Lessons on leadership during a pandemic

RCPI President, Prof Mary Horgan, outlines what the past two years have taught us about managing a public health crisis

As someone in a leadership role, one of the first lessons I had to learn during the early stages of this pandemic was one of humility. While I am a specialist in infectious diseases, with a good knowledge of virology, this was a totally new virus causing a totally new disease, and there weren’t any experts. When that happens, you have no choice but to be humble, because as we’ve seen over the past two years, every time you think you’ve got it figured out, the virus changes the game plan and you must be ready to change to match. 

So, while we may be experts in a particular area – whether you’re a public health person or you have experience in crisis management – this constant change of direction makes it extremely difficult to predict what will happen next. 

Collaboration 

The pandemic taught us all a lot about the importance of collaboration. Firstly, there was a huge collaborative effort between colleagues within Ireland. People from a wide range of specialties and sectors – virologists, infectious disease specialists, public health doctors, and microbiologists and policy makers – working together towards a common goal. 

Secondly, and perhaps even more significantly, there was unprecedented collaboration on a global scale. At one point – due to the way the virus travelled from East to West – we knew more about Covid-19 here than they did in North America. Because of this, it was crucial for us to share the knowledge as we got it and this is something that I feel we did well as a College through our webinars, sharing state-of-the-art information on best practice for clinical care as the science continued to evolve. 

As Irish people, I think we take for granted the worldwide network that we have available to us. There is an extensive Irish diaspora stretching across medicine, science and research and thankfully we were able to make those connections and leverage that invaluable resource, both from an educational and from a research point of view. Though we are a small country, that collaboration and connectivity allowed us to contribute to our shared knowledge at a global level. 

When it comes to preparing for future potential pandemics, there is no doubt that we must continue to strengthen those links with our neighbours in the UK and the EU. As part of a union, we have all enjoyed the benefits of looking at a larger block when it comes to research and innovation, particularly in the areas of variant surveillance, whole genomic sequencing and communicating to the population. 

Similarly, I believe that the EU can learn from Ireland’s very successful vaccination programme. We had one of the greatest vaccine uptakes in the world and, for me, this came down to us having an educated population who believed in science. The public saw the benefits of vaccination very quickly and knew it was our way out of some very difficult times for the country. People really did work together towards the greater good because everything we did in the pandemic, whether it be testing, vaccination, masking, or social distancing, it was never just about one person. It was always about the common good. We were protecting those vulnerable in our families, our friends, our communities, and ultimately, the country. 

Good leadership is about compassionate communication, understanding, and a willingness to listen. There were a lot of difficult messages that had to be delivered during this pandemic, but at the end of the day, there was trust in the public to hear the message. I think that’s reflected in where we are now, in that we are one of the first countries in the world to be able to lift most public health restrictions and that is down to people buying into what needed to be done. 

When it comes to preparing for future potential pandemics, there is no doubt that we must continue to strengthen those links with our neighbours in the UK and the EU 

Collective response 

While Covid-19 is predominantly a health issue, it also has a major impact on how we live our lives, both individually and as a society. So it was crucial that our collective response took both the economy and public health into account. If you don’t have a healthy economy, you won’t have a healthy society. A cross-sectoral approach is key when you are dealing with a virus that impacts everyone. 

There wasn’t a day went by in the past 22 months that people didn’t speak about Covid-19. It was the first thing on everybody’s mind. But once we started getting more and more knowledge about how to treat patients acutely in hospital and then especially when we could prevent infection with vaccinations, things started to change. 

To me, integrity and independent thinking are really important features of leadership. It is about doing the right thing and one thing I have learned is that if you follow the science, you won’t go too far wrong. The science will dictate the direction of travel and good science always does that. You follow the science and change direction as you need to. I also think it is essential to listen to those that are on the frontline, because they are going to be the first to sense the ground shifting, for better or for worse. 

Whatever the message is, I believe it’s important not to come out too definitively on it because you could say something today and the next day everything could have changed. Even though people wanted certainty, there aren’t really any certainties in life, and especially not during a pandemic. 

Another reality we had to confront is that there is no such thing as zero risk, just like there’s no such thing as zero Covid. It’s just not possible. Communicating that message was tricky, but the Government plan was always to minimise that risk as much as possible. 

Reflection 

When it comes to looking towards the future, it’s going to be about using the tools that we’ve developed, and reflecting on the lessons that we have learned, to make sure we are better prepared for whatever is coming over the horizon. We must keep on collaborating at the EU level; continue using that global network we have as Irish people; and keep doing the right thing, even though not everyone may agree it’s the right thing at the time. Ultimately, if it’s for the good of the country, then you can bring people along and I think the eventual success of the antigen testing programme was a good example of that. 

What we learned in this pandemic is that the vast majority of people can be trusted to do the right thing in a crisis. They were doing the right thing when it came to those non-pharmaceutical interventions, they did the right thing when it came to vaccination, and they did the right thing when it came to testing. 

I hope that we can leverage the important lessons that we’ve learned from this difficult time, especially that when you empower people to do the right thing, they rise to the challenge. We just need to give them the right information and that information is always based on science. I think we have shown that if you get the right information communicated in the right way, the people will step up. 

Prof Mary Horgan is the first female President in the history of the RCPI and is in her second term. She is a Consultant in Infectious Diseases and practises on the frontline in Cork University Hospital. A new portrait of Prof Horgan by the artist Jack Hickey was unveiled at a special event in Number 6 Kildare St on 28 February.