Pinning Down the Hypothetical. Pandemic Preparedness since the 1990s – Historical, Ethical and Legal Preconditions of Managing Corona Virus Response

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The "age of immunity" (Thießen) came to an end at the latest in the 1980s. As the flip side, so to speak, of a new phase of globalization, the perception of pandemigenic viruses as a threat to health, the economy, prosperity, and security increased. At the same time, contagion control, in many cases historically verifiable, was never accompanied by medical and hygienic consequences only, but always by—more or less far-reaching—political, social, economic, ethical, and legal ones as well. The pandemic plans that have been advanced since the 1990s were therefore directed at a field of action founded in epidemiology in a complex future contingent on numerous uncertainties. Hence both the World Health Organization (WHO) as well as responsible authorities in the Federal Republic of Germany attempted to plan for a pandemic future. These plans were readjusted following the outbreak of every new pandemic (e.g., the avian influenza in 2003). Who participated in the pandemic plans, the use of what resources the plans were based on, what public health measures were projected, what perspectives were included or excluded, what social segments were taken into account; and the values, such as equity, health, or the relationship between community and individual the plans were based on, are key issues in a historical approach as well as in ethical and legal considerations.The current Corona crisis reveals the limitations of the attempt to draw up plans for the hypothetical. It has become apparent that it is not just a matter of the ability of the healthcare system to respond, but that other—previously unconsidered—social segments are also important. In current debates, one of the key issues is what is system-relevant in the crisis.The aim of PreCoM is to understand the genesis of pandemic plans on an international (WHO) and national (Germany) level and to ask what had been taken into consideration in advance with respect to norms and values. Tying into this, PreCoM analyzes decisions as well as the associated legal and ethical ambivalences during the current Corona crisis and develops perspectives for future pandemic plans. This also includes a debate over the genesis and validity of values and rights. The historical subprojects draw on the values relevant for pandemic planning as identified and specified more precisely in the ethical and legal subprojects. Hence it is about both: historically deducing values and the understanding of the law (e.g., autonomy, equity, solidarity, responsibility) and at the same time reflecting on how these values and rights are taken into account, negotiated, applied, ignored, or argued in the current pandemic debate by political, legal and public health decision-makers. The strength of PreCoM lies precisely in the consolidation of different ways of accessing pandemic plans—a review of past plans, a contemporary analysis, and future recommendations.