COVID-19

COVID-19 Case Study: How to Manage (and Not Manage) a Large, Complex Project

This case study evaluates the performance of the U.S. officials managing the response to the COVID-19 pandemic virus in relation to the textbook principles of project management. The time period covered by this evaluation is December, 2019 through May, 2020.

The proven steps (or components) of project management and the assessment of the federal government’s activities are as follows:

Step 1. Recognition of the issue (including an understanding of its impact)

Concerns about the novel coronavirus were first raised to U.S. government officials in a November, 2019 intelligence report. In December, decision-makers throughout the federal government were briefed about the virus and were told that it could become a cataclysmic event.

On January 21, the first case of the coronavirus in the United States was reported near Seattle, Washington.

In effect, the issue had been put on notice to the American public. At the time, the President choose to minimize its impact saying“We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.”

On January 21, 2020, it is safe to say that no one who had been briefed by the experts should have believed or would have believed that “It’s going to be just fine” when it came to the impact of the coronavirus. 

Without the proper framing of the impact of the key issue in a project of any magnitude, its resolution is open to doubt.

Step 2. Developing an approach

Once a leader knows the magnitude of the problem, he or she must come up with an approach for addressing it.

With respect to COVID-19, the number of cases and deaths around the world continued to worsen and, by the end of January, President Trump announced the formation of the President’s Coronavirus Task Force. He charged the Task Force with leading the United States Government response to the novel 2019 coronavirus and with keeping him apprised of developments.

The Task Force would be led by Secretary of Health and Human Services Alex Azar, and would be coordinated through the National Security Council. It would be composed of subject matter experts from the White House and several United States Government agencies, and it included some of the Nation’s foremost experts on infectious diseases.

The Task Force would lead the Administration’s efforts to monitor, contain, and mitigate the spread of the virus, while ensuring that the American people had the most accurate and up-to-date health and travel information.

Such an approach was textbook perfect, albeit criticized by some as being slow relative to the urgency of the situation. 

Despite the formation of the task force, the Administration continued to publicly downplay the import of the virus. For example, soon after the task force was formed, CDC Director Robert Redfield said “I want to emphasize that this is a serious health situation in China, but I also want to emphasize the risk to the American public currently is low.”

A few weeks later in February, this assessment was undercut by Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, telling reporters that “it’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen.” She said that hospitals and schools should begin preparing for an outbreak, and that she had even spoken to her own family about “significant disruption of our lives.” 

The reality was that by the end of February, the virus had infected more than 81,000 people globally, killing nearly 3,000. 

At that point, President Trump appointed Vice President Pence to coordinate the government’s response to the outbreak. Presumably, this decision reflected his determination that the progress of the Task Force was insufficient to address what was then labeled as a public health emergency. Given the lack of tangible progress against specific priorities, this appointment appears to have been a sound decision by the President.

Moreover, Pence’s appointment was an excellent choice given that all of the resources needed to address this issue were not under the President’s control. VP Pence had served in an executive management position as Governor of Indiana as well as in a matrix management capacity as the representative of that state in the US. House of Representatives. The states as well as private industry had important roles to play in addressing the issues at hand. Despite the criticisms regarding the VP’s lack of healthcare qualifications, this position does not require a subject matter expert. In fact, the responsibilities would be better executed by a person without subject matter expertise, but rather by a person with executive and matrix management experience.

Despite this organizational change, a comprehensive plan of attack continued to be lacking, principally because sufficient knowledge of the magnitude and contours of the viral threat had not yet been ascertained.

Nonetheless, the various participants in the process gave the public daily briefings, usually led by the President. This was a mistake. The leader of the Task Force should have headed this effort initially, and later VP Pence should have conducted the briefings after he was appointed to lead the overall effort. The person at the podium “owns the issue”. The worsening situation came back to haunt the President as the self-appointed “owner”.

These daily briefings also belied the organizational structure that had been set up to address the issue. Their effect was to shift the focus to the unrelated comments spoken by the President. Additionally, these briefings occurred too frequently. For example, they should have been timed to coincide with the completion of a key priority or an important deliverable.

The result was a lack of focus on the key issue in formulating an overall plan – namely, getting sufficient information to make an informed decision on an approach. Getting the requisite information was dependent upon getting significantly greater testing capabilities. However, there was not a systematic, integrated approach in place to completing all of the components needed to expand the nation’s testing capabilities. Rather, the number of tests needed and/or projected seemed to change daily. The support and momentum for a particular approach never gained traction. 

In a nutshell, there was no firm understanding or buy-in throughout the country of a preferred approach to confront the virus.

Step 3. Defining the objective 

The first work product in developing a project management plan is to document exactly what it is that you would like to accomplish. This objective could require the organization to stretch its capabilities, but the objective should be achievable and not require a leap of faith.

The President said his highest priorities, in addition to the aforementioned assignments to monitor, contain and mitigate the spread of the COVID-19 virus, were the health and welfare of the American people.

In the case of a pandemic virus, the personal health of individual people and economic welfare of the general public often work in opposite directions. At one extreme, the government could banish virtually all public contact to maximize personal health (but shut down the economy). At the other extreme, the government could take a completely laissez-faire approach in order to maximize the economy and employment (at the expense of millions of unhealthy and dying citizens).

In such circumstances, the underlying data describing the incidences and projections of the virus among different groups of people and under different circumstances would be crucial to know.

Of course, any such an analysis is subject to political gamesmanship. For example, Senator Sherrod Brown recently asked Treasury Secretary Mnuchin how many people have to give their lives to boost the economy. Mnuchin responded that no one should die to boost the economy.

Despite such petty politics, the lack of systematic testing of target populations has undermined the ability to gain an understanding of the costs and benefits of various approaches. Apparently, the people involved in the overall process have not recognized or tracked this priority or even established what would be needed to make it happen.

Even with the issue of facemasks which don’t produce a trade-off between health and welfare, the Administration and Task Force were not clear on their value or desirability. Notably, President Trump and VP Pence choose not to wear masks at public events. No information was provided showing the impact of wearing masks on the health of the nation. Appendix A provides an example of the type of information that would be useful to decision-makers.

Without information, any course of action taken may be the best one, or it may be the worst one, or something in between. No one knows. The stated objective of maximizing the health and welfare of the American public cannot be measured. This undercuts the ability to achieve and document a real-world success. On the other hand, failure is more stark and is told by the number of people who are sick, dead or out work because of the virus.

As the President witnessed the continued growth in the number of cases and deaths from the virus, his statements concerning the objectives and progress of his Administration increasingly veered from reality. For example, at one point he claimed that injecting disinfectants could be effective in treating the virus. More recently, he announced that he was taking hydroxychloroquine, an unproven and possibly unsafe remedy for COVID-19. Such pronouncements were distractions from the mission and a sign of poor leadership.

What the leaders were trying to accomplish was unclear to the public, particularly as it related to the trade-off between healthcare and welfare.

Step 4. Delineating the steps to complete the mission

Each component of a plan being project managed should have a detailed list of deliverables with associated dates. This list should be developed from the bottom up, rather than from the top down. 

For example, if certain members on the project require face masks, the project leader on this specific component of the plan should develop a list of activities that need to occur to get masks produced and delivered to where they are needed on a specific schedule. Each activity needs to be tracked with exceptions to the schedule being highlighted.

In the case of COVID-19, the Task Force has not offered a Gantt chart, outlining all of the steps needed to complete each input to the overall plan. From the start, it was obvious that testing was intensely needed and woefully short. In his briefings, President Trump regularly increased the projection for the number of tests that would become available in the future. But there were no back-up plans showing each of the components needed for delivery of the tests and their inter-dependencies. Not surprisingly, deadlines were missed and all other downstream priorities that relied on testing were delayed. 

Getting out millions of tests for a new disease is a major logistical and scientific challenge, but it can be pulled off with the help of effective leadership. To begin, one must understand the logistics and inter-dependencies. For example, labs need samples of the virus to create tests, the FDA’s authorization is required for using any tests, some tests require special equipment that often is not available and so on. The reality is that a tremendous amount of coordination needs to occur between federal agencies such as the FDA and the CDC, state governments, care givers in private and public settings and the private sector companies producing the requisite products.

Without a roadmap, leadership cannot be effective and the objectives will not be met. The Task Force never provided a detailed schedule and followed-up by showing that it was delivering as promised (or not).

Step 5. Assigning resources and people to the necessary tasks to get the job 

done

Once a project’s objective and the desired time frame is established, it’s time to identify the number of people, their skill sets and necessary budgetary funds to make it happen.

In the case of COVID-19, there has been very little political constraint on government spending so budgeting has not been an issue. The higher priority has been getting the right people in the right jobs. There is no factual basis to assume that this did not occur with respect to COVID-19.

Step 6. Appointment of a Project Leader

The Project Leader not only coordinates activities among the team participants, but will also have to manage expectations and changing priorities. Expectations must be managed not only upwards and downwards in the organization, but in this case, also with state governments, private companies, and the American public.

The Project Leader is on the hot seat. Therefore, he or she should be able to withstand the intense scrutiny with grace. This characteristic was best exemplified on the task force by Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, although this is not to say that Fauci should have been the Project Leader. Fauci’s expertise as a scientific advisor was his strongest suit.

As such, it did not help to see that President Trump and Dr. Fauci were not on the same page – even with respect to issues in the doctor’s area of expertise.

All of the parties need to know who is the leader, and that person needs to deliver a convincing and consistent message. Moreover, when priorities and/or deliverables change, there needs to be a clear and logical explanation. These components of project management were missing from the COVID-19 roll-out.

As slippage occurred and the death count mounted, the President distanced himself from the effort, throwing the responsibility to the 50 state governors. This was a complete abjuration of project management principles, particularly given the need for central coordination and leadership on many complex issues on a national and even global basis. 

Step 7. Communicating the overall approach to achieve broad buy-in 

Any plan addressing COVID-19 will have costs and benefits. The best approach to gain buy-in is for the leader and project members to be truthful (and empathetic, where needed). The truth has been hard for the American public to come by with respect to COVID-19. A large part of this problem is that a detailed analysis of the costs and benefits of alternative approaches has not been made available.

Even where there are proven benefits from an approach with no offsetting costs such as with facemasks, there has been no consistent communication of the desired action for people to take.

Step 8Report progress against the schedule 

The project leader must regularly inspect what he or she expects and take action accordingly, including removing individuals where appropriate and/or revising the schedule if needed. The rationale for any such changes should also be communicated.

The COVID-19 Task Force has not shared its deliverables and associated timelines with the American public. As such it is not honoring an important step in project management.

Step 9. Issue a final report summarizing findings and lessons learned

It is too early to issue a final report on the fight against COVID-19. It will probably take 2-3 years for the country to fully recover. 

But there have been some lessons learned already. For example, this experience confirms that both leadership and management skills are needed to successfully execute large projects. In cases where all of the resources are not under the control of the top person, matrix management skills are also needed. 

It remains important to let participants voice contrary opinions for consideration. However, subject matter expertise is best suited for specific roles rather than overall leadership. The overall approach should be based on a balanced assessment considering all of the costs and benefits of the available alternatives.

The COVID-19 team has a wide range of very valuable expertise. But its direction continues to be multi-directional and sometimes inconsistent. As a result, the American public is not on the same page in terms of what they should be doing. The result will likely be a strong second wave of viral infections and the public will continue to bicker about the trade-off between its healthcare and welfare.

To pursue the best available approach to COVID-19, the President should return to the structure with VP Pence (or an individual with similar experience) coordinating all of the COVID-19 issues. A high priority should be placed on getting the results of the tests that various practices (such as facemasks, social distancing, etc.) have on specific segments of the population by age, gender, ethnicity, location, etc. Similarly, the impact of such practices on the economy and the job market should also be estimated.

Once the best available approach is identified, both the Task Force leader and then the President should counsel the American people on what to do and why, and follow their own advice. They should then strive to get everybody on the same page and committed to the preferred approach.

Effective leadership and management through the implementation of proven project management techniques is essential to address the challenge posed by COVID-19. To date, that has not occurred and the death toll in the U.S. has surpassed 100,000 and continues to grow. It’s time for a change in the approach for managing this project.

May 30, 2020

Appendix A. Requisite Information for Informed Decision-making

The following information would be helpful to decide which approach is appropriate for addressing COVID-19. The Task Force leader could assign the Treasury Department to develop estimates for the economic impact numbers and the CDC to develop numbers for the healthcare impact.

Alternative Approaches

Code Green – base case; no virus

Code Blue – public awareness of threat; carry hand sanitizer or frequent hand washing; masks required in public events; 

Code Yellow – frequent hand washing, masks for all public activities, limited social events(10 people or less), 6-foot distancing outside of home

Code Red — no social activities (stay at home); stay 6 feet from people when shopping for essential items; wear masks when outside and use of hand sanitizer 

Code Green: 

GDP = 

Job Employment = 

Number of infections = 0

Deaths = 0

Code Blue: least restrictive

∆ GDP = 

∆ Job Employment =

∆ Number of infections = 

∆ Deaths =

Code Yellow: moderately restrictive

∆ GDP = 

∆ Job Employment =

∆ Number of infections =

∆ Deaths =

Code Red: most restrictive ***

∆ GDP = 

∆ Job Employment =

∆ Number of infections = 

∆ Deaths =

       #         #          #