by Dominique Desjeux, anthropologist
Dominique Desjeux, an anthropological point of view on the mode of functioning of the explanations currently being given.
Anna Sauerbey is a Doctor of History and publishes opinion pieces in the New York Times. On Saturday, March 28, 2020, she published an article under the headline, “Germany Has Relatively Few Deaths From Coronavirus. Why?” Beware her conclusion is unexpected and illustrates the dangers of what is the “retrospective illusion” in history, commonly known as being “wise after the event”. This week in Germany we find the same controversies on the evolution of the coronavirus as a few weeks ago in France…
[I place in square brackets the methodological remarks that I have drawn from this analysis.]
Anna Sauerbey reminds us that it seems that very few people are dying, since there are only 403 deaths to date [compared to 8125 in Italy, 4858 in Spain and 1696 in France on 27 March 2020]. One of the particularities of Germany is that it started early and continued carrying out tests and, following these tests, reconstituting the links with the people who had been in contact with the infected person, emphasizing traceability, and then quarantined all these people. [This is a systemic reasoning which applies equally to health crises and economic crises, as well as concrete systems of action. The methodological principle is to follow an object, in this case Covid-19, throughout the chain of transmission of the virus, all along its route.]
In addition, Germany seems to have done a better job of protecting its elderly inhabitants. In percentage terms, the average age of infected persons is 46 years compared to 63 in Italy. However, still reasoning in percentage terms, the low number of elderly people may be due, according to Dr Karl Lauterbach, to a greater number of young people testing positive, which automatically lowers the proportion of elderly people. The greatest number of young people affected by the disease is thought to be due to skiing, which is particularly important in Germany in general (14.1 million in Germany out of 80 million, compared with 8.5 million in France out of 67 million, according to the site leconomiste.eu, 2015 07]) and among young people in particular. This practice favors groupings that are conducive to the spread of the disease. Similarly, it seems that hundreds of young people were contaminated following a carnival in the town of Langbroich.
[In the case of Covid-19, it can be noted that the usefulness of reasoning in percentages must be put into perspective, since the only figure of which we are sure is that of deaths. The number of sick people given as a figure varies with the number of people tested, no doubt combined with probabilistic models of diffusion of the disease from a contagious person.
It may also be noted, incidentally, that we should perhaps not compare the United States, China and each European country, but these first two countries and all European countries. The site fr.statista.com indicates as of March 27, 2020 that the number of deaths in China is 3292, in the United States 1147, but that if we take Italy, Spain, France and Germany together we are close to 15 000 deaths, which perhaps changes the way of perceiving the problem].
At this point in the description, we can see that countries that test less or that reserve testing only for those who are already sick, such as Italy, have a higher rate of people affected by the disease.
So not only has Germany carried out testing, traceability and quarantine, but it is also the country with the best rate of beds and respirators per 100 000 inhabitants.
[Here one might wonder why Germany has more “respirator beds”. In anthropology, we often find that the solutions we choose in terms of public policy, companies or individuals are directly influenced by past experiences. I remember, for example, a debate in China on security, between a French company and a Chinese company. The latter wanted to install only one generator, while the French company wanted to install two. The Chinese company was thinking mainly in terms of flooding risks and therefore all it needed was one generator set placed high enough to make the company safe, whereas the French company was thinking in terms of fire, which required two generators in terms of safety. We may therefore wonder whether Germany had more experience of the risk of respiratory diseases in its history, which would explain the greater number of beds. Most respiratory diseases in Western countries are apparently linked to industrial pollution. There may be a completely different reason, of course.
The explanation by reference to experience, often referred to in sociology as the “key event” decision associated with a crisis, seems to have played a role for Taiwan, Hong Kong and Singapore, which had already suffered several viral attacks since 2003, notably with SARS, and therefore understood much more quickly the importance to be given to screening, traceability, containment, limitation of mobility and the wearing of masks. Cf. the New York Times international article of March 16, 2020 “Here’s how they curbed coronavirus”.]
However, this is where the article becomes interesting in comparison with all the debates we have had and still have in France, since we find the same debates in Germany. The president of the Robert Koch Institute, which is responsible for epidemic management in Germany, is of the opinion that “We are only at the beginning of the epidemic… How it will develop is an open question.” It is therefore possible that the epidemic curve in Germany is a little behind that of Italy, Spain and France. [This statement is a matter of debate. Hence it is a controversial issue, as we are now used to seeing live on the media in France, and it is part of our learning about science].
Some doctors and researchers think that it is very unlikely that Germany will find itself in a situation similar to that of Italy, while others believe that the death rate may be rising at full speed. In recent days it has risen from 0.48% to 0.72%. Some even believe that the health care system could be overburdened in the near future. Many hospitals and doctors warn about the lack of vital materials such as masks and protective equipment.” An article published by several doctors’ associations on Wednesday predicts that in a very short period of time intensive care resources in Germany are unlikely to be sufficient to treat all patients despite the recent construction of new capacity. ”The worse may be to come,” writes Anna Sauerbey. “So there is perhaps one lesson we can draw from Germany’s experience. Don’t count your blessings — or your data — too soon.”
Conclusion: This analysis, which is made while history is being made and therefore without knowing what the future will be, informs us about a methodological danger, which is to think that the future is written. This is an optical illusion. Put simply, today we hear statements made with certainty, whereas everything is uncertain, given that we do not know the vast extent of the spread of the virus between December 2019 and January 2020 from Wuhan in China. These statements say that the government or “those in the know” (as if ignorance were a virtue, or as if everyone knew everything about everything), did not act fast enough, or intervened too late, or acted wrong, all of which could be true, except that we currently cannot be sure.
In a few weeks, in a few months or in a few years once we have the solution to the problem, which is a riddle for the moment, some will start from the point of arrival and go to the final result, or at least what we think is the final result, and will look in the past for all the elements that lead in “a straight line” to this final result, in order to conclude that it is good or that it is bad. This involves forgetting that at the time of decision-making the information was contradictory, that there were controversies among experts, that the phenomenon was unique – what Nassim Nicholas Taleb calls The Black Swan (2010), the unexpected event that contradicts all the long series – and therefore that all possibilities were open and nothing was written. And yet over time we will also find that some of the decisions made were rooted in social interplay, in the actors’ interplays and in their constraints. If the worst is not certain, what is certain is uncertainty.
Paris, Sunday March 29, 2020