Germany’s vaccination vexation puts nails in the coffin of reputation for efficiency

The meeting had dragged on almost three hours, oxygen levels were reaching a critical point and I was losing the will to live.

It was 2009, and my Irish Famine genes had commanded me to buy property, so I found myself trapped in a room with a so-called Baugruppe of 50 Germans. We were planning a co-operative to buy and convert into apartments an old Berlin hospital complex.

Though we were still in an early phase of planning, the scale of the project and our lack of experience meant I had one priority from the meeting: cost control. Rather than discuss quantity surveyors, however, this self-managing group of amateurs launched into a detailed discussion of swings.

Should swings be allowed near the buildings or restricted to the common area? What kind of swings: wooden frame or metal? Who would pay for their upkeep and the annual inspection from Germany’s – no joke – playground police?

Coombe doctor brought Covid-19 vaccines home for family, review finds

---

Coronavirus: 761 more cases and 18 further deaths in the State

---

EU states and US dropped from mandatory hotel quarantine list

---

I departed the project shortly after and watched as a fascinated observer the rows, tears and bankruptcies over a doubling of costs, for which no one was responsible.

A year into the Covid-19 pandemic, with Germans humbled by their stumbled vaccination start, I’ve been thinking again about that airless room 12 years ago and the obsession with small details while ignoring the bigger picture.

Once upon a time Germany prided itself on "Vorsprung durch Technik" – being ahead through engineering. These days, it's behind on vaccination, playing sullen midfield in the EU's already underperforming vaccination team.

Nails in the coffin

Each day the newspapers are full of further nails in the coffin of German efficiency. The latest: after weeks of struggling to operate vaccination centres, Germany's federal health minister Jens Spahn announced this week a revolutionary idea to speed up jabs – get doctors to administer them, starting after Easter.

When I checked with my doctor on Wednesday, he said that piles of forms had arrived for this process – eight pages per patient – but, as yet, no vaccine.

“You know why we’ll never have a German Covid variant?” he asked wearily. “Because efforts to register it with the authorities are doomed to failure.”

Every country has its own Covid dramas, a reflection of a fast-moving crisis; but the decisions taken – and their effects – offer telling insights into the people in question.

German cultural obsession with the detail rather than outcome is visible everywhere, from coffee shops to government departments. Plait this together with strict hierarchies and zero feedback loops from low to high, and you have a bureaucratic blueprint of Germany’s vaccination vexation.

This country's bureaucratic model was developed in the 19th century under Otto von Bismarck and was adopted across Europe because it had – and still has – a solid reputation for delivering independent, thorough and legally sound results. But the Covid crisis has exposed its two weaknesses: this model is not fast and it is risk averse.

Where Ireland fumes over private school staff getting unused vaccines, Germans are furious that some vaccination centre personnel chose to throw away shots rather than vaccinate someone, anyone, out of order.

For Prof Frank Ulrich Montgomery, the Berlin-based head of the World Medical Association, such disposal of vaccines is a collision of a deep-seated German cultural need for equity and accountability with a system that punishes initiative, pragmatism and risk-taking.

“A scarce vaccine has to be distributed fairly and strong prioritisation rules have to be observed; this leads to tremendous bureaucracy,” he said. “Sometimes the observance of rules becomes more important than a quick and easy solution of evident problems.”

Many-headed hydra

In the first pandemic wave, Germany’s decentralised, federal system was a boon, allowing local health systems, experts and hospitals make swift, far-sighted interventions.

Now the same federal system is proving a many-headed hydra, strangling itself as it tries to manage newly created vaccination centres, irregular vaccine distribution, online vaccine registrations and a lockdown-weary population.

Instead of by local experts, the third wave is being overseen by politicians, many facing re-election in six months, who have no experience in pandemic management.

One senior Berlin doctor tells me the politicians’ hands-on approach is a far cry from the 2015 refugee crisis, when the government quickly farmed out logistics to the Red Cross and the army.

“The refugees was like the Aids crisis, politicians didn’t want to touch it because they saw no gain,” said the doctor. “Today, vaccinations and protecting the population has a positive connotation. The politicians won’t let go, taking the kudos if it goes right but refusing responsibility if it goes wrong.”