A good doctor might understand the disease, but it takes a good project manager to wrangle a pandemic

May 26, 2020 12:01 am

Gov. Ralph Northam speaks at a news briefing in March 2020 on the spread of COVID-19 in Virginia and the state’s response. (Ned Oliver/Virginia Mercury)

When is a good doctor not necessarily the best person to put in charge of the response on behalf of 8.5 million people to the worst viral pandemic in 102 years?

When that governor isn’t also a great project manager.

A dozen weeks into the extended nightmare that the novel coronavirus has been for the world and our little corner of it, Gov. Ralph Northam continues to struggle getting all the essential moving parts working together.

To be fair, no leader had a ready playbook for dealing with a new and mysterious pathogen that has engulfed the globe, unimpeded by a cure or a vaccine, since it originated in the heart of China late last year.

From mayors and county administrators to the heads of the world’s superpowers, each to a large extent has had to surround himself or herself with the best available scientists and public health professionals and try to build the ship while sailing it.

And to be sure, Virginia seems to have fared better than some states. As of Monday, the commonwealth had topped 37,700 cases with more than 1,200 deaths according to Virginia Department of Health data. Depending on whose numbers you believe, the daily case counts and percent positives have begun to plateau if not arc downward. (The chart on VDH’s website bore an ironic resemblance to the outline of the state.)

But the testing is a big part of the problem. How aggressive has the state been in testing and how good is the sample?

Not very, says Johns Hopkins University research. It ranked Virginia in the bottom 10 states (including Puerto Rico) for the number of tests performed per 100,000 residents, meaning that to some extent the state is flying blind.

The Richmond Times-Dispatch and The Atlantic both called out Northam’s administration for merging numbers of viral tests (those done to determine if a person is infected with the coronavirus) and antibody tests which identify people who’ve contracted the virus, recovered from it and are no longer contagious. The state stopped the practice after it was reported. But as it turns out, at least three other states and the U.S. Centers for Disease Control were doing the same thing, skewing several vital metrics and providing a misleading epidemiological dashboard that leaders use to navigate the crisis.

And, as The Virginia Mercury’s Sarah Vogelsong reported last week, state health officials still seemed like they were struggling to get their arms around the scope of one of Virginia’s worst virus hotspots – meat processing plants in Accomack County on the Eastern Shore where nearly one in every five workers tested at the plants were positive for the virus.

The administration steadfastly refuses to disclose two specific pieces of public health information: confirmed cases and COVID-19 deaths in specific nursing homes and details of a nearly $600,000 contract with a global consultancy to procure personal protective equipment for front-line workers.

The governor’s vacillation, indecision and mixed messaging over when and how Virginia would begin its phased reopening has frustrated business owners and as local elected officials.

And while recent polling suggests that Northam – a gregarious, easygoing chief executive – enjoys good approval numbers, his performance has been panned by legislators in both parties, including a fellow medical professional.

“Virginia’s not the worst. Consistently we’re in the bottom five or 10 in things like testing. But when you’re the only state with a doctor as governor, then ‘eh … not the worst,’ shouldn’t be good enough,” said Del. Lee Carter, D-Manassas.

He’s frustrated at the administration’s slow and inconsistent testing, at what he says is poor communication with legislators and at the administration’s resistance toward making public information public, particularly when it would antagonize big business.

“There’s always been this attitude within the executive branch that it’s above transparency,” Carter said. Virginia’s General Assembly, unlike Congress, has no executive branch oversight committee, and the state’s Freedom of Information Act is among the weakest in America, he noted.

Indeed, effective communication with affected stakeholders could have helped Northam avoid some of his missteps, said Mark Rozell, a George Mason University political science professor and dean of its Schar School of Policy and Government.

That was evident from his reversal on the first phase of Virginia’s incremental reopening. Northam initially insisted that all regions of the state reopen as one despite appeals from rural areas with low case counts to allow them to restart commerce sooner. As the May 15 start date approached, however, he relented after several heavily populated Northern Virginia localities as well as Richmond and hard-hit Accomack chose to delay reopening.

It was also evident as recently as Saturday, days ahead of his planned order that masks be worn in certain public settings, when he was photographed unmasked repeatedly mingling closely with other unmasked people on the Virginia Beach Boardwalk.

“One of the most important aspects of leadership is being a good listener, talking to knowledgeable people and knowing ahead of time what the likely response will be to a policy initiative. Had he been in contact with political leaders with different parts of the state, he could have avoided that trap,” Rozell said.

That aligns with a criticism from one of the General Assembly’s medical professionals, Sen. Siobhan S. Dunnavant, R-Henrico and an obstetrician and gynecologist whose practice was affected by the COVID-19 crisis.

For starters, Northam needlessly terrified Virginia’s business sector in April when he projected that the full lockdown and the stay-at-home emergency order might not be relaxed until June 10, a death sentence for many businesses such as restaurants, barber shops, salons and retailers not allowed to remain open as essential businesses.

“That was a worst-case scenario. It caused a huge amount of anxiety and fear. He didn’t look at the whole scenario, didn’t look at all of its components – the social component, the mental health component, the access to food and a stable job. He didn’t educate himself and he didn’t do a good job educating the public,” Dunnavant said.

The administration focused for too long on the wrong metrics for guiding its decisions, she said.

“We should have always been watching the percent positive,” she said. “The total number of tests was irrelevant. We now know that risk is not the same everywhere; that the highest risk is in very discrete populations” such as nursing homes, jails and meat processing plants.

Maybe what’s lacking, Del. Carter said, is that Northam and his closest pandemic response advisers are all good doctors (Health and Human Services Secretary Dr. Daniel Carey and Health Commissioner Dr. Norman Oliver) whose strength is not project management.

“I think that ultimately, what you want is someone who is willing to at least listen to the expertise of other categories of professionals,” Carter said. “If your leader is a medical professional, you want to be surrounded by good project managers, and if your governor is a good project manager, surround him with good medical professionals.”

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Bob Lewis
Bob Lewis

Bob Lewis covered Virginia government and politics for 20 years for The Associated Press. Now retired from a public relations career at McGuireWoods, he is a columnist for the Virginia Mercury. He can be reached at [email protected]