Policy responses for Albania - HSRM

Albania


Policy responses for Albania

6. Measures in other sectors

6.1 Measures in other sectors

Many MEASURES IN OTHER SECTORS beyond the immediate scope of the health system are being taken to prevent further spread of the virus. This section contains information on many of these areas, including border and travel restrictions and economic and fiscal measures, among others.

• Borders
The entire country has been placed under lockdown (Decision of the Council of Ministers No.243 of 24 March 2020 “On the Declaration of Natural Disaster Situation”; Normative Act No.3 of 15 March 2020 “On special administrative measures during the period of infection caused by COVID-19”, amended by Normative Act No.12 of 2 April 2020).

All borders (air, sea, land) are closed until further notice. Only goods are allowed to pass through. Between 10 March 2020 and 16 March 2020, all airports, ports and ground crossing points with Italy, Greece, Montenegro, North Macedonia and the United Kingdom were closed. On 15 March 2020, the border between Albania and Kosovo was closed.

• Mobility (transport)
External travel (for goods and people)
• There are no restrictions for the transport of goods. Companies that transport goods through the borders are requested to deposit information on drivers and vehicle (https://www.infrastruktura.gov.al/masat-kunder-covid19-mie-kompanite-e-transportit-nderkombetar-te-mallrave-te-dorezojne-emrat-e-drejtuesve-te-automjeteve/)

• People are not allowed to exit or enter the country, except for repatriations and drivers that transport goods (https://www.infrastruktura.gov.al/njoftim-per-media-8/)

Internal travel (including public transport)
- All public transport has been discontinued.
- The movement of private cars has been restricted to travelling to work, with a maximum of two passengers applying protection measures, limited to the time of 5:30-8:00 am and 16:00 – 17:30, and only upon approval by the authorities (police/e-Albania).
(Order of the Minister of Health and Social Protection No. 168/1 of 15 March 2020 “On the restriction of movement within the country”; Order of the Minister of Health and Social Protection No. 259 of 10 April 2020 “For some additions and changes to the Order No. 193 of 20 March “For the closure and the restriction of the movement in the Republic of Albania”; Order of the Minister of Health and Social Protection No. 168/2 of 18 March 2020 “On the restriction of movement with private or state vehicles of public administration”)

• Economy
The Government has issued instructions on the postponement of the payment of certain taxes, tariffs and rent which are due in March-May 2020 (https://www.tatime.gov.al/d/8/45/0/1283/njoftim-mbi-dorezimin-e-deklarates-se-tatim-mbi-fitimin-dhe-pasqyrave-financiare-per-vitin-2019-si-dhe-pagesen-e-tatimit-mbi-fitimin-per-vitet-2019-dhe-2020)

The Government has issued decrees on the continuation of economic activities related to food production and food supply chains and other essential services (water supply, energy, pharmaceutical service, etc) (https://www.tatime.gov.al/d/8/45/0/1282/lista-e-aktiviteteve-qe-do-te-lejohen-te-ushtrojne-aktivitetin-e-tyre-dhe-aktivitetet-te-cilat-do-te-ndalohen-te-ushtrojne-aktivitetin-ekonomik-duke-filluar-nga-data-24-mars-2020)

The Normative Act “On some changes in the Law No. 88/2019“/ “On the budget of the year 2020” allows for the allocation of a Financial Package of ALL 12 billion to cope with the emergency situation created by the COVID-19 pandemic. In detail, the changes in the 2020 Budget under this Normative Act aim to support the basic pillars of efforts against the consequences of COVID 19, providing:
• ALL 6.5 billion for the Anti-COVID Social Package “in support of employees and/or other strata affected by the suspension of work processes nationwide including the needy, people who lose their jobs and communities”;
• ALL 2.5 billion in support of the Ministry of Health and Social Protection and Hospital Structures, to ensure the supply of various medicines, medical devices and emergency activities and in support of medical staff;
• ALL 1 billion for the State Budget Reserve Fund, for the creation of space for financing the necessary expenses with unforeseen character, for the following months;
• ALL 2 billion reallocation to an Emergency Fund to provide food to certain communities, which will be affected by the pandemic, or for families with economic aid and single pensioners who will need direct assistance. At the same time, this fund will be used for the needs of medical teams, both in civilian hospitals and in the military hospital;
• Updates on the local government budget, which create opportunities for local government to be part of the joint response;
• Compensation of revenue reduction in the state budget for the period of measures for coping with COVID-19 and subsequent impact;
• Reviewing macroeconomic indicators showing maximum attention towards orienting budget resources to the most emergency sectors and to enable support to citizens.
• Support for the private sector in coping with the situation, in the form of the instrument of the Sovereign Guarantee in the amount of ALL 11 billion (USD 100 million). This amount will be a guarantee for companies, which will be faced with the difficulty of paying the salaries of the employees during these months. This short-term loan guarantee aims to ensure that every family has enough income to cope with this difficult situation.

This Normative Act makes it possible to meet the needs for coping with the situation, reflecting an increase of the budget deficit to a level of ALL 68.7 billion, or 3.9% of GDP, up from the 2.2% of GDP expected according to the initial budget and, consequently, increasing public debt to an expected total of about 68.8% of GDP.

The Western Balkans region is expected to enter a recession in 2020, with all six countries forecast to experience negative economic growth, as they continue to grapple with the economic impact of the COVID-19 (Coronavirus) pandemic.

Regional growth in the Western Balkans is forecast to be 3-5.6%, according to the World Bank’s latest Regular Economic Report (RER). Source: https://www.worldbank.org/en/news/press-release/2020/04/29/recession-looms-for-western-balkans-as-countries-respond-to-covid-19



• State aid
Welfare benefits and other support to individuals, including sick pay, cash transfers, housing relief
Pursuant to Decision No. 254 of the Council of Ministers of 27 March 2020: “On determining the procedures, documentation and the measure of obtaining financial assistance for employees in business entities with annual income up to ALL 14 million, economic assistance and payment of income from unemployment during the period of natural disaster announced as a result of COVID-19”, which entered into force on 1 April 2020, beneficiaries of financial assistance equal to the minimum wage at the national level of ALL 26,000 per month are:
• self-employed physical persons;
• unpaid family employees of the commercial physical person;
• employees at commercial physical persons.
• employees in legal entities, with an annual income of up to ALL 14 million

Pursuant to the Decision of the Council of Ministers No. 305 of 16 April 2020: "On determining the procedures, documentation and the measure of obtaining financial assistance for current employees and dismissed employees as a result of COVID-19":
• Employees of entities with an annual income of over ALL 14 million, closed under Ministry of Health orders who were employed on the date of entry into force of the Ministry of Health orders, receive financial assistance of ALL 40,000.
• Employees of entities with an annual income of up to ALL 14 million, allowed to work according to Ministry of Health orders, who have been at work since the date of entry into force of the Ministry of Health orders, receive financial assistance of ALL 40,000.
• Employees of entities that exercise activities in the hotel sector, which appear in the payroll of entities, until the date of the Ministry of Health orders, receive financial assistance of ALL 40,000.

On 29 July, a Decision of the Council of Ministers established procedures, criteria and rules for an employment promotion program for people unemployed as a result of COVID-19. The employment program contains the following conditions:
• The employment program is a 4, 8 or 12-month employment program, in which the profile and needs of the jobseeker are adapted to the vacancy by the employer;
• The salary is determined in the employment contract, in accordance with the respective position and level of salaries in the open market.

For eligible persons, the program will subsidize the following costs:
• For the four-month employment program:
Salaries will be financed for up to the value of 100% of the national minimum wage, determined  according to the legislation in force, for 2 months for all program participants, compensated in the first and fourth month of the contract. Compulsory social and health contributions (part of the employer's contribution), calculated on the basis of the national minimum wage, will be provided throughout the duration of employment and reimbursed on a monthly basis.

• For the eight-month employment program:
Salaries will be financed for up to the value of 100% of the national minimum wage, determined according to the legislation in force, for 4 months for all program participants. It will be compensated in the first, second, seventh and eighth month of the contract. Compulsory social and health contributions (part of the employer's contribution), calculated on the basis of the national minimum wage, will be provided throughout the duration of employment and reimbursed on a monthly basis.

• For the twelve-month employment program:
The program will subsidize the costs of financing compulsory insurance (contribution of employer and employee) in the amount of 100%, calculated on the basis of the national minimum wage, determined by applicable law, of offered throughout the duration of the program, reimbursed monthly.

Home education support includes the following:
• Order of the Minister of Education, Sports and Youth No. 91 of 9 March 2020 “For the interruption of the school activities at all public and non-public education institutions”
• Order of the Minister of Education, Sports and Youth No. 101 of 1 April 2020 “For the closure of public and non-public education institutions”
• Instruction of the Minister of Education, Sports and Youth of 9 March 2020 “For learning at home, due to the situation created by the spread of COVID-19” (https://arsimi.gov.al/udhezues-per-mesimin-ne-kushtet-e-shtepise-per-shkak-te-situates-se-krijuar-nga-perhapja-e-virusit-covid-19/)
• Other instructions on the tools, methods and platforms for learning at home are given here: https://arsimi.gov.al/category/udhezime/

Protection for vulnerable people has been initiated by:
• Order of the Minister of Health and Social Protection No. 254 of 10 April 2020: "On the protocol of operation of public and non-public residential centres that provide housing services for victims of domestic violence and trafficking in the situation of pandemic COVID-19".
• Instruction of the Minister of Health and Social Protection No. 253 of 10 April 2020: “On managing cases of children in need of protection during the natural disaster period resulting from the COVID-19 pandemic”. This instruction aims to set out concrete procedures and actions to be taken by child protection structures in managing cases of children in need of protection during the natural disaster period resulting from the COVID-19 caused pandemic.
• Decision of the Council of Ministers No. 236 of 19 March 2020: "On measures to provide domiciliary assistance to the needy, in the conditions of the epidemic caused by COVID-19"

Decision No. 236 of the Council of Ministers provides for:
1. Providing housing assistance to the needy by state structures, in epidemic conditions caused by COVID-19.
2. The provision of assistance, according to this decision, will consist of sending monthly payments that individuals benefit from the social security programme from Social Insurance and in sending food and non-food products, minimal, reimbursable medicines and those upon request, to cope with the situation or to carry out supplies with the above products on their account.
3. Determining the quantity of food and non-food products, their minimum level, and type of assistance is carried out by decision of the Central Commission for the Provision of Assistance, set up for this purpose as defined in point 11 of this decision.
4. In the light of this decision, the needy will be considered:
a) persons / families who do not have family members capable of working in the administrative unit where they live, and belong to the groups, as follows:
i. Families / individuals in need, beneficiaries of economic assistance;
ii. Persons with disabilities;
iii. Persons who receive an old-age pension.
b) persons who, regardless of the family composition and its location, are part of the groups, as follows:
i. Families / individuals in need, who are homeless;
ii. Families who have lost their homes due to the earthquake.
5. Prefectures, Municipalities, at the request of the Central Commission for Providing Assistance, the State Social Service and the Social Insurance Institute will compile lists of beneficiary subjects, according to this decision, within 3 days from the entry into force of this decision.
6. The Central Commission for Providing Assistance verifies the lists, makes the relevant reconciliations, if necessary, and confirms it to the county prefects, mayors, State Social Service and the Social Insurance Institute.
7. After the confirmation of the lists, the prefectures of the regions and the mayors set up the commissions of civil protection and take all measures with their personnel as well as with the service of volunteers for sending products, food and non-food, to the needy, according to this decision.
8. The Armed Forces are also engaged in assistance to the needy, coordinating with civil defense commissions, in counties and municipalities. Areas and level of engagement will be determined by order of the Chief of the General Staff of the Forces Armed of the Republic of Albania.
9. Sending monthly payments in one’s apartment, which these persons benefit from the social protection program of Social Insurance, will be carried out by the postal service, based on the confirmed lists according to the provisions of this decision.

Vulnerable groups from the Mental Health and Psychosocial Support (MHPSS) point of view include the following:
- Children
- Women
- Victims of domestic violence
- Older people
- Individuals with high predisposition to develop mental health conditions or an exacerbation of prior mental health conditions
- Individuals with a chronic health condition
- Refugees

Civil protection:
Civil protection has been initiated through the declaration of a state of emergency (Order of the Minister of Health and Social Protection No. 156/2 of 11 March 2020) "On the declaration of the state of the epidemic by COVID-19 infection”) and the declaration of a natural disaster situation (24 March 2020).

Deployment of military resources
Pursuant to the Law No.15 / 2016, “Prevention and fight against infections and infectious diseases”, as amended by the Normative Act No.2 of 11 March 2020:
"5.1. In the event of an epidemic, natural disaster, serious accident, which can favour epidemic outbreaks, to ensure the implementation of preventive measures, under this law, the State Police and the Armed Forces are engaged in its assistance. The State Police is engaged at the request of the minister responsible for health. The Armed Forces are engaged by a decision of the Council of Ministers, on the proposal of the Minister of Defence, at the request of the Minister responsible for health and the Minister responsible for public order and security. When the Armed Forces are engaged, they are led by the commanders, according to the tasks they receive.”

• Cross-border collaboration

Two teams of Albanian doctors and nurses were deployed to northern Italy on 28 March (consisting of 30 health workers) and 30 April 2020 (consisting of 60 health workers), to help with the treatment and care of patients affected by COVID-19 (https://new.shendetesia.gov.al/30-mjeke-dhe-infermiere-shqiptare-nisen-drejt-italise/).

Measures effective since 20 April 2020
A long list of activities allowed to operate, starting from April 20th, was published in e-Albania. The list contains 9800 allowed activities.

Broadly, they cover:
- Industrial or production activities
- Agriculture / agrobusiness
- Food production/processing
- Construction
- Artisanal shops
- Family related activities
- Air and sea transport for goods (not for passengers)
- Hotels and other accommodations

International organizations are also allowed to operate.

All the businesses and activities are categorized according to COVID-19 transmission risk.

All the businesses and activities are to be conducted only under strict safety measures. Measures correlate with the risk category and business-specific conditions.

All employees of activities allowed to operate, or public administration personnel that need to move by car, should send their requests via e-Albania or SMS to number 55155. The permissions obtained are weekly, and, for normal working hours, should be between 05:00hrs until 08:00hrs in the morning and 16:00hrs-17:30hrs afternoon. For work in shifts, a person can choose the time for each day of the week, including weekends.

The permissions to drive are obtained via e-Albania. Drivers have to adhere to the itinerary home-work-home and can only take one other colleague or family member who also has permission to work, who should sit in the back, in a diagonal position to the driver.

Other measures:

Older people are allowed to move as pedestrians, not in groups, on Saturdays 8-10 AM

Mothers with children up to ten years old are allowed to go out on Sundays, until 11.00 AM.

For the movements as pedestrians, people may get permission to go out and return within 90 minutes for one family member, following the established procedure via e-Albania.

The permission for car movements is still issued via e-Albania and it is weekly.

Movements for medical emergency remain the same, by calling police at 112/129, providing information for the medical need in question, personal and vehicle information.

Measures effective since 27 April 2020

Additional businesses have been allowed to open. Part of the list, published on the e-Albania portal, are mainly retail stores, such as clothing, shoes, flowers, etc. Taxis are also allowed under strict conditions.

The pedestrian movement schedule is extended from 90 to 120 minutes.

The following measures are valid only for the municipalities/areas designated as “green areas”, with low infection circulation and risk:
•  Dibër district
•  Gjirokastër district 
•  Common area consisting of the municipalities of Pogradec, Prrenjas, Librazhd
• Common areas consisting of the municipalities of Sarandë, Himarë, Delvinë, Konispol, Finiq
• Divjakë municipality

- Driving by private vehicles will not require permission, will last from 09:30hrs until 17:30hrs, but with only two persons inside. Retired persons will not be allowed inside the cars.
- No one is allowed to enter/go out of the perimeter of these green zones
- Retired persons are allowed to go out walking until 08:30 hrs;
- From 09:30hrs until 17:30hrs all the rest of the population may go out; however, only two persons can walk in pairs/together
- Persons cannot go to parks in the next 14 days

Parks and beaches remain closed.

Bars, restaurants, cinemas, theatres, concert halls, sports facilities, beauty shops, gyms remain closed.

Schools
The schools will be open only for graduating high school students from 18 May-05 June 2020 under strict safety measures to prepare for exams (to be held 8-18 June), whereas home/online schooling for first to 11th graders will continue until the end of May. Other exams will be cancelled.

Measures effective since 4 May 2020
The Green Zones have been expanded to include the municipalities of Tropojë, Rrogozhinë, Peqin, Belsh, Cërrik, Gramsh, Ura Vajgurore, Kuçovë, Berat, Poliçan, Skrapar, Devoll, Pustec, Maliq, Mallakastër, Kolonjë, Vlorë and Selenicë.

In these Green Zones, movement of pensioners is allowed from 6:00 to 8:30 and other people from 9:30 to 17:30, with no more than one person accompanying.

There has also been an adaptation in the "Red Zones" where the risk of contagion is considered comparatively higher; there, movement of pedestrians was extended from 90 minutes to 2 hours. Selected retail businesses and services are allowed to operate. Taxies can move from 9:30 to 17:30 without permit and no more than one passenger. Older people are allowed to go out during Sat/Sun, until 09:30hrs, followed by the outing of parents with children up to 14years of age, from 10:30hrs until 17:30hrs. Food markets and pharmacies will remain open only during Saturday until 17:30hrs.

Measures effective since 11 May 2020
Only the red zones have remained under the same current regime of restrictions and movements will be allowed by permission only.  In the green areas, movement by private car is not restricted, until 21:00hrs; in addition, the restrictions for the green zones remain the following: no gatherings with more than five persons, no cultural/sport events, no public transportation and the closed businesses will remain closed until further notification.

Red zones:
• Tirana
• Durres
• Kruja
• Kurbini
• Shkodra
• Fier

Measures effective since 18 May 2020
• The movement time in the red zones is extended until 21:00 hrs.
• There is no need for authorization for movements by car or walk all over the country.
• Movement in green areas is unrestricted.
• Movements by car from Green zones to Red zones still will be restricted
• The measure of 14-day self-isolation remains in place
• Fieri district is considered a green zone starting on 18 May 2020

Red zones:
• Tirana
• Durres
• Kruja
• Kurbini
• Shkodra

• Schools are allowed to open only for graduating high school students from 18 May-05 June 2020 under strict safety measures to prepare for exams (to be held 8-18 June), whereas home/online schooling for first to 11th graders will continue until the end of May.
• Sports training is allowed only in open spaces.
• Bars, restaurants, and fast-food shops are allowed to open only in open areas, according to safety protocols.

References
Order of the Minister of Health and Social Protection no. 320, dated 15.05.2020, “On some restrictions to the services provided in bars, restaurants, fast food shops”
Instruction no. 18, dated 8.5. 2020, of the Minister of Finance and Economy "On the organization of teaching, assessment of students, final exams and closing of the school year 2019-2020, in public and non-public vocational schools, in the conditions of the state of natural disaster caused by the pandemic of COVID-19"
Orders of the Minister of Health and Social Protection no. 326-328, dated 18.05.2020.


Other measures

All audiovisual broadcasts with more than one person in the same television studio, which do not respect the safety distance of 2 meters from each other, are punished with a fine of 1 million ALL, and, in case of repeated violations, blocking of equipment and of the activity of the media operator (Reference: Normative Act no. 20, dated 20.05.2020)

Measures effective June 1st, 2020

1. All movements in the whole territory of the country will be free without time limitations (pedestrians, bicycles, motorcycles and vehicles).
2. All businesses are allowed to resume their activities, respecting the safety protocols.
3. All borders with the neighboring countries will be open. No quarantine is required for persons entering the country. Quarantine will be implemented only for specific cases that will be recommended by the health authorities in the country or protocols that will be issued/approved by the European Centre for Disease Prevention and Control (TBD).
4. All kindergartens, public and private, will be open under strict safety measures.
5. Vocational training courses, educational courses, entertainment courses, playing yards in open areas, gyms, and internet centers are allowed to open.
6. Competitions for admission to schools and work are allowed.
7. Parks and green areas are open.
8. Football matches are allowed to start, without spectators.
9. Beaches which are part of accommodating structures (hotels, resorts, camps, etc.) are allowed to open under strict safety measures.
 
Remaining restricted/closed activities:
1. Public transport
2. Cultural activities until 23 June, including theatres, cinema halls.
3. Some sport activities such as swimming in pools etc.
4. Public gatherings in open or close areas are not allowed, including weddings and funerals.

International commercial flights have not yet resumed, whereas the trade of goods with other countries continues unrestricted.

The Ministry of Health is calling on people and businesses to strictly follow the health safety protocols, personal hygiene, and physical distancing.

References:
Order of Minister of Health and Social Protection no. 351, dated 29.05.2020, "On special measures and restrictions to prevent the spread of COVID-19"
Decision of the Council of Ministers (DCM) no. 424, dated 27.5.2020, “For an addition to the decision no. 171, dated 27.3.2019, of the Council of Ministers “ On the approval of the regulation on the conditions and criteria for exercising the activity at beach stations”

Measures effective June 15th, 2020

Resuming of international flights with Greece, Serbia, Austria and Germany.

The EU countries still have a temporary restriction of non-essential travel from non-EU to EU countries and vice versa until 30 June 2020. This restriction is in force for international flights from Rinas to EU countries within the Schengen regime. After 30 June, the restriction should be lifted for countries selected together by EU Member States, based on a set of principles and objective criteria, including the health situation, the ability to apply containment measures during travel, and reciprocity considerations, taking into account data from relevant sources such as ECDC and WHO. It is recommended to lift travel restrictions for Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia as of 1 July.

All borders with Albania’s neighbouring countries are open. No quarantine is required for persons entering in the country. Quarantine will be implemented only for specific cases that will be recommended by the health authorities in the country.

All movements throughout Albania are free without time limitations.

Most businesses are allowed to resume their activities, respecting the safety protocols.

Remaining restricted/closed activities:
1. Public transport
2. Cultural activities until 23 June
3. Some sport activities such as swimming in pools etc.
4. Public gatherings
5. Schools (except the graduating high school students).

All businesses and institutions are obliged to abide by the safety protocols.

People are reminded to strictly follow the health safety protocols, personal hygiene, and physical distancing.


Support to vulnerable groups / mitigation of socio-economic impact

The Government of Albania is providing financial assistance, of 40,000 ALL, for former employees in entities that have been allowed to carry out activities or have been closed according to the orders of the Minister of Health and Social Protection, dismissed in the period March 1, 2020 until May 17, 2020.

Source: Decision of Council of Ministers (DCM) no. 423, dated 28.05.2020 “For some changes and additions to the decision no. 305, dated 16.4.2020, of the Council of Ministers, “On the determination of procedures, documentation and the measure of receiving financial assistance for current employees and employees dismissed as a result of COVID-19 "


Measures effective 16 July 2020
The public transportation in Albania has completely resumed, the latest being the capital  (Tirana) on July 6th .   The operators of the vehicles and the citizens are required to adhere to approved safety protocols.

The Albanian Government decided that the use the protective mask / textile barrier should be mandatory in any enclosed environment. Reference: Normative Act No.29, date 15.07.2020.
 
The use of masks to protect against COVID 19 transmission is an obligation for every individual in all enclosed spaces, in public and non-public sectors, in public transport, in offices, building stairs, elevators, in shopping malls, shops, supermarkets, markets and service units. etc.

In case of non-compliance with this obligation, the state police, municipal police, state inspectorate structures, will fine the violators. The amount of the fine is set at 2,000 ALL for each violation of the rule.

As of 15 July, in enclosed public and commercial premises a protective barrier (mask) should be worn (Normative Act no.29), made according to the definitions provided by the Institute of Public Health and approved by the Minister of Health. Failure to use the protective barrier by individuals in enclosed, public and commercial spaces, is punishable by a fine of 2,000 ALL. The institutions responsible for implementing this provision are the inspectorates responsible according to their area of responsibility for individuals in public and commercial environments. The State Police and the Municipal Police are responsible for individuals on public transport and those using other specific facilities as defined by joint instruction of the Minister of Health and the Minister responsible for public order.

Measures effective 20 July 2020
A national prohibition was introduced on the opening of nightclubs, discos, lounge bars or any kind of service of this nature either indoors or outdoors. The only exception to this rule is restaurants. Failure to comply with this obligation by the entities is punishable by a fine of 3,000,000 ALL and suspension of business operation for a period of one year.

There is also a new prohibition on music after 20.00 in all service facilities of any kind. Failure to comply with this obligation is punished with a fine of 1 000 000 ALL and in case of repetition, with suspension of business operation for a period of six months.

Measures effective from October
As of October 1 2020, the inside areas of bars, restaurants and indoor swimming pools have been opened. However, specific protocols that must be followed by the business operators have been published by the Ministry of Health (see https://new.shendetesia.gov.al/udhezues-i-masave-higjeno-sanitare-covid-19-ne-bare-ose-restorante-ne-mjedise-te-mbyllura/ and https://new.shendetesia.gov.al/udhezues-per-masat-higjeno-sanitare-ndaj-covid-19-per-aktivitetin-e-pishinave-ne-amjentet-e-mbyllura/). Pubs, night clubs, lounge-bars and discos remain closed.

As of October 15th, wearing masks outdoors is mandatory. Individuals who violate this measure will be fined 2,000 All.
The Council of Ministers has also approved a normative act that forgives all fines imposed by the relevant state authorities for violating the rules or bylaws issued in the framework of measures taken to prevent and combat infection caused by COVID -19, from 17.4.2020 to 7.10.2020. By November 15, the money of fines paid, and cars and permits blocked during quarantine and earthquake are to be returned (see Normative Act  No. 31, dated 7.10.2020: https://qbz.gov.al/eli/fz/2020/178/5f33c626-d67b-49ea-b5c1-86591e53d821)

Transition Phase

The COVID Technical Commission, at the Ministry of Health and Social Protection has developed and issued the “Transition Guide”, for the re-opening of the society (April 2020).

The overarching principles of the re-opening are:

A. Be gradual:
- When moving from one stage to the other, enough time (a minimum of 2 weeks) should be allowed to monitor for possible negative effects such an increased transmission of SARS-Cov-2.
- Activities with a greater effect on the economy and less effect on the transmission of infection should resume first.

B. Should be accompanied by some restrictions regarding the movement and contacts of people for at least 2 months from the moment of the gradual re-opening:
- Sports and arts events with gatherings of over 10 people should continue to be banned.
- The elderly and people with chronic diseases will need to continue restricting their movement and minimize other social activities.
- Low-risk individuals should be given priority with respect to travelling between different cities.
- Persons coming from high-risk countries (still reporting daily cases within 2 weeks and/or having over 15 deaths per million) should continue to be quarantined. This is particularly important during the summer months when tourism may restart.
- Whenever possible, working from home should continue to be encouraged.
- Special protocols must be prepared and implemented for commercial services and public transport.

C. Must be accompanied by strong recommendations for the public, employees and students regarding the minimization of transmission:
- Recommending individuals involved in activities implying human contact to wear masks;
- Recommending individuals to maintain physical distance of 2 meters between one another;
- Continuous recommendations on washing and disinfecting hands, etc.

D. Relief of restrictive measures should be performed while also providing sufficient capacities for the monitoring of the situation and dealing with a possible escalation of the epidemic:
- Epidemiological capacities to trace all suspected cases and their contacts;
- Laboratory capacities to test and diagnose all suspected cases and their contacts;
- Laboratory capacities for rapid tests and serological tests to assess immunity of the population;
- Strengthening the surveillance system and early notification system within the healthcare to identify any suspected cases and especially patients who need to be hospitalized;
- Hospital capacities with a high dedicated number of beds for acute and intensive care;
- Sufficient stock of personal protective equipment to withstand a period of at least 2 weeks of sustained transmission of the virus (20-100 new cases per day).

E. Must be accompanied by stricter measures regarding the isolation/quarantine of confirmed cases and their contacts:
- Wherever possible, and especially in cases where elderly or high-risk individuals are at play, isolation and quarantine should be carried out in centralized conditions, i.e. in a dedicated environment. This would minimize the risk of viral transmission in other family members, etc.

F. Moving from one stage to the other is done only after a steady decline or low level risk is observed for at least 14 days with respect to:
- Confirmed daily cases;
- Hospitalized patients;
- Patients in intensive care.

The surveillance of the implemented measures should be coordinated between the structures of the National Health Inspectorate and the State Police.

In the event that during the relief phase, trends will change and the number of active, hospitalized or ICU cases will increase, a timely review of measures according to the given stage will ensue and the need for the immediate return to the strict measures of social distancing will be evaluated.

The four stages of easing restrictions

Based on WHO recommendations as well as risk assessment within the country, the return to normalcy should be carried out gradually and will include several phases extended over time.

Stage 1:
This phase requires rigorous tracing of contacts and strict monitoring of the effectiveness of isolation and quarantine measures. It also requires daily monitoring of the rate of transmission of the infection, the capacity of hospital beds, capacities of the National Center for Medical Emergencies, number of traced contacts for each confirmed case, and the percentage of positive samples. In this stage it's also important to improve the infrastructure of the epidemic intelligence service and increase the personal protective equipment stock for healthcare workers and social workers. It is also important to evaluate all diagnostic tests that identify individuals that have had an asymptomatic infection, thus allowing an investigation of the role they play in the transmission of the virus.

The Institute of Public Health will draft the study of the virus transmission in the population and start its implementation. The IPH will also draft a plan regarding the determination of the population's immunity, when the necessary tests and tools are available and implemented. It is also necessary to draft treatment protocols and perform preliminary assessments of these protocols and the medications used, to assess their efficacy.

Online or by phone health services for COVID-19 will continue, while the re-opening of other healthcare services will gradually begin in this stage.

It is worth noting that the principle of regionalization is applicable in this stage: restrictive measures can vary by region based on the level of risk.

Stage 2:
At this stage, the same measures as above are applied regarding the tracing of contacts, testing and improvement of infrastructure and monitoring processes, but measures implemented are less restricting. If the infrastructure allows, and relevant tests are available, an evaluation of the immunity of the population must be performed. Data on relevant therapies and their efficacy will also be collected and studied.

It is worth noting that the principle of regionalization is applicable in this stage: restrictive measures can vary by region based on the level of risk.

Stage 3:
At this stage, studies on the population's immunity must be performed and finalized in order to have clear figures on the number of people who have had the infection. Testing, contact tracing, and monitoring must continue, but only personal physical distancing measures are applicable. At this stage effective treatment protocols are determined and there is clear data on reducing the frequency of infection.

Stage 4:
Full recovery will occur when a high level of immunity to the disease is achieved in the general population, through vaccination too, and when the rate of infection is no longer a major public health threat.

Source: https://shendetesia.gov.al/wp-content/uploads/2020/01/Covid_Strategjia-e-rihapjes.pdf