COMMENTARY

How COVID-19 could prompt a public service renaissance

As a former state public health official, watching the reactions of governors and mayors across the country to the global coronavirus pandemic is familiar.

Earlier in my career as secretary for health and environment in Kansas, I led the public health agency that worked to prepare the state for novel diseases, beginning with the SARS scare in 2003. In 2009, when H1N1 began to spread, state, local, and federal government responses sprang into action to coordinate surveillance and containment. I helped to lead Kansas’ response to this emerging threat.

The lessons of that experience are instructive as we face an even greater threat in COVID-19.

One of the most critical lessons of that experience—one we must remember and take to heart today—is to follow the science. Epidemiologists are providing our most advanced understanding of this virus and how it will progress. We need to take their guidance seriously and allow their insights to inform the decisions both public and private sector organizations make, particularly when it comes to relaxing social distancing and other restrictions. Any response will be ineffective if it is not scientifically sound.

With adherence to the best data and scientific understanding in mind, public sector officials will lead their organizations through four overlapping phases that will present unique challenges and opportunities that hopefully will culminate in a digital renaissance and leave us better prepared for the next crisis:

Reaction Phase

The reaction phase—which kicked into high gear during the week of March 9th—made abrupt changes to the way we work and live. The most important capability for the public sector in this phase is communication: with citizens, businesses, federal and local officials, and health experts.

During H1N1, this meant swiftly activating the federal incident response framework that coordinates all levels of government—bringing our Kansas health departments into alignment with federal and state activities. The ability to quickly synthesize and disseminate information to the public, and the tools to monitor social media for evidence that key messages are not being absorbed, are crucial to begin slowing the advance of the current and future pandemics.

Response Phase

As the new realities of COVID-19 set in, the reaction phase gave way to the response phase: public sector organizations began to refine and organize service delivery pathways and processes. These changes are taking place while more public sector employees are working remotely for the first time, and demands on public assistance are skyrocketing. These dual pressures are forcing a reckoning for some state and federal agencies, which may lack the technological infrastructure and support to quickly scale relief programs and expand capacity for communication with citizens.

In many cases, state governments are deploying new digital solutions to facilitate testing and contact tracing to help identify and contain the spread of the virus. Some are using chatbots and intelligent agents to reduce strain on state agencies and communicate essential information.

The states have become labs for response strategies, where we can observe the effects of specific technologies and strategies, and scale them up as needed. In Rhode Island and Massachusetts, for example, public-private-academic partnerships are helping to scale technologies quickly.

The success of these response efforts at every level will dictate how quickly we move into the next two phases.

Recovery Phase

“Recovery” has now become the focus of the national conversation about how, and when, to ease restrictions and reopen local economies. In order to strike the right balance, reopening strategies must include enhanced COVID-19 diagnostic testing capabilities, swift and accurate contact tracing, serological tests to identify persons with immunity from the disease, and finally, mass vaccinations.

The magnitude of this challenge is stark: H1N1 was halted by the vaccination of 90 million Americans. Experts project we may need 200 million COVID-19 vaccinations to achieve herd immunity.

We will also see secondary effects from the economic and social shocks caused by the pandemic. Young children are isolated from their peers and teachers, and many families are facing financial stress and food insecurity. Poverty has profound effects on children, and our public institutions will have to adapt to provide enriching experiences to support healthy development.

Other vulnerable segments of our society, including elderly residents of nursing and rehab facilities, communities of color, people with disabilities, homeless people, and the frontline workers who are keeping communities running, are facing disproportionate impacts from COVID-19, putting into sharp relief inequities which must be addressed.

The COVID-19 pandemic has shown us how connected we are to one another: how meaningful moments of social interaction are to our wellbeing, how much we depend on our public and private institutions, and how members of our communities step up in moments of crisis to help those in need.

A new age of public service and government responsiveness can emerge as a positive outcome of COVID-19.

Renaissance Phase

This final phase, the Renaissance, will be defined by trends we are already seeing, and some that have not yet taken hold. First, the public sector is already being challenged to be more transparent and responsive to customers who are more digitally connected than ever before. Second, citizens are seeking human and social services through multiple channels and on mobile platforms. Third, our human and social service systems are being scaled beyond typical capacity to accommodate surges of new users.

Looking ahead, I believe we will see a rising demand for preparedness for future outbreaks. After H1N1, our disease surveillance systems were updated to give epidemiologists better information about the presence of flu and other viruses, and in Kansas, we began a regular examination of hospital capacity to understand what the system could handle. In the future, better preparedness will mean investment in modern public health infrastructure and technology.

I am hopeful that on the other side of this crisis, we apply the lessons learned through our experiences to improve public service delivery models and help secure our collective future.

About the Author

Rod Bremby is the senior director of health and human services at Salesforce and is the former secretary of the Kansas Department of Health and Environment.

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