Session #14: BCG Live: How To React To COVID-19 Impacts?

BCG Live Session #14:
How to react to COVID-19

impacts?
June 19th, 2020
BCG Brazil COVID Task Force
bcg.brazil.covid19@bcg.com
The situation surrounding COVID-19 is dynamic and rapidly evolving, on a daily basis.
Although we have taken great care prior to producing this presentation, it represents
BCG’s view at a particular point in time. BCG does not guarantee or make any
representation or warranty as to the accuracy, reliability, completeness, or currency
of the information in this document nor its usefulness in achieving any purpose. This
presentation is not intended to: (i) constitute medical or safety advice, nor be a
substitute for the same; nor (ii) be seen as a formal endorsement or
recommendation of a particular response. As such you are advised to make your own
assessment as to the appropriate course of action to take, using this presentation as
guidance. Please carefully consider local laws and guidance in your area, particularly
the most recent advice issued by your local (and national) health authorities, before
making any decision.
No recipient shall rely on this document for any purpose and BCG will not be liable
for any loss, damage, cost, or expense incurred or arising by reason of any person
using or relying on information in this document. BCG shall have no liability
whatsoever to any party, and any person using this document hereby waives any
rights and claims it may have at any time against BCG with regard to the document.
Receipt and review of this document shall be deemed agreement with and
consideration for the foregoing.
The summary is for internal use only and not for commercial use by the recipients.
No part may be reproduced in any form.
1
The situation surrounding COVID-19 is dynamic and rapidly evolving, on a daily basis. Although we have taken great care prior to producing this presentation, it represents BCG’s view at a particular point in time. BCG does not guarantee or make any representation or warranty as to the accuracy, reliability, completeness, or currency of the information in this document nor its usefulness in achieving any purpose.
This presentation is not intended to: (i) constitute medical or safety advice, nor be a substitute for the same; nor (ii) be seen as a formal endorsement or recommendation of a particular response. As such you are advised to make your own assessment as to the appropriate course of action to take, using this presentation as guidance. Please carefully consider local laws and guidance in your area, particularly the most
recent advice issued by your local (and national) health authorities, before making any decision. No recipient shall rely on this document for any purpose and BCG will not be liable for any loss, damage, cost, or expense incurred or arising by reason of any person using or relying on information in this document. BCG shall have no liability whatsoever to any party, and any person using this document hereby waives any
rights and claims it may have at any time against BCG with regard to the document. Receipt and review of this document shall be deemed agreement with and consideration for the foregoing. The summary is for internal use only and not for commercial use by the recipients. No part may be reproduced in any form.
Agenda
COVID-19 evolution update
Businesses in the new normal: What do leaders expect going forward?
Impacts of COVID-19 on the healthcare sector
2
COVID-19 evolution update
3
Recap: Three phases of the COVID-19 development
Flatten Fight Future

Re-start Cure
GDP
Critical care
patients
Time
Note: Flags intended to illustrate each country phase and are not in scale.
Source: Johns Hopkins CSSE; Press search; IBGE; Google Community Mobility; BCG analysis 4
Daily new cases are increasing globally;

propelled by South America, Asia, and Africa Data as of 18 June
Countries in South America, Asia, and Africa witness an increase in daily new cases
New daily cases (seven-day rolling average)
World 150,000
Copyright © 2020 by Boston Consulting Group. All rights reserved. Updated 16 June 2020 Version 10.1.
Africa
~8.5M cases South America

100,000
~455k deaths Brazil
Brazil North America

50,000
Europe
~984k cases
Asia1
~48k deaths 0
Mar Apr May Jun
1. Includes Middle East & Oceania

Source: Our World in data; BCG 5
BCG Brazil COVID Task Force Disclaimer: Reported cases may be
underestimated given low number of testing
Brazil has managed to flatten the curve compared to US and

Europe, but decline in new cases yet to be seen Data as of 18 June
Daily new confirmed cases per 1M hab. (7-day moving average)

World
Copyright © 2020 by Boston Consulting Group. All rights reserved. Updated 24 April 2020 Version 3.1.
400
~8.5M cases 300

Chile
~455k deaths
200
Brazil Peru
Brazil
100
US
~984k cases Germany

Italy S. Korea
~48k deaths 0
0 10 20 30 40 50 60 70 80 90 100 110 120 130
Days after 100th case
Note: Chile data as of June 16; Countries shown on the graph have more than 1.000 reported confirmed cases
Source: Johns Hopkins CSSE, United Nations, BCG Analysis 6
Number of new cases and deaths in Brazil have shown

signs of stabilization Data as of 18 June
New confirmed cases showing early sign Deaths by COVID-19 are growing at
of plateauing slower pace
New confirmed cases/1M habs New deaths by COVID-19/1M habs
(7 days moving average) (7 days moving average)
x.x Ratio of test per case
150 5.0
4.6
121.0 4.0
100
3.0
2.0
50
2.6
1.5 1.0
1.8
0 0.0
0 20 40 60 80 96 0 20 40 60 80 96
Days after 100th case Days after 100th case
Daily growth for
considered period 22% 6.3% 6.6% 4.5% 1.2% N/A 8.6% 7.0% 1.8% 0.3%
Note: Ministry of Health changed the way the number of cases and deaths are reported, creating uncertainty about the data. We're using data from States Health Secretaries whenever possible
to avoid inconsistencies; Number of testing are not updated on a daily manner. We're using a linear distribution between released dates for the ratio calculation.
Source: States Health Secretaries; IBGE; BCG analysis 7
São Paulo: Unclear trends in terms of daily new cases and

deaths Data as of 18 June
New confirmed cases showing early sign Deaths by COVID-19 are growing at
of plateauing slower pace
New confirmed cases/1M habs New deaths by COVID-19/1M habs
(7 days moving average) (7 days moving average)
150 6.0
5.3
100 4.0
93.7
50 2.0
0 0.0
0 20 40 60 80 96 0 20 40 60 80 96
Days after 100th case Days after 100th case
Daily growth for
considered period 16% 2.6% 4.5% 1.9% 1.5% N/A 5.2% 5.8% 1.4% 0.8%
Note: Ministry of Health changed the way the number of cases and deaths are reported, creating uncertainty about the data. We're using data from States Health Secretaries whenever possible
to avoid inconsistencies; Number of testing are not updated on a daily manner. We're using a linear distribution between released dates for the ratio calculation.
Source: States Health Secretaries; IBGE; BCG analysis 8
bcg.brazil.covid19@bcg.com underestimated given low number of testing
Data as of 18 June
Brazilian states at different stages of COVID-19 response

Conc. Of new New daily COVID-19 cases/1M habs (7 days moving average) New daily COVID-19 deaths/1M habs (7 days moving average)
daily cases April May June April May June
GO GO
MG MG
MS MS
Early control
MT MT
S: 100% PR PR
CO: 44%
RS RS
SC SC
AL AL
AP AP
BA BA
DF DF
Increasing ES ES
SE: 72% PB PB
NE: 65% PI PI
N: 60% RN RN
RO RO
RR RR
SE SE
SP SP
MA MA
Plateauing PA PA
TO TO
AC AC
Decreasing AM AM
CE CE
N: 24%
NE: 16% PE PE
RJ RJ
0 500+ 0 17
Note: Non-linear scale
Source: States Health Secretaries; IBGE; BCG analysis Peak ~70 Peak ~170 Peak ~15 Peak ~16 10
Growth in active cases has been challenging the health system

capacity in many states (I/II)
Data as of June 11th
~20% of reported ~5% of reported
cases may demand cases may demand !
some care¹ critical care¹
Average daily growth of reported active cases (7-day moving average)
45%
Higher growth but lower Higher demand of
! demand of health system health system
21% of GDP 56% of GDP 6% of GDP
30%
Active cases
AL doubling: 4 days
GO
Active cases
15% RO
SP ES RN RR2 doubling: 7 days
PR MS MT DF SE Active cases
TO PB
AC stability
0% SC PI
RS RJ MG AM MA AP
BA PA CE
Negative growth and lower PE
demand of health system
17% of GDP
-15%
0.1 1 5.0 10.0 20.0 100
Active cases / ICU Beds (log)
# of reported active cases
Note: Ministry of Health changed the way the number of cases and deaths are reported, creating uncertainty about the data. We're using data from States Health Secretaries whenever possible to avoid
inconsistencies; Active cases considers the confirmed cases excluding the people who have died or recovered. Number of people who recovered was not available in the state of GO and were computed using
the avg. % of recovered cases in Brazil. RN, MS and TO data as of June 10; 1. Based on study of 44,672 confirmed cases in Mainland China 2. RR active cases/beds is 190, plotted as 100 because of the scale
Source: States Health Secretaries; Press search; IBGE, China Center for Disease Control (CCDC); Worldometer; BCG Analysis 12

capacity in many states (II/II)
75% Higher growth but lower Higher demand of

22% of GDP 55% of GDP GO 9% of GDP
60%
Active cases
doubling: 4 days
15% Active cases

PR SE doubling: 7 days
MT SP ES
PI
RS MS DF AM RN RO Active cases
AP2
MG PB stability
0% PE
PA CE TO AC RR2
Negative growth and lower RJ
SC BA AL MA
14% of GDP
-15%
0.1 1 5.0 10.0 20.0 100
# of reported active cases
inconsistencies; Active cases considers the confirmed cases excluding the people who have died or recovered. Number of people who recovered was not available in the state of GO and were computed using the avg.
% of recovered cases in Brazil. RN, MS and TO data as of June 17; 1. Based on study of 44,672 confirmed cases in Mainland China 2. Active cases/beds is 225 in RR and 119 in AP, plotted as 100 because of the scale

capacity in many states (II/II)
75% Higher growth but lower Higher demand of

22% of GDP 55% of GDP GO 9% of GDP
60%
Active cases
doubling: 4 days
15% Active cases

PR SE doubling: 7 days
MT
BA ES
MS RN RO
RS DF AM PI AP2
Active cases
MG PB stability
0% RJ PE
PA SP AL CE TO AC RR2
Negative growth and lower SC MA
14% of GDP
-15%
0.1 1 5.0 10.0 20.0 100
Week over week change in daily new confirmed cases (7-day moving average) : <-25% -25-0% 0-25% >25% # of reported active cases
inconsistencies; Active cases considers the confirmed cases excluding the people who have died or recovered. Number of people who recovered was not available in the state of GO and were computed using the avg.
% of recovered cases in Brazil. RN, MS and TO data as of June 17; 1. Based on study of 44,672 confirmed cases in Mainland China 2. Active cases/beds is 225 in RR and 119 in AP, plotted as 100 because of the scale
Stable or decreasing utilization of ICU beds in many states

in the last few weeks Data as of 17 June
Variation of ICU occupancy rate from 06/06 to 17/06 (p.p.)
40 MT
Increasing
Increase of 5 p.p.
PR SE1
20 or more
MS BA
PI SP AL
MG RS RN1 Stabilizing
0 SC1 RO ES Less than 5 p.p. of
AM variation.
PB MA
CE PE
-20 PA Decreasing
RJ Decrease of 5 p.p.
or more
-40
0% 20% 40% 60% 80% 100%
Average occupancy rate of ICU beds from 14/06 to 17/06 (%)
1. Public ICU beds occupancy rate

Note: Acre, Amapá, Distrito Federal, Goiás, Roraima and Tocantins not included given data unavailability for all considered time periods;
Source: States Health Secretaries; Press search; BCG analysis 15
Concerns regarding second waves
in Brazil following reopening
15/06 Are there second
waves in other
countries?
15/06
What can we learn

from countries
that are ahead of
Brazil?
15/06
Source: Press Search 16
US sustained a plateau whereas Europe and Asia with no

signs of new outbreaks after the peak
US cases are slowly decreasing In Europe, cases increased and In Asia, the curve had much
after a sharp increase decreased rapidly less intensity
Daily new confirmed cases per 1M inhab. (7-day moving average)

200 200 200
150 Brazil peak1 150 Brazil peak1 150 Brazil peak1

so far: 128 so far: 128 so far: 128
Copyright © 2020 by Boston Consulting Group. All rights reserved.

100 100 100
UK
US France
50 50 Spain 50 Korea, South
Italy Japan
Germany China
0 0 0
0 20 40 60 80 100 120 0 20 40 60 80 100 120 0 50 100 150
Days after 100th case
1. Daily new confirmed cases per 1M inhabitants (7-day moving average)

Source: Johns Hopkins; BCG analysis 17
US: Outbreak shifting across the US, explaining the

sustained plateau in the country Selected States
Data as of 15 June 2020
New daily COVID-19 cases/1M inhab. (7 days moving average)
March April May June
Washington 9 12 15 14 17 18 22 26 27 26 29 34 37 42 46 51 58 57 60 63 60 63 64 61 69 61 61 60 52 44 40 31 27 26 25 26 28 30 31 32 27 29 29 29 27 28 30 31 32 31 33 33 34 36 33 31 32 31 33 30 29 29 30 29 28 28 27 25 25 18 26 27 26 27 31 34 39 35 36 37 39 37 36 39 38 39 41 35 38 41 39 39
Louisiana 3 4 6 8 11 16 21 23 32 37 47 59 68 78 83 88 118 142 210 232 282 291 333 339 326 281 275 231 233 189 161 151 131 119 110 102 108 103 102 99 93 90 87 78 75 74 70 79 81 79 80 83 84 81 66 70 69 66 63 70 87 92 83 87 89 92 82 93 95 86 84 95 93 98 71 58 81 84 78 83 81 85 98 89 89 83 88 89 89 92 117 117
First New York 4 6 10 21 39 59 82 112 146 177 204 236 268 299 322 336 368 390 401 427 451 466 478 470 493 509 509 493 484 469 464 466 455 428 415 399 387 371 321 292 301 328 328 320 305 305 300 270 226 208 198 192 178 170 162 148 139 133 127 123 114 113 111 108 105 105 101 98 91 86 84 84 81 78 75 74 71 68 66 68 67 62 58 56 54 52 47 45 42 40 39 38
affected
New Jersey 1 3 4 6 11 14 20 30 43 55 64 99 128 158 185 222 242 287 301 339 370 388 393 414 405 409 397 386 392 378 393 379 391 384 374 377 388 379 400 397 382 387 382 361 345 329 300 305 293 285 275 269 250 247 236 220 193 192 166 156 140 131 124 125 129 136 148 143 138 129 123 110 103 94 90 101 104 101 94 93 87 86 72 69 60 58 52 53 53 45 44 44
Massachusetts 2 3 4 3 5 6 8 10 12 20 33 43 59 77 89 103 113 122 136 148 155 156 168 178 188 207 219 231 269 270 269 272 274 290 292 274 277 283 284 301 346 356 354 353 360 365 342 284 276 281 271 258 256 251 243 231 215 208 201 189 189 180 183 183 190 190 186 174 166 151 149 141 131 120 111 105 106 99 92 90 86 80 76 70 62 58 57 53 54 52 47 45
Michigan 1 1 1 2 4 6 8 16 20 26 33 39 48 61 66 77 86 104 117 134 141 150 158 167 162 158 144 140 128 126 120 115 110 114 108 107 96 86 90 98 102 97 98 96 102 100 95 89 95 93 90 82 77 71 66 61 58 61 62 58 68 66 66 70 75 74 79 69 68 68 63 54 50 47 45 47 45 47 47 47 44 41 43 38 32 31 28 22 21 12 13 16
1 2 3 4 6 7 7 12 15 22 31 34 44 53 67 86 101 107 113 145 150 148 174 186 169 239 225 250 255 259 249 279 244 251 242 237 258 255 309 289 286 282 293 248 238 172 184 193 188 161 159 173 169 164 146 148 171 152 149 155 147 147 149 155 174 164 167 150 142 133 122 110 115 91 94 85 80 69 75 67 72 67 68 72 71 54 48 50 49 49 47 45
Connecticut
2 2 3 4 6 6 6 8 11 14 13 16 20 23 28 41 49 59 65 69 76 85 91 100 119 146 137 208 235 213 273 243 243 330 289 275 327 303 349 368 340 356 369 353 327 324 319 305 291 275 262 271 264 257 245 229 242 242 227 220 200 194 195 189 181 180 205 210 205 205 188 171 170 134 124 121 117 116 125 122 117 112 109 84 69 88 78 72 72 68 68 68
Second Rhode Island

0 4 4 6 8 14 20 21 20 24 32 39 40 42 49 57 72 81 85 98 121 134 141 145 173 176 183 177 177 174 171 153 167 165 180 186 197 211 204 205 213 209 212 195 181 182 195 229 222 238 259 269 274 269 251 264 254 247 235 227 219 197 190 172 178 192 196 213 207 187 200 193 182 173 143 131 152 140 128 112 123 127 134 112 107 108 119 105 95 92 89 88
affected D.C.
0 1 1 2 2 3 4 5 6 7 8 11 15 19 24 27 31 37 41 47 50 56 62 64 84 91 99 108 109 116 121 106 109 109 109 109 112 112 112 117 119 129 135 137 140 144 142 162 158 163 164 166 173 180 166 167 168 165 164 157 154 154 152 147 151 177 177 180 176 178 177 175 145 144 146 155 154 153 146 153 155 145 137 129 123 120 112 106 103 91 90 88
Maryland 1 1 2 3 4 6 8 11 14 16 18 24 27 31 40 43 50 58 58 66 77 75 81 85 91 98 101 99 108 110 109 107 105 109 113 107 107 111 119 126 136 142 153 162 170 172 180 185 189 198 202 201 202 202 200 198 183 172 193 186 192 187 185 185 197 169 177 166 170 173 182 175 171 157 148 135 125 112 104 109 107 101 95 90 85 81 72 68 66 60 56 54
Illinois 1 1 2 3 4 5 6 7 9 13 15 15 18 25 26 29 32 37 39 42 56 65 76 89 110 120 129 130 140 143 146 132 126 145 155 134 145 147 174 182 165 152 219 208 241 213 209 217 214 172 165 117 165 177 175 182 157 187 201 172 188 185 186 204 191 190 182 171 170 144 167 161 151 132 115 104 131 101 94 91 90 84 79 62 65 54 49 50 53 59 56 47
Delaware 1 1 2 2 4 5 6 7 8 10 16 21 23 27 32 33 35 32 34 43 44 44 50 56 60 70 69 76 85 84 84 83 78 77 71 63 64 65 72 70 69 62 73 69 68 62 59 60 75 69 74 80 84 93 99 97 95 97 96 95 97 94 95 89 91 91 111 104 109 116 128 137 155 141 153 159 153 164 173 148 133 120 112 127 121 109 126 149 179 205 216 242
Alabama 0 1 1 2 2 4 6 10 11 14 16 21 24 25 26 29 30 33 33 37 38 42 43 47 45 52 53 57 55 58 56 65 65 64 64 72 75 78 74 73 79 84 79 76 78 80 80 85 83 79 86 90 89 90 90 93 94 86 82 80 86 82 84 86 84 86 90 83 88 90 94 97 97 100 103 104 107 109 110 111 109 105 95 87 84 97 100 104 92 111 111 108
Recently Mississipi 1 1 1 2 3 4 6 8 12 15 17 20 23 25 28 27 34 42 40 37 38 40 39 37 30 34 38 38 39 38 35 31 32 29 30 33 34 33 33 44 52 54 54 56 56 62 52 66 73 73 76 76 75 70 53 44 38 41 51 51 54 53 52 50 52 48 43 47 51 53 58 53 52 60 57 56 58 51 42 72 74 73 75 76 82 93 68 65 66 72 71 81
affected Tennessee 1 1 2 2 3 4 5 6 10 12 13 15 17 22 25 24 26 24 31 35 37 39 39 38 43 34 38 35 31 31 30 31 37 31 32 34 38 39 40 41 44 46 47 46 47 47 47 47 46 47 48 49 49 47 49 50 48 47 44 46 46 44 43 44 46 48 49 50 51 53 51 51 49 44 47 54 57 63 66 70 80 84 89 101 101 104 105 105 109 104 97 100
Utah 0 1 1 1 2 3 4 5 7 8 10 10 12 13 16 17 21 24 31 32 35 35 36 37 31 34 38 36 35 32 32 34 32 29 29 29 29 25 31 27 27 28 31 32 36 31 33 33 34 31 32 31 29 29 31 29 28 29 30 30 29 29 31 32 32 31 32 33 34 34 36 34 38 40 39 41 42 49 55 55 50 45 64 57 67 74 78 93 112 103 125 125
S. Carolina 0 0 0 1 1 2 3 3 3 4 5 6 7 9 11 12 14 15 17 19 20 22 24 25 27 30 31 32 32 31 30 30 28 28 28 28 27 27 27 28 29 27 28 27 28 29 30 30 33 35 37 37 38 36 37 37 36 38 37 40 42 42 45 45 42 45 43 42 39 36 37 36 33 34 36 36 39 43 45 50 51 50 57 58 53 54 54 59 60 61 61 65
0 500+
1. 7-day rolling average of daily new case per 1M inhab. Peak: ~70 ~128 ~170
Source: Johns Hopkins CSSE; BCG analysis 18
US: States showing a "second wave trend" never actually

experienced sizable first wave Data as of 15 June
Some states are experiencing a late first … while others have a second wave
peak in number of cases… pattern, but case count is low so far
Daily new cases¹ Daily new cases¹
Ph 1 Ph 2
200 30.04. 15.05. 200 03.04. 04.05. 05.06.
Arizona Florida
100 100
0 0
Daily new cases¹ Daily new cases
Ph 1 Ph 2 Ph 1 Ph 2
200 07.04. 20.04. 18.05. 200 13.04. 30.04. 22.05.
S. Carolina Tennessee
100 100
0 0
Daily new cases¹ Daily new cases¹
Ph 1 Ph 2 Ph 1 Ph 2
200 200
17.04.² 01.05. 14.05. 02.04. 04.05. 23.05.
Utah Washington
100 100
0 0
01.03. 01.04. 01.05. 01.06. 01.07. 01.03. 01.04. 01.05. 01.06. 01.07.
Stay-at-home order Ease on restrictions

1. 7-day rolling average of daily new cases per 1M inhab. 2. No stay-at-home order was enacted. On Apr 17 local Government announced the state was in the high risk stage
Note: Second wave is defined as sustained increase in cases after a period of decrease in growth Source: Johns Hopkins CSSE; Ballotpedia; Press search; BCG analysis 20
US: Testing capacity remained high, even in States with

uptick in cases Data as of 15 June
Decreasing cases Late peak Second wave pattern

Daily new cases¹ Positivity² Daily new cases¹ Positivity² Daily new cases¹ Positivity²
600 100% 600 100% 600 100%
New York
Arizona
Florida
300 50% 300 50% 300 50%
0 0% 0 0% 0 0%
600 100% 600 100% 600 100%
New Jersey
Tennessee
Carolina
South
300 50% 300 50% 300 50%
0 0% 0 0% 0 0%
Massachusetts
600 100% 600 100% 600 100%
Washington
Utah
300 50% 300 50% 300 50%
0 0% 0 0% 0 0%
01.03. 01.05. 01.07. 01.03. 01.05. 01.07. 01.03. 01.05. 01.07.
Daily new cases Positivity
1. 7-day rolling average of daily new cases per 1M inhab. 2. Positivity defined as the number of positive cases per total tests realized; calculated as 7-day rolling average
Source: Johns Hopkins CSSE; The COVID Tracking Project; BCG analysis 23
US: More lax rules in the reopening may have contributed

to recent increase in cases
Decreasing cases Late peak Second wave pattern
New York N. Jersey Mass. Arizona S. Carolina Utah Florida Tennessee Wash.
Restaurants
(dine-in)¹
Bars¹
Reopened activities
Schools Schools remain closed until the end of 2019-20 academic year
Gyms & Sport
activities²
Personal Services²
Place of Worship²
Retail
(non-essential)³
Parks
Limit on Gathering Max. 10 Max. 10 Max. 10 No Max. 3 Max. 50 Max. 50 Max. 50 Max. 5
Social
Rules
Mask requirement Recommended Required⁴ Required⁴ No⁵ No Recommended Recommended Recommended Recommended
Open Open with restrictions Closed

1. Restrictions varies by State, and may include limited occupancy or only outside sitting; 2. Restrictions may include limited occupancy or practice-only activities; 3. Restrictions may
include limited occupancy; or curbside-only 4. Required were social distancing, is not possible. Enforcement conducted by business owners 5. No state-wide order or recommendation,
but airports, schools and business may require use in their dependencies Source: Ballotpedia; Press search; BCG analysis 24
Europe: Countries continue reopening process with more

restrictions lifted in the last few weeks Selected examples
Several restrictions already lifted

Restrictions lifted in the
Restrictions lifted until June 5th
last 2 weeks
Restaurants All schools Restaurants and

and bars Senior and except high bars inside and
Restrictions
Shops outside area Hotels pre-schools school outside area
eased: May 11

Restaurants Cinemas & Places of Night Professional
Restrictions
Shops and bars Hotels Theatres worship clubs sports
eased: May 4
Restaurants Cinemas & Professional

Restrictions
eased: May 4
Construction Factories and bars Gym Hairdressers Shops Theatres sports
Exit plan begun

No information
Lockdown wasn't adopted
Source: Press search; BCG analysis 25

Europe: Successful measures observed in European

countries to contain a second wave Selected examples
Key measures during reopening in selected countries
Phased lockdown Social distancing and Testing and People encouraged

exit plan per region IPE usage tracking to stay home
• Whereas most of the country • Mandatory use of masks • Testing of people who had • Most companies still have
already in Phase III, outdoors and in public spaces. contact with confirmed part of their staff working
Barcelona and Madrid still in • Police surveillance and fines cases remotely
Phase II for non-compliance enforce

use of masks
• Regions are evaluated with 4 • Mandatory use of masks in • Along with testing, France set • People are more reluctant to
well defined criteria public transportation and up a team to keep track of use public transport and work
• Paris metropolitan zone was public spaces suspicious cases movement from home is still encouraged
the latest to become a green • Gatherings in public spaces mainly with phone calls and needed as there are social
zone are limited to 10 people distancing rules to offices
• Phased approach with • Mandatory use of masks in • Testing are not homogeneous • Most companies still have
restrictions being applied in a public enclosed spaces and in across the country, with part of their staff working
regional level public transportation regions having much more remotely
testing capacity than others
Source: Press search; Expert interviews; BCG analysis 27

Europe: As summer arrives, countries are opening borders

Selected examples
Most countries opened their borders … restrictions that apply vary by

totally or partially… country
Which countries have closed their borders to EU tourists?
Open Partially open Closed Opening Restrictions
Date
Jun 15 Mandatory 14-days quarantine only for

travelers arriving from UK and Spain (by air)
Mandatory 14-days quarantine for every

Jun 08 visitor, except from Ireland, the Channel
Islands or the Isle of Man
No restrictions in place, however no

Jun 061 commercial flights are allowed to or from
Spain and Italy
Border to open to Schengen area countries on

Jun 21 June 21 (Portugal border set to reopen on July
01). No quarantine will be mandatory
Note: Countries with open borders are open to any European country, however restrictions can still be imposed. Countries with partially open borders are accepting visitors only from specific
EU countries 1. Portugal's land border with Spain set to reopen only on July 01. Source: Press search; BCG analysis 28
Selected examples
Virus is still circulating
The number of new daily cases are under control, but hundreds
of new cases are still being reported everyday by major
European countries
Europe: Life
is going back
to normal, Still far from herd immunity
Herd immunity is estimated to be reached when 50-90% of population
however a has antibodies. Only 11.3% of Madrid citizens are estimated to have
2nd wave risk antibodies for COVID-191
is still
possible
No vaccine available yet
Oxford vaccine, only one in phase 3 yet, will not be available at least
until October. Clinical trials are still underway to prove that the
vaccine is safe and efficient
1. Study by the Spanish government of 60,000 people in Spain published in May

Source: Press search; BCG analysis 29
Asia: Adoption of stricter measures aiming to eradicate the

infection completely
Massive testing at airports. Passengers Systems to track people movement Readiness to lockdown specific
required to take walk-through test and quickly identify suspicious places as soon as a new
and install self-reporting app cases and monitor quarantines infection cluster arises
• All arriving passengers (~95k/day) go • People arriving in Hong Kong has to • On June 12 a seafood supermarket was
through a health questionnaire wear tracking bracelets for 2 weeks to closed in Beijing after 36 new cases were
• Suspected cases are tested; results ensure to compliance with the 14 days linked to it
ready in a few minutes and positive quarantine • On June 15, 21 residential communities
cases transferred to hospitals • In China the use of the app is enforced and a second seafood supermarket were
• Negative cases install app and self- by limiting basic actions(e.g. access to closed
report/self-quarantine for 14 days public transport) without a QR code • On June 17, authorities imposed citywide
generated in the app movement restrictions
Source: Foreign Affairs: South Korea Offers a Lesson in Best Practices, 10 April 2020; The Straits Times: South Korea dials up coronavirus testing; Testing on
the move: South Korea's rapid response to the COVID-19 pandemic, David Lee and Jaehong Lee, May 2020; Press search; BCG analysis 30
Brazil showing early signs of outbreak stabilization in number of
new cases and new deaths
Brazilian states at different stages of outbreak, with many states

still fighting to flatten the curve
Plateau in US is a result of peaks at different points in time in its

Key states, with late peaks associated with lax reopening plans
takeaways Reopening process in Europe continues and strategy so far was
successful in managing new outbreaks…
…but there is still risk of a 2nd wave as relaxation continues
Asia imposing strict measures to eradicate new outbreaks rather

than managing the infection
31
Business in the new normal: What
do leaders expect going forward?
32
BCG is surveying companies around the world to

understand COVID-19 impact and response
Immediate
impact on business
Short and midterm

20+ 25+ 60+ actions to guarantee
business stability
Industries Countries Companies
Permanent business
Environment changes
Note: Survey dimensions are: Magnitude and length of financial impact, Major pain-points and support required, Health & safety measures taken, Business
continuity measures and recession preparedness, Opportunities & long-term structural enhancements 33
Actions
Immediate concern with workforce safety and COVID-19

within the company; testing is not a consensus
1st to 21st May
Measures to restore customer/employee trust Actions against COVID-19
Companies decided to test employees

Set-up a COVID-19 rapid response team 93% 1%
6%
Social-distancing measures
88% 11%
in customer/employee contact areas 2%
Increased adoption of
83% 15% 3%
digital/contactless procedures
Articulate plan for what if

75% 19% 6%
a positive case is found in workplace
Mobile app to trace COVID-19 infections
Articulate plan for potential
43% 43% 14%
adaptation in case of second wave
Testing of front-line employees

19% 39% 42%
for COVID-19 infection and immunity
Legend
Have Taken Plan to Take Not Planned
Source: BCG COVID-19 Company Survey; BCG Henderson Institute Analysis 34

BCG Brazil COVID Task Force Permanent
Changes
Customers expected to change: shift to online and

health/safety trends anticipated to be more persistent
1st to 21st May
Changes in customer behavior Strong acceleration of E-Commerce in Brazilian market
Shift to online purchasing channels
More health / safety conscious purchasing 47%

59% 16%
37%
25%
16%
13%
of Brazilians
bought online
Shift in marketing channel effectiveness 46% 36% 18% for the first
time in 2020
Trading up/down within product categories 23% 47% 31%
Shifting demand between product categories 21% 54% 25%
Change in customer stocking behavior 16% 54% 30% 24% 51%

of Brazilians
Change in preferences are buying
more accesses
11% 57% 32% in e-commerce
for terms on timing of payments more online
Legend
Persistent Change Temporary Change No Change
Source: BCG COVID-19 Company Survey; BCG Henderson Institute Analysis, Iinterativa, Conversion 36
BCG Brazil COVID Task Force Permanent
Changes
Structures and processes to change: home office, crisis

response and travel policies expected to persist
1st to 21st May
Permanent changes to business structures and processes Examples of companies embracing changes caused by COVID-19
73%
Remote-working and meeting policies
96%
+32% Implemented/implementing WFH
68%
Crisis response procedures +1%
69%
45%
Travel policies +53%
69%
20%
Marketing, media and advertising plans +165%
53%
34%
Employee communication policies +44%
49%
Sales channel mix

25% +132% Established internal system for emergency responses
58%
30%
Supply chain structure +33%
40%
NA during First Survey
Manufacturing automation
27%
Legend
First Survey Second Survey
1. WFH = Working from Home
Source: BCG COVID-19 Company Survey; BCG Henderson Institute Analysis 37
Impacts of COVID-19 on the
healthcare sector
40
We anticipate impact on HC sector in three spheres
Healthcare demand and economic impact
Care delivery and engagement models
Structural changes to supply chain & infrastructure
41
Shift from private to public HC Unemployment reduces # of lives in PHI

system (SUS) Employers review & reduce HC benefits
Increased patient flow & demand on SUS
Pent up demand for non- But… Unpredictable timing & intensity:

Healthcare urgent care drives HC rebound • Patient concerns regarding hospital safety
demand and • Lower spend on elective procedures
• Fewer health plans to cover costs
economic
impact Acceleration of Value-Based Alternative payment structures
Healthcare policies & actions Population health management services
Tighter restrictions on approvals, incorporations
Sub-segments: (A few) winners Winners: PPE, infusion pumps, Gx, diagnostic

tests, preventative health meds & services, etc.
and (a lot more) losers
Losers: Aesthetic procedures & related
equipment, non-essential procedures
42
COVID-19 crisis may further reduce private health

plans, replicating impact of recent economic crisis
Employment rate is corelated to Unemployment likely to spike over

beneficiaries in private plans the coming weeks, due to COVID-19
# of beneficiaries in
Employment rate (%) Monthly balance of formal jobs
private HC plans
100% 185k
225k
50M 130k
113k
41k
90% -42k 2019

2020
-241k
45M
80%
40M 70% -861k

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Jan Feb Mar Apr
Source: Sistema de Informações de Beneficiários-SIB/ANS/MS, Cadastro Geral de Empregados e Desempregados – CAGED, BCG analysis 43
SUS faces threat of financial challenges: demand might

increase and public accounts see decline in revenues
As the public health may face an … and tax collection declines public
increased patient inflow… health spending may be pressured
Total accumulated tax collection¹ (R$ B)
Pent up demand for non-urgent care
600
-4,2%
Cancer and chronic patients without treatment
or early diagnosis are getting more serious and
400
may consume more resources
524,4 502,3
Shift from private to public healthcare system 200
due to the economical crisis
0
Social isolation and financial crisis can effect Jan - Apr/2019 Jan - Apr/2020
mental health, increasing number of depressed
1. Does not account for inflation
Source: Receita Federal; press search; BCG analysis 44
Demand for elective procedures in sharp decline

Selection of data from private health system
-50% -80% -70% -60%
Elective surgeries Medical exams Demand in clinical Demand in diagnostic

performed¹ conducted¹ labs imaging²
1. Estimated decrease since beginning of pandemics in Private and Philantropic Hospitals 2. Estimated decrease in exams performed in March and April 2020
in comparison with same period in 2019
Source: ANAHP (Associação Nacional de Hospitais Privados); Abramed (Associação Brasileira de Medicina Diagnóstica) 45
BCG Brazil COVIDBCGTask
BrazilForce
COVID Task Force
Fear of contamination a driving factor among Brazilians

Top words that come to mind when Brazilians think about the virus (Free response, unaided associations)
Rank Δ rank positions Rank Δ rank positions
Wave 3 Wave 3 W2 & W3 Wave 3 W2 & W3
1 Fear 1 9 Crisis 11
Caution worry health
Death
2 Death 1 10 Unemployment 1
Risk 3 Isolation 4 11 Caution 3
Fear
Insecurity 4 Worry 4 12 Insecurity 6
Crisis vaccine 5 Virus 1 13 Health 9
sadness
pandemic isolation 6 Disease 6 14 Quarantine 11
disease unemployment Sadness 2 Vaccine
quarantine Virus
7 15
8 Pandemic 3 16 Risk 3
Question text: “What comes to your mind when you think about the corona virus?”. Similar responses categorized together.
Source: BCG COVID-19 Consumer Sentiment Survey – BR: May 10–11, 2020 (N = 1,318, weighted) 47
BCG Brazil COVIDBCGTask
BrazilForce
COVID Task Force
Population is conditioning "return to normal" to events

that may not happen in the near future
When will you be comfortable doing these activities? (%)
Going to Essentials in- Non-essentials in- Restaurant Local leisure Flying

shopping centers store purchases store purchases outings activities¹ (Domestic & International)
Vaccine available 66 44 49 53 60 57
Treatment available 42 35 36 48 38 41
No new cases 37 27 32 40 40 38
Less cases 36 41 40 33 47 26
More tests available 32 26 20 27 32 24
No gov. restrictions 18 23 38 30 29 20
Already comfortable 17
1. Option text: "Local leisure activities like movies, theaters and bars"
Source: BCG COVID-19 Consumer Sentiment Survey – BR: May 10–11, 2020 (N = 1,318, weighted) 48
Telemedicine & digital/virtual Expanded use of telemedicine

engagement models Digital patient journeys
Virtual care & monitoring
Virtual promotional models
Care delivery Digital marketing & novel sales tactics
and Accelerated trend toward Shift away from centralized, general care
engagement decentralization of care hospitals to specialty & ambulatory clinics
Increase in self-diagnosing
models Increase in home delivery and home care
Weight loss services & clinics

Renewed interest in
Nutrition and diet services & clinics
preventive care and fitness
Wellbeing centers
Primary care services
Gyms
51
CONFIDENTIAL. These analyses represent only findings based on discrete data from one point in time
(April 6-12, 2020) . They are not intended as a prediction or forecast, and the situation is changing daily
The 'new normal' expected to

embrace virtual Patients and
Changes expected to be a part of the 'new normal' after the resolution physicians will
of the crisis1
both want to keep
Leverage more virtual engagement
with patients
51% doing virtual visits.
Limit face-to-face interactions
33%
For the patients
with external partners more
there's
Provide longer-term refills 29%
Leverage more virtual engagement with
convenience and
28%
colleagues and external partners for providers
26%
Spend more time educating myself
there's reduced
Spend more time on patient education 24% overhead
Prescribe more self-administered products 20%
— Oncologist in a large
Other 3% private practice affiliated
with a large health system
(%)
1. [Q3.14]: How do you expect the ‘new normal’ of your day-to-day work and patient care to be different than in the
past following the resolution of the COVID-19 crisis?
Note: Survey conducted with 260 US-based HCPs specializing in Hematology & Oncology, Neurology, internal & family
medicine, cardiology, and immunology. Respondents were allowed to select multiple answers - percentages do not
52
sum to 100%.
Source: COVID-19 HCP Response Survey & interviews, April 2020; BCG analysis
COVID-19 outbreak has imposed ongoing

adaptation for health providers
From now on, we will
extend our services
to 20+ specialities
such as general clinic,
cardiology,
17% 51% dermatology, geriatry,
59%+ increase in home care of health care providers1 are psicology and pediatry
in the usage of delivery
services demand in April providing remote medical
apps in April vs. period
vs. previous month… care during the pandemic…
before social distancing…
- CEO from Dr. Consulta
... phone calls and … as patients look for … with highest rate of
websites from precautious ways for usage (69%) from
pharmacies are being having a consult in the Whatsapp, followed by
leveraged to place orders actual context telephone and e-mail
1. Survey conducted by Associação Paulista de Medicina, from Apr 9th to Apr 17th, N = 2.312
Source: Press search, BCG analysis 55
BCG Brazil COVID Task Force CONFIDENTIAL. These analyses represent only findings based on discrete data from one point in time
bcg.brazil.covid19@bcg.com (May 1-14, 2020) . They are not intended as a prediction or forecast, and the situation is changing daily
Remote diagnostic without physical interaction, and ability for

patients to use tool /connect remotely as main challenges
Challenges for patient to Cardiac & EP &
return vascular Interventional Gastrointes- Ophthal- Orthopedic &
Average rank (scaled 10 – 0) Total surgeons Cardiologist tinal surgeon Neurosurgeon mologist spine surgeon Radiologist
N = 109 N = 15 N = 15 N = 15 N = 16 N = 17 N = 15 N = 16
Difficulty making diagnoses

5,5 6,0 4,7 4,4 5,5 7,9 6,9 2,8
without physical interaction
Patients struggle to use tools 4,8 4,0 4,9 4,4 4,2 4,7 5,9
5,2
4,6
Difficult connecting with patients 3,9 4,0 5,1 3,2 5,3 3,3 2,1
2,6
Patients don’t want to 3,1 3,2 3,9 4,3 2,9 3,2 1,6
4,0
Safety / privacy concerns 2,6 1,7 1,9 2,3 3,5 2,5 2,0
2,8
Reimbursement is
2,6 3,7 1,5 2,3 2,6 2,2 2,9
not reliable or available 2,9
Dont have the right tools 2,4 2,3 2,7 1,6 2,1 1,6 4,0
2,1
Operational processes and
2,1 1,6 2,3 2,9 1,0 2,6 2,0 1,1
workflows are not in place or are challenging
Technology is unreliable 1,5 1,6 1,3 2,3 2,0 1,3 0,9
Top 3 pain points
Question: What are your biggest pain points when interacting with patients virtually?
MedTech COVID-19 Response Survey, May 2020; BCG analysis 56
Reconfiguration of global Increased national health security concerns

supply chains "Re-nationalization" of some medication and
medical supplies, equipment
Movement to reduce dependency on China
Structural
changes to Accelerating HC provider & Acquisition & mergers due to increase in
supply chain payer consolidation distressed assets
Potential set-back to innovative start-ups
& infra- (bankruptcies, reduced investment capital)
structure
Increased investments in Investments in R&D platforms for vaccines &
(some) HC infrastructure diagnostics tests
Monitoring & fast-response systems
Emergency capacity for future crises (e.g.
campaign hospitals, rapid deployment services)
57
Boston Consulting Group Answers and suggestions
at LinkedIn BCG.Brazil.Covid19@bcg.com
58
The situation surrounding COVID-19 is dynamic and rapidly

evolving, on a daily basis. Although we have taken great care prior
to producing this presentation, it represents BCG’s view at a
particular point in time. This presentation is not intended to: (i)
constitute medical or safety advice, nor be a substitute for the
same; nor (ii) be seen as a formal endorsement or recommendation
of a particular response. As such you are advised to make your own
assessment as to the appropriate course of action to take, using
this presentation as guidance. Please carefully consider local laws
and guidance in your area, particularly the most recent advice
issued by your local (and national) health authorities, before
making any decision.
59
bcg.com

Session #14: BCG Live: How To React To COVID-19 Impacts?

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Session #14: BCG Live: How To React To COVID-19 Impacts?

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BCG Live Session #14:

How to react to COVID-19

Recap: Three phases of the COVID-19 development

Flatten Fight Future

Daily new cases are increasing globally;

New daily cases (seven-day rolling average)

~8.5M cases South America

Brazil North America

1. Includes Middle East & Oceania

Brazil has managed to flatten the curve compared to US and

Daily new confirmed cases per 1M hab. (7-day moving average)

~8.5M cases 300

~984k cases Germany

Number of new cases and deaths in Brazil have shown

São Paulo: Unclear trends in terms of daily new cases and

Brazilian states at different stages of COVID-19 response

Growth in active cases has been challenging the health system

Growth in active cases has been challenging the health system

75% Higher growth but lower Higher demand of

15% Active cases

Growth in active cases has been challenging the health system

75% Higher growth but lower Higher demand of

15% Active cases

Stable or decreasing utilization of ICU beds in many states

Variation of ICU occupancy rate from 06/06 to 17/06 (p.p.)

1. Public ICU beds occupancy rate

What can we learn

US sustained a plateau whereas Europe and Asia with no

Daily new confirmed cases per 1M inhab. (7-day moving average)

150 Brazil peak1 150 Brazil peak1 150 Brazil peak1

Copyright © 2020 by Boston Consulting Group. All rights reserved.

Days after 100th case

1. Daily new confirmed cases per 1M inhabitants (7-day moving average)

US: Outbreak shifting across the US, explaining the

Second Rhode Island

Utah 0 1 1 1 2 3 4 5 7 8 10 10 12 13 16 17 21 24 31 32 35 35 36 37 31 34 38 36 35 32 32 34 32 29 29 29 29 25 31 27 27 28 31 32 36 31 33 33 34 31 32 31 29 29 31 29 28 29 30 30 29 29 31 32 32 31 32 33 34 34 36 34 38 40 39 41 42 49 55 55 50 45 64 57 67 74 78 93 112 103 125 125

US: States showing a "second wave trend" never actually

Stay-at-home order Ease on restrictions

US: Testing capacity remained high, even in States with

Decreasing cases Late peak Second wave pattern

600 100% 600 100% 600 100%

300 50% 300 50% 300 50%

US: More lax rules in the reopening may have contributed

Open Open with restrictions Closed

Europe: Countries continue reopening process with more

Several restrictions already lifted

Restaurants All schools Restaurants and

Copyright © 2020 by Boston Consulting Group. All rights reserved.

Restaurants Cinemas & Professional

Exit plan begun

Source: Press search; BCG analysis 25

Europe: Successful measures observed in European

Key measures during reopening in selected countries

Phased lockdown Social distancing and Testing and People encouraged

Copyright © 2020 by Boston Consulting Group. All rights reserved.

Source: Press search; Expert interviews; BCG analysis 27

Europe: As summer arrives, countries are opening borders

Most countries opened their borders … restrictions that apply vary by

Jun 15 Mandatory 14-days quarantine only for

Mandatory 14-days quarantine for every

No restrictions in place, however no

Border to open to Schengen area countries on

1. Study by the Spanish government of 60,000 people in Spain published in May