Special Report: Gambling with Risk Avoidance in a Pandemic and the Real-World Cost of Clinging to a Worldview

Today's post is by Corona-zona Senior Europe Correspondent Maria Iovine 

There’s a German expression, sicher ist sicher—safe is safe, or it’s better to be on the safe side. But in a pandemic, is it really? What is the cost of clinging to that worldview assumption?

A recent story in the New York Times concludes that European institutions are risk avoidant and hold to the strategy of choosing caution when risks cannot be clearly defined. By contrast, the same article describes U.S. dealings with drug makers by saying “[t]he United States made the negotiations easy — its critics say far too easy.”

And there you have it, the cultural dimension known as uncertainty avoidance. Germany high, United States low. Beneath the NYT’s analysis lies this phenomenon. It’s fair to say both approaches have their advantages and disadvantages. But this post is about how the inflexibility, unwillingness, or inability to shift a tightly-held worldview assumption, to “err on the side of caution,” can have disastrous consequences.

It’s not that the U.S. approach of making drug company negotiations “too easy” is without fault or risk. Yet while awaiting my turn in line at a Walmart pharmacy to get the jab (I am currently in the U.S.) I read on the vaccination handout that the potential benefits of getting vaccination exceed the potential risks of NOT getting it. Decision made. Low risk avoidance.

From the same NYT article: “But there is no dispute that in Washington, officials had decided that money was no object if vaccines could avert the economic cost of a lockdown. Europe, on the other hand, was on a tight budget, so its negotiators chased cheaper doses.”

But you’re talking about the life and death of your citizens! What’s the benefit of saving on taxpayer burden if the taxpayer is dead? To be blunt, no more burden. The financial detriment of the entire economy likely outweighs any potential savings for the taxpayer.

I flashback to fall 2020 and another personal vaccination story. In the U.S., it starts with the annual flu shot drive that shows up around the same time as Christmas decorations. Noticeable in front of almost every grocery store or pharmacy, large signs are displayed. “Did you get your flu shot?” or “Get your flu shot today.” Such signs do not exist in Germany—not that I’ve seen. So, when it came time to get my flu shot while I was in Germany, I had to hunt it down.

The seven-step process (I’m not kidding) consisted of (1) calling my general practitioner to order the vaccine, (2) waiting for a phone call from the Apotheke (pharmacy) many days later to learn it had arrived, (3) walk down to pick it up, (4) bring it home to my refrigerator, (5) call the GP back to schedule an appointment to administer it, (6) retrieve it from the fridge, and walk it down to the doctor’s (passing the pharmacy on the way), to (7) finally get the injection. I might actually have contracted the flu in that process. 

Perhaps that kind of thoroughness and Ordnung (order) is becoming self-defeating. I have to conclude there’s a connection between my flu shot experience and Germany’s missteps in the current SARS-CoV-2 vaccine rollout.

My German friends were stunned to learn how flu shots happen in the U.S. Shopping cart, eggs, ice cream, some Twinkies, oh, and a flu shot. But what about the risk and control?!? An article in  The Guardian bluntly entitled “Heroes to zeros” sums up the problem with this frame of mind: “If you want an effective crisis management, fear of committing errors is a toxic attitude.”

According to Johns Hopkins, Germany has fully vaccinated a mere 5.01% of the population, contrasted with 17.13% in the U.S. That’s more than 3x as many! German Green Party MP (and former physician) Janosch Dahmen stated, “[w]hether you are dealing with a bleeding patient or with a pandemic: speed trumps perfection.”

There is such a thing as playing it too safe. And while the German vaccine rollout has been frustrating, disappointing, even shocking, I still couldn’t help but take offense on behalf of my German friends at the Guardian calling us “zeros.”

On both sides of the ocean friends always ask me which health system is better. Are there benefits of Germany’s high uncertainty avoidant approach? Admittedly, I have enjoyed the help of a trained healthcare professional at the Apotheke offering counsel on anything one might ingest to cure an ailment. Sicher ist sicher. 

Over the counter is not really a “thing” in Germany. You can’t just pick up a package of any kind of medication off the shelf. Sometimes I miss just tossing a bottle of ibuprofen in my shopping cart without having to discuss it with a parental figure in the form of a pharmacist. I could make similar plusses-and-minuses comments about cost, availability, hospital stays, and more.

But this is a pandemic. And in this case, I just can’t defend Germany, no matter how much it stings to be called a zero.

To be fair, this single cultural dimension cannot account for all of Germany’s vaccine roll out problems, but clinging to this worldview in the midst of a pandemic is gambling with far more than the economy or a perfect distribution system. The sicher ist sicher view is a gamble with citizens’ lives.

Image by Corona-zona