Pandemic –
In December 2019, a few pneumonia-like cases, later identified as a novel Coronavirus, were identified in Wuhan, China. On January 31, 2020, the World Health Organization (WHO) declared a global health emergency. 1 As the health crisis worsened and the WHO declared a global pandemic on March 11, 2020, the United States faced a nationwide emergency for which it was not prepared.
The crisis combined the supply chain and manufacturing challenges of World War II with the health catastrophe of the Spanish Flu. A whole of nation approach would be required to address the pandemic, repair the economy, and ensure national security. The crisis would require the public and private sectors to exercise new response models that could combine resources with expertise and transcend the organization-specific silos of knowledge and excellence that had developed over the last several decades. The models would focus on three means: communication, collaboration and transparency.
After a rocky start at the beginning of the Coronavirus (COVID-19) crisis, over time the public and private sectors developed a more effective approach to fighting the pandemic, realizing that partnerships based on transparency, clear communication and collaboration across organizations were critical to dealing with the overwhelming challenges posed by COVID-19. The newly emerging crisis models can be categorized as: Public-Public (internal government); Public-Private (a hybrid combination of government and industry working together; and Private-Private (industry to industry).
At the start of the pandemic, the U.S. government (USG) did not have a logical nexus for interagency coordination of a comprehensive coast-to-coast response. The USG, led by the White House, would somehow need to pull multiple USG agencies together. In particular, the Department of Health and Human Services, the Federal Emergency Management Agency, and the Department of Defense played crucial roles in the nation's federal support. The public-public model presents a discussion and analysis of how the government formed task forces and adjusted internal resources to align with expertise.
As U.S. domestic demand for PPE increased and global supply chains broke down, manufacturers could not produce the PPE that consumers needed to protect themselves. With the Strategic National Stockpile quickly depleting, the U.S. government partnered with Corporate America and took extraordinary steps to bolster the nation's industrial manufacturing base, implementing the Defense Production Act (DPA) for the first time since the Korean War. The public-private model focuses on the use of the DPA and the creation of a common operating picture to be shared between industry and the federal government to better align supplies.
At the same time, in a show of exceptional cooperation, many private firms formed partnerships among themselves to create and distribute PPE as well as medical and diagnostic products. The private-private model is the story of American business stepping up voluntarily to meet the nation's needs.
While studying the models, the authors identified many organizational, operational, and procedural gaps. The authors developed multiple observations that may inform a United States whole-of-government and society mobilization in future crisis.
Observation 1: The White House was unprepared to manage a national health emergency. The National Security Council (NSC) was not adequately organized to provide the White House with early warning and recommendations on appropriately responding to the emerging pandemic.
Observation 2: The United States' heavy reliance on offshore-produced medical material and supplies reduced its momentum to meet the increased demand for PPE. Dispersed supply chains abroad, distant sources of raw materials, and offshore manufacturing plants exposed domestic production capability gaps. The USG's lack of sufficient industry knowledge and market intelligence affected its ability to collaborate with Industry. Industry can utilize its existing facilities, established relationships with manufacturers, ordering systems, and efficient shipping networks to deliver critical products.
Observation 3: The U.S. government created synergies with Industry that should not be lost. The USG, with Industry, created tremendous national crisis management momentum. Government DPA Title III contracts drove the expansion of domestic production to mitigate the impact of crippled international supply chains as well as maintain critical defense industrial base capabilities. The USG de-risked the vaccine development process for Industry by leaning forward with the purchase of thousands of doses of vaccine in advance of the normal approval threshold.
Observation 4: The U.S. government was inconsistent in messaging. Although the USG's pandemic industrial response was as successful as it was due to collaboration, communication, and transparency, the Seminar observed several weaknesses. To varying degrees, the pandemic messaging between USG and Indu􀃶try was inconsistent or ineffective. For example, the lack of clear instructions from the federal government at the pandemic onset created confusion. It slowed the national response, including everything from the initial messaging (requirement for and ttvailability of PPE) to vaccine distribution. The lack of clarity and agreement on the federal government's role versus the roles of states, tribes and territories hampered the consistency of response. Additionally, Industry was frustrated by the USG's communication to the public. For instance, the USG communicated to the American people that it had ordered Industry to implement specific actions to increase domestic production capacity whereas Industry had already begun to work on those actions before the USG's announcements.
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