Is it time for your business to hire a chief public health officer?

Adam Aron, CEO and president of AMC Theatres, the world’s largest chain of movie cinemas, remembers the early days of the pandemic as a blur. As the novel coronavirus spread around the world, he and his team scrambled to talk with health officials—first in Milan, then in Spain, then pretty much everywhere else the company operated, trying to sort out what to do with its 1,000 or so theaters in the middle of a fast-unfolding global health crisis.

The picture and the pace at which it was changing were dizzying. Over the course of a few days in mid-March, AMC announced plans to fill its theaters to only half capacity; then—prompted by an official’s remark on a Sunday morning talk show—AMC limited screenings to groups of 50 or fewer; and finally, on March 16, it closed its cinemas altogether.

“We had no experts on retainer internally,” says Aron, who admits when it came to understanding epidemiology and infection control and how to factor it into business, he and AMC’s senior execs were amateurs. “We were trying to make the best and smartest decisions we could under the circumstances.”

Of course, AMC was hardly the only company caught off guard and confronted with big business decisions—and little public health expertise in the C-suite to help make them—when the coronavirus hit. Even months into the global health crisis, companies, from meat processors to cruise lines to brick-and-mortar retail, continue to struggle with questions around doing business safely in a time of COVID-19—how and when to reopen, and, in the process, ensure their workforces and customers remain healthy.

“The single biggest issue facing businesses in the United States is how do we manage our way through the coronavirus crisis,” says Aron, who is hoping his company will begin reopening theaters in the U.S. later this month. (AMC has previously warned it may not survive the pandemic.) “The CEO of every major company in the country is going to have to make public health the single top vision of the company.”

With no quick or easy end to the pandemic (nor a host of other public health problems) in sight, figures from both the business and public health worlds say it’s time to bridge the gulf that has traditionally separated the two sectors. Some, including Michelle Williams, dean of the Harvard School of Public Health, envision a world where public health considerations are regularly integrated into business plans and where maybe even a new brand of executive, a chief public health officer, has a seat at the table.

“CEOs are now recognizing the primacy of public health,” says Williams, who has noticed an unprecedented thirst for knowledge from the business community in recent months. “CEOs are clamoring. They’re clamoring for an understanding of how do you develop reliable models that include inputs that they’ve not thought about beyond financial parameters?”

As a jumping-off point, she hosted a series of online symposiums called “When Public Health Means Business” last month and plans to launch curriculum this fall for business executives to help them understand the foundations of public health and how to apply them in business.

Korn Ferry, the global organizational consulting firm, has also noticed interest from companies in adding health expertise to their leadership teams.

“Health concerns are top of mind for the executives I work with,” says Radhika Papandreou, a senior client partner who specializes in the travel, hospitality, and leisure sectors. She notes that the companies she works with have typically had health and safety officers at the property level—say, at an individual hotel or a casino—rather than a high-level executive thinking strategically about such issues across the company. As a result, large companies tended to have “a very patchwork” response to the threat of COVID-19.

“There wasn’t a process,” says Papandreou, who notes some businesses leaned upon HR officers or formed working groups of leaders across the company to respond to the pandemic; others tried to form partnerships with health institutions like Johns Hopkins. “There hasn’t been one person driving the process.”

She and her colleagues, early into the pandemic, began holding focus groups to develop a prototype for a corporate chief health and safety officer, a role that would involve mitigating risk of disease spread and promoting health and safety more generally across the organization, says Mindy Kairey, a senior client partner at the firm. “It’s not a role that is going away as we go back to work and things become more normal,” says Papandreou.

Such a role would not be totally unprecedented in corporate history, says Christy Ford Chapin, an associate professor of history at the University of Maryland Baltimore County. Around the turn of the 20^th century, as the second Industrial Revolution ramped up and the progressive era began, American corporations developed “industrial medicine” departments aimed at preventing accidents and stopping the spread of infectious disease. This period coincided with spreading awareness of germ theory, Chapin explains. While business wanted to keep employees healthy for the sake of their operations, they also were looking to counter union power, negative publicity, and calls for regulation, says Chapin, who suspects today’s corporations will be similarly motivated to develop more robust public health efforts to avoid bad PR and lawsuits.

Industrial medicine went away with the transition to a more white-collar, service-oriented economy as well as improving public health conditions nationwide. While occupational health and safety departments still exist, they’re “just not as big a deal” and often focused on compliance with OSHA regulations, Chapin says.

At a moment when companies are grappling with a pandemic, as well as systemic racism and resulting health and social disparities, Harvard’s Williams imagines a broad and important role like chief public health officer: “Public health is about preserving, promoting, and protecting health and wellness of a population. And the workforce right now is under siege.

“We start to think about essential workers as really primary drivers for our economic and societal engines, and this is going to mean I think a sharper focus on health and wellness of workers at a level of population health,” she says. With such an orientation, she expects businesses will more clearly understand racism and structural inequality as burdensome and costly to business, and that a chief public health officer would bring a more rigorous, scientific, and ultimately just approach to addressing those issues.

“I think the chief public health officer brings a lens of assessing the social determinants of health,” she says. “They bring modeling and appreciation and understanding of health and social justice to the table where these can inform practices like wage determination.”

They would also, of course, help companies make more science-based decisions about reopening in the midst of uncertainty around the ongoing global pandemic. That’s why Aron, the CEO of AMC, sought out Williams’s counsel in the early stages of the pandemic. She referred him to Joe Allen, a Harvard School of Public Health faculty member and the coauthor of Healthy Buildings: How Indoor Spaces Drive Performance and Productivity, who with current and former faculty and graduates, has been advising AMC on issues like air filtration, electrostatic sprayers and intensified cleaning protocols.

“The only way people are going to go to movie theaters is if people trust theater operators to run their theaters safely and cleanly. It became quite obvious to us in April that we were going to have to seek out the best experts on the planet to advise us what to do,” says Aron.