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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 (CMO) 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- to four-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 are thus at 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 health care workers. How should Pandit respond to the surgeon?