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International Health News Brief: Special Issue on COVID-19 Protection and Recovery

News period covered: July–September 2020

This special issue of International Health News Brief focuses on preparations for rolling out COVID-19 vaccinations, strengthening safeguards for patients and providers, and accelerating economic recovery from the pandemic. All the countries we report on take part in the Commonwealth Fund’s annual international survey.

Preparing for Nationwide Vaccination Efforts

In designing their COVID-19 procurement strategy, many countries, including Canada and European Union members, are working to ensure a diverse portfolio of promising vaccines from multiple suppliers. The EU has also joined the World Health Organization (WHO)–led COVAX initiative, investing EUR 400 million (USD 491 million) in the effort to facilitate global access to vaccines.

Still, countries are grappling with the issue of which populations should have access to vaccines first. In addition to elderly people and those with underlying health conditions, Canada’s National Advisory Committee on Immunization has decided to prioritize health care workers and individuals facing an elevated risk of infection because of their inability to work remotely, such as police, firefighters, and grocery store employees.

While France’s vaccination distribution strategy prioritizes similar populations, a recent study of potential COVID-19 vaccine acceptance found that more than four of 10 French people are reluctant to get a coronavirus vaccine. In contrast, 74 percent of New Zealanders intend to get the COVID vaccine, a higher rate than seen in the United Kingdom and the U.S.

In Germany, hundreds of vaccination centers have been set up across the country. The federal government will pay for the vaccine and establish a central database to track vaccination activity. Similarly, Swedish parliament passed a law stating that COVID-19 vaccinations will be included in the national vaccination register.

Policy Takeaways

  • The logistical challenges of procuring and distributing COVID-19 vaccines highlights the importance of having a well-defined and clearly communicated national prioritization strategy.
  • Cross-national collaboration is an opportunity to ensure international equity in accessing and distributing vaccines.

Heavy Reliance on Telehealth to Safeguard Patients and Providers

The COVID-19 pandemic has accelerated the delivery of care through digital platforms as increased infection risks for people with preexisting conditions, hospital overcrowding, and closures of medical facilities have necessitated a reimagining of care delivery. Given that 10 percent of global infections are among health workers — according to WHO estimates — telehealth has a crucial role in protecting providers as well as patients.

The U.K. made additional funding available to expand electronic prescribing, while Australia accelerated the timeline for its previously planned launch of an electronic, paperless prescription service. For its priority populations, Australia’s Home Medicines Service also covers free home deliveries of essential medicines by local pharmacists.

Sweden, Netherlands, and Norway also report high rates of telehealth service use throughout the pandemic.

Even after COVID-19 case rates decreased during the summer, telehealth continued to be the preferred method of delivering care, particularly primary care, in many countries. In Norway, for example, nearly all general practitioners downloaded video consulting software during the first wave, and hospitals established video consultation rooms. Indeed, telehealth has been made available across health care settings and providers. In Australia, the national health insurance program, Medicare, subsidizes telehealth services provided not only by general practitioners and nurses but also midwives, allied health professionals, and mental health providers. Essential specialist services such as geriatrics and neurosurgery will soon be added.

While previous payment policies had made the cost of delivering digital care prohibitive, there have been great strides in payment innovation during the pandemic. Payers and providers are now working to ensure that this preferred method of care delivery is available to patients on a permanent basis. For example, France, which quickly moved to fully reimburse telehealth consultations early in the first wave of the pandemic, recently voted to continue 100 percent reimbursement for two years — meaning teleconsultations will be entirely free for patients until the end of 2022. It seems telehealth may be here to stay.

Countries have innovated to protect health care workers through other means as well. The Netherlands launched its “Extra Hands for Healthcare” digital platform, in partnership with regional employers’ associations, to recruit additional lay personnel to help with simple tasks as well as offer mental health support for overloaded health professionals.

Policy Takeaways

  • Countries have expanded electronic consultations and prescriptions, which may reshape health care delivery permanently.
  • Virtual and at-home care are important for protecting health care professionals.

Nursing Homes Prepare for Future COVID-19 Waves

With their entire populations at high risk for both contracting COVID-19 and dying from the disease, nursing homes were quick to close their doors to visitors. But the resulting social isolation has led to deteriorating mental health for many residents, as those falling ill have been cut off from loved ones as they struggle to fight the illness.

Going into the pandemic’s second wave, some nursing homes in Germany reported they had put in place stronger safety precautions that allowed for family visits. The steps include separating healthier residents from those at greater risk; outfitting visitation spaces with plexiglass protective screens and personal protective equipment; and making rapid COVID-19 tests available to visitors.

In France, the international aid organization Doctors Without Borders reported recruiting emergency help for nursing homes to relieve overworked staff in the face of surging infections.

Policy Takeaways

  • Addressing the mental health needs of nursing home residents can be balanced with appropriate safety measures.
  • Workforce protections for long-term-care staff can continue to be prioritized.

Continued Government Intervention Key to Economic Recovery from COVID-19

The jobs crisis created by the pandemic is turning into a social crisis, a recent report from the Organisation for Economic Co-operation and Development (OECD) finds. The European Commission, meanwhile, forecasts a deeper recession than what was predicted just a few months earlier. Both reports highlight the need for continued government intervention to help ease the path to economic recovery.

In August, the Canadian federal government passed legislation extending Canada’s Emergency Response Benefit by one month (though September 27). To support out-of-work Canadians not eligible for employment insurance, a new bill introduced three temporary recovery benefits, including CAD 500 (USD 393) per household per week for up to 26 weeks for individuals unable to work because of caregiving responsibilities necessitated by COVID-19.

The French government unveiled a EUR 100 billion (USD 118 billion) economic stimulus package to “prevent and fight against the slide into poverty.” The plan’s priorities include reducing unemployment, particularly among young people, supporting vulnerable populations, and addressing the needs of those who “feel abandoned by the state.” In the Brest region, local government expanded emergency food provision, including a referral system to identify people most in need of food vouchers.

Originally slated to last one year, Germany’s short-term wage-support program (Kurzarbeit) has been extended through the end of 2021. The scheme enables financially struggling companies to reduce workers’ hours while keeping them employed, with the government paying up to two-thirds of wages for missed time.

Policy Takeaway

  • With effects of the economic devastation of COVID-19 likely to be felt for years to come, it is critically important that governments continue to help people meet their basic needs.

Editorial Team

Authors: Roosa Tikkanen, Molly FitzGerald, Katharine Fields, and Reginald D. Williams II

Editors: Roosa Tikkanen, Reginald D. Williams II

Country Correspondents

World news — Roosa Tikkanen

Australia — Sonĵ Hall

Canada — Fredika Scarth

France — Angèle Malâtre-Lansac, Véronique Raimond

Germany — Michael Laxy

Netherlands — Marit Tanke, Umar Ikram

Norway — Christer Mjåset

Sweden — Ulrika Winblad

Switzerland — Lars Hemkens

United Kingdom — Adam Briggs, Nason Maani

Publication Details

Publication Date: January 13, 2021

Experts

Roosa Tikkanen
Senior Research Associate, International Program in Health Policy and Practice Innovations, The Commonwealth Fund
Molly FitzGerald
Senior Program Associate for Fellowships and Research, International Program in Health Policy and Practice Innovations, The Commonwealth Fund
Katharine Fields
Program Assistant, International Program in Health Policy and Practice Innovations, The Commonwealth Fund
Reggie Williams
Vice President, International Health Policy and Practice Innovations , The Commonwealth Fund