In order to know when to lift or impose restrictions, governments need good data and the ability to interpret it.
In this regard, accurately measuring trends in COVID-19 cases and deaths, a major current concern for many countries, is only one part of the problem. Governments also need indicators of public health and health care capacity in order to accurately assess the effects of easing or tightening restrictions. These include indicators of testing capabilities, contact tracing capacity and the effective capacity of health systems in terms of both facilities and workforce. According to the COVID-19 Health System Response Monitor, governments are responding to these challenges in different ways.
Taking steps to strengthen contact tracing is crucial
Countries are developing plans to increase testing capacity, the success of which to combat the spread depends on contact tracers, but also patients and civil servants. Germany’s plan is to hire 5 contact tracers per 20,000 residents, with the federal authorities enlisting medical students and mobilizing officials from other sectors to meet this goal. Denmark will ask all individuals who test positive for the virus to track down recent contacts with those they might have infected. Belgium will hire 2,000 investigators to identify individuals having been in contact with confirmed or suspected cases (200 in Brussels, 600 in Wallonia and 1,200 in Flanders). Luxembourg will aim to test all of its 600,000 residents. Some countries, including Poland, and France, are prioritizing testing of residents and staff in nursing homes and homes for older people, as well as testing of health professionals and vulnerable individuals.
Some countries have decided to use technological solutions to track the spread of COVID-19. They differ, however, in their approaches. Germany, Italy, Austria and Switzerland have launched a COVID-19 contact-tracing mobile application that avoids location tracking, as well as a centralized database, opting for a standard created by Apple or Google that they regard as more privacy-friendly. The Italian mobile application, called “Immuni” will use a smartphone’s wireless Bluetooth signal to track potential points of contact with the virus. No personal information will be included on the data. France and the UK opted to use technology in which a central database, controlled by the government, gathers data on who came into contact with an infected individual. These choices have stirred political debates about privacy concerns. In Belgium, for instance, the government decided to abandon contact tracing apps over data privacy concerns. Additionally, experts agree that between 60% and 80% of the population have to actively use an app for it to be effective. In Austria, only an estimated 5% of the population is currently using the contact-tracing app, one month after its release. Finally, most of these apps are not interoperable, which might become a real issue at the European level as borders reopen.
Making use of expert advice
In order to develop their strategic plans, many countries have set up specialist task forces to develop exit strategies. In Belgium, the Group of Experts in charge of the Exit Strategy (GEES) is responsible for advising the National Security Council on defining a national transition strategy. Other governments rely on preexisting scientific entities, such as Denmark, where the Statens Serum Institut has developed a mathematical model to support decision-making during the reopening phase.
Good communication of surveillance data is important to justify future lockdowns to the public
The ability to explain policy decisions based on publicly accessible data will be crucial for governments going forward, with any differences in the public visibility or accessibility of different kinds of data, e.g. case counts versus capacity measures, likely to pose communications challenges. France is planning on increasing transparency of epidemiological surveillance at the local level. Poland is using text messaging to inform citizens about new measures. Most governments provide information via daily or weekly briefings with experts and state officials. Many countries share information about the virus through existing websites or those developed specifically for Covid-19, such as Bulgaria.
Holly Jarman, Sarah Rozenblum, Scott L. Greer, Matthias Wismar