The New Normal: The Pandemic Path Ahead for Businesses

Author: Dr. Yuchia Tsai, Global Medical Director for Health Intelligence ( Hi™) Consulting Services at Doc Privē. She is a Medical Doctor and holds a Master of Public Health in Epidemiology and Biostatistics and a Master’s in Business Administration.

The coronavirus pandemic has caused unprecedented health and economic impact globally, with African governments responding with equally aggressive countermeasures to curb its spread in order to protect their citizens and public health systems.

The World Bank predicts a -1.6% GDP growth for sub-Saharan Africa as a result of the pandemic. In this exceptional environment, organizations and businesses need to be adaptable, resilient and agile to survive and thrive in the ongoing seismic shift.

The way in which businesses should respond to the pandemic in the coming weeks and months is dependent on the mitigation strategy adopted by the countries they operate in. There are three potential risk mitigation pathways to combat the pandemic: lockdowns; herd immunity, precision testing or a combination.

Scenario 1: Business First -Herd Immunity

The pathway of herd immunity in the context of COVID-19 means infecting at least 60% of people to prevent further spread as immune individuals build up in the population. This is assuming that the immunity from natural infection is long-lasting, which has not been confirmed in the case of COVID-19. Studies have shown insufficient immunity or waning immunity after 2 to 3 months. Evidence of longer duration of immunity is still to be demonstrated.

In theory, more than 60% of the population must be infected before protective herd immunity is achieved. Assuming a case-fatality rate of 3% of 60% of the population, about 1.8% of the population will surmise . For Africa, that equates to 24 million people. However, pandemics do not stop at 60% infection exactly due to a phenomenon called the “overshoot effect” where the momentum of the epidemic drives the infection rate up to 90% of the population. Herd immunity without any active intervention or effective vaccines will result in significant health risks for the population, which in turn, will influence the economy.

Scenario 2: Health First -Lockdowns

Many countries in Africa have adopted either partial or complete lockdowns, causing major social and economic disruptions and negatively impacting the economy, causing further geo-political disruptions. Lockdowns may cause a shift in the way authorities exercise control over the civil society, requiring shifts in the boundaries of civil liberty, civil obedience and governmental control.

In South Africa the lockdown will cost an estimated R13 billion per day. Many countries will have to attempt the very difficult act of balancing protecting human life with that of economic loss. Organizations will have to, in turn, adapt to the fast-changing landscape of major economic upheaval.

Previous pandemics and predictive modelling also showed that lockdowns may only postpone the damaging effect of a potential second wave of exponential growth in infection. Until there is an effective vaccine, most countries can be expected to have intermittent partial or complete lockdowns periodically until the pool of susceptible individuals in the population have been infected . Organizations with a medium to longer-term strategy will, therefore, be better prepared for the resulting financial and operational disruptions.

Scenario 3: Keep Going -Precision Testing

Countries such as Taiwan and South Korea have employed a different strategy learned from previous epidemics such as SARS in 2003. This involves the least change to the fabric of society, allowing the economy to continue without disruptions.

The strategy deployed was a combination of early action and precision action. By testing a highly exposed, “sentinel” population: health-care workers, taxi and public transport workers, and cashiers who are exposed to large amounts of people daily, an accurate picture of the infection rate can be determined. Coupled with reduction in social contacts (cancellation of events of mass-gathering) and precise contact tracing , infected individuals can be effectively detected and isolated, stopping the epidemic where it starts.

By engaging academic and governmental facilities to utilize maximally existing testing infrastructure and expertise in Africa, the cost can be as low as $20 USD per test. The efficacy of this containment strategy is proven in Asia, resulting in low case-loads, allowing businesses and schools to continue operations as usual. This is also the most cost-effective strategy applicable especially in resource-constrained settings in Africa.

The New Normal

In the current setting in Africa, after the initial lockdown has brought time for each country to now start implementing containment strategies and incrementally return to normal, it is crucial for businesses and civil society to shape actively the direction of the normalization in the next few months.

The pandemic is expected to linger for the next 18 to 24 months until an effective vaccine can be mass-produced and rolled out. This means that any preventive mitigation will have to remain in place, at least intermittently, for the same amount of time. The supply of a healthy, fit workforce may become irregular with frequent absenteeism from illnesses and family responsibility. Highly vulnerable individuals may be required to work from home for an extended period. Supply of goods and material may be disrupted. Accelerated digitization, automation, flexible work schedule, job-sharing and telecommuting may become the norm in a contact-less future.

Businesses cannot expect “business as usual” for the foreseeable future. However, businesses need to maintain operational viability and sustainability to provide the duty of care to their employees. Businesses must comply with government regulations on safety measures and are encouraged to implement additional measure where they can to ensure safe environments for their employees and clients and to support the community they are working in. There may be requirements from authorities for proof of testing, screening and immunity at schools and workplaces. There may also be requirements for employers to provide personal protective equipment or protection for their at-risk population. Vaccine or treatment access may become a premium service in the setting in Africa with high levels of inequality.

Travel risks and country specific COVID-19 impact will have to be assessed and incorporated into travel policies as the business world may partiallyshift towards a contactless business culture. Organizations will also have to reassess their current business structure with major shifts towards repurposing, re-engaging, regrouping and reallocating. Businesses will have to repurpose their business lines and their people for the new world, reengage with their employees and customers to realign their value proposition, regroup and reskilling the workforce for the new structure and new lines of work, and reallocate resources to profit-generating lines to ensure business viability. Non-traditional collaborations with local partners and rapid digitization may assist with the agility of organizations to rapidly return to profitability.

It is also imperative for businesses to engage with the government in public-private partnerships to shape and guide government decisions and the public response to the pandemic. Corporate Social Investment initiatives can be redirected towards the funding of testing, vaccine development and innovative containment and contact tracking programs to ensure the survival of corporations and the society in which they operate. The best way to return to normal operations is to assist government and academia to contain the disease.

Additionally, in Africa, the economic upheaval has and will continue to cause age-old challenges such as geo-political shifts, food insecurity, social unrests and counter-measures from the authorities, all of which can influence substantially return normal business operation.

How has Health Intelligence responded

Being a leading healthcare consultancy with a global footprint, Health Intelligence has maintained operations by using innovative methods to overcome new, unexpected obstacles that present themselves with the evolving epidemic. In the Africa region, Health Intelligence is adept at assisting and guiding organizations through crises such as the Ebola outbreak and now the COVID-19 pandemic by providing a full suite of medical services and advisory. In sub-Saharan Africa, we are actively managing more than 50 project sites to support the Oil and Gas industry, Mining, Infrastructure construction, retailers, food manufacturers amongst other organizations with their pandemic response. This ranges from Angola, South Africa, Mozambique, Ghana amongst other locations in health monitoring Initiatives, workplace COVID-19 screening, in-depth health and consulting, customized webinars to educate employees to solutions that builds resilience into organizations during this challenging time through various stages of the COVID-19 Pandemic Curve.

Health Intelligence has been assisting organizations preparing for the pandemic and guiding organizations every step of the way, providing expert advice, practical guidelines and innovative services such as the mental health hotline, advising and procuring medical equipment, assisting in medical and security evacuation and repatriation of staff.

We are constantly adapting our solutions to adjust to the “new normal” using digital applications and medical intelligence network to guide organizations in navigating the post COVID-19 world on the physical, business strategy and psychological health front during and after the pandemic.

What businesses should do?

Organizations need to have effective immediate, medium-term and long-term plans

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Immediate response for case management and emergency protective implementations such as workplace closure, medium-term strategy of Return to Operations and workplace readiness and long-term restructuring of the organization are crucial topics to consider. As the current stage of the pandemic, there should also be a return to operation procedures and protocols to reintroduce the workforce in a safe manner. This will be a multi-step process requiring support and guidance from medical and public health experts.

Some questions that businesses should be asking at this stage:

• How can businesses safely resume operations? With carefully thought out and planned Return to Work Procedures involving internal information and communication, traveller management, case management and scientifically based return to operations procedures under the guidance of experts.

• Which employees are more at risk? Known risk factors to severe Coronavirus disease are chronic diseases such as hypertension, heart disease, diabetes and those above the age of 60.

• Should we be testing all our employees for COVID-19? Testing strategy should comply with local public health guidelines and epidemic progression. Each testing method has its own pros and cons and should be carefully structured to suit the need of the organization and each specific location with the assistance of healthcare professionals.

• How should we adapt the workplace to create a safe environment for our employees? There are basic principles such as provision of Personal Protective Equipment, Masks, Sanitizing equipment and material as well as physical space to allow for physical distancing. There are procedures that can be implemented at the workplace such as temperature screening or travel /symptoms questionnaire to improve the safety of employees. Employers have a duty of care and the Duty of Loyalty to their employees.

• How can we inform and engage with our employees and customers? By communicating regular, reliable information, businesses can prepare their employees and customers on the different stages of the pandemic. It is also important to look after the psychological wellness of the organization during the pandemic.

In the new reality created by the COVID-19 pandemic, organizations need to be innovative, agile, adaptable and resilient to respond to the myriad of challenges being supported by medical expertise in public health and occupational health. This pandemic may turn out to be the serendipitous impetus to drive meaningful, sustainable and long-lasting changes in the way business is conducted.

A long term plan shall address how Health is addressed with organisations, from employee training, accessibililty to preventive and curative care, safer workplace, etc. in preparation of potentially next similar infectious crisis / threats