[H1N1 pandemic. Measures and experiences on the state level]

Infection surveillance measures during the COVID-19 pandemic in Germany

Introduction: To address the question as to which infection surveillance measures are used during the ongoing COVID-19 pandemic in Germany and how they differ from pre-existing approaches. Methods: In accordance with the systematic approach of a scoping review, a literature search was conducted in national and international medical literature databases using a search string. The search in the databases was limited to the period from 01.01.2000 to 15.11.2020 and has been subsequently completed by hand search until 08.03.2021. A hand search, even beyond 15.11.2020, seemed necessary and reasonable, since due to the dynamics of the ongoing COVID-19 pandemic, a large number of articles and regulations are being published very quickly at short notice. Results: The literature search resulted in the following number of hits in the databases listed below: PubMed: 165 articlesCochrane: 1 review and 35 studiesWeb of Science: 217 articlesRobert Koch Institute: 49 articles Thus, a total of 467 hits were identified, with a total of 124 hits being duplicates. From these, 138 articles were considered relevant to the COVID-19 infection surveillance situation in Germany based on established criteria. After reading the full texts, 92 articles and websites were ultimately included in the scoping review. Discussion: Many of the lessons learned from previous outbreaks seem to have been implemented in the infection surveillance measures during the ongoing COVID-19 pandemic in Germany. Most of the changes compared with previous measures were based on technological streamlining of existing procedures and changes and more inclusion of the population in different infection surveillance measures.

COVID-19-Pandemie – Rationalität statt Regelungschaos tut not

Die COVID-19-Politik (nicht das Virus SARS-CoV-2 selbst) hat das Land im Griff. Mit den seit Anfang Oktober steigenden Infektionszahlen werden Regelungen über Regelungen erlassen von Sperrstunde, Versammlungseinschränkungen, verschärfter Maskenpflicht bis hin zum Beherbergungsverbot – verbunden mit der Drohung, dass, wenn dies nicht wirke, ein neuer Lockdown unerläßlich sei. Ohne die sich abzeichnende Wirkung der vorherigen Maßnahmen abzuwarten, beschließt die Politik rasch einen weiteren sog. „Lockdown light“. Die Gesundheitsämter schaffen die Nachverfolgung nicht mehr? Kein Problem: die Politik schickt Soldaten. Die Ordnungsämter sind mit der Kontrolle der vielen Verordnungen überfordert? Kein Problem: die Politik schickt die Bundespolizei.

Prioritätensetzung im Katastrophenschutz

Die Frage der „Prioritätensetzung bei Rettungsmaßnahmen“ lässt sich in unterschiedlichen Reichweiten betrachten. Sehr eng fokussiert kann man sie auf die Auswahl reduzieren, wer von mehreren Verletzten zuerst behandelt wird, wenn (zunächst) zu wenige Rettungskräfte vorhanden sind, um alle zugleich zu behandeln. Im Zusammenhang mit komplexen Schadenslagen stellt sich die Frage der Prioritätensetzung jedoch sehr viel umfassender dar. Sie betrifft bereits die Katastrophenvermeidung und -vorsorge. In der konkreten Lagebewältigung spielen verschiedene Rechtsgüter und die Wechselwirkungen zwischen ihnen eine erhebliche Rolle. Dabei existieren kaum rechtliche Regelungen, die die Prioritätensetzung steuern.

[Structures and concepts for nationwide outbreak management in a federal state]

With pandemic influenza in 2009/2010 and an EHEC outbreak in 2011, the Federal Republic of Germany experienced two extensive outbreaks in the course of only 3 years. Although both infectiological crises were comparatively successfully coped with, certain aspects have been critically examined. One point of criticism has been the presumption that federal structures may not be well suited for the management of a nationwide outbreak. This has been linked to the request for a central authority with responsibility. In fact, centralized as well as federal structures have advantages and disadvantages during infectiological crises. However, the "first response," i.e., immediate action against the spreading of infectious diseases, has to take place locally anyway. Regional differences, even in the context of a nationwide outbreak, might well demand regional action. After all, the federal structure of the Republic of Germany is deliberately firmly rooted in the German constitution, and there are no indications that this may change in the near future. Suitable concepts and structures should be used so as to benefit from the advantages and avoid the disadvantages of a federal state. The current structures are described, and improvements that may be necessary are discussed. The existing structures are shown to be entirely appropriate in allowing necessary decisions to be made and a fast transmission of information even in a federal state. Occasional shortcomings are seen as mainly due to the inadequate implementation of already existing regulations and partly to the ambition of a few spotlight seekers rather than to actual inadequacies of existing federal structures.