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The Healthcare Ecosystem: What Lessons Have We Learned From COVID-19?

Unfortunately, COVID-19 is not the last time we will find ourselves in a globally shared crisis; emerging and resurging diseases are a growing fact of life.

While investing in science is an absolute priority for future health security, science alone will not get the public health job done. It must be complemented by philanthropic investment in the public health institutions that enable science to reach community.

So, what have we learned about the healthcare organizations that are lifeblood to our communities? About our ability to respond to crisis? And about what it takes to rebound?

Public health is much more than just healthcare institutions, it is about the entire ecosystem of organizations that touch people’s lives – an ecosystem that needs to pay much more attention to communication.

Communication has proved itself a particularly hard problem for public health in the past year.  Scientists are not always the best communicators and messages must sometimes change as science learns more about a problem. The result can be confusion, delayed public action and/or damage to much-needed credibility. Social media, ever-present in the equation, spreads so much information – good, bad and ugly – so constantly that it overloads nearly everyone. People are human. They tire of confusion.

Crisis will exploit every weakness we have as a people, together and individually. Understanding the complexity of health, and developing initiatives to strengthen health across the board, are the first defense for community. 

The underlying chronic conditions of heart disease and diabetes became some of COVID’s closest allies. Racism and inequity are silent, often unseen, yet they too play into the deadly impact of COVID-19.  When chronic disease and inequity join together, the results are incendiary for tragedy. The cavalry of science cannot ride to the rescue if there is no one left to rescue.

The nonprofit and philanthropic sectors can, and will, respond quickly when crisis calls. 

As COVID descended, foundations suspended reporting requirements and moved funds quickly to affected nonprofits. Nonprofits expanded service programs as the economy seized up, businesses closed, and unemployment skyrocketed. And this ability to act and adapt quickly was demonstrated not just by large nonprofits with national or global capacity. This is a critical lesson.  And it is important to capture and understand how that was done, because it will need to be done again.

It is time for nonprofits to tear down walls between themselves and the power of commerce, between health and education, between service and academics, between sectors, between geographies. 

The proof is clear –  institutions can do more together than any one of them can do separately. The work on vaccines reflected unprecedented collaboration across scientific disciplines, across borders, and between academic institutions, corporations and nonprofits. Collaboration will not be easy. Your brand, your donors, your programs are important and unique—a strength that has doubled as a liability when nonprofit collaboration has been more talk than action. But, in a crisis, it will be essential. Any community’s game plan for crisis response must be premised on the ability and willingness to tear down walls between institutions and specialty sectors, to mobilize both prevention and crisis response.

Our collective response to COVID-19 has taught us that nonprofits must occupy a central role in creating and strengthening community trust. 

A growing distrust of institutions pre-dates the pandemic.  For at least the past decade, surveys have documented the erosion of trust in institutions – particularly public institutions – on the part of the people.  COVID-19 has brought this into glaring relief.  Distrust eats away at the bonds of civil society; it builds walls of silence between people and those who represent them politically and serve them institutionally.  We tread on dangerous ground here.  Nonprofits are, by definition, committed to the common good, to the wellbeing of community.  Rising above is a central duty of nonprofits in a crisis. This is true during COVID-19 and will be true again.

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