Collective action during the Covid-19 pandemic: The case of Germany’s fragmented authority

Abstract

Countering the calls for more centralized public decision-making and unified command-and-control administration, we show how fragmented authority can foster collective action to mount an effective response to the COVID-19 pandemic. To this aim, we use a conceptual framework that integrates emergency management and political economic theory and provide several examples to illustrate how public and private actors in Germany met the challenges of the pandemic with coordinated, cooperative, and collaborative action. The motivational, strategic, and structural solutions we identify in this research offer to scholars and practitioners insight into the design of resilient public health systems.

Keywords:

• Collaborative governance
• emergency and disaster management
• federalism
• public health

Introduction

The COVID-19 pandemic poses an unprecedented challenge to public institutions around the world. Political leaders have been searching for clues in the reports released by the first countries that were affected, eager to learn which strategies show promise in managing the outbreak. As the pandemic started spreading from Asia to Europe and the U.S., several governments passed with little or no political opposition laws and directives that would have most likely raised protests at any other time. Many governments have assumed emergency powers, which in some cases are so far-reaching as to undermine the division of power that is traditionally enshrined in democratic constitutions. Especially at the onset of the pandemic, the impression was that open societies were at a disadvantage compared to authoritarian regimes (Pérez-Peña, 2020) and that federal and decentralized systems (Haffajee & Mello, 2020; Kilgore, 2020) were not capable of dealing with the crisis as effectively as centralized systems (Roland, 2020).

The desire for decisive, unequivocal leadership at the top of a unified hierarchy is a well-known response to threats. Historically, emergency and disaster management (EDM) has typically prescribed a command-and-control approach to civil defense to protect the population in case of armed aggression (Alexander, 2015). This principle of organization is still relevant today, as many first responders operate within strict hierarchies. However, the complexity of natural, technological, and societal hazards has led to a new EDM paradigm, based on a more decentralized, bottom-up approach (Comfort, 2019; Waugh & Streib, 2006). This paradigm echoes the shift from vertical structures of administrative authority to the horizontal structures that New Public Governance proposes (Osborne, 2006). Typically, these horizontal structures rest on networks of interagency and cross-sector collaboration. Public administrations based on this type of fragmented authority are commonly expected to be more resilient in times of crisis (Duit, 2016). However, in decentralized systems there are considerable challenges to aligning numerous actors without an omnipotent Leviathan.

Several political economists have detailed the various dilemmas that interdependent actors who engage in the provision and consumption of public goods are confronted with (e.g., Ostrom, 1990). Social distancing constitutes precisely such a dilemma: society is better off when everyone follows the rules, but individual citizens have strong incentives to deviate (Johnson, Dawes, Fowler, & Smirnov, 2020). In other words, individual rationality does not necessarily result in collectively rational outcomes.

From this standpoint, it is indeed questionable whether decentralized decision-making is enough in itself to direct public and private actors toward the common good. Democratic processes on multiple levels of authority can be too time-consuming and cumbersome, making it hard to organize an expeditious collective response to a crisis (Scharpf, 1988). While most studies in the EDM literature acknowledge the benefits of centralization in connection with various forms of joint response to a crisis, they also consider relying on a few central actors as too precarious (Waugh, 2009). Fortunately, there are alternative approaches to centralized command-and-control for fostering collective action; these include motivational, strategic, and structural solutions (Kollock, 1998). For instance, the purposeful selection of partners or positive partnership outcomes in the past can mitigate collective action dilemmas in fragmented systems. Especially in the cases of emergencies (Morgeson & DeRue, 2006) and collective risks (Comfort, 2019), individual and collective rationality may align better than expected.

In this article, we detail how a system based on fragmented authority achieves collective action that amounts to an effective response to a crisis. More precisely, we use Germany as a critical and politically important case in point to counter the calls for more centralized and hierarchical approaches to the COVID-19 pandemic. Our article adds to the EDM literature insights into how coordination, cooperation, and collaboration can help tackle crises such as the current pandemic and discusses generative mechanisms that help enable collective action. These insights can help policymakers and administrators understand better how a decentralized, resilient public health system can be designed and what challenges this may involve. We do not draw our conclusions from “hard evidence” but ground them in rich descriptions of the case of Germany. In that respect, our article is in line with Waldo’s (1965) normative-interpretative tradition of research on public administration.

In the next section, we draw on the EDM literature to disentangle the concepts of coordination, cooperation, and collaboration, detailing the challenges each poses to collective action and sketching possible solutions. We then outline our methodological approach and describe briefly Germany’s federal system, focusing on how the German healthcare system and public health administration are organized, to shed light on Germany’s state of preparedness before the pandemic. Thereafter, we illustrate the response to the crisis, describe the patterns of collective action, and discuss how the relevant dilemmas were resolved. We conclude that decentralized systems that govern public and private organizations on multiple levels of authority can be resilient and capable of collective action during a crisis.

The challenges of coordination, cooperation, and collaboration

The general consensus in the EDM literature is that some form of coordination, collaboration, or cooperation is necessary during a crisis (e.g., Kapucu, Arslan, & Demiroz, 2010; Martin, Nolte, & Vitolo, 2016). However, whether a centralized or a decentralized approach is most appropriate is a matter of much debate. Centralized approaches focus on establishing a coherent emergency-management strategy (e.g., Waugh & Streib, 2006) whereas decentralized approaches emphasize emergent interactions between organizations in response to disasters (e.g., Comfort, 2007). Given that an effective response requires that both of these goals are satisfied, Moynihan (2008, p. 206) famously described the resulting tensions as the “crisis management paradox.” In addition, the concepts of coordination, collaboration, and cooperation remain ambiguous in the EDM literature. Most studies use the terms almost interchangeably (e.g., Kapucu et al., 2010). Only a few scholars conceptualize them in relation to a continuum of interaction intensity, though locating them at different positions (e.g., Martin et al., 2016; McNamara, 2012).

To address the debate on centralized versus decentralized responses and to differentiate between coordination, collaboration, and cooperation we draw on political economic theory. In this literature, coordination, collaboration, and cooperation indicate related but distinct types of collective action that impose specific incentive structures on individual actors who, as a result, will either align themselves with or deviate from a collectively rational solution (e.g., Ostrom, Gardner, & Walker, 1994). While the field of peace and security studies frequently scrutinizes the behaviors of political actors through the lens of political economics (e.g., Kleiboer, 1997; Snyder, 1984; Soroos, 1994), this approach is less pronounced in the EDM literature. Among the few exceptions are Busch and Givens (2013), who discuss challenges to public–private partnerships in disaster management as a prisoner’s dilemma and propose assigning predefined responsibilities as a possible solution. Nohrstedt (2018) demonstrates how stable relationships and mutual trust attenuate the problem of free-riding in collaborative networks in the context of local crisis management. However, we are not aware of any study that has developed a comprehensive framework for analyzing the various dilemmas associated with collective action, which arise when public and private actors on the local, state, and federal levels interact in response to an emergency.

The framework displayed in Table 1 integrates the EDM literature with insights from political economics to derive a heuristic for identifying collective-action dilemmas in the empirical material we use in this study. This framework will help us clarify the concepts of coordination, cooperation, and collaboration, depict the incentive structures and dilemmas associated with each, and relate the respective dilemmas to possible solutions.

Table 1. Coordination, cooperation, and collaboration dilemmas.

	EDM literature	Political economics
	Definitions	Definitions	Incentive structures and dilemmas
Coordination	Actors align their actions with those of other actors in order to achieve a common goal, often established via formal linkages (Comfort, 2007; Martin et al., 2016; McNamara, 2012).	Actors share a common goal but the absence of obvious points of alignment creates the need for interactions on how to achieve the goal (Snidal, 1985).	Coordination dilemma (Snidal, 1985): moderate compatibility between individual and collective incentives.
Cooperation	Actors work together in the context of often short-term, informal relationships characterized by low levels of intensity and risk for individual actors (Martin et al., 2016; McNamara, 2012; Waugh & Streib, 2006).	Actors pursue individual goals and work together only if it benefits their short-term interest, notwithstanding the possibility of higher long-term benefits for all (Ostrom, 1990).	Tragedy of the commons (Hardin, 1968) and of the anti-commons (Buchanan & Yoon, 2000): low compatibility between individual and collective incentives.
Collaboration	Actors establish long-term relationships and work together to pursue complex goals, creating high levels of interdependency and sharing risk (Brown & Keast, 2003; Martin et al., 2016; McNamara, 2012).	Actors may work together to achieve a collective outcome, but the outcome depends on the contribution of other actors (Samuelson, 1954).	Public-good dilemma (Olson, 1965): low compatibility between individual and collective incentives.

Coordination is the least interaction intensive of these three concepts: it involves aligning different actors who share a common goal but among whom there is no consensus on how to achieve this goal (Martin et al., 2016). The coordination game in game theory illustrates this setup: in a coordination game, individual and collective incentives align enduringly if an external actor or a communicative process facilitates an existing or latent agreement among the participating actors (Snidal, 1985).

The next mechanism, cooperation, requires more interaction between the actors, often in the form of short-term and informal arrangements (Martin et al., 2016). Cooperation resembles the prisoner’s dilemma, a setting in which individuals have strong incentives to deviate from a collectively rational solution. The negative outcomes of the prisoner’s dilemma have been described as “the tragedy of the commons” (Hardin, 1968), a situation in which individuals exploit common resources, and as “the tragedy of the anticommons” (Buchanan & Yoon, 2000), a situation in which meritocratic goods are sealed off from collective use.

Collaboration is the most intensive of these three forms of interaction. Collaborating actors execute interdependent tasks to achieve goals that they cannot accomplish individually. The actors have incentives to collaborate, but only if others also contribute. This form of interaction has been analyzed in public-good contribution games. If individual actors act as free-riders, the outcome is an undersupply of common goods (Olson, 1965).

We analyze the dilemmas associated with each of these three modes of interaction, without suggesting that they cannot be resolved independently of any external intervention (Ostrom, 1990). On the contrary, we identify features in the design of Germany’s public health system and responses to the pandemic that preempt the seemingly inevitable failure of voluntary collective action. Following Kollock (1998), we propose motivational, strategic, and structural solutions to collective-action problems.

In the case of motivational solutions, actors take into account the outcomes of their partners’ actions when making a decision. This behavior may result from adherence to social norms that encourage cooperative behaviors, direct communication between partners, or perceiving one’s partners as members of the same social group. In the case of strategic solutions, actors still behave rationally as individuals but their behavior prompts their partners to respond in ways that lead to collective action. Strategic solutions include reciprocity, the selection of benevolent partners, and social learning in repeated interactions. Lastly, structural solutions alter the design of the situation and therefore manipulate incentive structures, the possibilities to defect from collective action, or both. Structural solutions include interacting more frequently, being transparent about one’s choices, putting in place (dis)incentives for (un)cooperative behaviors, imposing an external authority, or distributing property rights.

Case analysis

Case selection

We selected Germany because it is a critical and politically important case of purposeful sampling (Patton, 2001). Germany is a federal parliamentary republic consisting of 16 states with a total of 83 million inhabitants. The chancellor holds fewer executive powers than in presidential systems and the states are independent from the federal government with regard to most matters, including healthcare and disaster management. The constitution guarantees that municipalities have the right to local self-governance. Germany was one of the hardest-hit countries in terms of the number of infections when the pandemic reached Europe; nevertheless, its healthcare system was not overwhelmed while the number of daily cases was still rising. On those grounds, Germany’s federal political system and the decentralized organization of its public health system provide a setting that promises to yield rich information about collective action during the COVID-19 crisis.

Methodological approach

In this article, we follow an abductive approach (Peirce, 1955) to elaborate on responses to the COVID-19 pandemic in Germany’s public health system. As a form of methodological reasoning, abduction functions as a link between deduction and induction, between logical and empirical reasoning (Mingers, 2012). We use theoretical arguments to specify conditions that probably caused certain outcomes (Bertilsson, 2004)—in other words, we try to explain why the solutions we discuss here were (most likely) necessary for collective action. This approach allows us to combine individual observations—i.e., specific instances of coordination, cooperation, and collaboration—with a generic theory based on political economics to explain how effective collective action is possible in a fragmented system.

We derived our data from structuring content analysis, which was enriched by explorative expert interviews (Mayring, 2004). We began by analyzing official statements, press conferences, and news reports to tag specific aspects in Germany’s response to the COVID-19 pandemic. Next, we explored regulatory frameworks and the “grey” literature to identify the systems and actors involved in the response and Germany’s state of preparedness before COVID-19. We then linked the empirical material to our conceptual framework by assessing the interactions we observed between actors and categorizing them as instances of cooperation, coordination, or collaboration. Additionally, we identified the dilemmas associated with each type of response and the motivational, strategic, or structural solutions that had emerged. To gain additional insights into undocumented, “behind-the-scenes” aspects, we conducted short interviews with key informants in Germany’s public health system (e.g., federal and state health officials, hospital management staff).

Preparedness of Germany’s public health system

Germany’s healthcare system is well resourced, with the highest number of practicing nurses and physicians per capita among the G7 member states. Its governance structures are complex, with authority distributed across multiple levels and sectors. This complexity is partly due to the heritage of having the world’s oldest social health-insurance system, which embraces the principles of solidarity, self-governance, and competition. Medical insurance is mandatory, so every citizen has equal access to healthcare. There is some competition with regard to coverage and costs between the private nonprofit and for-profit insurance providers; however, the former deposit their annual surplus in a collective fund. While the government heavily regulates the healthcare system, it delegates most of its operations to self-governing bodies consisting of professional associations and special-interest groups. Within this regulatory framework, they are responsible for the sufficient, appropriate, and cost-efficient delivery of health services. Almost 2,000 public, private, and nonprofit hospitals operate in Germany, but the 34 public university hospitals conduct almost 10 percent of all treatments. They also serve as regional innovation hubs, in collaboration with several nonprofit research institutes and private companies. The first point of contact for non-emergency patients is one of the 60,000 primary care physicians, who refer the patient to another specialist or to a hospital, if necessary. About 200 laboratories conduct diagnostic tests across the country.

In line with the principle of subsidiarity, Germany’s public health administration is located on the municipal level. Approximately 400 local health authorities are responsible for implementing infection-control measures, while the 16 states serve as intermediate institutions that deal with cross-state issues and provide centralized services. At the federal level, the Robert Koch Institute (RKI) is tasked with epidemiological surveillance and scientific research, primarily on infectious diseases. Its role is not operational, but to support and advise local and state health authorities, healthcare providers, and politicians. The federal government has hardly any competencies or hierarchical elements dedicated to coordination; however, it comprises several informal coordination bodies that represent a broad spectrum of formats, from mainly technical to mainly political.

This decentralized approach has not gone without criticism and there have been demands for stronger federal leadership in Germany’s EDM. A group of federal lawmakers who analyzed the constitutional separation of responsibilities (Reichenbach, Göbel, Wolff, & Stokar von Neuforn, 2010, p. 42), stated that it “remains to be seen whether, in the event of a Germany-wide epidemic, the current federal structures of healthcare and disaster management are the appropriate organizational form” [translated by the authors].

Response to the pandemic

By mid-January 2020, when COVID-19 was still considered a Chinese epidemic, a German university hospital had already developed and published an open-source polymerase chain reaction (PCR) test for detecting SARS-CoV-2. A nearby biotech company contacted the researchers and started producing test kits on a large scale. Thus, Germany’s laboratories were able to roll out testing rapidly once the virus hit the country several weeks later. Health insurance providers coordinated quickly to cover PCR tests, so local public health authorities were able to trace and contain COVID-19 cases early on.

Following the skiing holidays and carnival season in February, multiple hotspots emerged simultaneously. Local health authorities were no longer able to track every chain of infection. In mid-March, individual states started implementing certain social-distancing measures, such as restricting mass gatherings and closing schools. This created greater demand for coordination. Chancellor Merkel managed to harmonize these measures in a series of meetings with the heads of all 16 states. Despite reports of controversies, each meeting ultimately led to a commonly agreed solution that nevertheless allowed individual states to modify it according to their specific epidemiological situation.

When the strategy gradually shifted from containment to mitigation and it became clear that intensive care units (ICUs) are a bottleneck resource, both the federal government and state governments agreed on an emergency plan to double the available ICU capacity. Although suspending non-critical surgery created financial burdens for hospitals, the vast majority complied immediately. Ten days after the plan was launched, a new law provided that hospitals would be reimbursed for excess capacities from the public health fund’s liquidity reserve. Without an explicit mandate, the Federal Crisis Committee coordinated several federal agencies to ramp up a joint procurement program for personal protective equipment (PPE) in order to utilize economies of scale and avoid competition between the states. This centralized process neither became mandatory nor did it prohibit individual organizations or states from making their own purchases.

While the local health authorities ensured a good level of situation awareness and provided local networking opportunities, they were commonly understaffed and used diverse standards for testing and quarantining. At first, the RKI mainly monitored the situation, determined risk areas, and collected scientific evidence on SARS-CoV-2. In the course of the crisis, however, it started publishing guidelines for local health authorities and healthcare providers. Although the RKI has no formal authority, most of its guidelines were implemented throughout Germany, albeit sometimes adapted to the local situation. In late March, an amendment on “epidemics of national concern” to the Federal Infection Protection Act (FIPA) endorsed the role of the RKI as an inter-level coordination interface and established direct counterparts within local health authorities.

At the beginning of the crisis, there was no central overview of actual hospital resources. Although a database of such resources had been created as a result of the H1N1 pandemic of 2009, only 85 out of 2,000 hospitals had participated. In the course of the COVID-19 crisis, several medical associations and state authorities collaborated in an ad-hoc effort to revive that database and map ICU capacity. After more than 95 percent of hospitals with ICUs joined voluntarily, the Federal Ministry of Health issued a regulation that obliges hospitals to report vacant and occupied ICU capacities on a daily basis.

When some social-distancing measures were relaxed in late April, a controversial debate about the remaining restrictions unfolded. State governors with prospects of becoming the successor of Chancellor Merkel were the first to defect from the coordinated response. Some lobbied for lifting social-distancing measures much faster while, in contrast, others lobbied for prolonging them. In early May, in view of declining infection rates, the Chancellor and the heads of the 16 states abandoned most common positions and agreed to regionalize social-distancing measures according to the local situation. They established a threshold of infections per week, beyond which the state governments would have to intervene locally. However, some states lowered this threshold while others refrained from overruling local authorities once a region in their state hit the threshold. In the following weeks, local health authorities successfully contained several local outbreaks through measures such as quarantining small clusters in residential blocks and farms. A larger cluster of more than 1,500 infections associated with a slaughterhouse led to a temporary regional “lockdown” in two districts in the state of North Rhine-Westphalia that were designated as COVID-19 risk areas. However, even local measures demand coordination on a higher level. Initially, individual states issued different regulations to prohibit travelers from those risk areas from staying overnight at hotels; later on, however, all states agreed to exempt travelers who could provide a recent negative test result for SARS-CoV-2.

Collective action during the pandemic: Dilemmas and resolutions

In this section, we discuss the dilemmas that the collective responses to the COVID-19 pandemic in Germany posed and how they were resolved. Table 2 summarizes the findings in a structured way, listing the most important collective actions along the typology of coordination, cooperation and collaboration, as well as displaying the respective issues, involved systems and actors.

Table 2. Collective action during the COVID-19 pandemic.

	Issues	Systems	Actors	Dilemmas	Solutions
Coordination	Coverage of PCR tests	Public health administration/healthcare system	Health insurance companies & healthcare providers	Coordination dilemma: which tests to cover and at what cost? Common goal: cost coverage and identification of infections.	Motivational: direct communication (self-governing bodies). Structural: incentives modified already before the pandemic due to mandatory insurance.
	Harmonization of social distancing (early)	Public health administration	Federal & state governments	Coordination dilemma: how to align measures between states? Common goals: suppression of epidemic and legitimacy of measures.	During the height of the epidemic: Motivational: same social group (politicians). Structural: increased meeting frequency (between federal and state governments) and transparency of decisions (joint press conferences).
	Establishment of RKI as central hub in the network	Public health administration	RKI & 400 public health authorities	Coordination dilemma: how to align responses between regions? Common goals: better and more legitimate responses.	Strategic: social learning (transfer of best practices). Structural: transparency (daily reports by the RKI) and increased interaction frequency (establishing counterparts per 10 local health authorities).
Cooperation	Development and production of PCR tests	Healthcare system	University hospital & private companies	Tragedy of the anti-commons: privatize knowledge and generate licensing revenues or publicize knowledge, gain reputation, and ensure broad usage?	Motivational: social norms (scholarship and Hippocratic Oath). Structural: incentives modified already before the pandemic due to publicly funded research.
	Central procurement and distribution of PPE	Public health administration/healthcare system	States, hospitals, primary care physicians	Tragedy of the commons: incentives for hospitals to over-use central PPE supply, while still purchasing more PPE individually.	Motivational: social norms (Hippocratic Oath) and same social group (medical services). Strategic: social learning (decreased orders after hospitals learned that PPE is supplied regularly).
	Harmonization of social distancing (late)	Public health administration	Federal & state governments	Prisoner’s dilemma: gain political capital by defecting or implement common measures?	While recovering from the first wave of the epidemic: dilemma not resolved.
Collaboration	Doubling available ICU capacities	Healthcare system	Hospitals with ICUs	Public-good dilemma: financial burden for individual hospitals, but little added overall capacity if other hospitals do not contribute.	At first, motivational: social norms (Hippocratic Oath). Later on, structural: incentives for collaboration (reimbursement of hospitals for excess capacities).
	Reporting ICU capacities via a monitoring system	Public health administration/healthcare system	RKI & hospitals with ICUs	Public-good dilemma: administrative burden and disclosure of competition-relevant data, but using resources effectively is not possible if other hospitals do not contribute.	At first, motivational: social norms (Hippocratic Oath), and belonging to same social group (medical services). Later on, structural: disincentives for not collaborating.

In Germany, the fast production of the PCR test and the agreement among all health insurances to offer it can be attributed, at least in part, to the fact that the public health system relies on public funding. The principle of providing public funding increases the incentives for creating pure public goods (Ostrom, 1990), most notably in the areas of scientific research, health care, and health insurance. Direct communication within self-governing bodies enabled German insurance providers to resolve quickly the dilemmas that coordination posed. Similarly, the social norms of open scholarship and the Hippocratic Oath seem to have changed the incentive structures for the medical researchers to cooperate with the company that produced the test.

While our evidence is anecdotal, it suggests that these medical norms are the main reason why most hospitals responded to the calls for increasing and reporting on their ICU capacity to the central monitoring system, despite the considerable financial and administrative burden this entailed. Although there were a few free-riders, ultimately the state intervened and imposed structural solutions in the form of (dis)incentives to press free-riders to collaborate.

Professional medical values and group pressure also appear to have weakened the incentive for hospitals to over-use central supplies. However, it was not before hospitals ascertained that PPE would be supplied reliably that they stopped overstocking on PPE. Through this process of social learning, the high volumes of PPE orders dropped after the first few rounds of distribution. Social learning through the transfer of best practices also helped resolve the difficulties of coordinating the actions of local health authorities. As they all shared a common goal—namely, to adopt effective and legitimate practices—the RKI was designated as the central lead agency in the network (Kenis, Schol, Kraaij‐Dirkzwager, & Timen, 2019). This led to a hybrid type of response based on fast, self-organized, locally tailored action, a set of best practices, but also a centralized hub for information and guidance. These examples illustrate a “smart mix” of centralization and decentralization (Aubrecht, Essink, Kovac, & Vandenberghe, 2020).

A comparison between the preparedness and the response phases indicates that the degree of voluntary collective action increased considerably during the pandemic. The urgency of the matter seemed to have influenced strongly the behaviors of the actors involved (Morgeson & DeRue, 2006). The database for ICU capacity is a good example: without the urgency of having to respond to a collective risk, initially only few hospitals participated. Voluntary participation increased in response to urgency, while the few free-riders ultimately forced the state to make participation mandatory by ordinance (Kollock, 1998). According to our interviews, public health officials assume that voluntary participation was hindered by the additional administrative burden the new reporting system created, the burden of duplicated effort due to existing local reporting systems, and the fear of disclosing competition-relevant data.

At the height of the pandemic, the federal and state governments resolved the dilemma of coordination mainly through structural solutions, such as increasing the frequency of high-level meetings and the transparency of decision processes through joint press conferences. As a result, social-distancing measures were harmonized across all states. During this phase, political coordination focused on joint problem-solving rather than on self-interested political bargaining, avoiding the “joint decision trap” of federal decision-making (Scharpf, 1988). The FIPA provided a flexible and amendable framework for state governments and local authorities to act on (Sauer, 2020). However, once the first wave receded, the incentive structures changed and the coordination problem became more of a cooperation problem. The economic pressures caused by social-distancing measures and certain epidemiological considerations tempted some politicians to gain political capital by withdrawing from the common solution.

Although an increase in self-interested political bargaining is likely during the recovery phase of a crisis (Nohrstedt, Bynander, Parker, & ‘t Hart, 2018), in this case this trend can be dangerous as there is still the risk of a second wave of infections. To maintain the capability of collective action, it is vital to develop a shared cognition about the degree of collective risk (Comfort, 2007). This poses a challenge to federal systems, in which the distributed local responses of public and private organizations are difficult to monitor. Before the second revision of the FIPA, there was no legal obligation to report negative tests, the number of cured patients, or the severity of each confirmed disease. In the absence of mandatory reporting and of a fully integrated electronic reporting system, the RKI can only collect epidemiological data that are neither complete nor up-to-date. Consequently, different administrative levels may assess the scope of the pandemic and perceive the associated risks very differently. This, in turn, could hamper collective action and lead to a patchwork of measures based on beliefs, rather than epidemiological data. Such a lack of coordination could create a partly dysfunctional response and, therefore, to the false conclusion that “federalism is part of the problem” in the COVID-19 crisis (Kreitner, 2020).

Discussion

So far, Germany’s federal democracy and decentralized public health system have proved to be resilient in the face of the pandemic. Especially in the beginning of the crisis, per capita testing was higher than in most other countries. Important indicators, such as the number of active infections and the effective reproduction number (R) have decreased considerably since their peak in late March. Healthcare capacity sufficed, so every patient received intensive care when necessary, including more than 200 patients from Germany’s hardest-hit European neighbors. The case fatality rate and excess mortality have remained at the lower end of the global spectrum. Germany never introduced lockdown measures as strict as those implemented in Wuhan or in many other European countries. While a few politicians argued that, in the absence of debates, the measures taken lacked democratic legitimacy, simulations show that the timely onset of social-distancing measures was crucial (Dehning et al., 2020) to managing the crisis effectively. We should note, however, that these conclusions are preliminary and subject to the limitations of epidemiological statistics (Ioannidis, 2020).

Necessary conditions for resolving the dilemmas associated with coordination, cooperation, and collaboration

Our analysis highlights the conditions that are at the very least strongly conducive—if not essential—to resolving the dilemmas that coordination, cooperation, and collaboration pose. We proposed that coordination is the least problematic of these three forms of interaction as individual and collective goals are already aligned; the problem that needs to be resolved is how the actors involved can also align their actions (Snidal, 1985). We further suggested that establishing formal linkages between those involved would help resolve coordination problems (Comfort, 2007; Martin et al., 2016; McNamara, 2012). Our evidence supports these arguments: First, direct communication enabled health insurance companies and healthcare providers in self-governing bodies to agree speedily on covering the cost of PCR tests. Second, increasing the frequency of meetings between federal and state officials helped harmonize social-distancing measures. Third, establishing contact persons for local health authorities at the RKI greatly facilitated interactions in Germany’s decentralized administrative context. If such communication systems are not in place before an emergency occurs (Kapucu, 2006), implementing them swiftly seems to be crucial to overcoming coordination problems.

In the case of cooperation, problems arise when actors pursue individual goals, notwithstanding the possibly higher long-term benefits of cooperation for all (Ostrom, 1990). As the successful development and production of PCR tests and the procurement of PPE shows, short-term relationships entailing relatively low risk for individual actors (Martin et al., 2016; McNamara, 2012; Waugh & Streib, 2006) facilitate cooperation. However, although strong professional ethos persuaded actors to deviate from the individually rational strategy, and is therefore a necessary condition for cooperation, they still had to be convinced that PPE would be supplied regularly to adjust their orders so that central supplies would not be overused. Thus, social learning is another key factor. The existence of prior cooperation between the researchers at the university hospital and the biotech company further stresses the importance of experience as an important partnership input (Nolte & Boenigk, 2011).

A similar pattern emerges in the case of dilemmas associated with collaboration. Collaboration demands that all actors involved contribute to a collective outcome (Olson, 1965). In this case, the actors were able to share risks and build long-term relationships on the basis of professional values and social norms (Brown & Keast, 2003; Martin et al., 2016; McNamara, 2012). However, the condition of reciprocity and orientation toward the common good did not suffice to prevent free-riding altogether. This problem was only resolved when the Federal Ministry of Health implemented top-down structural solutions, which suggests that some form of interorganizational hierarchy is necessary when decisive action is required (Moynihan, 2008).

Tailoring EDM systems to different types of disasters

A cursory international comparison indicates that Germany’s fragmented authority enabled a broadly adequate response, while the cases of France and the U.K. suggest that too centralized approaches may hinder local initiatives (The Economist, 2020; Watts, 2020). However, this may not hold true for emergency and disaster management in general. Especially high-impact, sudden disasters like earthquakes and wildfires require that clear chains of command and predefined standard operating procedures are already in place, as the establishment of the Incident Command System in the US and its German equivalent (“FwDV 100”) in the aftermath of severe wildfires in the 1970s illustrates (Alexander, 2015).

In contrast, the approach presented here is more suitable for tackling complex crises that resemble wicked problems in that they are characterized by high degrees of uncertainty and ambiguity and the absence of evidence-based solutions (Head & Alford, 2015; Rittel & Webber, 1973). Scenarios such as the Fukushima disaster in 2011 or the challenges of climate change demand the involvement of a broad range of different actors and perspectives (Managi & Guan, 2017) with diverse, and sometimes competing, ideas (Oates, 1999). The design of federal systems usually favors this mode of crisis management. In contrast, the problems that Spain (Gallardo, 2020) and Brazil (Ricard & Medeiros, 2020) have been facing in their attempts to manage the pandemic underline the importance of mechanisms that align multiple levels of authority (Vampa, 2020) and combine the advantages of local awareness and responsibility with guidance and support on the national level (Boyd & Martin, 2020).

Our analysis also shows that Germany oscillated between decentralized and centralized solutions, which, however, did not alter the overall fragmented design of the public health system. Australia is a similar case in point, having delegated many responsibilities to its states and territories in the aftermath of past health disasters; a move strongly supported and coordinated by the Commonwealth (Moloney & Moloney, 2020).

In the U.S. (Carter & May, 2020), in contrast to Germany, individual states adopted different approaches to handling the pandemic, which undermined people’s trust in public institutions (Curley & Federman, 2020; Hall & Battaglio, 2020). The lack of federal leadership hampered communication among decision-makers. As a result, the COVID-19 pandemic was politicized and, in the absence of consensus on a unified approach, the problem of self-interested political bargaining remained unresolved.

Limitations and implications for research and practice

There are, of course, some limitations to our study, which qualify our overall optimistic testimony about the advantages of fragmented systems. At the same time, these limitations point to interesting avenues for further research.

First, this article follows an abductive approach; that is, the conclusions we draw from our data are the most plausible; however, we cannot exclude alternative explanations. Related to this, our argument for a decentralized federal system is based on a single case. Although we briefly discussed the responses of other countries, a rigorous comparative study of decentralized and centralized public health systems would provide more insights into the factors that make a public health system resilient and promote effective collective responses. Future research should also compare the COVID-19 pandemic with other emergencies to relate different adaptive governance approaches to the complexity of a crisis (Kenis et al., 2019). Second, in this paper we have discussed dilemmas and their solutions fairly broadly, to include every important response to the pandemic in Germany. A more thorough analysis could identify specific structural designs (Feiock, 2013) or psychological factors (Van Lange, Joireman, Parks, & Van Dijk, 2013) and link them to particular aspects of social dilemmas, such as the number of actors involved (Ostrom et al., 1994). Lastly, our analysis focuses on the public health system; however, the COVID-19 pandemic poses a myriad of challenges (Hall, Zavattaro, Battaglio, & Hail, 2020). For instance, closing national borders reduces international trade and travel (Garrett, 2020), certain ethnic groups have been stigmatized as alleged carriers of the disease (Roberto, Johnson, & Rauhaus, 2020), closing schools and universities has complicated the provision of education (Blankenberger & Williams, 2020), and crime control has become more difficult, especially in financially and institutionally constrained settings (Alcadipani et al., 2020). Moreover, the repercussions of lockdown on the economy (Goodell, 2020) and, consequently, on public budgeting (Maher, Hoang, & Hindery, 2020) are manifold and serious. Solving these intertwined problems will require substantial collective action, which implies that there will be more challenges and possibly more dilemmas to tackle in the future.

Within these limitations, our analysis could also help practitioners create in the preparedness phase the conditions that are necessary for resolving collective-action dilemmas when crises arise. For example, governments can implement instruments such as periodic and holistic risk analysis, scenario techniques, or tabletop exercises, involving various public and private actors (Fischhoff, de Bruin, Güvenç, Caruso, & Brilliant, 2006). Such tools can foster a shared mental model of risks as well as consensus on the appropriate level of protection, both of which should expedite motivational solutions in future crises (Comfort, 2007). Similarly, joint planning groups and regular exercises can help build inter-organizational relationships that facilitate the principle of reciprocity, social learning and, ultimately, strategic solutions (Hu et al., 2014; Kapucu, 2006). Finally, introducing legislation that enables health authorities to respond quickly if the parliament declares a health emergency would enable tailored structural solutions to collective-action problems (Klafki, 2020; Sauer, 2020).

Conclusion

The COVID-19 pandemic provides numerous opportunities for investigating the fundamental question of how public institutions should be designed so that they can respond effectively to a crisis. Drawing on the German response to the COVID-19 pandemic, this study has explained what makes decentralized systems resilient and capable of collective action during a crisis. The key factors include an increase in coordinated, cooperative, and collaborative collective action early on in the pandemic. The main driver seems to be a common sense of urgency and a shared cognition based on reliable information. Both of these will prove crucial to tackling similar challenges in the future.

Acknowledgements

We would like to thank the reviewers for their constructive comments. We are also grateful for the voluntary collaboration of Artemis Gause who proofread an earlier version of this article free of charge.

Additional information

Funding

This work was supported by the German Federal Ministry of Education and Research (BMBF) under Grant 13N14354.

Notes on contributors

Fabian Hattke

Dr. Fabian Hattke is Interim Professor for Organization and Leadership at Universität Hamburg, Germany. His research concerns public leadership, bureaucratic rules, and performance management in public sector institutions.

Helge Martin

Helge Martin is research associate at the Centre for Science and Peace Research at Universität Hamburg, Germany. His research addresses crisis and disaster management in complex multi-actor settings.