On the occasion of the publication of ” COVID-19, une crise organisationnelle “, IFRIS is pleased to interview François Dedieu, co-author of the book and member of IFRIS.
Interview with François Dedieu (Researcher at INRAE, member of UMR LISIS and IFRIS) on the occasion of the publication of the book “Coronavirus: an organizational crisis, by Henri Bergeron, Olivier Borraz, Patrick Castel and François Dedieu, published in October 2020 by Presses de Sciences Po.
Marc Barbier (MB): François, you have a research agenda in the sociology of organizations and public action, having already worked on the 1999 storm with your thesis, and then on pesticides for several years. Could you tell us how this work fits into your research agenda at the crossroads of crisis management and processes of creating ignorance or invisibility?
François Dedieu (FD): My work focuses on public action in environmental matters. I first worked on the management of natural disasters, then on pesticide policy, seeking to understand why a certain number of warnings and dangers are ignored, even though they are well known. The book “Coronavirus: an organizational crisis”, co-authored with my colleagues at the CSO, Olivier Borraz, Henri Bergeron and Patrick Castel, is in line with my work on extreme situations, since in the management of this pandemic, we find a certain number of recurrent traits encountered in crisis situations, such as the underestimation of alerts, the lack of coordination between the parties involved, or the capacity of actors to improvise in order to deal with this unknown situation
MB: This book comes in the context of the 2nd wave of the epidemic; can you tell us about the production of this book and what it was intended to say and propose? It is not very usual to see such a research perspective exposed in the middle of a crisis situation, what can this book add among many others?
FD: During the lockdown, we exchanged a lot with my colleagues and friends from the CSO, Henri Bergeron, Olivier Borraz, and Patrick Castel on crisis management. Henri and Patrick are very familiar with the health organization, while Olivier and I have worked on risks and disasters. We tried to put these two perspectives together in order to better understand what was being observed in this crisis. We thus published two articles in the AOC magazine, which quickly led to the writing of the book.
This crisis, probably more than any other, is a tangle of complex factors, which makes it particularly difficult to understand and calls for a lot of humility. The social sciences, in the broadest sense of the term, can help us to understand what is going on. Our contribution comes from the sociology of organizations and public action. It seeks to understand the constraints that weigh on decision-makers in order to better understand the various trade-offs, such as the one between the economy and health, for example. This approach is also interested in the coordination between actors at the national level (scientific council and the government), and at the territorial level (hospital and city medicine; prefects and regional health agencies, etc.). This type of analysis thus makes it possible to question the relationship between science and politics: what scientific knowledge is mobilized and what tends to be relegated to the margins? How is it mobilized in the current context, which is particularly controversial, as we have seen with Chloroquine? Does the political decision rely mainly on epidemiological modeling? And which one? What are the indicators used in the face of a virus that presents so many unknowns? We observe for example at the moment, that contrary to the first wave, the R0 seems to be less important, contrary to the positivity rate and especially the occupancy rate of resuscitation beds to justify decisions.
The work is an unusual exercise. It consists in delivering a “hot” analysis of the event. We start from surprises on the observation of facts to formulate hypotheses from the first empirical elements available and from the literature on crises, disasters and health organization. For example, one surprise, which is at the heart of the book, consists in noting the gap that exists between the haste with which the containment decision was taken and the plans and preparatory measures such as the Pandemic plan conceived 15 years ago and which foresaw all the problems we are facing: closing of schools, massive transport stoppages etc. We also wonder about the excessive confidence of the government in the face of the first alerts between January and March 2020. The first empirical elements collected, combined with the literature, allow us to hypothesize that these first decisions (and sometimes non-decisions) are based on an undue sense of preparedness, which itself comes from a slow drift of the means allocated to the pandemic risk after the bad lessons learned from previous crises such as H1N1 in 2009. Similarly, we show how hospitals were able to cope with the crisis, by adapting their organizations and modifying the more unusual modes of collaboration (shift of power from directors to physicians). We hope that this “on-the-spot” analysis will help to shed light on what is happening. But it has a counterpart that we assume. Even though we are continually seeking to collect data, we do not have the hindsight to collect all the data we would need to test all our hypotheses.
MB: The book develops an analysis of a form of organizational failure. Are there any “crisis management” situations that call for a particular form of organization that would be so difficult, if not impossible, to put in place based on what the State and its administrations are in France? How does your work fit into the reflection on what is called “post-crisis” when we are not yet truly out of it?
The book is less concerned with organizational flaws than with the nature of the organizational system put in place to manage the crisis. We note, for example, the omission of certain agencies and crisis specialists, such as the Cellule Interministérielle de Gestion de Crise (CIC), which was mobilized rather late, and which would have contributed to a broader vision of the problems raised by the crisis (transport, security, inequalities, etc.) than those strictly medical. We hypothesize that there is a form of mistrust on the part of the executive towards the traditional crisis management organizations that failed during the management of Hurricane Irma in 2017. These agencies are mobilized late, under pressure from critics, and without really specifying their role. We then observe a classic phenomenon of crisis situations: overlapping jurisdictions, conflicts of territories between crisis managers. We also observe that there is very little reflection from the central administration on the concrete implementation of measures, as shown by the confusion surrounding screening strategies, which undermines the identify-trace-isolate strategy.
What should be done? As far as emergency management is concerned, we must be modest. Many studies agree that there is no such thing as “good crisis management” but that it is necessary to constantly reconcile anticipation and adaptation, which implies accepting a certain amount of failure and error. On the other hand, it seems very important to learn quickly from the actions undertaken and to learn from what did not work, especially in this crisis that is stretching out over time. The question is: in which organization and at which territorial level should we set up these mechanisms that generate these learning vectors: the CIC? the Prefecture? Sociologists do not have an infallible science, and we should work on these aspects hand in hand with crisis managers on this point.
On the other hand, and for the post-crisis period, we are convinced that the way in which we prepare for and learn from crises in France needs to be reviewed in depth. Indeed, official feedback tends too often to “single out” crises, insisting on their exceptional and singular character. Crises have their own singularity, of course, but they also have strong recurrences such as the de-sectorization or innovation of responses, aspects that are stubbornly ignored and yet appear crucial for dealing with unknown situations. We therefore propose to use the history and cumulative analysis of crisis management cases as management tools, which can be used for training or crisis exercises, for example.
MB: You speak of an organizational crisis, but isn’t that reducing the biological component of this crisis too much? Moreover, we are dealing with a pandemic, managed in a particular way by nation-states which have different health systems and government practices, do you already have a comparative perspective from your approach of the French case?
FD: Having worked on natural disasters, I am all too familiar with the constructivist pitfall of the sociology of disasters, which would give the impression that the answers alone would be sufficient to explain the dynamics of disasters. In this crisis, “everything” is not a social construct, since this virus still presents very strong unknowns related to its modes of action and its modes of circulation. Acknowledging the importance of biological and viral uncertainties in the choices that are made should not make us forget, however, that the responses that are made also have an impact on the control of the pandemic.
It would be interesting to make an international comparison to better understand the capacity of national responses to contain the circulation of the virus. For example, until recently, Germany was praised for its efficiency, its decentralized organization in Lander, its superior hospital and testing capacities, and even more, a Chancellor with a scientific background. However, we can see that Germany is now aligning itself with the other European countries and is forced to apply a partial containment since it is beginning to have difficulty in containing the virus. German scientists state that the main difference between France and Germany lies in the faster initial formation of clusters (especially the one in Mulhouse) which, once they have reached a certain critical size, no longer allow the application of testing and screening strategies. The same is true for Switzerland and Belgium, where the epidemic suddenly flared up.
The international comparison can therefore better show how, despite the (more or less) great diversity of the measures taken, the States are still overwhelmed by the number of cases, which could allow to better identify the weight of the uncertainties on the circulation of this virus. On another level, an international comparison can also help us to better understand the nature of the responses to this crisis. Thus, and for example, we observe certain similarities between France and the United States in their preparation. The risk of a global pandemic has been on the agenda of the American authorities for about ten years and the country has an agency dedicated to this risk with significant resources: the Center for Disease Control. And like France, the USA was also surprised and overwhelmed. Do we observe the same undue sense of preparedness built over a long period of time? Research still has a lot to do on this subject.
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