Back in May I reported (here and here) about a scholarly German paper (pdf) by Stephan Kohn, the head of an Interior Ministry crisis management task force that issued a report on its analysis of authorities’ handling of the coronavirus crisis. It concluded that the government had badly overestimated the threat, and that the severe restrictions that had been implemented were the result of a false alarm.
The report was announced, and then the text was leaked to the media. The reaction to the report was predictable: the author was removed from his position, and his conclusions were suppressed to the extent possible.
JLH has undertaken the huge task of translating the executive summary of the scholarly paper, and Miss Piggy has kindly provided this introduction to the Stephan Kohn affair:
The Corona Paper — Covid-19 is a ‘Global False Alarm’
by Miss Piggy
Stephan Kohn was a senior civil servant (Oberregierungsrat) within the German Ministry of the Interior in Berlin under Interior Minister Horst Seehofer (CSU). Mr. Kohn worked for Section KM4 and was in charge of the project “Renewal of the strategy for national critical infrastructure” and tasked with the protection of critical infrastructures.
On May 8, 2020, Mr. Kohn released a 192-page report of his analysis of the response to the Corona pandemic by the federal government to his counterparts in the sixteen German states (Länder) of the Federal Republic of Germany. This report had been drafted by a scientific panel appointed by the interior ministry and composed by external medical experts from several German universities. Among these experts were at least ten of Germany’s leading scientists and doctors. Interior Ministry staff and superiors had been involved in drawing up the paper. The head of the KM4 department had even praised the document before he was abruptly transferred from his post.
The analysis included a medical damage assessment of the lockdown, which came to the conclusion that the measures should have never been taken. It stated that in terms of the dimensions of a national civil protection system, the Corona infection never had the potential to trigger a national disaster with a significant threat to the general public. The report also noted the fact that all the figures, including those from the RKI (Robert Koch Institute) confirmed this. The analysis included a detailed description of how the error in the decision-making processes occurred during the reaction to Corona.
Within two hours of the release of the report, the government tried to dismiss it as, “the work of one employee”, and its contents as “his own opinion”.
Following that, the Corona paper was also leaked to at least two websites (Achgut and Tichys Einblick). The German government and taxpayer-funded media engaged in damage control, because the report challenged the established Corona narrative. Stephan Kohn was suspended (May 10th) and a ministerial statement was issued dismissing the contents of the paper as the opinion of a rogue, mentally disturbed person who did not have permission to distribute the paper. Günter Krings, the representative for Interior Minister Horst Seehofer — the whistleblower’s boss — said the following when asked if he would take the document seriously:
“If you start analyzing papers like that, then pretty soon you’ll be inviting the guys with the tinfoil hats to parliamentary hearings.”
Der Spiegel reported on May 15, 2020 the following: “Stephen Kohn (the whistleblower) has since been suspended from duty. He was advised to obtain a lawyer and his work laptop was confiscated.”
The authors of the report issued a joint press release on May 11th, berating the government for ignoring expert advice, and asking for the interior minister to officially comment upon the experts’ joint statement:
Therapeutic and preventive measures should never bring more harm than the illness itself. Their aim should be to protect the risk groups, without endangering the availability of medical care and the health of the whole population, as it is unfortunately occurring…
We in the scientific and medical practice are experiencing the secondary damages of the Corona-measures on our patients on a daily basis…
We therefore ask the Federal Ministry of the Interior, to comment upon our press release, and we hope for a pertinent discussion regarding the [Corona] measures, one that leads to the best possible solution for the whole population.
Here are some of the report’s key points:
- The dangerousness of Covid-19 was overestimated: probably at no point did the danger posed by the new virus go beyond the normal level.
- The people who die from Corona are essentially those who would statistically die this year, because they have reached the end of their lives and their weakened bodies can no longer cope with any random everyday stress (including the approximately 150 viruses currently in circulation).
- Worldwide, within a quarter of a year, there have been no more than 250,000 deaths from Covid-19, compared to 1.5 million deaths [25,100 in Germany] during the influenza wave 2017/18.
- The danger is obviously no greater than that from many other viruses. There is no evidence that this was more than a false alarm.
- A reproach could go along these lines: During the Corona crisis the State has proved itself as one of the biggest producers of Fake News.
JLH’s translation of the executive summary:
KM4 Analysis of crisis management (summary)
Prefatory remarks: The task and goal of crisis management teams and any crisis management whatsoever is to recognize exceptional dangers and combat them until a normal situation is achieved again. Therefore, a normal situation cannot be a crisis.
Summary of results of analysis
|1.||Crisis management has in the past (unfortunately counter to better judgment) established no adequate instruments for the analysis and evaluation of dangers. In the present crisis, the SITREPS in which all information relevant to decision-making should be summarized, show thus far only a small band of the spectrum of dangers. An evaluation of the danger is not possible on the basis of incomplete and unqualified information in the situation overviews. Without correctly achieved evaluation of the danger, there can be no appropriate and effective planning of measures to be taken. In every transformation, the methodological deficit moves to a higher level. The policy thus far has a severely reduced chances to make the factually correct decisions.|
|2.||The observable effects and impact of COVID-19 identify no sufficient evidence — in terms of health impact on the population as a whole — of more than a false alarm. At no point in time did a greater-than-normal danger to the population exist (comparison standard is the usual deaths in the EU). Statistically, the people who die this year are at the end of their lives and their weakened bodies cannot resist the random strains of everyday life (including the ca.150 currently active viruses). The danger from COVID-19 was overestimated. (Within three months worldwide, no more than 250,000 deaths from COVID-19, against 1.5 million during the 1917-18 influenza epidemic). The danger is clearly no greater than that from many other viruses.
We are most likely dealing with a long unrecognized false alarm. This analytical result has been validated, and does not substantially contradict the data and evaluations of risks presented by the Robert Koch Institute.
|3.||Essentially, the suspected false alarm remained undetected for weeks, because the applicable guidelines for the actions of the crisis team and crisis management in a pandemic lack any appropriate detection instruments for automatically setting off an alarm that would cause an immediate halting of measure soon as a pandemic warning proves to be a false alarm or it can be foreseen that collateral damage — including danger to human life — threatens to become greater than the health-related deadly potential of the disease in question.|
|4.||The collateral damages become greater than perceptible benefit. This determination is not based on a comparison of material damage to human (personal) damage! It is based on a comparison of deaths from the virus to date with deaths from state-mandated protective measures (both without a certain base of data). An overview compilation of collateral health damage (including deaths) validated by scientists is appended below.|
|5.||The (completely pointless) collateral damage is now gigantic. Some of this damage will manifest in the near and more distant future. This cannot be stopped, only limited.|
|6.||Critical infrastructures are the arteries of modern societies. In critical infrastructures, as a consequence of protective measures, there is no security of supplies, as is customary (gradual reduction of the security of supply, which may decrease in coming times of stress on the system). The resilience of the highly complex and strongly interdependent system of critical infrastructures has lessened. From this point on, our society will be living with a heightened vulnerability and greater risk of default in critical infrastructures. The results may be fatal, should the reduced resilience level of KRITIS (1) be confronted by a truly dangerous pandemic or other threat. UN General Secretary António Guterres spoke about a fundamental risk four weeks ago. According to a report from Tagesschau on April 10, 2020, Guterres said: “The weaknesses and the faulty preparation exposed by this pandemic offer an idea of what a bio-terrorist attack could look like — and [these weaknesses] may possibly raise the risk of that.” According to our analyses, there is a serious lack of an adequate system of danger analysis and evaluation in crisis situations (see above).|
|7.||Largely still in force are the state-decreed protective measures, as well as the social activities and initiatives — initially protective measures which have meanwhile lost all meaning. It is imperative to rescind them completely, to prevent damage to the populace — especially unnecessary additional deaths — and, if possible, to stabilize the increasingly precarious situation in critical infrastructures.|
|8.||The deficiencies and errors in crisis management have led to transmission of invalid information and thus loosed disinformation on the public. (A criticism could be: In the Corona crisis, the state has proven to be one of the greatest sources of fake news.) From these findings, it follows:
|a.||The proportionality of interference in the rights of citizens is unknown at this time, since there has been no appropriate state assessment of consequences. The (Supreme) Federal Constitutional Court ordered that an appropriate assessment be carried out of measures with negative results (PSPP [presqualene diphosphate] decision of May 5, 2020).|
|b.||The SITREPs of the crisis team of the Ministry of Health and the Ministry of the Interior and the federal government reports to the states must therefore from this point on:|
|i)||undertake an appropriate analysis and evaluation of dangers,|
|ii)||contain additional division with diagnostically conclusive data on collateral damage (see explanation I extended version),|
|iii)||be purged of superficial data and information unnecessary for evaluation of danger, because they impede overview.|
|iv)||key numbers must be generated and prefixed.|
|c)||It is absolutely necessary to complete an analysis and evaluation. Otherwise, the state could be liable for damages that have occurred.
Elucidations for better understanding correlations in a pandemic
A severe pandemic occurs seldom and is therefore a great challenge. The responsible authorities must control a critical situation for which there are no experientially established standards. In the division, Ministry of the Interior and the Federal Office for Protection of the Population and Aid in Catastrophe (in cooperation with other authorities like the Raiffeisen Climate Protection Initiative, with partial leadership of the cooperative partners) emergency plans for delivery of provisions, pandemic plans and other organizational and legal requirements for combating pandemics (inter alia) are developed. In the past, studies on the scenario during a pandemic were occasionally done, less often extensive works and even less often comprehensive risk analyses. All of these works could offer little more in the present crisis than a rough framework. Above all, for good, smoothly running crisis management, much experience with similar crises and constant improvement of the management environment is necessary. Over time, this has been continuously optimized in the areas of fire-fighting and rescue services. In the case of a pandemic, no routine can be established, and that means that most of those acting in this situation will be poorly prepared and severely overtaxed, and crisis management will be prone to mistakes. The beginning of crisis intervention is always the presence of an unusual and dangerous situation. Determination of an unusually dangerous situation (pandemic) does not necessarily presume that some damage has already been done. In the event of a suspected pandemic, an assessment of possible damage is undertaken. Without predictable protective measures. This assessment must be continuously updated in the course of a pandemic, because it is originally just a plausible surmise. If this surmise is no longer seen as plausible, or if the extent of damage is not unusual, then there is no unusual danger.
Protective measures as a danger in and of themselves.
Intervention with protective measures for multiple threats cannot be introduced at will, because they have the potential of causing extraordinary damage. There are two dangers of which crisis management must be aware: health damages caused by a pathogen, collateral damage from side-effects of protective measures or (special case) of a false alarm. As a consequence of this dualism, the probability of extraordinary damage occurring and the predictable level of resulting harm from all threats must be tracked simultaneously and continuously throughout the course of a pandemic. Evaluation of data on the incidence of infection and the number of deaths is far from sufficient.
Suitable for that purpose is a systematic, multi-threat analysis (see extended version for criteria of a multi-threat analysis).
Significance of collateral damage
A central recognition from all previous studies, exercises and risk analyses is that collateral damages always arise in combating a pandemic (from effects of protective measures), and that these collateral damages can be considerably greater than the damage caused by the pathogen. Acceptable collateral damage has the best cost-benefit relationship if it is no greater than minimally necessary for achieving the goal. The worst cost-benefit relationship is when the original of an unknown virus is exaggerated, or in an extreme case, turns out to be a false alarm. In that case, the total damage from the pandemic consists of the completely purposeless collateral damage.
Attempting only to trace in finest detail the exact stages of the failure of crisis management makes little sense and moves us no closer to a solution. A remedy will only be possible by confronting those systemic effects which, in the entire dynamic of the Corona crisis, can lead to an existential damaging of both the community and governmental order. Crisis management and the state as a whole are in a precarious situation. A careful examination leaves no reasonable doubt
- that the Coronavirus warning was a false alarm,
- that crisis management did a less than optimal job of defending against danger, and made mistakes which caused, and continue to cause, great damage (including deaths) of which the measures cannot be absolved.
Since the crisis team and the entire crisis management including the political element have, to the greatest extent possible, acted in accordance with legal, organizational and other standards, they seem to have little incentive to undertake changes. However, the findings worked out in this analysis will not suffice, not even if the results are factually correct and reorientation is urgently required in the interest of the country and its people. Even a rejection of the proffered analysis with all the affected offices of ministerial governance would — on the basis of heterogeneous interest and the situation as regards responsibility of the many likely participants — foreseeably lead to a leveling (or sorting out) of its content.
It may be possible for our country to avoid a complete by-the-book disaster. But at this time, only by means of a creative information strategy by those who would be in a position to identify and organize a practicable way out. In fact, a new crisis would now have to be identified and a new crisis management put in place, to combat the dangers of a pandemic crisis management that has become automatized and therefore gone out of control. That would be sound practice. If the administration itself does not do that, there are basic means of correction in a state with separation of powers:
|a)||The law-making body (the federal parliament and those of the states) could change the legal parameters and thus cause (force) crisis management to change its behavior. In recent weeks, the legislative branch has proven that it can make short-term decisions.|
|b)||Judicature could intervene. The federal and state constitutional courts have recognized the directive of extreme curtailment of elementary and constitutional rights by the chief executive as justified on the basis of an alleged unusual threat by a dangerous virus. It has rejected every basic complaint, accusation and resistance to the legality and legitimacy. Thus far, they have done so without a serious test of plausibility. Such a test is, as I have shown, possible, and would reveal the error.|
|c)||The electronic mass media and the leading nationwide media could also provide a solution. The fact that this is not happening provokes two thoughts: The parameters for media are below par; they openly impede the original intended diversity of opinion in our country. The unity thus produced is oriented, not toward opposing directions and opinions, but rather toward established political directions, especially the intentions of governments (thus indirectly stabilizing and shielding existing governments from opposition, even when specific government action — e.g. based on a factual error — is directed against the existential interests of the state). The leading media seem overwhelmingly to view themselves as the bearers to the populace of the generally agreed political direction.
Overview of the health effects (damages) of state-decreed measures and restrictions in Corona crisis 2020 (as of May 7, 2020)
Methodological prefacing remarks
Risks have been taken, which are regarded as basically plausible by 10 highly regarded experts/scientists in their respective fields. The selection of experts was random, so the result is not representative. For future systematic evaluation of collateral health damages, it is important to consult with specialists in the scientific disciplines included. A realistic comprehensive is otherwise not possible.
|a.||Postponed or canceled operations because of the contraction of available hospital space (and of qualified physicians). In all, in 2018, we had ca. 17 million inpatient operations. That is an average of 1.4 million per month. In March and April, 90% of all necessary operations were postponed or not performed. That is, 2.5 million patients were not cared for in these two months. 2.5 million patients were not operated on in March and April 2020, although operations were necessary. The predictable death rate cannot be seriously estimated. Speculations by experts range from less than 5,000 to 125,000 patients who have died or will die because of postponed operations.|
|b.||Because of the limitation of available clinical facilities (and treatment capacities), postponed or canceled follow-up those stricken (e.g., by cancer, stroke or heart attack): The negative effects from interrupted cancer care programs, as with breast cancer, are clear. These treatments have proven their usefulness in long studies, and are used for this reason. Here, too, the count begins in the millions. In some of the cases, the constriction of clinical facilities leads to the premature death of patients.
A prognosis of these effects is difficult. Experts who have commented began with the assumption of several thousand additional dead, who had already died or will die in March and April of 2020.
|c.||Concerning the medical care of those in need (in Germany totaling 3.5 million people), because of governmentally decreed restrictions, the level of care and of quality of care declines with ambulant services as well as care given intrafamily. Since it has been shown that good medical care in Germany protects many people from premature death (which is the reason that so much money is spent on it), the forced decline in the level of services in March and April 2020 will have caused premature deaths. With 3.5 million in need of care, there would be an additional death rate of one-tenth of one percent. In the absence of more exact estimates, it is not known whether that is more or less.|
|d.||The increase in suicides (to date, 9,000 per year). Reason for the increase in suicides: long-term, substantial negative effect on living conditions, which can be critical for the psychologically unstable. Many suicides as reaction to economic ruin must also be expected — diverse professional groups that are not equal to their burdening by social and personal changes, and their own (co-)responsibility.|
|e.||Additional deaths from heart attack and stroke. In recent years and decades, integrated concepts have been developed which have been successful in influencing morbidity and mortality, and depend upon the earliest possible intervention (in the course of the disease), least possible time elapsed (until care) and the most competent care. These interdisciplinary chains are damaged in many ways (outpatient care, withdrawal of resources) and also suffer greatly from one-sided and exaggerated information policy causing affected people unjustly to fear Corona Virus more than other illnesses and suppress the warning signs, and also fear incorrect treatment in a Corona-fixated hospital doctor late, or not at all, which, in the case of these illnesses, means heightened morbidity, worsened rehabilitation and greater mortality.
2. Other damages to health (together with the suffering of those affected and the effect of the high cost to the social security system, the health system and the labor market)
|a.||The elderly, especially those in need of medical care, are affected by the measures and suffer greatly and in many ways from them. In part the measures taken (closed borders, quarantine regulations, forbidden contacts, etc.) negatively impact the already critical care situation for inpatients and outpatients (and therewith optima care in relation to Corona).|
|b.||In need of treatment are (severe) psychoses, neuroses (anxiety, OCD,…) on the basis of years-long, substantial damage to all living conditions, which, for psychologically unstable personalities can cause medical conditions. Years of medical treatment and rehabilitation are required, there will be work absences for health reasons. 1% to 2% of the German work force experiences a psychosis at least once in a lifetime. If there is a disposition or tendency, there is a heightened probability that this will manifest within the parameters of Corona virus.|
|c.||More conflicts and bodily injuries as a consequence of limitations on and prohibitions of contact; domestic violence, child abuse.|
|d.||Widespread disturbance of communication from psychic effects (see above) and also e.g. from mandatory wearing of masks, through which gesticulation and mime are greatly reduced as means of communication, leading to misunderstandings, mistrust and — depending on economic developments — lowered life expectancy. This could, over time, be one of the greater damages of the crisis. Based on positive economic developments, Germany since the 1950s has enjoyed a substantial rise in life expectancy (an average 13-14 years of life). The permanent rise in standard of living enabled, inter alia, a continuous upswing in preventative care. With severely negative economic development and a corresponding reduction in the standard of living, the development is reversed. Life expectancy will decline. (The Robert Koch Institute has demonstrated that high unemployment reduces life expectancy.)
In the case of more than 80 million inhabitants, state protective measures (not the virus) can destroy a substantial volume of life-expectancy years. Common to most of the above-mentioned effects is that, even after repeal of the restrictions, there will be a long time before these measures and treatments are in the preparatory stage, because all of he interconnected limbs must function again, resources must be re-allocated (returned) and patients’ trust must be restored. As for the rest, there can also be countervailing, initially apparently paradoxical reactions. So the damage phase will predictably last longer than the original interruption. And with a limited future life expectancy, the damage will continue into the future.
Since, theoretically, countervailing effects must be expected — e.g., what appear at first glance to be paradoxical reactions — numerically more exact evaluations of expected damages are foreseen. Those numbers will show the extent.
There are two significant reasons for sending this information without previous consultation of other available sources:
|1.||There is danger ahead!
Measures intended to protect are now causing further severe damage every day, from material and health damage to a great many deaths. The deaths are caused by the actions of crisis management, which will be answerable for them, when the analyzed facts of the reports are known — including the sender of this analysis, who is a member of crisis management. A remedy is only possibly if this knowledge is passed on and made known.
All possibility of “upstream” intervention has been exhausted by the sender.
|2.||In regard to the factual content of the analysis and the contrasting policy decisions, damaged outsiders may come to fear that the decisive purpose of national crisis management is no longer the security and health of the populace, but rather the credibility and acceptance of the governing parties and members of the administration. From such perceptions — which are not irrational per se — can grow an unfavorable dynamic based on common interest, which can be well curtailed, first and foremost, with subsequent rational decisions on the basis of complete analyses.