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Set during the COVID-19 pandemic, this case follows a day in the life of Professor Meghana Pandit, chief medical officer at Oxford University Hospitals NHS Foundation Trust (OUH). It is 17 March 2020, and Pandit must prepare the hospital’s four locations and 12,000 employees for the peak of COVID-19 cases projected to hit Oxfordshire in two weeks’ time.

On this busy morning of back-to-back meetings, Pandit receives an email from a concerned surgeon: he and his team no longer want to continue certain elective-surgery procedures. They feel that they lack sufficient specialised protective equipment and thus face undue risk of exposure to COVID-19. National health authorities had advised that elective procedures should continue, and maintained that standard protective gear should be sufficient. Yet government guidance was changing rapidly. Not only did this hamper quick and informed decision-making for hospital leaders like Pandit, but it also contributed to confusion, anxiety and distrust among frontline healthcare workers. How should Pandit respond to the surgeon?

In 2019, India, like many countries around the world, was laying the groundwork for the deployment of 5G mobile telecom technology. 5G, with its high-speed, high-capacity and low-latency potential, was expected to transform the economy and society, with projections suggesting that it would create a cumulative economic impact of $1 trillion in India by 2035. The dominant vendor of 5G technology was China-based Huawei, which, in 2019, offered end-to-end solutions that were cheaper, faster and higher quality than its competition. But several intelligence agencies in the West suspected that Huawei would install ‘backdoors’ into its equipment to allow the Chinese government to conduct espionage activities.

India, with its longstanding security concerns vis-à-vis China, was faced with a dilemma: embrace costlier and slower 5G equipment from Huawei’s competitors, potentially setting back its economic targets for 5G, or develop ways to work with Huawei to address the security concerns. Huawei had been instrumental in allowing Indian telecom operators to rapidly expand access to previous-generation mobile and internet services in recent years. And while the US had banned the use of Huawei equipment across its public and private networks, and was strongly encouraging allied countries to do the same, other countries such as the UK had signalled a willingness to continue to do business with Huawei. With time of the essence, Indian Telecom Secretary Aruna Sundararajan had to advise the new government on the way forward.

In September 2019, the regulator Transport for London (TfL) was deliberating over the renewal of Uber’s operating licence. Since 2017, Uber had been in a precarious position in London, one of its largest markets, after TfL first decided not to renew its licence due to public safety concerns. Uber appealed and received a probationary licence, and now was awaiting a more permanent verdict. The licensing decision was just one flashpoint in an ongoing debate as numerous interest groups actively lobbied politicians and regulators over Uber’s position in London’s longstanding car-hire regulatory regime. The drivers of London’s iconic black cabs argued that TfL let Uber operate between the lines of the otherwise strictly regulated car-hire industry, giving Uber a competitive edge. But Uber – buoyed by its hundreds of thousands of loyal customers – asserted that the app enhanced competition, expanded customer choice and created jobs.

On 24 September 2019, TfL announced that it would give Uber a two-month extension as it reviewed additional information. TfL’s Commissioner Mike Brown now had two months to decide if TfL should grant Uber a licence. Meanwhile, Mayor of London Sadiq Khan – up for re-election in May 2020 – had to determine how to navigate the contentious debate.