Skip to Main Content
HBS Home
  • About
  • Academic Programs
  • Alumni
  • Faculty & Research
  • Baker Library
  • Giving
  • Harvard Business Review
  • Initiatives
  • News
  • Recruit
  • Map / Directions
Working Knowledge
Business Research for Business Leaders
  • Browse All Articles
  • Popular Articles
  • Cold Call Podcast
  • Managing the Future of Work Podcast
  • About Us
  • Book
  • Leadership
  • Marketing
  • Finance
  • Management
  • Entrepreneurship
  • All Topics...
  • Topics
    • COVID-19
    • Entrepreneurship
    • Finance
    • Gender
    • Globalization
    • Leadership
    • Management
    • Negotiation
    • Social Enterprise
    • Strategy
  • Sections
    • Book
    • Podcasts
    • HBS Case
    • In Practice
    • Lessons from the Classroom
    • Op-Ed
    • Research & Ideas
    • Research Event
    • Sharpening Your Skills
    • What Do You Think?
    • Working Paper Summaries
  • Browse All
    Ebola’s Call To Arms About Disaster Preparedness
    31 Oct 2014Op-Ed

    Ebola’s Call To Arms About Disaster Preparedness

    by Gautam Mukunda
    US health care has just received a critical wake-up call. Risk management tools used to handle normal disruptions are completely inadequate to quell a major catastrophe such as Ebola, says Gautam Mukunda.
    LinkedIn
    Email

    First of all, many more Americans will die of heart attacks than will ever die of Ebola. This is not like smallpox, whose spread can only be controlled with great difficulty. The nature of the disease is that, because it can only pass from person to person through direct contact with bodily fluids, it is self-limiting. It is chiefly a disease of caregivers for that very reason. In that regard, we must give the doctors and nurses on the front lines credit for being willing to take significant risks to help and treat others afflicted with this horrific disease. There are heroes in the military, and we're seeing some real heroes in our public health system, too.

    Once we get beyond the individual heroics, however, we should be quite concerned about breakdowns of protocol in the nation's hospitals.

    Ironically, part of the problem may be the unintended consequence of scientific advancement in the United States. In the absence of having to be on alert for treating infectious diseases, American hospitals have let their guard down and their skills lapse. Partisan politics has exacerbated the problem by leaving the nation in the lurch without a surgeon general. Normally that's the person responsible for managing major public health issues, the leader with the skills to coordinate responses and put the public at ease. Absent that, the President has tapped Ron Klain, a Washington insider known for his ability to manage crises, to be his "implementation expert." We desperately need someone like that because, while the Center for Disease Control has fantastic scientists, management has never been their main skill set.

    “The goal should be to optimize to mitigate catastrophes while managing routine concerns without interruption”

    Our ability to safeguard against infectious disease is also stymied by the fact that public health in the United States is largely relegated to the states, which vary in their commitment and capacity, and none of which have the resources of the federal government. Ebola may serve as a badly needed wake-up call about something the public health and biosecurity community has been banging the drum about for years: the US has massively underinvested in public health. As in so many other areas of the nation's infrastructure, the elements of our health care system have eroded, and we need to shore them up before the inevitable next virulent disease threat materializes.

    For example, hospitals are the first line of defense in an outbreak. Yet the number of patients that our hospitals can manage with extreme cases is extraordinarily low. We have only four bio containment units in the nation specifically equipped to handle a disease such as Ebola.

    Furthermore, in the interest of efficiency, we've decreased the number of beds available for extreme cases, leaving ourselves unable to admit patients in the face of an epidemic. There's a constant trade-off between efficiency and slack capacity that seems unimportant until you are suddenly in desperate need of that slack.

    With public health, however, efficiency should not be the chief goal. Rather, the goal should be to optimize to mitigate catastrophes while managing routine concerns without interruption. That way, when resources are required, they are available. We learned a parallel lesson in the wake of the 2008 financial crisis. The risk-management tools and safety margins needed to manage normal disruptions in the market were completely inadequate to handle a major catastrophe. We got rid of the buffers against crisis in the name of efficiency, but we would have been much better off keeping them around and paying for them so that we had them to protect us.

    More broadly, people don't appreciate how valuable a lot of the government's services are until they need them. Public health is the quintessential example. If you're doing it right, no one notices. As Benjamin Franklin said, "Experience keeps a dear school, but fools will learn in no other." With Ebola, we're learning the hard way about the decline of the public health infrastructure in the United States. The time has come to take action before something even worse comes along.

    Post A Comment
    In order to be published, comments must be on-topic and civil in tone, with no name calling or personal attacks. Your comment may be edited for clarity and length.
      Trending
        • 31 Jan 2023
        • Research & Ideas

        It’s Not All About Pay: College Grads Want Jobs That ‘Change the World’

        • 17 Jan 2023
        • In Practice

        8 Trends to Watch in 2023

        • 25 Feb 2019
        • Research & Ideas

        How Gender Stereotypes Kill a Woman’s Self-Confidence

        • 27 Jan 2023
        • Op-Ed

        Have We Lost Sight of Integrity?

        • 02 Feb 2023
        • Research & Ideas

        Why We Still Need Twitter: How Social Media Holds Companies Accountable

    Find Related Articles
    • Government and Politics
    • Health
    • Health
    • North & Central America
    • United States

    Sign up for our weekly newsletter

    Interested in improving your business? Learn about fresh research and ideas from Harvard Business School faculty.
    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
    ǁ
    Campus Map
    Harvard Business School Working Knowledge
    Baker Library | Bloomberg Center
    Soldiers Field
    Boston, MA 02163
    Email: Editor-in-Chief
    →Map & Directions
    →More Contact Information
    • Make a Gift
    • Site Map
    • Jobs
    • Harvard University
    • Trademarks
    • Policies
    • Accessibility
    • Digital Accessibility
    Copyright © President & Fellows of Harvard College