[COVID-19 outbreaks in precarious living and working conditions: findings from an after-action review and recommendations for public health services].

BACKGROUND: The COVID-19 pandemic posed significant challenges for the public health service (ÖGD) in Germany, particularly during outbreaks in precarious living and working conditions. METHODS: As part of an after-action review (AAR) conducted in May 2023, 29 professionals from public health offices and other authorities analyzed nine such outbreak events from 2020 to 2022 based on the methodological recommendations of the World Health Organization and the European Centre for Disease Prevention and Control. The aim was to identify key challenges and successful approaches in the areas of "preparedness and response" and "public health and social measures" and to derive practical recommendations for future action. RESULTS: The two-day online event facilitated active discussions, which were documented and consolidated with the participants. Major challenges identified included official communication with the public, civil society, and businesses; intersectoral collaboration with diverse stakeholders; and the ÖGD's structural preparedness for complex situations. At the same time, numerous examples of good practice were documented-such as cross-sectoral cooperation, the development of internal structures, and target group-specific communication. Based on these findings, participants developed recommendations to strengthen crisis management in future outbreaks in precarious settings. DISCUSSION: AARs are accepted and applicable tools for structured analysis of epidemic situations and for knowledge transfer within the ÖGD and can thereby contribute to improved preparedness for future crises.