The GOVERNANCE of the health system with regard to COVID-19 relates to pandemic response plans and the steering of the health system to ensure its continued functioning. It includes emergency response mechanisms, as well as how information is being communicated, and the regulation of health service provision to patients affected by the virus.
With 21st September, the Epidemics Act and the COVID-19 Act were modified. For harmonisation, changes were made also to the tuberculosis law.
Changes to the Epidemics Act: Hotels and transport companies are required as of now to provide personal data for contact tracing if requested to do so by the Ministry of Health (also across borders). Screenings are made possible in schools, even though participation in screening is voluntary. Events may be regulated more strictly.
Changes to the COVID-19 Act: Access to workplaces and public places as well as use of transport vehicles may be regulated to avoid spread of COVID-19. Regulations concern distance regulations, the use of face masks, other protective measures and obligatory prevention concepts.
Changes in the possibility to leave the house may be regulated, especially to avoid scarcity of health care resources if general measures are not sufficient. Even if stricter regulations are made, leaving the house for one of the following reasons will be allowed under all cirumstances: emergencies, family obligations/help, necessities of daily life, work-related reasons, staying outside for physical and mental respite.
More details can be found under: https://www.sozialministerium.at/Informationen-zum-Coronavirus/Coronavirus---Rechtliches.html
In Austria, there is a 2006 Influenza pandemic response plan, which will now be (again) updated in the face of the challenges of the pandemic involving the federal and the state governments as well as other stakeholders. The Influenza pandemic response plan was initially developed as a framework for crisis response possibly applicable to other viruses such as the SARS-COV-2 virus. A routine, regular exchange between all relevant bodies on questions of communicable diseases and procedures in the event of outbreaks is the basis for updates of the pandemic response plan. Yet, the plan was last updated in 2009 (3rd edition). In addition, state governments are not obliged to publish their updated response plans. For example, Vienna’s Influenza pandemic response plan (dating back to 2006) is published, and said to be updated whenever new challenging communicable diseases appear (e.g. SARS-COV 2012).
The 2006 Austrian Influenza pandemic response plan includes determination on structures to be activated during the crisis at federal and regional level (crisis management teams). These have been activated for the COVID-19 crisis with a 24/7 emergency service. Crisis management teams communicate by phone, mail and video conferences (between federal and regional level) and meet physically at each level. The crisis management teams regularly inform the government as laid down in the pandemic response plan. The crisis management team at federal level (also called “Taskforce Corona”) is located at the Ministry of Health and is led by the Federal Minister for Health. The Minister is supported by an officer of the Red Cross, the cabinet, and a group of other experts in the field.
The lead on the national response to COVID-19 lies at the federal level and is driven by the federal crisis management team and the federal government (mainly the federal chancellor and the Minister of Interior Affairs).
The State Crisis and Disaster Management (SKKM) is located at the Ministry of Interior Affairs. It coordinates tasks regarding the government’s response to the crisis. Its most important task is the maintenance of infrastructure and public safety.
According to the pandemic response plan public information provided by the crisis management teams as well as the federal government has to be transparent and based on facts. Further, groups of institutions, organisations and persons are defined as key forces or critical professions, which continue to work during the COVID-19 crisis (e.g. police, fire brigade, garbage disposal, patient transport etc.).
The Influenza pandemic response plan also refers to the Austrian Epidemic Act, which defines quarantine measures and further measures to contain outspread of diseases. The Epidemic Act also provides the possibility of legal actions in response to an epidemic crisis, including: quarantine of infected persons; implementation of protective measures for health personnel or other vulnerable persons (vaccinations, chemoprophylaxis); measures against social gatherings; traffic restrictions; use of special "epidemic doctors" and the closure of schools and kindergartens or other community facilities. The pandemic response plan also foresees regulations on masks, surveillance, medicines, vaccinations, and preparedness of hospitals but rather focused on influenza. Furthermore, public security bodies may be used to support and enforce functioning of these measures.
The state governments are in charge of executing decisions taken at federal level, i.e. implementing measures, yet have the freedom to apply stricter measures, such as quarantine for smaller regions. For instance, some villages in Tyrol or Salzburg were put under quarantine. State governments also have some leeway in whether or not to close parks and playgrounds or reinforce bans on public gatherings or leaving the house.
Regarding international reporting of cases, the Austrian reporting system works through the early warning system (EWRS), a platform for the exchange of information with other EEA countries, and a WHO system for worldwide exchange. International reporting is coordinated within the Ministry of Health.
In addition to the Epidemics Act, a series of COVID-19 Acts (in total five until April 6) have been issued defining measures to combat COVID-19. The basic Act included a ban on entering public places and defined exceptions thereof. These latter apply in cases where it is necessary to avert immediate danger to life, for persons who care for or assist those in need of support, to cover necessary basic needs of daily life with ensuring a minimum distance, to follow necessary professional activities while ensuring a minimum distance and for leisure purposes only with persons from the same household or with ensuring a minimum distance (see also section 1.5 Physical distancing). Spa institutions were closed for guests, and rehabilitation facilities for patients, except for necessary medical measures of the rehabilitation after acute medical treatment as well as for support services for general hospitals. The minimum distance of one metre between people in public transport was established and entering of sport sites was prohibited. Public organs may control and interrogate why persons enter public space. The COVID-19 Acts I-V (in addition to the basic Act) lay down different measures in the areas of the functioning of the labour market, measures for borrowers and tenants, measures for the protection of vulnerable groups (e.g. home office or paid leave), the organisation and financing of support funds, changes in other laws etc.).
As regards regulation and licensing of medical devices and aids, the Federal Office for Safety in Health Care may, upon request, authorise the placing on the market and the commissioning of individual medical devices for which the conformity assessment procedure and the CE marking have not been carried out (according to § 32 Abs. 1 of the Austrian Medical Devices Act). This approval is only valid for single application in Austria if their use is in the interest of health protection.
On May 13, the parliament passed an amendment of the COVID-19 legislation. The 16th COVID-19 Act enables a more standardised use of screening programs to identify high-risk areas or facilities/institutions and to enable systematic testing of specific groups of the population (e.g. health professionals). These systematic screenings are meant to allow differentiated analyses with a main objective to assess and support implementation and planning of measures, ease COVID-19 restrictions, protect particularly affected persons and maintain the health system’s safety. Participation in screening requires prior consent as screenings are implemented in accordance to existing data protection laws. Results from screenings will be administered in an electronic data recording system (screening register). Both, standardised use of screening programs for COVID-19 as well as the screening register are planned to end with the year 2021.
Legislation see also https://www.rechtsanwaelte.at/covid-19/gesetze-und-verordnungen/bundesgesetze/3-4-und-5-covid-19-gesetz/ (accessed on April 7th 2020).