Running red lights: Risk recognition versus follow‐up implementation in the case of Germany's pandemic preparation

Abstract

AbstractThe discrepancy between formal arrangements to ensure health security, as assessed in the Global Health Security Index, and COVID‐19 outcomes points to a broader problem where formal risk recognition is de‐coupled from potentially resource‐intensive follow‐up policy implementation. Germany is an extreme example of this. Pre‐COVID‐19, Germany's Federal Office of Civilian Protection conducted two pandemic preparation exercises based on scenarios which closely mirrored the current COVID‐19 pandemic: (a) a multi‐jurisdictional, multi‐agency crisis management exercise assuming a global influenza pandemic and (b) a joint federal and expert‐agency based risk‐analysis assuming the outbreak of a modified severe acute respiratory symptom virus. While informing legal and institutional reforms, key recommendations on storing personal protective equipment (PPE) and disinfectants for front‐line staff were subsequently ignored. PPE shortages initially put staff at risk, led to export restrictions on PPE, and later on hampered the country's ability to address a second wave of the pandemic. This short paper calls for a fuller exploration of factors which hinder ‘‘implementation post‐cognition.’’