National pandemic plan for Germany

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Ban on visits to a Munich clinic, March 2020: A measure as part of the second phase (protection) of the pandemic plan for Germany adapted to the COVID-19 pandemic

The National Pandemic Plan for Germany ( NPP ) is a collection of instructions for the occurrence of a pandemic in Germany . It was first published in 2005 and last updated in March 2017. "The NPP serves the targeted preparation of authorities and institutions at federal and state level for an influenza pandemic and provides a framework that forms the basis for the pandemic plans of the federal states and the implementation plans of the municipalities." The creation of national pandemic plans took place in April 1999 a guidance from the World Health Organization (WHO) (“Influenza Pandemic Plan”), which should help medical and public health leaders better respond to future threats from influenza pandemics. The National Pandemic Plan for the Federal Republic of Germany was at the same time a response to the SARS pandemic of 2002/2003 and the worldwide spread of H5N1 . Since the beginning of the COVID-19 pandemic in early 2020, the preventive measures specified in the National Pandemic Plan have also been used to ward off the SARS-CoV-2 virus .

The National Pandemic Plan consists of two parts: Part 1 primarily names the measures to protect the population and the institutions responsible for them, Part 2 contains the scientific basis for the measures selected in Part 1.

Since the health system in the Federal Republic is largely a matter for the federal states , the German federal states have drawn up their own pandemic plans. Their implementation is basically the responsibility of the community board , the magistrate or the responsible body of the district , which are usually active through their health authorities .

Goals of the pandemic plan

Strategy of the federal government to ensure the medical care of patients with severe disease by slowing down the spread of the Sars-CoV-2 epidemic with the help of protective measures . If the capacity is exceeded, triage would have to be introduced.

The measures of the pandemic plans are intended on the one hand to ensure that important infrastructure is maintained and on the other to stop the spread of the pandemic pathogen; this is the case when an infected person infects less than one person on average during the period of infection.

With the help of the National Pandemic Plan , authorities and institutions at federal and state level are to be prepared for an influenza pandemic. At the same time, it provides the framework on the basis of which the pandemic plans of the federal states and the implementation plans of the municipalities are formed. It is primarily aimed at those responsible and the responsible authorities in the federal, state and local governments. Essentially, the National Pandemic Plan serves to achieve the following goals:

  • Reducing morbidity and mortality in the general population;
  • Ensuring the care of sick people;
  • Maintaining essential public services;
  • Reliable and timely information for policy makers, professionals, the public and the media.

The creation of company pandemic plans is also suggested, particularly for companies that are of particular importance for maintaining the state community. The organizations and facilities of the "critical infrastructures" include a. the sectors energy, information technology and telecommunications, transport and traffic, water, nutrition (food industry, including agriculture and food trade) as well as finance and insurance are counted.

"The scientific part (Part II) of the National Pandemic Plan describes the scientific status of pandemic influenza planning and pandemic influenza management and thus serves as a technical basis for decisions about measures to prepare for the pandemic as well as measures in the event of a specific pandemic." In addition, in May 2007 one was called "Part III "was published, in which the" scientific connections to pandemic planning in Germany "were discussed and the development of the German pandemic plan was explained.

Legal framework

The national pandemic plan is part of the disaster risk reduction planning. Part 1 will include a. refers to laws and ordinances that have been passed by the legislature for the prevention and control of communicable diseases. These are particular

  • the Infection Protection Act (IfSG)
  • the Ordinance on the Notification of Avian Influenza in Humans (AIMPV)
  • the general administrative regulation on the coordination of infection protection in epidemically significant cases (IfSGKoordinierungs-VwV)
  • the Law on the International Health Regulations (IHR)
  • the law for the implementation of the international health regulations (IGV-DG)

Furthermore, the Federal Ministry of Health (BMG) is authorized to issue the following ordinances in the event of a pandemic:

  • Adoption of an ordinance in accordance with Section 15 (1) and (2) IfSG, with which the reporting obligation can be adapted to the epidemic situation
  • Adoption of an ordinance in accordance with Section 20 (4) IfSG, which regulates the assumption of costs for a vaccination by the statutory health insurance
  • Adoption of an ordinance in accordance with Section 20 (6) IfSG, with which a mandatory vaccination can be introduced

The epidemic hygiene measures which can be used to try to reduce the spread of an infection that can be transmitted from person to person are regulated in particular in the Infection Protection Act and include, among other things. a .:

  • the passive or active health control of potentially contagious persons ( § 29 IfSG)
  • the arrangement of quarantine for suspected contagion and sick people, at home or in a separate facility ( § 30 IfSG)
  • the order of a professional activity ban ( § 31 IfSG)
  • Acceptance of medical checks when entering the federal territory ( Section 36 IfSG)
  • the enactment of legal ordinances by the state governments , by which the fundamental rights of the freedom of the person ( Art. 2 Abs. 2 Satz 2 Grundgesetz), the freedom of movement ( Art. 11 Abs. 1 Grundgesetz), the freedom of assembly ( Art. 8 Grundgesetz), the Inviolability of the home ( Art. 13 Paragraph 1 Basic Law) and the confidentiality of letters and mail ( Art. 10 Basic Law) can be restricted ( § 32 IfSG)

Pandemic plans at the municipal level

The measures taken by the health authorities can be broken down into three stages: 1. Provide information, 2. Appeal, 3. Order. Municipal pandemic preparedness includes:

  • to intensify awareness- raising about epidemics and general hygiene measures,
  • to significantly increase the vaccination quota (a high vaccination quota helps the pharmaceutical industry to maintain capacities in order to be able to produce larger quantities of vaccine in an emergency ),
  • Detect abnormalities at an early stage with committed participation in the reporting system and contribute to their research,
  • To take various measures to help break the chains of infection during the crisis , for example through
    • Closure of community facilities
    • No gathering of people
    • quarantine
    • Enforcement of vaccination requirements
    • Disinfection
    • secured water supply and sewage disposal

Examples of municipal pandemic plans are the pandemic plan of the city of Frankfurt am Main and the influenza pandemic plan of the Hanseatic city of Rostock.

Supplement to the national pandemic plan as a result of the COVID-19 pandemic

In response to the spread of the SARS-CoV-2 virus in the course of the COVID-19 pandemic , the Department of Infection Epidemiology at the Robert Koch Institute (RKI) presented the first version of a supplement to the National Pandemic Plan in March 2020 in which “Recommendations and measures to cope with the COVID-19 incident in Germany ”.

This supplement to the national pandemic plan is primarily aimed at the specialist public in the health sector, in particular at the public health service at all levels, at the medical profession and at all other professional groups of medical staff. In the supplement u. a. three phases of infection control are described, the transitions of which are fluid: "Containment, Protection and Mitigation" (containment of the spread, protection of endangered groups, reduction of the consequences):

  • Containment : If individual infections and short chains of infection occur, an attempt should be made to prevent the spread of the virus by identifying contact persons for cases of infection confirmed by laboratory diagnosis and placing them in quarantine at home. These measures are intended to delay a possible wave of illness and weaken its dynamics. "The aim of this strategy is to gain time in order to prepare as best as possible and to learn more about the properties of the virus, identify risk groups, prepare protective measures for particularly vulnerable groups, increase treatment capacities in clinics, sound out antiviral drugs and vaccine development."
  • Protection : If the spread of the new type of coronavirus can no longer be stopped, protection against the viruses is primarily focused on people and groups who are at increased risk of developing serious illnesses. The State Office for Social Affairs, Youth and Supply Rhineland-Palatinate specifies the term "vulnerable groups of people" used by the RKI as follows:
- Elderly people (> 50 years),
- People with various underlying diseases (e.g. cardiovascular diseases, diabetes, lung, liver, kidney and cancer diseases),
- People with a weakened immune system (e.g. due to a disease that is associated with an immune deficiency or due to the use of medication that is supposed to suppress an immune reaction, e.g. cortisone).
The RKI has published an extensive list of “options for measures to reduce contact in areas in which more cases have become known”; These options include a. Conditions and restrictions for and cancellation of major events, the preventive closure of community facilities and public facilities such as theaters and swimming pools, voluntary business closings and the enabling of home and teleworking.
  • Mitigation : If SARS-CoV-2 continues to be transmitted in the population, "the protective measures used are more aimed at reducing further consequences." The main goal in this phase is to prevent a large number of people in need of treatment from falling ill at the same time and the resulting overload Avoid medical infrastructure so that particularly serious illnesses - including those from other causes - can still be treated. This also means that in the health care system, care for SARS-CoV-2 infected people and other patients should be established as separately as possible.

literature

  • R. Fock, H. Bergmann, H. Bußmann et al .: Management and control of an influenza pandemic. Conceptual considerations for a German pandemic influenza plan. In: Federal Health Gazette - Health Research - Health Protection. Volume 44, 2001, pp. 969-980, doi: 10.1007 / s001030100267 .
  • Tobias H. Witte: Law and Justice in the Event of a Pandemic. Storage, distribution and costs of scarce medicines in the event of an outbreak . Münster's contributions to law, new series, volume 24. Nomos, Baden-Baden 2013, ISBN 978-3-8487-0687-7 .
  • Risk analysis "Pandemic by Virus Modi-SARS". Section 2.3 in: German Bundestag (Ed.): Report on Risk Analysis in Civil Protection 2012. Printed matter 17/12051 of January 3, 2013, full text (PDF)

See also

Web links

Individual evidence

  1. ^ Robert Koch Institute (Ed.): National Pandemic Plan, Part I: Structures and Measures. Berlin 2017, p. 7 ( full text ).
  2. ^ Influenza Pandemic Plan. The Role of WHO and Guidelines for National and Regional Planning. On: who.int , Geneva, April 1999.
  3. ↑ Pandemic plans of the federal states. In: rki.de. Robert Koch Institute, accessed April 6, 2020 .
  4. ↑ National Pandemic Plan, Part I , p. 7.
  5. ↑ National Pandemic Plan, Part I , p. 43.
  6. ^ Robert Koch Institute (Ed.): National Pandemic Plan, Part II: Scientific Basics. Berlin 2017, p. 7, full text .
  7. ↑ National Pandemic Plan Part III, status: May 2007. From : gmkonline.de , accessed on March 14, 2020.
  8. ↑ National Pandemic Plan, Part I , p. 9.
  9. ↑ Text of the Infection Protection Act
  10. ↑ Influenza pandemic plan of the state capital Schwerin, September 2009, foreword
  11. ↑ Municipal Pandemic Plan of the City of Frankfurt am Main, 2012.
  12. ^ Municipal pandemic plan of the Hanseatic City of Rostock
  13. ↑ Robert Koch Institute : Supplement to the National Pandemic Plan - COVID-19 - novel coronavirus disease. Status: March 4, 2020, full text .
  14. ^ Robert Koch Institute: Supplement to the National Pandemic Plan, pp. 7–8 (as of March 4, 2020).
  15. ↑ State Office for Social Affairs, Youth and Supply (LSJV) Rhineland-Palatinate: Recommendations on COVID-19 for old people's and nursing homes, outpatient care services and workshops .
  16. ↑ COVID-19: Options for measures to reduce contact in areas in which increased cases have become known. On: rki.de from March 3, 2020.
  17. ↑ The following statutory ordinances of the Hessian state government are exemplary for the implementation of the recommendations:
    Ordinance to combat the corona virus. From March 13, 2020. On: Soziales.hessen.de , viewed on March 15, 2010. Aim: To ensure the necessary staffing in health care for people and to maintain public safety and order.
    Second ordinance to combat the corona virus. From March 13, 2020. On: Soziales.hessen.de , accessed on March 15, 2010. Aim: Access restrictions for facilities such as hospitals and old people's homes.
    Third ordinance to combat the corona virus. From March 14, 2020. On: Soziales.hessen.de , accessed on March 15, 2010. Objective: Ban public and non-public events with more than 100 visitors.