Thursday, March 18, 2021

Paul Krugman

Opinion | Vaccines: A Very European Disaster - The New York Times
Credit...Bryan Anselm/Redux

Opinion

Vaccines: A Very European Disaster

When policymakers are averse to the wrong risks.

Credit...Bryan Anselm/Redux

The United States has a lot to learn from Europe’s policy successes, especially when it comes to health care. Every wealthy European nation provides universal health insurance while spending far less than we do, even though our system leaves tens of millions uninsured. And all indications are that the general quality of care is very good; on average, for example, the French can expect to live four years longer than their American counterparts.

Yet at this crucial moment in the Covid-19 saga, when new vaccines finally offer a realistic prospect of returning to normal life, policy in the European Union has been marked by one bungle after another. Jabs in arms got off to a slow start: Adjusted for population, Britain and the U.S. have administered around three times as many doses as France or Germany. And the E.U. countries are still lagging, administering vaccines less than half as rapidly as we are.

Europe’s vaccination debacle will almost surely end up causing thousands of unnecessary deaths. And the thing is, the continent’s policy bungles don’t look like isolated instances, a few bad decisions made by a few bad leaders. Instead, the failures seem to reflect fundamental flaws in the continent’s institutions and attitudes — including the same bureaucratic and intellectual rigidity that made the euro crisis a decade ago far worse than it should have been.

The details of the European failure are complex. But the common thread seems to be that European officials were not just risk averse, but averse to the wrong risks. They seemed deeply worried about the possibility that they might end up paying drug companies too much, or discover that they had laid out money for vaccines that either proved ineffective or turned out to have dangerous side effects.

So they minimized these risks by delaying the procurement process, haggling over prices and refusing to grant liability waivers. They seemed far less worried about the risk that many Europeans might get sick or die because the vaccine rollout was too slow.

Reading the tale of Europe’s sluggish vaccine efforts, I was reminded of H.L. Mencken’s definition of Puritanism as “the haunting fear that someone, somewhere, may be happy.” Eurocrats seem similarly haunted by the fear that someone, somewhere — whether it be pharmaceutical companies or Greek public-sector employees — might be getting away with something.

During the euro crisis this attitude led to the imposition of harsh, destructive austerity policies on debtor nations, lest they somehow fail to pay a sufficient price for past fiscal irresponsibility. This time it meant focusing on driving a hard bargain with drug companies, even at the cost of a possibly deadly delay, lest there be any hint of profiteering.

Needless to say, here in America we have a much more relaxed attitude toward corporate profiteering — too relaxed, much of the time. But in this case it served us well, because we didn’t pinch pennies in a health crisis.

Europe also has other problems. Vaccination was delayed by attempts to pursue a common European policy, which would be OK if Europe had anything resembling a unified government. But it doesn’t; instead, national governments held back on drug contracts while waiting for consensus.

Furthermore, purchasing vaccines isn’t the end of the story; you also have to get them in people’s arms. And there’s nothing in Europe comparable to the national distribution and vaccination push that has rapidly gained momentum since the Biden administration came to power.

Finally, Europe turns out to have a problem with widespread hostility to science. Of course, so do we — but theirs is different, in ways that are doing a lot of harm.

In America, most — although by no means all — hostility to science comes from the right, especially the religious right. We’re a nation full of anti-evolutionists, climate change deniers and, more recently, Covid deniers — forms of science denial that are much less common in Europe. But other anti-scientific attitudes, less easily placed on a left-right spectrum, are distressingly widespread.

Reluctance to take a Covid-19 vaccine, even if available, is hardly unknown here, but anti-vaccine sentiment appears to be alarmingly broad in Europe, especially in France.

All of these problems came to a head this week, when a number of European nations suspended use of the AstraZeneca vaccine based on probably spurious hints that some recipients may experience blood clots. Again, policymakers were obsessed with the wrong risks — even if there are adverse side effects, they surely pale in comparison with the damage to the inoculation drive. And again Europe failed to coordinate: Germany unilaterally suspended AstraZeneca, and others rushed to follow out of fear that they would be blamed if anything went wrong (other than people dying because they didn’t get their shots).

As I said, the most disturbing thing about this whole fiasco is that it can’t be blamed merely on a few bad leaders. Instead, it seems to reflect fundamental flaws in institutions and attitudes. The European project is in deep trouble.

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