Corona Crisis – Tunnel Vision vs Comprehensive Risk Assessment

Summary of a Leaked Report from the Crisis Management Unit KM4 of the German Ministry of the Interior (BMI)

Mainstream and alternative media in Germany are brewing with news of a leaked report assessing the German government’s crisis management with respect to COVID-19. The liberal-conservative magazine Tichys Einblick first published extracts of the report that was circulated by its author, a civil servant who has since been suspended. Another alternative media platform, Die Achse des Guten, documents that a draft of the “corona paper” had been presented internally as early as March 23 and the minister’s office was approached by the report’s author on April 25, but as the report continued to be shut down, the author decided to circulate it more widely and it was eventually leaked. The Ministry responded with an unusual Sunday press release dismissing the report as a personal opinion. Interestingly, nine eminent medical experts who were consulted in preparing the report issued a press release of their own on Monday, stating their surprise that the Ministry seems determined to continue ignoring expert analyses of the collateral damage of the COVID-19 response and fail to substantiate its claims that the protective measures taken were effective and are continuously being reassessed.

So what’s in the leaked report? The 187-page PDF document that I downloaded from Achgut.com consists of an anonymized 1-page cover letter, an 8-page summary, an 82-page full report, and a 96-page appendix (pages 3-5 of the appendix are missing). The subject line of the cover letter – “Results of internal assessment of corona crisis management” – is supplemented with three brutally honest bullet points:

  • Grave errors of judgement in crisis management
  • Deficits in the regulatory framework for pandemics
  • Corona crisis likely proves to be a false alarm

The report’s summary starts with the definition of the goal of crisis management: to detect and combat threats until the “normal” state is re-established (p. 2). The author further notes: “Therefore, a normal state cannot be a crisis.” This reads like a personal statement against the idea of a “new normal”, which has recently been promoted by many politicians and experts globally.

The remainder of the summary document outlines results of the author’s analysis (pp. 2-3, points 1-8) and conclusions (p. 2, points a) to c)). These sweeping points, which I will paraphrase below, are followed by an explanation of interdependencies during a crisis, including the declaration of an eminent threat (the pandemic) and the impact of protective measures and resulting collateral damage (pp. 3-4). The author then professes his perspective with respect to available courses of action (pp. 4-5) – also outlined below. What follows on pp. 5-8 is a section titled “Overview of health impacts (damages) of the government measures and limitations during the 2020 corona crisis”. This section is given a separate date of May 7 and is also attached to the press release of the nine medical experts mentioned above.

The report’s summary concludes with the author’s reasons to proceed with circulating the report without further consultation (p. 8). The stated reasons include the ongoing threat of collateral damage of the lockdown measures including avoidable deaths and the inability to have his analysis acknowledged through the ministerial hierarchy. The main report, which is double-dated to April 25 and May 7, 2020, is titled “Corona Crisis from the Perspective of Critical Infrastructure Protection”. In this blog post, I focus on summarizing, paraphrasing, and commenting on the 8-page summary.

Results of the Analysis

The author, who speaks alternatively in singular (“I”) or plural (“we”), summarizes his analysis in eight results:

  1. Despite better knowledge, crisis management [in Germany] has not developed adequate tools for threat analysis and assessment. Status reports in the current crisis include only a fraction of information on the range of threats. Incomplete and unsuitable information does not allow for a proper threat assessment and thus does not support appropriate and effective emergency response. This methodological deficit translates upwards through levels of public administration; politics has had a much reduced ability to make evidence-based decisions.
  2. The observed health impacts of COVID-19 on the general population suggest that we are dealing with a global false alarm. In relation to general mortality, there has likely never been an unusual threat to the population and the danger of COVID-19 was over-estimated. The author of the report adds a special note that these results were scientifically vetted and do not contradict the data and risk assessments presented by the German centre for disease control, the Robert Koch Institute (RKI).
  3. The fact that the false alarm remained undetected to this point is owed to the lack of instruments that would trigger a warning in case of an unwarranted pandemic declaration or a situation in which the collateral damage of the response measures exceeds the disease’s impacts on public health, and specifically on fatalities.
  4. At this point, it is plausible to assume that the direct loss of lives owed to the emergency response measures [i.e. lockdown, distancing, hospital procedures] is already greater than the COVID-19 death count [in Germany].
  5. The collateral damage of the corona crisis is gigantic and pointless, will primarily manifest itself in the future, and can only be limited, not prevented any more.
  6. As a consequence of the protective measures, the security and resilience of critical infrastructure has declined. Our society is subject to increased vulnerability and risk of failure of survival systems that could be fatal if a truly dangerous pandemic or another threat, such a bioterrorism attack, would occur.
  7. Emergency orders and other protective measures that lost any meaning and are now causing collateral damage are still in place for the most part. It is urgently recommended to lift these measure immediately to avert harm to the population – in particular additional unnecessary deaths – and stabilize the possibly precarious state of critical infrastructure.
  8. Deficits and errors in crisis management have led to the distribution of misinformation to the population. It could be said that the state has become one of the greatest producers of fake news in the corona crisis.

Conclusions

Three broad conclusions are drawn by the author:

a) The proportionality of restrictions of civil liberties is not evident, since governments have not properly assessed the consequences, as required by the German constitutional court on May 5.

b) Status reports from the ministries of the Interior and Health as well as federal communications to the provinces should immediately:

  • undertake an adequate risk analysis and assessment,
  • include a section with meaningful data on collateral damage,
  • be cleared of superfluous data and information that are unhelpful for risk assessment, and
  • develop and emphasize metrics [this point remains oddly vague].

c) An adequate risk analysis and assessment is to be completed immediately; otherwise, the state may become liable for damages.

Available Courses of Action

The report’s author sees the German government and administration in a precarious position, since in his assessment there is no reasonable doubt that the corona warning was a false alarm and that crisis management failed with respect to danger prevention and instead caused harm, including fatalities that continue to occur every day that the emergency response measures are kept in place.

The author further notes, which is not without humour, that technically a new crisis situation should be declared and the out-of-control pandemic crisis management itself be battled. In case the executive arm is not be able to regroup, the following options for a correction are proposed:

a) The legislative arm, i.e. the federal and provincial parliaments, could change the crisis management framework to force a change in the direction of the executive.

b) The judiciary has so far supported restrictions of constitutional rights with reference to the eminent threat but without in-depth test of plausibility of the government’s threat assessment. This could change as demonstrated in the author’s report.

c) The online and mainstream media could also serve as a corrective. However, at present the leading media not least the public broadcasters seem to view themselves as messengers of the dominant political orientation. This lack of plurality of opinions tends to stabilize the executive even when their actions threaten the existential interests of the nation, e.g. in case of a factual error of judgement.

Collateral Health Impacts

The following information was obtained from 10 eminent experts who were randomly selected (not representative) by the report’s author.

  1. Fatalities:
    a) Due to limited availability of hospital beds and services, it is estimated that 2.5 million surgeries were delayed or cancelled that would have taken place in March or April. This could result in between 5,000 and 125,000 premature deaths.
    b) For the same reason, follow-up treatment for cancer, stroke, or heart attack patients, which number in the order of million(s) annually, were delayed or cancelled, resulting in the possibility of avoidable death of up to several thousand patients.
    c) The quality of long-term care homes and services with 3.5 million recipients has declined; a concrete estimate of fatalities is not feasible, yet even a tenth of a percent impact would result in 3,500 premature deaths.
    d) The current annual average of 9,000 suicides will increase due to long-term impact on living conditions that could become critical for psychologically unstable persons. Additional suicides also have to be expected due to personal bankruptcies and destroyed livelihoods, as well as emotional pressures for specific professional groups that are most affected by ongoing change.
    e) An unspecified number of acute heart attack and stroke sufferers will not receive timely treatment resulting in death or reduced life expectancy in the short- or long-term.
  2. Other health and psychological damage from:
    a) isolation experienced by elderly long-term care patients;
    b) persons with psychoses and neuroses requiring treatment;
    c) domestic violence and child abuse;
    d) broad-based communication disorders, e.g. due to mandatory wearing of face masks.
  3. A long-term reduction in life expectancy is likely to become the greatest harm from this crisis. The decline arises from reduced general prosperity and wellbeing.

My Take

As you can tell, the leaked BMI report convincingly argues for a comprehensive risk assessment and holistic crisis management rather than the current tunnel vision focused on virology and acute medical concerns around COVID-19. The report’s summary does not engage with the actual threat of the novel coronavirus, which I hasten to add is a serious illness that has caused deaths and individual hardship around the world. However, viewed at the population level, the report’s assessment is in line with a growing number of international experts who demonstrate that the threat of COVID-19 is no worse than a severe influenza cycle.

Our political decision-makers and public health officials would be well advised to conduct continuous (re)assessments of the lockdowns and other emergency response measures in comparison to their collateral damage, and inform the public of the outcome of these assessments. As a geographer, I am particularly interested in the fact that there is strong spatial clustering of confirmed COVID-19 cases and attributed fatalities, which suggests geographically specific responses. As a data scientist, I am puzzled by the high degree of uncertainty in all coronavirus-related datasets and the multitude of interpretations that each time series generates. In addition to the ongoing medical and epidemiological research there will be many more topics to study if and when we are able to leave this crisis behind us.