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

“免疫时代”（Thießen）最迟在20世纪80年代结束。可以说，作为全球化新阶段的另一面，人们越来越多地将泛病毒性疾病视为对健康、经济、繁荣和安全的威胁。与此同时，在许多历史上可以证实的情况下，传染病控制从来不仅仅伴随着医疗和卫生后果，而且总是伴随着或多或少深远的政治、社会、经济、伦理和法律的后果。因此，自1990年代以来提出的大流行病防治计划，是针对流行病学基础上的一个行动领域，而这个行动领域的复杂未来取决于许多不确定因素。因此，世界卫生组织（世卫组织）和联邦共和国（德国）的负责当局都试图为未来的大流行制定计划。这些计划在每一次新的流行病爆发后都进行了调整（例如，2003年禽流感）。谁参与了流行病计划，计划所依据的资源的使用情况，计划采取了哪些公共卫生措施，纳入或排除了哪些观点，考虑到了哪些社会阶层;以及这些计划所依据的价值观，如公平、健康或社区与个人之间的关系，是历史方法以及伦理和法律的考虑中的关键问题。当前的科罗纳危机揭示了为假设制定计划的尝试的局限性。很明显，这不仅仅是医疗保健系统响应能力的问题，而且其他以前没有考虑到的社会阶层也很重要。在当前的辩论中，一个关键问题是危机中什么是系统相关的，PreCoM的目的是了解国际（世卫组织）和国家（德国）层面流行病计划的起源，并询问在规范和价值观方面预先考虑了什么。结合这一点，PreCoM分析了当前Corona危机期间的决策以及相关的法律的和道德矛盾，并为未来的流行病计划制定了前景。这也包括关于价值观和权利的起源和有效性的辩论。历史上的子项目借鉴了与流行病规划相关的价值观，这些价值观在伦理和法律的子项目中得到了更精确的确认和说明。因此，它是关于两者的：历史地推导价值观和对法律的理解（例如，自主、公平、团结、责任），同时反思政治、法律的和公共卫生决策者在当前的大流行病辩论中如何考虑、谈判、应用、忽视或争论这些价值观和权利。PreCoM的优势恰恰在于整合了获取流行病计划的不同方法--对过去计划的回顾、当前分析和未来建议。

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.