Being trustworthy is one of the key indicators of leadership success and a fundamental element of successful relationships between leaders and followers. When leaders are considered trustworthy, they unlock co-operation and increase openness and mutual acceptance with those they wish to lead.
In assessing government leadership during the COVID-19 pandemic, it seems trust levels have dropped. Two polls conducted in May of 2021 in the U.S.[1]and Canada[2]indicated that faith in government is deteriorating. The U.S. poll found that only 24% of Americans reported trusting their government to do what is right. In the Canadian poll, 63% of respondents indicated that their trust in the federal government eroded during the COVID-19 pandemic. Furthermore, a U.K. study[3]from February of 2021, conducted by doctors and researchers at the London School of Epidemiology and Tropical Medicine and the Department of Epidemiology and Public Health at the University College of London, found that trust was not consistent. Respondents expressed concerns about the transparency and communication of evidence and insights involved in making decisions about the response to COVID-19.
Frances Frei, professor at the Harvard School of Business, and Anne Morriss, founder of the Leadership Consortium, assert that trust amongst followers has three core drivers:
- Authenticity, one’s belief that they are experiencing the real leader
- Empathy, belief that their leader cares about them
- Logic, confidence that the leader’s reasoning and logic are sound.
The study authors concluded that trust is lost almost always because of a breakdown in one of those fundamental areas.[4]
The past 22 months of the rapidly changing COVID-19 situation means that for politicians to lead through this crisis successfully, they would be well advised to continually consult with credible experts, seeking the most reliable and up-to-date information from trustworthy sources. They would then need to share that information and articulate how it helped form their argument and guide their response to COVID-19.[5] Interestingly, a study conducted by researchers at MIT concluded that “full and timely disclosure of all vital information serves to help ensure that the crisis leader retains legitimacy in the mindset of all stakeholders.”[6]
In the areas of transparent decision making and logic, we are witnessing a breakdown in public confidence. Transparency in decision making is critically important, as during times of crisis, how leaders communicate – specifically, how they make decisions – is crucial to keeping people calm and informed. Let’s evaluate three rapidly changing areas of real-world data that could help government leaders review and potentially reformulate their responses to COVID-19.
First, the transmission of the virus amongst the vaccinated cohort. Second, severe breakthrough infection amongst the vaccinated cohort, and, finally, the validity of natural immunity in the previously infected but not vaccinated cohort.
At the start of the COVID-19 vaccination rollout, leaders the world over seemed to believe that the vaccine would stop transmission of the SARS-CoV-2 virus. However, as vaccination continued, real-world data emerged indicating that the vaccine might not be as sterilizing as initially thought, making new research that much more important. As a result of this emerging evidence, in July of 2021, the CDC[7]revised its masking guidance, based on 469 confirmed cases in Barnstable, Massachusetts, of which 364 cases occurred in the fully vaccinated cohort, to recommend that fully vaccinated individuals resume mask usage in crowded public areas. On Sept. 29, 2021, a Vietnam study, published in The Lancet,[8] confirmed transmission between fully vaccinated healthcare workers. A second study published in The Lancet[9]on Oct. 29, 2021, further acknowledged community spread between fully vaccinated household close contacts.
As information about the spread of COVID-19 between the vaccinated cohort began to circulate, it became evident that the primary role of the vaccine would be to help prevent severe illness and hospitalization, therefore, relieving pressure on overstretched healthcare systems. However, as time went on, evidence has appeared indicating that the vaccines have rapidly waning protection. Even as vaccinated populations grew, a proportion of breakthrough cases increased in severity sufficiently to increase the cohort of fully vaccinated patients in ICUs. This increase in disease severity has progressed to increased numbers of COVID-19 deaths amongst the fully vaccinated. In Ireland, with over 89% of the eligible population fully vaccinated, a recently released report from the epidemiology team at the Health Protection Surveillance Centre,[10]Ireland’s agency for the surveillance of infectious diseases, showed 63% of COVID-19 deaths between June 27 and Dec. 4, 2021, were among the fully vaccinated. The report cautions that these percentages are relative to an overall declining death rate resulting from the beneficial effects of vaccination. Regardless, the pressure on health care systems remains.
At the start of this pandemic, there was little information about natural immunity after infection from COVID-19, resulting in many governments not factoring this element of protection into their pandemic response. However, after almost two years and nearly 300 million cases, a significant amount of data has become available for further scientific review. Peer-reviewed (non-pre-print) studies are available in the following journals: the Lancet,[11]the European Journal of Immunology,[12]the National Institutes of Health,[13]Cell Reports Medical,[14]the Infectious Disease Society of America,[15]Nature.org,[16]Emerging Medicines and Infection,[17]Science.org,[18]and most recently the CDC,[19]all confirming long-lasting and robust protection post-infection from COVID-19.
In conclusion, there is little doubt that leading through a crisis such as a global pandemic is immeasurably difficult, let alone a situation that is continually evolving and changing as our understanding of science shifts with new evidence. The evolving environment and evidence related to transmission and hospitalizations within the vaccinated cohort, and the impact on hospital capacity and the role of natural immunity in recovering from this pandemic require an urgent and transparent review of the path forward from our nations’ leaders. Such an open review could help restore public trust in our government leaders’ response to COVID-19, and could give people confidence that we will finally emerge from this pandemic not divided as a people but united in the belief that a brighter future lies ahead.
References
[1] Pew Research Center (2021, May 17th), Public Trust in Government 1958 – 2021
[2] Leger Polls (2021, May 26th), COVID-19 and Trust: S Postmedia Leger Poll
[3] Enria L, Waterlow N, Rogers NT, Brindle H, Lal S, Eggo RM, et al. (2021),Trust and transparency in times of crisis: Results from an online survey during the first wave (April 2020) of the COVID-19 epidemic in the UK., PLoS ONE 16(2): e0239247
[4] Harvard Business Review, X. Frei & A. Morriss (2020, May), Begin with Trust
[5] Center for Creative Leadership (2020, December), How to Lead Through a Crisis
[6] MIT Sloan Management Review, M. Useem, R. Jordan, M. Koljatic (2011, August 18th), How to Lead During a Crisis: Lessons From the Resuce of the Chilean Miners
[7] CDC (2021, August 26th), Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings
[8] The Lancet (2021, September 29th), An Observational Study of Breakthrough of the SARS-COV-2 Delta Variant Infections Among Vaccinated Health Care Workers in Vietnam
[9] The Lancet, (2021, October 29th), Community Transmission and Viral Load Kinetics of the SARS-COV-2 Delta Variant in Vaccinated and Unvaccinated Individuals in the UK: a prospective, longitudinal, cohort study
[10] Ireland Health Protection Surveillance Center (2021, December 13th), Vaccination Status of COVID-19 Deaths in Ireland from June 27th, 2021 – December 4th, 2021
[11] UK Health Security Agency (2022, January 6th), COVID-19 Vaccine Surveillance Report Week 1
[12] Provincial Health Services Authority of Ontario (2022, January 21st ), Hospitalization Data Summary
[13] The Lancet, (2021, November 8th), Protective Immunity After Recovery from SARS-COV-2 Infection
[14] The European Journal of Immunology (2021, September 27th), Persistance of Neutralizing Anti-bodies a Year After SARS-COV-2 Infections in Humans
[15] National Institutes of Health (2021, Junary 26th), Lasting Immunity Found After Recovery from Covid-19
[16] Cell Reports Medicine (2021, July 27th), Longitudinal Analysis Shows Durable and Broad Immune Memory After SARS-CoV-2 Infection With Persisting Anti-Body Responses and Memory B and T Cells
[17] Infectious Disease Society of America (2021, October 5th), One-Year Sustained Cellular and Humoral Immunity of COVID-19 Conavlescents
[18] Nature, (2021, May 24th), SARS CoV-2 Infection Induces Long-Lived Bone Marrow Plasma Cells in Humans
[19] Emerging Microbes and Infection (2021, April 29th), Live Virus Neutralization Testing in Convalescent Patients and Subjects Vaccinated Against 19A, 20B, 20I/501Y.V1 and 20H/501Y.V2 Isolates of SARS-CoV-2
