How the rules of bureaucracy influenced the course of vaccination

Last Monday, late at night, the government abruptly stopped vaccination with AstraZeneca. It was just as suddenly allowed to happen again on Thursday. When asked why they stopped and then allowed it again three days later, officials and politicians say convincingly: we were looking after people's health. Vaccination was stopped because the AstraZeneca vaccine was suspected to be dangerous. As soon as the vaccine was found to be safe, we authorized it again. Everything is clear and seemingly logical. However, there is reason to believe that it only seems logical. So how is it really?

Covid mortality varies across countries, but averages around 2%. According to the European Medicines Agency, among the 20 million vaccinated in the European Economic Area and the United Kingdom, there were 496 cases of thromboembolism or just over 0.002%. This means that the probability of dying from Covid is almost a thousand (!) times higher than from the side effects of the vaccine. If one threat is a thousand times smaller than the other, then the choice to ignore one to eliminate the other is obvious. This is how the possibility of a patient dying in a car accident while taking him to a hospital by ambulance is ignored. The fact that ambulances sometimes get in accidents does not mean that their use must be stopped.

This obvious truth is so noticeable that the question arises: why was it ignored by the government, the Ministry of Health and the part of the public that talks only about Covid and vaccinations on a daily basis? The answer, on the one hand, is simple, on the other, paradoxical. Because society is so accustomed to the rules of the game dictated by the bureaucracy that it does not notice this contradiction. Even more, it sees these rules as the norm.

What are the rules? One of the most important rules of bureaucracy is: If there is even the smallest chance that someone will be able to blame you for something later, then it is better to not do anything at all. To paraphrase Henrik Ibsen's Brand: That you did not do it may be forgiven, — But never that you did [which after the war, when everyone is wise, will turn out to be wrong].

Therefore, the main task of bureaucrats/politicians is to convincingly justify why something cannot be done. A clear example is the long-term politician, the current Minister of Finance Jānis Reirs, who has spent all his political life doing just that - justifying why something cannot be done. Why the salaries of doctors can't be increased according to the law; why the small pensions can't be increased (when he was Minister of Welfare). So far, everything for him, and for the whole army of bureaucrats, has gone smoothly, but in the new circumstances, this strategy is beginning to lag. But habits have tremendous power and the deep subconscious belief that doing something increases the risk of getting in trouble has not gone anywhere. Therefore, it is better to play it safe and do nothing. There are no draw-backs for that. Especially if it can be justified by the interests of human safety.

It must always be remembered that politicians and officials saying that they act primarily in the interests of the people is in reality just blowing smoke in people's eyes.

Even if they really think so. They act primarily in their own interests (like all people). They are just doing the job and, as in any job, they are forced to adapt to the rules there. Sometimes people ask why a promising politician or civil servant, when he enters the system, quickly changes his initial zeal to routine and, following the example of a senior colleague, begins to explain why this or that idea, which until recently he was ready to fight for, cannot be realized. Because he is drowning in the swamp of bureaucracy.

How was all this reflected in the vaccine saga? The responsible officials (officials and politicians) overslept the vaccine reservations right from the start. It may be that there was also lobbying by some companies, but more likely the risks were not properly assessed. Risks here must be understood as the danger of decision-makers to themselves. Pfizer vaccines are more expensive than AstraZeneca and their logistics are significantly more complex due to their temperature requirements. Bureaucrats always think from a defensive standpoint. Namely, making a choice that has a lower risk of getting in trouble. If I buy the most expensive vaccine, then later there might be some issues, when the first wave of anxiety (we must save lives no matter how much it costs) will die off, and information from various "benefactors" will start to flow behind the scenes that we have heavily overpaid. Therefore, it is better to buy the cheapest option. Thus far, everything has been played by the rules.

However, there was another risk in this case. AstraZeneca had not yet completed registration in the EU. A standard politician or bureaucrat (such as Reirs) would never run the risk of ordering something cheaper but not yet accepted by the EU. After all, I am not paying out of my own pocket. However, the then Minister of Health Ilze Viņķele is a rather non-standard politician, who manages to take a different stance even when there is no need for it. She did not assess the risk that AstraZeneca's registration of the vaccine might be delayed and she was forced to resign. If in the meantime someone also pursued their personal interests, then it does not change the essence of the case as a whole.

The latest fuss over the potential dangers of the AstraZeneca vaccine also indicates that there is likely to be a major war between the big pharmaceutical companies over the billions that can be earned in vaccination. Our politicians got caught in these millstones, which was immediately used by political competitors. If the AstraZeneca vaccine had gone through the EU registration process as originally planned, all the talk of blaming the perpetrators would simply not have happened. No one would even talk about it.

When deciding whether to allow or ban the AstraZeneca vaccine, the current Minister of Health Daniels Pavļuts and the government as a whole keep in mind this experience of Viņķele, also the former Director of the National Health Service Edgars Labsvīrs. Therefore, without thinking too much, they follow the principle - it is better to overinsure than to underinsure. Looking at the actions of the big EU countries, vaccination with AstraZeneca was stopped, but when the "big brothers" in Brussels and Berlin decided that it was not dangerous, it was resumed here.

The mathematical probabilities mentioned at the beginning of the article were not even considered. Perhaps only those who did not receive their planned vaccine in those three days remembered them. But should bureaucrats think about people's interests? Of course not. That's why everything is fine with Pavļuts, Kariņš & Co.

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