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Vortex (Oxford English Dictionary) [figurative] -

A situation into which persons or things are steadily drawn, or from which they cannot escape

 

When we think of a vortex, we usually imagine a large amount of matter, water or air, circulating at a fixed point which then gathers speed, like a violent whirlpool, causing widespread or localized destruction.

However, as the COVID-19 pandemic has swept across the globe, we have found the figurative definition particularly interesting. The major decisions that our leaders have made are affecting every area of life. Whether with the intention of mitigating, eradicating, or suppressing the virus, our leaders have all had to focus on responding to COVID, largely to the exclusion of everything else.

In the UK, it is widely acknowledged that the UK Government’s response to COVID was determined by the modelling studies carried out in March 2020. A report from Imperial College London predicted over 500,000 deaths if suppression strategies were not instituted. As a result, unprecedented government-led public health strategies have been implemented, including lockdowns, curfews, and global travel restrictions, all of which were initially supposed to last weeks, but went on for many months, and still continue.

Throughout this period, several leaders have justified these strategies on the need to rapidly manage the pandemic. However, we cannot think of any scenario in which the balance of benefits to harms of a healthcare intervention should not be considered before implementation. While we do not necessarily question the need to deploy some of these strategies, we do question whether collateral damage from the pandemic response has being fully considered by our leaders. Worryingly, lack of effective communication and transparency makes this a difficult question to answer.

What could be driving this lack of communication and transparency? We fear that some of our leaders may be displaying elements of what we have called “Vortex Leadership”, which we have defined as

A process of leadership in which a person(s) responds, by reason of rush or excitement, to a state or condition of human affairs or interests, into which they are steadily drawn. The process has such absorbing, sometimes damaging, effect, that leaders are unable to readily extricate themselves from the affairs or interests and view other perspectives.”

As the pandemic has evolved, so has our understanding. The response to this understanding has been an interesting phenomenon. Some leaders appear to have recognised the need for dynamic, responsive, and sensitive leadership. Others have displayed vortex leadership, appearing to ignore the need to be dynamic and to recognise wider perspectives, and have instead remained fixed on a single interest.

We believe that existing theories can explain some of the traits seen in Vortex Leadership. Psychological studies have shown (Kiesler) that once a decision is made and freely committed to, those who have made the decision feel a need to justify it.

Human observations have suggested that people who have ‘made a decision feel compelled to prove that ultimately their own wisdom will be demonstrated’.  Equally Janus and Mann (1977, 1982) identified five styles of decision making that involve psychological conflict, implying that people will deal with conflicts differently.

The five styles suggested (with our minor adaptations) are:

-        uncritical adherence, continuing with an existing course of action ignoring potential risks;

-        unconflicted change, embarking on a new course of action without evaluating it;

-        defensive avoidance, avoiding decisions by delay or denial of responsibility;

-        hypervigilance, desperately searching for a solution and seizing on the first one that appears to offer relief;

-        vigilance, careful, analytical options sought in an unbiased manner.

We feel many of these styles may be relevant in current circumstances.

 

In conclusion, we recognise that much of the world’s population remains vulnerable to the COVID-19 pandemic and the response to it. As a result, we urge our leaders to avoid displaying Vortex Leadership. Instead, we ask them to reflect and communicate a more balanced view of the pandemic response that appreciates the balance of benefits to harm.

 

Sean Heneghan is a Chartered Organisational Psychologist and Senior Tutor at the University of Oxford.

Kamal R. Mahtani is a GP, Associate Professor at the Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences.

Both authors lead the University of Oxford Evidence-Based Healthcare Leadership Programme.

Acknowledgements: We thank Jeff Aronson for helpful comments on an earlier draft.

Disclaimer: The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute for professional medical advice.