Health Pass and Strikes in French Hospitals in the Midst of the Pandemic

Strikes by healthcare workers were launched in France during the pandemic: this will long remain the best example of friction undermining the operational efficiency of prevention. And a quitessential example of an inability to conceive, foresee, and prevent this phenomenon. Georges-Yves Kervern would have made this diagnosis: epistemic shortcoming, lack of training in Cindynics.

In the event of a crisis or disaster, when actions have to be decided, most of the time a consensus emerges between actors. From a cindynical point of view, crisis management consists in implementing an intentional transformative operator made up of organisational actions aimed at modifying the behaviour of actors.

However, sometimes the efficiency of these actions is not optimal. The need for operational efficiency gains is one of the issues that led to the emergence of second-order Cindynics.

Conceptually, this lack of efficiency is described as resulting from a friction  phenomenon, in the sense proposed by Clausewitz: the difference between what is planned in theory, and what actually happens on the ground.

Second-order Cindynics are based on a breakthrough that will have many consequences: the relativisation of the notion of situation. Each actor in a situation is indeed also an observer, and has a personal assessment of what it should be ideally, and how to achieve that ideal. The notion of vulnerable situation, where vulnerability is a propensity, is thus extended by the notion of spectrum of situations (set of relative situations) and field of propensities: each actor is likely to want to implement actions that are different from those desired by the other actors. These prospective divergences are factors of friction and conflictuality which undermine the operational efficiency of prevention or crisis management.

Guy Planchette reminds us that Georges-Yves Kervern indeed considered conflictualities between actors, such as disagreements between experts, and that they can be modeled as teleological dissonances (differences of objectives) between actors. The contribution of second-order Cindynics is to consider that these various objectives are not usual objectives, but are transformative objectives. As soon as it is noticed that actors have different transformative objectives2 , situations are relativised. Second-order Cindynics result from this observation.

Therefore, the first question to ask when faced with a crisis is: is the situation consensual, or is it marked by prospective divergences and perception disparities? If there are differences, the actor in charge has two options: take these differences into account, or railroad through other actors. If he tries to force his way, from a cindynical point of view it is simply obvious that at best the actions taken will not be efficient.

Even Clausewitz notices this when he says that while it takes an iron will to overcome friction, that same iron will also destroys the machine. In a crisis situation: the actors of this situation.

Thus the implementation of a health pass in France has led hospital workers to launch strikes: it is one of the worst things that can happen in the heart of a pandemic, which perfectly illustrates the need to use second-order Cindynics in the event of crisis or non-consensual situation.

Among the many issues that can be observed in this situation, two can be mentioned:

Some actors conflate opposition to the health pass and opposition to vaccines, which is incorrect and obfuscates the issues that have led actors not opposed to vaccines to oppose the health pass, such as distrust of a policy of pervasive surveillance and control which has been systematically made definitive since September 11, 2001. How can one be surprised at the lack of confidence of actors during a crisis when distrust has been systematically constructed for the twenty years preceding this crisis?

Another issue is the decree claiming to determine the cases of exemption from vaccination. The daily work of physicians consists of doing the best with their knowledge and their means, which they know to be limited. What about a decree which claims to know all the cases? This kind of policy disregards physicians, places the law above their proficiency, and therefore contructs distrust.

In practice, it would be naive to hope to be able to reduce all the divergences of a non-consensual situation: second-order Cindynics do not claim to achieve it, but enable to adopt a rational approach aimed at minimising these divergences, constructing or reconstructing confidence, and getting operational efficiency gains.