Niemiecka polityka zdrowia publicznego w okresie pandemii COVID-19. Widziane z perspektywy Dolnej Saksonii

Due to the federal system in Germany, we find different forms of organization of healthcare in each of 16 federal states. In addition to the federal law being in force in all German states, there are state laws that only apply in a given state. The federal, state and local government institutions as well as their competences, functions and tasks will be described in the context of the Covid-19 epidemic. The statistical data from the federal states, particulary of the state of Lower Saxony, allow to observe the differences in the intensity of the spread of coronavirus infection cases, cures and death rate. The document “Lower Saxony everyday life in the context of Covid 19” is indicating a gradual exit from lockdown. Information about assistance measures, but also restrictions, bans and general rules as well as a reflection on social reactions, habits and moods will complete the whole picture.

Ukrainian response to the COVID-19 pandemic: governmental interventions

In this article, the governmental response to the COVID-19 pandemic in Ukraine is described, starting from the first detected cases, up until the summer of 2020. Pandemic caught Ukraine’s health care system in the midst of a reform. At the time of COVID-19 outbreak, the first steps of primary health care reform were already being implemented while the reform at the secondary health care level were about to started. However, changes of the political environment (due to the elections 2019), two changes of the Minister of Health (since the beginning of the pandemic), the absence of the general plan of action followed by the inconsistent political decisions, and the uncertainty in financing mechanisms of the secondary health care facilities, made the COVID-19 pandemic challenging for Ukraine. The Ukrainian government had difficulties in devoting additional recourses to medical facilities to protect medical professionals and provide treatment for patients. Instead, as a main intervention to combat COVID-19, the government implemented lockdown from 12 of March to 12th of May that only postponed the raise of infections, preserved lives. While the pandemic still had a highly negative impact on the economy, initial analysis indicate that lockdown could be considered effective from the economics point of view.

Health Sector responses to the COVID-19 pandemic in Ontario, Canada – January to May 2020

The first positive case of COVID-19 in Canada was reported on January 25, 2020, in the city of Toronto, Ontario. Over the following four months, the number of individuals diagnosed with COVID-19 in Ontario grew to 28,263 cases. A state of emergency was announced by the Premier of Ontario on March 17, 2020, and the provincial health care system prepared for a predicted surge of COVID-19 patients requiring hospitalization. The Chief Medical Officer of Health and the Minister of Health guided the changes in the system in response to the evolving needs and science related to COVID-19. The pandemic required a rapid, concerted, and coordinated effort from all sectors of the system to optimize and maximize the capacity of the health system. The response to the pandemic in Ontario was complex with some sectors experiencing multiple outbreaks of COVID-19 (i.e. long-term care homes and hospitals). Notably, numerous sectors shifted to virtual delivery of care. By the end of May 2020, it was announced that hospitals would gradually resume postponed or cancelled services. This paper explores the impact of the COVID-19 pandemic on multiple health system sectors (i.e., public health, primary care, long-term care, emergency medical services, and hospitals) in Ontario from January to May 2020. Given the scope of the sectors contributing to the health system in Ontario, this analysis of a regional response to COVID-19 provides insight on how to improve responses and better prepare for future health emergencies.

Canada’s multi-jurisdictional COVID-19 Public Health response – January to May 2020

In late January 2020, the first COVID-19 case was reported in Canada. By March 5, 2020, community spread of the virus was identified and by May 26, 2020, close to 86,000 patients had COVID-19 and 6,566 had died. As COVID-19 cases increased, provincial and territorial governments announced states of public health emergency between March 13 and 20, 2020. This paper examines Canada’s public health response to the COVID-19 pandemic during the first four months (January to May 2020) by overviewing the actions undertaken by the federal (national) and regional (provincial/territorial) governments. Canada’s jurisdictional public health structures, public health responses, technological and research endeavours, and public opinion on the pandemic measures are described. As the pandemic unravelled, the federal and provincial/territorial governments unrolled a series of stringent public health interventions and restrictions, including physical distancing and gathering size restrictions; closures of borders, schools, and non-essential businesses and services; cancellations of non-essential medical services; and limitations on visitors in hospital and long-term care facilities. In late May 2020, there was a gradual decrease in the daily numbers of new COVID-19 cases seen across most jurisdictions, which has led the provinces and territories to prepare phased re-opening. Overall, the COVID-19 pandemic in Canada and the substantial amount of formative health and policy-related data being created provide an insight on how to improve responses and better prepare for future health emergencies.

Świadczenia rehabilitacji medycznej w Polsce w czasie pandemii COVID-19. Zagadnienia regulacyjne i organizacyjne

Medical rehabilitation in Poland during the COVID-19 pandemic. Regulatory and organizational issues The medical rehabilitation system in Poland includes various rehabilitation services, financed by various institutions, including the NFZ, ZUS, KRUS, PFRON and local governments. The aim of the study is to identify the most important problems and limitations of this system, especially in the context of the COVID-19 pandemic. The most important issues to be solved and proposed reforms of the medical rehabilitation system in Poland presented in recent years were identified. The impact of the COVID-19 pandemic on this system, providing rehabilitation services and problems related to the im­plementation of further legal regulations in the first months of the pandemic were discussed. One of the most important recommended changes is the implementation of the comprehensive care model and the activities aimed at coordinating various elements and levels of rehabilitation.

Zarządzanie kryzysem zdrowotnym w pierwszym półroczu pandemii COVID-19. Analiza porównawcza na podstawie opinii ekspertów z wybranych krajów

Public governance of the health crisis in the first six months of the global COVID-19 pandemic. Comparative analysis based on the opinions of experts from selected countries From among the numerous analyses of the health crisis caused by the COVID-19 pandemic, the authors looked for those that would enable assessment of institutional solutions. They put forward the thesis that good institutions (with appropriate regulations, means and expert support) constitute an essential resource enabling fast, accurate, and effective measures in terms of protection and therapy. The authors turned to experts from other countries with whom they have been cooperating for many years in the field of public health and used their competences in the field to answer questions about public governance in the first six months of the pandemic outbreak (January to June 2020) when lockdowns were widely implemented and then gradually lifted. Particularly significant for the assessment of health crisis management, the experts chose countries that are diverse in terms of: state of decentralization, social structure, and resources available, as well as healthcare organization and political tradition in dispute resolution. Reports from Italy, the Netherlands, United Kingdom, Norway, Germany, the Czech Republic, Ukraine, and Canada (with focus on Ontario) – attached as an appendix – were supplemented with direct consultations. The comparative analysis of the obtained information and the exchange of opinions are the subject of this article. In the comparative analysis, we also refer to Polish activities and solutions. The Polish perspective of public management signifies a concern for the neglected area of public health. This article is enriched with the authors’ reflections and generally formulated recommendations.

Norway’s strategy to cope with Corona pandemics

Pandemics sudden influx claimed reaction from national authorities to protect their societies and ensure an operative functioning of the public health care. This article explains how the Norwegian government reacted in this unpredictable situation, which lockdown option was chosen and what economic consequences the applied measures might bring. How to weight public health against economic offers and future downturn? Trade-offs are compound and it is too early to conclude which country has made the best choice.

Dutch public health policy during the COVID-19 pandemic of the first half of 2020. Answers to questions on public health activities January–June 2020

The authorities’ first responses were the classification of COVID-19 as Group A-disease in the sense of the Law on Public Health, scaling up of regular crisis control structures, installation of an Outbreak Management Team OMT and a “National Operational Team-Corona”. COVID-surveillance is done by the RIVM (National Public Health Institute), and is based on data from Municipal Public Health Services (GGDs) supplemented with additional (inter)national sources. The OMT is the main advisory body regarding preventive measures and includes experts from relevant medical specialisms. Organisations of medical professionals gave separate advices. Sanctions to preventive measures can be fines and closure of accommodations. Initially, 80% of the population trusted the government’s messages and “intelligent lockdown” strategy. The Prime Minister’s addresses to the people were highly appreciated. However, at slow-down of the outbreak (May-June) society’s trust crumbled (“quarantine-fatigue”). The initial testing policy was very restricted and contrary to WHO’s adagium “Test, test, test!”. In June the Minister of Health announced that a capacity of 30.000 tests per day was achieved, to be scaled up to 70.000. The crises management’s primary concern was to increase the (ICU-)bed capacity and was achieved by transforming regular wards into COVID-care, setting-up external “Corona-wards” in hotels, and regional, interregional and crossborder spreading of COVID-patients. This focus on ICU-bed capacity was criticized, as half of the death cases and extreme equipment shortages occurred in other sectors (nursing homes, homecare, homes for the elderly, psychiatry, mental handicaps). Transformation of hospital wards also led to waiting lists for non-COVID care. End of June the government presented a step-by-step easing of the lockdown in which a fine-tuned epidemiological surveillance dashboard and the continuation of economical support for the economic sector are the backbones.

Wymogi i nakazy dotyczące noszenia masek ochronnych

In the absence of effective drugs that could be used in the treatment of infection caused by SARS-CoV-2, behavioral methods of preventing infection have become important in counteracting the epidemic, including wearing protective masks. A historical overview of the epidemic and the introduc­tion of the mask order allows an epidemic to be better understood not only as a biological event, but also as a social process. Many countries have enforced the wearing of masks in public despite conflicting opinions about whether their use could prevent transmission of the coronavirus from one person to another. In Poland, the content of the official message on the effectiveness of wearing masks was changing, ultimately introducing the obligation to cover the mouth and nose with masks or an element of clothing in generally accessible places.

Early COVID-19 pandemic response in Italy: Pros and cons

Since the beginning of the COVID-19 pandemic, Italy was one of the worst-affected European countries. The rapid surge of cases and the limited capacity of intensive care unit departments have posed a serious threat to the Italian national health system. In this paper we describe the first response and the main measures carried by Italian policy makers, as coordinated by a governmental committee of public health experts, which have succeeded in preventing the pandemic from turning into a disaster. Early closure of the school, quarantine measures and lockdown were put in place and the response of the population has been good overall. Despite the Italian health care system of universal coverage is considered the second-best in the world, during phase 1, the Italian decentralisation and fragmentation of health services probably restricted timely interventions and effectiveness. In northern Italy, Lombardy, Emilia Romagna, Piedmont, and Veneto, which reported most of the Italian cases, carried out different strategies against COVID-19, with great differences in testing, quarantine, and public health procedures. The improvement of the epidemiological situation has allowed an easing of the restrictive measures, with a progressive restarting of work activities. The government and technical-scientific bodies have prepared health strategies to support a possible second epidemic wave in the autumn.