France and the United States are, unfortunately, among the nations hit hardest by Covid-19. Take a simple and uncontroversial criterion: The number of deaths per million inhabitants. France is at 1,600 and the United States at 1,800, that is, a total of 111,000 deaths in France and 603,000 in the United States. At a stage of development equivalent to our own, Japan counts only 14,000 victims (110 per million inhabitants). The virus is therefore not solely responsible for the disaster. It enters by any door it can find, but it relents wherever a mask or a vaccine blocks the way. In other words, the inevitability of the pandemic is relative, dependent on our behaviors and policies. It is still too early to draw definitive conclusions, but it is possible to outline a rough comparison of France and the United States, since the pandemic is a snapshot of who we are.
The same national vanity was initially expressed as denial in both of our countries. While Asia took the measure of the scourge, the French and Americans remained disdainful. This “little flu,” we heard in Washington and in Paris, could not destabilize our countries, equipped, as we then believed, with the best healthcare systems in the world. This vain nationalism cost France and America six fateful weeks, allowing the virus to invade us. The denial was deadly, and became the main cause of a massive mortality rate from which we could not recover. Later, in March 2020, when Donald Trump and Emmanuel Macron recognized that we were “at war,” the rifts in our two political systems proved to be gaping.
France, which has been hyper-centralized for centuries, fell behind in requiring preventive measures, and then in the ordering, shipping, and utilization of masks and vaccines. Nothing could happen without every decision being endlessly contested, and then action only came at the end of a long chain of agencies, each jealously guarding its prerogatives. We think of the French president as all powerful, but in reality he is a Gulliver tied down by the Lilliputian bureaucrats below him. Emmanuel Macron could not escape this long history. In France, elected officials give orders but only the bureaucracy acts; in the United States, the opposite is true because of the spoils system.
While petty bureaucrats debated the proper rules to follow before a mask could be approved, people were dying for want of masks. Even after vaccines were available, debates raged over the ability of nurses to administer them, the requirement that a doctor be present in every vaccination center, and the consent form to be signed by each candidate for vaccination. While the ministries pursued bureaucratic perfection and made sure that no one would be held responsible in case of an accident, French citizens were dying. It was at this point that mayors, the only really effective elected officials in France, offered to take over and organize the distribution of masks and vaccinations locally. The state bureaucracy countered this defiance of its sovereign functions by prohibiting these initiatives – only later to authorize them, but according to rules dictated from Paris. Thus, more deaths. In France we say that the country is dying under its bloated state; with Covid, this metaphor became a reality.
In the United States, the path towards disaster was the opposite, driven by the failure of an anemic federal government. In the name of federalism, President Trump passed the fight against the pandemic on to the states. It is true that public health is a state responsibility, but were we not at war? If so, then it was up to Washington to lead this war, which it did not do. In France, people died from an excess of centralization, and, in the United States, from an excess of decentralization.
At least France was and remains spared from the politicization of the pandemic. If some in France refuse vaccination, this is due to motivations that are religious, obscurantist, or based on conspiracy theories. In the United States, this refusal is on the whole along party lines. Trumpists express their attachment to the former president by refusing masks and the vaccine, which harms their neighbors as well as themselves. In America, mortality rates remain the most constant in Republican states, while Democratic New York has more or less overcome the pandemic.
This public health crisis has revealed another distinction: The power of American scientific research, which, allied with American capitalism, has dominated the market from the outset. While France was waiting for the venerable and publicly-funded Pasteur Institute, Pfizer grabbed the top prize, followed by Moderna. This American corporate success, from which the whole world is now benefiting, reflects the advantage of the United States in innovation compared with France. The economist Philippe Aghion estimates that the number of innovative patents registered annually in the United States is a hundred times greater than those “made in France.” This American capitalism is backed by the state, since Washington places its trust in profitable businesses. It was therefore hardly surprising that Donald Trump audaciously bought millions of doses of the vaccine in advance, before they were tested, from private laboratories. Meanwhile, the French and the European Union held laborious negotiations and quibbled with these same laboratories over prices.
Eighteen months after the beginning of the pandemic, have our two countries taken account of their failures? Yes, they have. The fantasies about miraculous remedies, such as the hydroxychloroquine so dear to Dr. Didier Raoult in Marseille, have dissipated. Charlatans no longer have the limelight on social media or extremist television channels such as Fox News in the United States or CNews, its French equivalent. The majority now accepts the fact that only vaccination will bring the pandemic to an end. It is also accepted that the new generation of RNA vaccines is the effective solution. In both Washington and Paris, the governments have achieved a better process of coordination with local authorities, states, and cities, in order to accelerate the pace of vaccination. But the pace remains slow because neither France nor the United States have mastered the persuasive language needed to sweep away the hesitations of obscurantists.
In both countries, the doses are available, their effectiveness has been proven, the risks are almost non-existent, but demand is falling short. Governments should probably leave advocacy to those who are more believable and more persuasive. Americans trust their pastors more than their representatives, and the French would sooner listen to Catherine Deneuve and Omar Sy talk about vaccines than President Macron and his health minister. It is asking a lot of politicians to give up the microphone, but ultimate success against the pandemic by means of vaccination requires the mobilization of civil society.
Editorial published in the August 2021 issue of France-Amérique. Subscribe to the magazine.
