Lessons from the Covid Tsunami

March 2021 marked a full year of our battle with Covid 19 in India. At Max Healthcare, this was a time for us to look back and more importantly to look ahead with confidence. Clearly, the worst of Covid appeared to be behind us. We had already fought off two successive waves of Covid 19 in the summer and in the late autumn last year, the Covid numbers were declining fast, the vaccination drives were underway and the spring was awash with hope. We believed that, while Covid will continue to bother us for a while, the chances of Covid 19 taking over our lives once more were remote.

The next 15 days turned everything on its head. We were hit by a massive Covid tsunami which inundated everything in sight. The disease was fueled by a capricious mutant virus now dubbed as the Delta virus, about which we knew very little. The hospitals suddenly had no beds, no oxygen, no medicines and no ventilators to support the relentless march of patients. They were overwhelmed, yet most of them, continued to provide great patient care and support. Their staff turned up for work, put in incredibly long hours, they added beds and managed to find supplies of oxygen and Remdesivir and ventilators. While the politicians fought amongst themselves, the leadership teams of the hospitals put their heads together and focused on the task at hand – saving as many lives as possible.

So what made this possible? Here are some thoughts and learnings.

It isn’t the beds that are important but the person besides the bed who matters – The politicians never shy of telling us how well prepared the city is against Covid 19 by citing the number of beds available for patients in city hospitals. They hardly ever bother to share how many trained and willing people are available to take care of patients on those beds. The real lesson, while handling the Covid crisis has been that the most important resource in the battle against Covid 19 are trained and resolute professionals willing to do their duty even in the face of insurmountable odds. They are the ones, who keep the flame alive. Hospitals, aspiring to fight and win against a deadly foe like Covid must have a way to keep the frontline healthcare workers and their immediate supervisors motivated and well looked after. They need to know that they are indeed the most valuable resource that the organization has and that their own needs will be taken care of and that they will be recognized and rewarded.

Those who move fast, succeed – In a crisis, agility is critical. The speed of execution is everything. Thus, the operational teams need to be suitably empowered to act fast and take decisions rather than wait for someone higher up to ‘approve’. If more beds need to be converted to Covid 19 beds, if more people need to be deployed in Covid wards, if more staff needs to be hired and put to work in the Covid areas and if they need to be paid more or supported better , the hospital operations team should have the authority to take these and more such decisions without hesitation. They should know that they have the full support of the leadership team in moving ahead fast.

Resourcefulness and Flexibility are Critical Attributes – In a crisis of this scale, we have seen the governments muddle through their policy agenda. The hospitals are often confronted with conflicting policy directives from various government bodies and they struggle to wade through the quagmire of daily changing regulations. It is thus important to build flexibility in the system and be prepared (as best as one can) for the changing government policies. One day, the hospital might be told to increase bed capacity overnight, the other day their might be an order to source medicines from a ‘nodal’ agency and another day their might be another impossible order to reserve ‘80% of ICU beds’ for Covid 19 (without giving a thought to what the hospital does with non-covid patients in the ICU). These should be assumed to be par for course and the best is to be prepared to execute as best as possible.

A Focused and Committed Leadership – The role of leadership in healthcare companies during the crisis will be evaluated by experts in the months ahead. In my experience, the leadership team contributes the best by aligning itself to the greater cause and issuing unambiguous directions for the teams to follow. It is essential that the leadership team takes and supports bold initiatives and focuses on the most critical aspects of the crisis. In the middle of April, Delhi had a major shortage of liquid medical Oxygen. The demand had sky-rocketed and it was impossible for the oxygen suppliers to produce enough medical oxygen to meet the demand. The politicians were busy squabbling amongst themselves and the courts too had jumped in the fray, with orders that were well-nigh impossible to execute. The Max Healthcare leadership team resolved that they will not allow a single oxygen related death in their hospitals. The leadership team formed a whatsapp group and relentlessly pursued their oxygen supplies. They pleaded, they yelled, they had people escorting their oxygen supplies from the manufacturer’s plants, they moved courts and pleaded with the government mandarins and they stayed awake late every night to ensure that their hospitals did not out run out of oxygen. They did not even once fail their operational and frontline teams. They remained focused and committed to managing the most intractable problem during the crisis. They led from the front.

Communication ties it all together – We often communicate what needs to be done in clear unambiguous terms. However, while this is necessary, I believe what truly motivates the teams is an explanation of why a task needs to be done. This is something that usually gets left out. In difficult times this is of far more importance because we are asking our teams to get many things done and mostly in impossible timelines. During a crisis, the hospital communication channels need to be always open and buzzing. The directions and the reasoning behind those directions should be clear and couched in a language that is easily understood. In these times, it is also important that we appreciate and communicate the good and selfless work that is happening everywhere around us. That, adds to the magic immeasurably and motivates the hospital teams to do better.