'Quaranta Giorni' Leadership Test: Time To Transform Healthcare

In March 2020, the WHO declared the COVID-19 outbreak a global pandemic. As of 26 June 2020, there have been 9.6 million confirmed COVID-19 cases, causing about 490 000 fatalities. In the midst of this unprecedented global health crisis, extraordinary containment measures have been implemented. The WHO has emphasised the importance of specific regional estimates to enact proportional control measures and to guarantee adequate public health intervention funding.1 The widely different responses of healthcare systems to this pandemic have been interesting and of varied effectiveness. Draconian measures in China and Singapore resulted in good control of pathogen transmission,2 3 while the slightly more relaxed but still highly restrictive measures in Italy, Germany and the USA seem to have had different levels of effectiveness.4–6 In Saudi Arabia, the COVID-19 pandemic has fostered the same tensions and fears that arose in healthcare staff and the public during the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak.7 The difficult lessons learnt by leadership during that time now constitute a ‘silver lining’, given that early mobilisation and specific strategies and plans established during the MERS-CoV outbreak were rapidly implemented nationally prior to confirmation of the first COVID-19 cases in the country. Specifically, at King Abdulaziz Medical City, Riyadh, the staff were vigilant and able to identify the first COVID-19 case at the drive-through respiratory/influenza screening station, rapidly admitting the patient to the existing respiratory isolation ward. The patient was well cared for as per standard infection control practices, and there were no healthcare-derived secondary cases. The COVID-19 pandemic has not only quarantined people but entire countries. ‘Social distancing’, ‘self-quarantine’ and ‘flattening the curve’ are now everyday expressions used to describe the deliberate increasing of physical space between people to avoid spreading the virus.8 The word quarantine comes from quarantena, a 14th-century …