Lessons from COVID-19 on Boundary-Setting and Systems Change

I’m a lifelong Dodgers fan, and I watched elatedly as the Dodgers stormed the field a few weeks ago after winning their first World Series since 1988. I left the TV on to watch the celebration. I love seeing the joy and tears on the players’ faces, watching them hugging their loved ones, listening to the fans cheering. That’s right, fans. They were playing in a sort-of bubble in Texas, where the rules around large gatherings are looser, and there were some fans in the stadium, most of them rooting for the Dodgers, so it felt like a home game.

In the course of the celebration, the sportscasters reported that Justin Turner, the Dodgers steady third-baseman and long-time leader, had tested positive for COVID-19, which was why he had been abruptly pulled from the game and isolated in the eighth inning. Hearing this left a pall on the celebration. It was a stark reminder that this was not normal times, and it led to many questions. Who else on both teams had already been exposed? Would they be okay? What if the Dodgers hadn’t won, and there was another game scheduled the following day? Would they have played?

Then Justin Turner came back onto the field to join his teammates for their celebration. He hugged his teammates and family members, he took off his mask, and he participated in the team photo. My sobriety shifted to shock, then unhappiness. What the heck was he doing?! Why wasn’t anyone stopping him?!

It took a few weeks, but Turner and Major League Baseball’s commissioner, Rob Manfred, finally released statements explaining what happened. Turner had apparently asked to step onto the field with his wife (who was isolating with him) for a photo. In his statement, Turner wrote:

I assumed by that point that few people were left on the field. I was under the impression that team officials did not object to my returning to the field for a picture with my wife. However, what was intended to be a photo capturing the two of us turned into several greetings and photos where I briefly and unwisely removed my mask. In hindsight, I should have waited until the field was clear of others to take that photo with my wife. I sincerely apologize to everyone on the field for failing to appreciate the risks of returning to the field. I have spoken with almost every teammate, coach and staff member, and my intentions were never to make anyone uncomfortable or put anyone at further risk.

According to the ESPN article on the statements:

Manfred said teammates “actively encouraged” Turner to leave his isolation room and return to the field, adding that “many teammates felt they had already been exposed” and were willing to tolerate additional risk. Manfred’s statement said Turner believed he received permission from at least one Dodgers employee and that an unidentified person incorrectly told him that other teammates had tested positive, “creating the impression in Mr. Turner’s mind that he was being singled out for isolation.”

MLB previously chided Turner for breaking protocol, adding that Turner “emphatically refused to comply” when asked to leave the field. But Manfred acknowledged Friday that the league “could have handled the situation more effectively” by assigning a security person to closely monitor Turner and quickly transporting him to the team hotel.

“Mr. Turner has publicly recognized that his conduct was wrong and has expressed remorse for that conduct,” Manfred wrote. “I have spoken to him personally and I know that he is extraordinarily upset by the incident. By all accounts, Justin is a leader in the clubhouse, a contributor to his community and a responsible person who was instrumental in the Dodgers diligently following the health protocols all season long.”

I think this was a good outcome, and I applaud everyone involved. There was no single person at fault. It was a collective responsibility, and everyone owned up. The next step is to learn from this and to improve the system.

I live in San Francisco, where our local leaders have moved cautiously in accordance with public health officials and scientists, and where there’s been a culture of compliance and support. People wear masks for the most part, and folks are generally well-intentioned in supporting differing tolerances for risk.

Still, it hasn’t been easy. I’ve felt more cautious than many of my peers, and I’ve drawn some boundaries around distancing and being outdoors, which has meant not doing a lot of the things that my friends want me to do. Everyone has been supportive in principle, but I constantly feel that support tested in practice. People ask to go on a distanced walk, and then they walk right next to me, or they wear their masks below their noses. People gather outdoors, and then it gets cold, and they say, “Why don’t we go inside?” Even though I’m generally good at protecting my boundaries and I’m not conflict-averse by any means, I’ve given in more than once. I feel like I’m constantly fighting a number of forces and tendencies — many of them based on my own longing for normalcy — and afterward, I always feel crappy and scared. But I don’t blame anyone. I know it’s hard for everyone, and I can’t imagine living in other places right now where there’s violent disagreement around what the norms should be.

Last month, my sister shared this comic by Ali Solomon that exactly encapsulates how I feel about all of this. Check it out. It’s brilliant.

Last May, Atul Gawande wrote a wonderful article about how we might safely transition out of lockdown based on what he had learned from his hospital’s practices. He wrote:

These lessons point toward an approach that we might think of as a combination therapy—like a drug cocktail. Its elements are all familiar: hygiene measures, screening, distancing, and masks. Each has flaws. Skip one, and the treatment won’t work. But, when taken together, and taken seriously, they shut down the virus. We need to understand these elements properly—what their strengths and limitations are—if we’re going to make them work outside health care.

And later in the article:

As I think about how my workplace’s regimen could be transferred to life outside the hospital, however, I have come to realize that there is a fifth element to success: culture. It’s one thing to know what we should be doing; it’s another to do it, rigorously and thoroughly.

In my professional life, which is fundamentally about systems change, we get so caught up with finding high-leverage strategies, it’s easy to forget that nothing works in isolation. And among the different combinations that are necessary for success, culture is almost always one of the required strategies. As we’re experiencing right now in a large-scale, visceral way, culture change is really, really hard, even when everybody is aligned and has the best of intentions, which is rarely the case.

2 replies to “Lessons from COVID-19 on Boundary-Setting and Systems Change”

  1. It hasn’t been / isn’t easy being more cautious than friends or co-workers, but it’s my life and my husband’s life (both of us susceptible) so I live by my boundaries…knowing there are still risks no matter what I do. Stand your ground Eugene, your life is worth it.

    1. Thanks for the encouragement, Patsy. I’m glad you and your husband are maintaining your boundaries. I can imagine it’s culturally far more challenging for you to do that where you are than it is here.

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