Friday, April 26, 2024

In an unlikely pandemic success story, Europeans overtook Americans on the road to vaccination

Raphael Minder, Spain and Portugal Correspondent for The New York Times

Few governments can draw plaudits for their handling of the coronavirus pandemic. Even if such a health crisis forced them to sail uncharted waters, the litany of errors and U-turns that politicians forced upon their citizens seems to be without precedent. As a result, courtrooms are starting to wade through a mountain of litigation, filed in large part against public authorities for mishandling the pandemic.

Since early 2020, international organizations also failed to live up to the challenge. The World Health Organization, a United Nations agency that should be offering medical leadership on the global stage, made some woeful calls, starting with its initial advice that people should not wear a face mask unless sick. It also repeatedly showed itself to be little more than the pawn of the powerful and often conflicting political interests that underpin the U.N. The fruitless visit by a W.H.O. delegation to Wuhan in early 2021 was just one example of its shortcomings.

As a resident of the European Union, I also found it hard to watch the E.U.’s flawed handling of the pandemic, even in areas in which the European Commission should have been able to coordinate a common response, acting as the E.U.’s executive agency. Freedom of movement is one of the cornerstones on which the whole E.U. project was built, yet every member state set its own travel rules, making such movement anything but free flowing.

Of course, the pandemic struck in weird and unpredictable ways, affecting some parts of Europe far worse than others. In some cases, countries that managed to remain relatively unscathed in 2020 then later got hit by the worst of Covid-19, particularly once the more infectious Delta variant of the virus surfaced. But none of this can serve as an excuse for not articulating at least some basic and common guidelines for the E.U. For instance, how could it be that a child traveling across the E.U. last summer only had to test for Covid-19 if above the age of 15 to enter Denmark or 11 for France, or 6 for Belgium and Germany but only 2 years of age in order to land in Italy or Portugal? Why could there not be a consensus decision, reached at E.U. level, over the age from which a child should need testing?

But amid this wreckage of divergent and often contradictory policies, there is at least one silver lining, namely the vaccination rollout across the E.U. Not every E.U. member state has advanced at the same rate, but the E.U. as a whole reached a milestone in July, when it overtook the United States in terms of the percentage of its population that had received a first jab of vaccination. Since then, the gap has widened significantly in the E.U.’s favor, which should be a source of pride for Europeans.

This is a particularly positive development given how bad things had looked for the E.U. at the outset.

Remember the situation January 2021. President Joe Biden entered the White House with a promise to carry out 100 million vaccinations in his first 100 days in office. In terms of vaccination, America appeared to be the promised land, a place to which those foreigners who were considered by Washington to present a low infection risk could also travel to get vaccinated for free. The debate was not about whether Americans would get vaccinated en masse, bu whether the U.S. and its efficient pharmaceutical industry would be generous enough to share some of America’s surplus of vaccine doses with other nations less fortunate.

At the same time, dark clouds were gathering on the other side of the Atlantic. After launching its vaccination program in late 2020, the European Union appeared to have rapidly sunk into another bureaucratic mess, unable to distribute efficiently across its member states vaccines for which it had also apparently overpaid. The blame game between Brussels and the E.U.’s national governments rapidly intensified.

Adding to the confusion and chaotic distribution efforts, the E.U. then got caught in an internal fight over whether it made the wrong choice by selecting AstraZeneca as one of its main suppliers. The rollout of AstraZeneca’s vaccines was briefly put on hold, while health experts determined whether it had been responsible for the blood clots that some people developed after getting vaccinated. While myriad Europeans were left anxiously waiting for their second jab, and the European Commission took AstraZeneca to court, the anti-vaccination movement grew exponentially.

In some parts of Europe, the criticism of the vaccination rollout was also fueled by scandal. In Portugal, for instance, the head of the vaccination task force was forced to resign after failing to act upon reports of queue jumping at a hospital where he was the chief executive. He was swiftly replaced by a Navy officer, Vice-Admiral Henrique Gouveia e Melo.

Now let us fast forward 9 months. Portugal has reached one of the highest levels of vaccination in the world and Vice-Admiral Gouveia e Melo is a national celebrity, who has been urged by many to use this popularity to launch into politics.

How did a country like Portugal turn into a poster child for vaccination? In a phone interview during the week that he stepped down from the vaccination task force, Vice-Admiral Gouveia e Melo offered several reasons to explain why he felt his mission had been accomplished so swiftly.

When he took charge in early February, Portugal was struggling to get supplies of vaccines, so that only about 30,000 people were getting vaccinated each week. Vice-Admiral Gouveia e Melo set a very different goal: vaccinate 100,000 per day, in a country with a population of just over 10 million residents. To do this, he reorganized the vaccination centers to operate “like a factory,” using staff from the military to lead the way. As he said: “We pushed the people toward vaccination, we were not waiting for the people to go the vaccination centers.”

But none of this would have worked without some external factors that played in the Vice-Admiral’s favor. First, Portugal had a long established national vaccination program, dating back to its fight against polio in the 1960s, which meant that it was not a fertile land for the anti-vaccination movement. Second, he took charge just as the E.U. started to overcome the distribution bottlenecks that it had been struggling with, meaning that a trickle of vaccine doses turned instead into “a tsunami of vaccines arriving into the country,” he recalled. Third, he was able to impose his views upon a healthcare system that had just come close to collapse, after a brutal onslaught of the pandemic. In a country that had been forced to call on Germany and its other E.U. partners to provide healthcare reinforcement, the Navy officer used the urgency of the situation to his advantage, as well as the climate of fear generated by the rapid spread of the virus.

As Tomás Lamas, a doctor who works in the intensive care units of two hospitals in Lisbon, put it to me, it was a time when everybody realized that “something had be done to change our situation.”

Even so, a less decisive leaders would probably not have made the progress that was made in Portugal. As a former submarine squadron leader, Vice-Admiral Gouveia e Melo once spent 31 days in a submarine, a feat that requires not only being able to stay calm under pressure but also an acute ability to plan ahead. “From the submarine world, I learnt that the planning is very important, because you don’t have a second chance to do it right,” he said.

But if there is one personal advantage that the admiral wanted to highlight, it was his ability to navigate outside the murky waters of politics. “My advice to the politicians is to stay outside a vaccination campaign,” he said. A rollout “must be run by a professional without any connection with the politics.” As the pandemic continues to shape our lives, it is a lesson that should resonate across the E.U.

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