive news of our first case. The level of anticipation will go up even higher next week. But we’ll deal with that then.
In this article I’ll discuss playbooks and templates, managing information asymmetry, case management, internal communications, and protective masks.
Here’s our lessons from Week 2 of managing the COVID-2 epidemic in South Korea.
Playbooks and Templates
In my last article I discussed the importance of developing playbooks and templates for mitigation and response. In this last week we started “paving the cowpaths”, codifying many of the policies and procedures we’d developed on the fly in response to the events in my first week on the ground.
I recommend having a central repository where you can record policies and procedures so that you can apply them consistently to different cases across the organisation. If you deviate for a valid reason, make a note of that so that it’s clear why you deviated, and why you may need to deviate again.
It’s ok to be a bit fluid here, and iterate over time. You’ll find that some policies will be immediately apparent, for example those relating to your mitigation plans. Case management policies and procedures will be slightly different, and you’ll find that you’ll adapt and refine these over time.
As our case volume increased over this past week, having these playbooks and templates in place has made the process of dealing with different cases significantly easier (along with our “Rosetta Stone”, below). We now have tried and tested workflows that we have confidence in.
Managing information asymmetry
If you’re managing the COVID-19 epidemic day-to-day, you’ll be fully up to speed on symptoms, incubation periods, and facts like whether or not the virus can be contracted by touching a door handle. Don’t expect that everyone in your organisation will have the same level of knowledge or access to same information that you do.
While you and your team are sourcing information from the WHO or your national health authority (in our case the Korean CDC), many of your employees will be sourcing their information from their family, friends, or social networks. These may not always reliable sources.
You need to reduce information asymmetry, and ensure your employees have access to good information.
To reduce information asymmetry, you can:
- Have an employee FAQ. This is the central repository for all information relating to the virus and to key company policies. The FAQ should provide basic information, and should answer the obvious questions that most employees will have. It can also contain details on company policies, for example work from home. All of the information contained in the FAQ should be reliably sourced. Where appropriate, you should include links to official sources. The FAQ should be a living document that you build on over time as new employee questions or concerns emerge.
- Employee emails. Regular email updates are an excellent way to communicate company initiatives and protective health reminders to employees. You can adapt sections of your employee FAQ to include in employee email updates. Depending on your organisation, not all employees may have access to email. Consider using posters, messages, and announcements to share information.
- Management emails. Where employees have questions, it’s likely they will go to their managers. It’s important that their managers are sufficiently knowledgeable to respond to basic questions, and that they have access to either another resource or a hotline number they can refer employees to. You can send additional emails to managers reinforcing key aspects of policy. This is also a good opportunity to remind managers at different levels about the importance of leadership during situations like this. They have a key role in managing fear and panic.
Facilitate habit building
There will be a habit building phase at the start of the epidemic when you and your employees won’t be used to wearing protective masks, or regularly washing your hands. This is a period of vulnerability. Well-engineered messaging during the first few weeks will help to get past this period quickly, socialising good habits. To give you a sense of what it’s like here, it’s actually quite jarring to see someone outside in Seoul without a protective mask on. And yet the rate of confirmed cases here is comparatively very low.
Just to provide some perspective on this, Seoul is a city of around 10 million people. As of this morning, there were 108 confirmed cases in Seoul. If San Francisco had the same percentage of confirmed cases as Seoul, it would have around 10 confirmed cases. Of course, other parts of South Korea are significantly harder hit, particularly the “Special Care Zones”, which include Daegu city, Gyeongsan city, and Cheongdo County.
Our COVID-19 Rosetta Stone
One of the challenges we faced this last week was dealing with the many different ways that cases presented themselves. Thus far each case we’ve faced has been slightly different. We’ve analysed these cases (and others we’re aware of) and refined them into a list of typologies. We now have a list of 14 different types of cases. For each case type, we’ve outlined our response — whether we raise a case report, place the individual on quarantine, conduct contact tracing, and/or quarantine their close contacts. We’ve also included communication requirements (outlined in the next section).
This is literally our “Rosetta Stone” for interpreting different cases. This has made the case handling process considerably easier, and will eventually allow us to delegate most of the case management to a Case Management Team (yep, we’re starting to deal with so many suspected cases that we’re setting up a dedicated team to collate information and track them).
Internal Communications
Once you have suspected or confirmed cases, you’ll need to communicate.
Deciding when to communicate, who to communicate to, and what to say, has been a continual challenge. There can be a significant downside to getting it wrong, including losing employee trust, inciting anxiety, and adding to the level of fear in the broader community.
One thing we’ve quickly identified is that there’s a big difference between your first case and subsequent cases. The first case in your organisation has the potential to cause alarm amongst employees, and may even result in media attention. Subsequent cases may be treated differently from a communication perspective. Our communications templates for first cases have an additional paragraph designed specifically to address the additional fear and concern that a first case will have. We wouldn’t use this for subsequent cases.
It’s also important to segment your communications so that you address the needs of different audiences. Here’s how we’re approaching segmentation:
- Direct team members that may have been exposed. This message incorporates additional details, including shift timings for the employee that has contracted the disease. We may also include the employee’s name (more on this below).
- Other employees at the facility. Word will quickly get out that there’s a case. To prevent fear and rumours, it’s important to brief other employees at the facility. Again, you’ll need to provide some details of the case, such as work location and shift timings (this will allow employees to assess their own level of potential exposure).
- Managers at the facility. You should provide a specific briefing managers on what has happened and the actions you’re taking regarding contact tracing, quarantine, cleaning and disinfection, and communication. This ensures that managers can respond effectively to employee questions, helping to quell rumours.
- Other employees in the company. This will be a judgement call, and will depend on the case. Our current view is that we would issue a special announcement to all employees for the first confirmed case, but would not necessarily issue a special announcement for subsequent cases (instead we’d include case summaries in our routine updates).
- Third-parties. During your contact tracing, you should determine whether the affected employee had close contact with any third parties. You should then evaluate your requirement to inform their employees, or their management. This can be complicated. If you’re not sure, ask yourself whether you’d want them to inform you if the positions were reversed.
You’ll need to release these communications in sequence, starting with the facility management team, then the direct team, other employees at the facility, and other company employees, where you think that’s appropriate. Third parties would be last.
Remember that establishing a pattern of openness will help to establish trust. Some employees may think that companies will be trying to hide cases, so it’s important to reassure them that that’s not the case for your company. You’ll need to actively build trust over the period of the crisis. You’ll never know when you’ll need to fall back on it.
A significant aspect to your message is to reinforce that the company has professionals managing the situation, that there are policies and procedures in place, and these policies are being applied carefully and equitably. It’s a good practice to provide an overview of the processes you are following to respond to each case. This helps convince employees and managers that their safety is in good hands.
One of the issues we’ve struggled with is sharing the name of the employee who contracted the disease. When you have a confirmed case, you will have two options: (1) Expect the employees to trust you that you’ve conducted contact tracing and have already placed any close contacts on quarantine; or (2) Share the name of the employee that contracted the disease with them and ask them directly whether or not they recall having close contact with that employee. The approach we’re taking is to share the name verbally with only those people that need to know, and remind them of the importance of maintaining confidentiality.
Practically, if you don’t provide the name, the employees will try to find out, or will make assumptions (which could be wrong and could result in accusations and bullying). The reality is they’ll find out anyway. We manage the privacy aspects by reinforcing the importance of keeping the information confidential.
Protective Masks
Oh boy. Where do I start?
Many companies right now are ramping up their supply of masks so that they can provide them to employees. At the same time, many governments are nationalising some or all of their domestic supplies. Combined with the public buying every mask they can get their hands on, this is creating significant shortages of supply.
There is a scenario here where, as an organisation, you may not be in a position to provide masks to your employees. That’s a contingency worth planning for. It also raises a bunch of different questions regarding how you can best manage the supply you have.
From my experiences to date, here’s a few thoughts on how you can approach managing the supply of protective masks:
- Maintain a supply of masks to provide to employees working at your facilities. Not all businesses can work from home. If you’re expecting people to come to your facilities, you should provide a mask. To encourage employees to bring their own masks, you could consider providing incentives.
- Establish policies for distribution, and ensure that distribution is tightly controlled. For example, you may only permit employees to take two masks per day. Will you hand them to employees each day as they arrive or leave from work? Or will you give each employee a week’s supply at the start of the week? You may decide to have a box of masks positioned in a location in your facility, and allow employees to go there and help themselves. Whatever you decide, the key is to make sure the supply is controlled and is equitable. If you don’t establish controls from the start, your inventory may run out the door, and it will be hard to clamp down later.
- If you’re able to, don’t make the wearing of masks compulsory at all facilities. For facilities located in areas where there is no evidence of clusters or outbreaks, you can have a policy that masks are highly recommended when employees are in close proximity to each other, for example in elevators and when in meetings. Otherwise they can be optional. This will reduce the number of masks required, allowing you to divert supply to those facilities where there are clusters or outbreaks in the community.
It’s also important to provide guidelines to employees regarding how long employees should wear masks for. This can be in your employee FAQ, and you should link back to an official source. The number of masks that employees use per day will affect your supply, and is a key determinant in forecasting your requirements.
If employees are working from home, it will be difficult to resupply them with masks. You may decide that the best approach is to just have these employees get their masks from pharmacies. The problem here is that going outside and queuing up for masks will expose your employees to unnecessary person-to-person contact. If your employees are on quarantine because of potential close contact with someone who has contracted the disease, they shouldn’t be leaving their homes to get masks. You’ll need to be able to ensure they have enough masks for the quarantine period (along with masks for anyone they are staying with). These requirements must be carefully planned for in advance.
It’s also useful to establish policies for family use. Theoretically it’s good to be able to provide masks for each employee’s family, as this helps to keep your employee safe while at home. But this has the potential to place an even greater strain on your company’s supplies of masks. This may also result in concern about equitable distribution (some employees being perceived to be taking more masks than others). It’s important to establish fair policies for this up front that make sense based on the number of masks you’re actually able to supply. Again, forecasting is key.
Governments are cracking down
In South Korea, we’ve heard that the government has sent officials to factories to check on mask production. They’re even asking for information on the supply of raw materials that go into mask production. In some factories, police are on site. We’re also aware of police checking warehouses and distribution centres.
As a company, be careful about hoarding. In South Korea we have heard of one case where a company had stockpiled masks. These were identified and taken by the government.
Shutting down operations
Let’s say you do have a confirmed case at one of your facilities. Should you close your facility? If so, for how long?
I’ll use an example to illustrate some of the challenges here. On Monday morning an employee calls in and says they are feeling unwell. In accordance with your procedures, you ask them to stay at home. On Wednesday, they call in to say that they’ve gone for testing. They call in again on Friday and say that they have tested positive for COVID-19. At this point, they’ve been out of the facility for almost five working days. If you have a regime of twice daily cleaning and disinfection of communal areas, by this stage you’ve cleaned the facility at least ten times since the employee was last at the facility. What’s the value in closing the facility and conducting additional cleaning and disinfection? There’s probably none. At this point it’s a purely psychological measure designed to ensure the confidence of employees and the public.
As per our “Rosetta Stone” approach outlined above, we’ve come up with our own plans regarding when we would conduct additional disinfection, and when we would close a facility. However, the reality is that a lot of these decisions will be guided by public (and employee) perception. In many ways, the facts are secondary to how you’ll be perceived.
In fact, the majority of the risk is carried within the employee group, not with the facility. If you’ve failed to conduct proper contact tracing and quarantine employees that had close contact with the confirmed case, it doesn’t matter how often you clean and disinfect, you still run the risk of additional infections.
In South Korea, we’re actively watching other cases to see how the company responds when they have employees that test positive. We’re seeing what the precedents are, recognising that we’d probably be expected to follow similar practices. If other companies are closing down for a day (regardless of whether or not they’ve thought through the reasons why), it would look bad for us if we quickly cleaned and disinfected and re-opened the same day. People may get the impression that we’re putting the business ahead of employee and public safety.
The other factor driving this in South Korea is the limitation of the number of approved cleaners. If we had a case here, we would need to wait for government approved cleaners to come on site, which could take one or two days, particularly in the designated “special case areas”. The cleaning and disinfection process doesn’t take long at all, even for larger facilities. The main delay will be getting the cleaning teams on site.
Right now, the number of cases impacting workplaces is still relatively low and each case is getting some media attention. If cases continue to increase, eventually the public won’t even know (or care) that a specific organisation has a case and the primary focus should be on addressing the concerns of employees rather than the public. If you’re able to effectively communicate the risks, your shut down time may be minimal.
That’s it for week 2.
At this stage I’m likely to be here in Seoul until April, so expect at least a few more updates. If there are any other crisis management professionals out there doing similar things, feel free to get in touch to compare notes.
Stay safe, take care of each other, and don’t hoard masks.
If your organisation needs support during the COVID-19 pandemic, please feel free to reach out to us for advice and assistance. We can help you to implement mitigation measures, establish best practice for case management, or implement back to work plans that won’t place your employees at risk. You can learn more about what we do here.
