In December, two weeks before the European Medicines Agency authorized the first Covid-19 vaccine for use across the European Union, Berlin unveiled a plan to boost its immunization with German precision engineering. The jabs would be administered en masse in specially constructed vaccination centers, where patients could be transported in lines like cars in a car wash.
A Lego display demonstrating the efficiency of the complex system impressed journalists at a press release, but set off the alarm in the head of Janosch Dahmen, a former doctor who became a Green Party MP. “Everything seemed very logical in theory,” says Dahmen, who worked on the front line of the pandemic until November. “But looking at it as a doctor, I thought: this is not how vaccination works in practice.
“You want your grandmother to get a call from the family doctor who has been treating her for 20 years and tell her not to worry about the side effects she heard about on the radio. People are not cars. “
Three months later, the alarms are ringing loud enough for the whole of Germany to hear.
Last spring, at the start of the pandemic, the country looked like a model for how to deal with the viral threat. He was managing to contain the outbreaks thanks to a high rate of tests and an advanced contact tracking system. In mid-April, its death rate from Covid-19 infections was less than 3%, compared to 14% in the UK and 13% in France, despite a milder blockade than in other parts of the continent. Compliance levels were high, as were government approval ratings.
However, on Friday, the head of Germany’s disease control agency warned that the country was heading for a third wave of the pandemic that was likely to be the worst, while the government seemed lost in response. Easter block plan without offering alternative restrictions instead.
The frustration is heightened by an increasingly difficult patchwork of rules, emitted after increasingly bitter videoconferences between Angela Merkel and the heads of Germany’s 16 federal states.
Worst of all, the immunization hyperdrive remains stuck in first gear: 90 days since the first jab was administered, only 10% of the population in Germany received their first dose, compared with 42% in the UK and 26% in the United States . Even France, once considered the vaccine laggard in Europe, gave a larger dose to a larger portion of its population than Germany.
Outside, Germany’s relatively successful management of the first wave of the pandemic used to be linked to the wise decision-making of its chancellor, a trained quantum chemist who could calmly explain the complex scientific calculations where other leaders resorted to martial metaphors. .
“Macron’s response to the pandemic was’Nous sommes en guerre, ‘”Said Andreas Rödder, a historian at the University of Mainz. “Merkel’s was: ‘Remember to wash your mask at 60 degrees’ ”.
Seen from within Germany, both the country’s first victories and the current malaise were more easily explained by structural factors, cultural priorities and a degree of luck – good in 2020, less in 2021.
When Germany imposed its first blockade on March 22 last year, it was fortunate, unlike Italy, that the virus has not yet spread silently across the country and in nursing homes. In the highly decentralized country, Covid-19 also came across a political system that was surprisingly well placed to deal with the initial challenges.
Since health is one of the policy areas assigned to the country’s federal states, Germany had more than 400 local health officials who were already experienced in implementing contact tracking schemes. And a competitive network of regional universities and private laboratories has given the country an early edge in testing.
“German federalism in its current form may have been historically designed as a straitjacket for a notoriously aggressive state,” said Siegfried Weichlein, a historian of federalism at the University of Freiburg. “But it is a popular straightjacket. At best, as we saw at the beginning of the pandemic, it is a dynamic system that can lead to competition for the top and greater average acceptance of political decisions ”.
By some measures, Germany still stands out: its relative number of pandemic deaths remains considerably lower than in comparable countries in Western Europe, such as France or the United Kingdom. But the fear of losing prestige in the race for immunization came to dominate the national debate.
A joint procurement program that placed a lot of faith in the wrong candidate vaccines created a shortage of supply across the EU. However, Europe’s biggest economy has been slow to administer even the doses at hand, injecting vaccines into people’s arms at a slower rate than 13 other EU states.
Germany’s stock of unused vaccines grew to 3.5 million doses at the beginning of last week – partly, but not only, because the health ministry insists on maintaining between 20% and 50% of doses for the second injection, depending from the manufacturer.
In some cases, the immunization campaign saw the positive aspects of federalism turned into negative ones. The city of Wuppertal, in the west of the country, announced on Wednesday that it had 2,000 unused doses of the vaccine because it had finished inoculating all residents over 80, but was prevented from moving on to the next age group by North Rhine-Westphalia authorities. , who wanted the entire state to move in sync.
Far from seeing a race to the top, the immunization program created a scenario in which “stragglers are setting the pace,” as the head of the city’s crisis task force said.
“Whether you’re dealing with a bleeding patient or a pandemic: speed exceeds perfection,” Dahmen said. Observer. “In Germany, we try to reinvent the wheel with the launch of the vaccine, to perfect a system before putting it into practice. That kind of meticulousness is now becoming counterproductive. ”
The logic behind the program only through vaccine centers, said Dahmen, was in part that mRNA vaccines like BioNTech / Pfizer and Moderna required high-tech storage facilities, but also for fear of excessive decentralization: family doctors , authorities concerned, might have been tempted to deviate from the order of priority and administer precious jabs to private patients or friends instead.
Without using GPs, each German state had to build its own system to find the right people in the right age groups for a vaccine appointment, with some patients inviting by letter, while others depend on being contacted by overloaded hotlines and noisy online portals. In Lower Saxony, authorities used postal records to search for candidates for the first round of jabs, guessing people’s ages based on their first names.
These misfortunes can be caused locally, but public anger is now also coming to the doors of the chancellery in Berlin. Cautious pragmatism served Merkel well for most of her 15 years in power. But among an unvaccinated 90% audience, many are now calling for bolder leadership.
Hopes that German doctors’ offices would soon be able to join the vaccination effort were dashed earlier this month, when the vaccination authority recommended a temporary suspension of the use of the AstraZeneca vaccine because of reports of blood clot disorders in one small number of receivers.
Contrary to some speculation in Britain, Merkel’s decision to follow the regulator’s advice had little to do with attempts to politicize the vaccine developed at Oxford University. Instead, it was the opposite: an assertion of the belief that an incipient bureaucratic management culture can still beat the virus. Not interrupting the vaccine’s release, despite the caution of the regulator, would have been a political action – but a risk that many Germans would have forgiven their chancellor for taking on.
“Instead of making a mistake, it seems, we prefer to stay put,” said former doctor Dahmen. “If you want effective crisis management, the fear of making mistakes is a toxic attitude.”