Policy responses for Bulgaria - HSRM

Bulgaria


Policy responses for Bulgaria

1.2 Physical distancing

Initially, self-isolation was advised only for those who had returned from countries with confirmed cases (such as China), and physical distancing was recommendable in cases of contact with a symptomatic person. First measures, announced in February, included screening passengers arriving from China and some other countries on airports and quarantine of symptomatic passengers.

After the first four confirmed cases on March 8, self-isolation for 14 days of passengers from pandemic countries and contacts of confirmed cases became compulsory. Between March 8 and 11, the Minister of Health ordered the suspension of mass events for children, indoor sports events, ban on visits to institutions for residential care, restrictions for outdoor sports events (without an audience), culture and other mass events (requirements for 1-meter distance) for all regions with confirmed cases. Requirements for 1-meter distance for all sports, culture and other mass gathering events were set for regions without confirmed cases as well. On March 13, the number of diagnosed patients rose to 31, and the parliament declared a state of emergency for one month, and on April 3 extended it to May 13.

Since then the Minister of Health issued consequently several orders, aimed at containing the spread of pandemic:
• March 13 - closure of kindergartens, schools, universities, restaurants, discotheques, cafes, bars (except for takeaway food sales), sports and entertainment businesses, big shopping centres (except supermarkets, pharmacies, bank and insurance offices located in such centres); suspending all other activities for children, all public gatherings, maternity and child consultations, prophylactic check-ups and vaccinations, planned hospital admissions and visitors to all health care establishments;
• March 17 – ban on gatherings of more than two people in public places;
• March 17 - full 14-days quarantine of the town of Bansko (ski resort with several confirmed cases), prohibition of entering or leaving the town, going out except for food and drug delivery and medical reasons in case of emergency and closure of all shops and offices except groceries, pharmacies, banks, insurance offices and gas stations;
• March 19 - ensuring space for physical distance at least 1-1.5 m in institutions and other offices allowed working with citizens;
• March 21 - closure of parks, sports grounds and playgrounds; travelling in and out district cities is permitted for work and health reasons only (declaration from an employer or medical documentation is required); the time slot between 8.30 and 10.30 am must be reserved for elderly (60+) in supermarkets, groceries and pharmacies;
• March 25 – the reasons for travelling within the country are extended with taking care of relatives and buying essentials (declaration is required);
• 18-26 March – gradual closure of borders to foreigners allowing only Bulgarian citizens in;
• March 30 - compulsory wearing protective face masks when people go out in public; on March 31, the order was revoked due to public discontent;
• April 11 – closure of open food and farmers markets on April 12 (Palm Sunday) and during Easter holidays;
• April 11 – compulsory wearing protective face masks or other means covering the mouth and nose (such as scarf) when outdoors or in public places for the period April 12 – April 26.

Besides, many municipalities have implemented further measures such as the closure of some day-care facilities, ensuring physical distancing and preventing gathering at queries, train and bus stations, ban on vending machines at outdoor places and public beaches.

In the second half of April, the MoH and local authorities placed the village of Panicherevo of around 2000 inhabitants under mandatory quarantine due to high infection rates. Inhabitants are not allowed to leave the settlement except for emergency medical reasons. Besides, several Roma neighbourhoods in the capital and some other cities were locked down due to the high number of reported COVID-19 cases and signs for compromised overall measures in these settlements. The neighbourhoods have been subject to checkpoint controls, and people are not allowed to enter or leave except for meeting of basic needs or work. Immediately after the lockdowns, mass testing of randomly selected inhabitants has been initiated, using serological tests.

During the Easter holiday break, the government released more drastic restriction on leaving and entering the capital Sofia, where the most COVID-19 cases in Bulgaria were reported (approx. 58% of all coronavirus patients as of April 21). The ministerial order determines time slots in the morning and evening for the purpose of work engagements, requiring a declaration of employment. Exceptions were allowed for transport trucks, ambulances, police cars, vehicles transporting people for treatment or medical staff. The stricter measures were taken as a response of many attempts for leaving the capital during the first day of the Easter holidays.
After the Easter holidays, farmers and open food markets were reopened under strict regulations on physical distancing and disinfection. The government announced that lifting the ban on public parks and gardens is also being considered. Depending on epidemiological data, this could happen by the end of April.
Formally, going out is not further restricted (except public gathering). The responsible authorities appeal daily to the public to stay at home and keep physical distancing, particularly individuals who are considered vulnerable (elderly and people with chronic diseases). National media have started a “Stay-at-home” campaign, supported by many celebrities. Work at home is recommendable if it is possible, the MoH and the Ministry of Labour and Social Policy issued requirements for hygiene and anti-epidemic measures at working places, including physical distance at least 1-1.5 m.
In fact, all non-essential shops and offices (except located in shopping centres and explicitly included in ministerial order) are allowed to stay open but with ensuring physical distance and avoiding gathering of many people. For retail shops and business, it is recommendable to ensure a free flor area at least 10-15 m2 for each customer, a physical distance of at least 1.5-2 m at check-outs and in front of the shops. Groceries and other food stores are required to ensure that employees use gloves when selling non-wrapped food, conduct regular disinfection of retail areas, shopping carts, baskets and other contact surfaces, display information posters on proper hygiene and appropriate conduct of non-wrapped fruits and vegetables and provide one-off gloves and hand sanitizers for customers. There are also requirements regarding open food and farmers markets, which are allowed to work, except during Easter holidays.

The police have been authorised to enforce these measures through fines and dispersing gatherings. According to the State of Emergency Measures Act (passed on March 24), violation of orders is fined BGN 5,000 (EUR 2,556) for a natural person and BGN 15,000 (EUR 7,700) for a legal entity. On April 6, the parliament voted significant cutbacks in fines.

The Bulgarian Orthodox Church denies suspending religious events and will hold its 2020 Palm Sunday and Easter services outside churches. People will be allowed to enter churches to light candles, but priests will be required to prevent crowding. For these decisions, the Orthodox Church has been criticised on social networks.
In the second half of April, the MoH and local authorities placed the village of Panicherevo of around 2000 inhabitants under mandatory quarantine due to high infection rates. Inhabitants are not allowed to leave the settlement except for emergency medical reasons. Besides, several Roma neighbourhoods in the capital and some other cities were locked down due to the high number of reported COVID-19 cases and signs for compromised overall measures in these settlements. The neighbourhoods have been subject to checkpoint controls, and people are not allowed to enter or leave except for meeting of basic needs or work. Immediately after the lockdowns, mass testing of randomly selected inhabitants has been initiated, using serological tests.

During the Easter holiday break, the government released more drastic restriction on leaving and entering the capital Sofia, where the most COVID-19 cases in Bulgaria were reported (approx. 58% of all coronavirus patients as of April 21). The ministerial order determines time slots in the morning and evening for the purpose of work engagements, requiring a declaration of employment. Exceptions were allowed for transport trucks, ambulances, police cars, vehicles transporting people for treatment or medical staff. The stricter measures were taken as a response of many attempts for leaving the capital during the first day of the Easter holidays.
After the Easter holidays, farmers and open food markets were reopened under strict regulations on physical distancing and disinfection. The government announced that lifting the ban on public parks and gardens is also being considered. Depending on epidemiological data, this could happen by the end of April.


Sources and links:
Ministry of Health; https://www.mh.government.bg/bg/
Ministry of Labour and Social Policy; https://www.mlsp.government.bg/
National Association of the Municipalities in Republic of Bulgaria; http://www.namrb.org/lang/bg
State of Emergency Measures Act. State Gazette, No. 28, 24 March 2020, amended 9 April 2020
Orders regarding the COVID-19: https://www.mh.government.bg/bg/informaciya-za-grazhdani/informaciya-otnosno-noviya-koronavirus-2019-ncov/

On April 27, the Minister of Health permitted visits to public parks and gardens by certain categories of persons:
• children up to 12 years old, accompanied by parents or family members, but no more than two adults during the time slot between 9.30 am and 6.30 pm daily;
• dog owners and athletes, up to 9:30 am and after 6:30 pm every day.

Visits to city parks and gardens are allowed in strict compliance with anti-epidemic measures e.g. wearing protective masks, observing a physical distance of 2.5 meters, entering and exiting parks areas through designated checkpoints, as well as keeping designated routes. Alcohol consumption in parks and gardens is prohibited. Citizens should avoid contact with surfaces, such as benches and lawns.

The ban on visits to sports grounds and playgrounds remains in place.
The mayors of the municipalities are responsible for implementation of the measures.

From May 1, protection of the mouth and nose in outdoor public spaces is no longer compulsory when a physical distance can be guaranteed. However, the requirement for a face mask or other protective means in indoor public places such as stores and public transport is still in place.
At the beginning of May, the government announced to ease some restrictions:
• from May 1 onwards, visits to mountains and parks outside settlements are allowed in strict compliance with requirements for keeping 2.5-meter physical distance, avoiding gathering, entering and exiting parks areas through designated checkpoints. The use of lifts, huts, shelters, rest areas such as gazebos, sheds and benches is prohibited.
• from May 4 onwards, transport, aviation, railway and marine training centres may restore their activities, meeting requirements for physical distancing, wearing face mask and disinfection;
• as of May 4, individual outdoor sports such as tennis, athletics, bicycling are permitted; in addition, all swimming pools are allowed to provide services in compliance with all anti-epidemic measures and temperature screening for visitors entering the facilities;
• from May 6 onwards, open-air spaces in cafés, restaurants and bars are allowed to reopen with a distance of 1.5 meter between tables and strict disinfection measures. Only four adults or members of one household may share one table.
• on May 6, the checkpoints at the district cities’ entries and exits were removed. Some restrictions are still in place for one district centre, where a neighbourhood has been locked down due to the high number of confirmed cases.
At the beginning of May, the Minister of Education and Science announced that the schools would not be reopened and the school year will be completed in remote mode. Only pupils in the 7th and 12th grades will take final examinations at school.
As of May 11, visits of museums, galleries, and libraries in compliance with the anti-epidemic requirements and physical distancing are allowed.
• From May 11, cultural events can be held on outdoor stages if adherence to the physical distancing and other anti-epidemic measures is possible. Additionally, the occupancy rate is limited to 30 per cent.
• Cinemas are also allowed to reopen from May 11, with up to 30 per cent of their maximum capacity. Adherence with all anti-epidemic measures is mandatory, and using air conditioning systems is prohibited.
• From May 11, outdoors non-professional sports activities with up to 10 players, and without an audience are also allowed. However, using changing rooms and communal showers is not permitted.

The prime minister warned that all restrictive measures could be put back if newly confirmed cases exceed one hundred a day.
On May 13, the state of emergency was replaced with an emergency epidemic situation for one month, based on amendments of the Health Act (see Section 5.1). On May 14, the Minister of Health released several orders confirming the most restrictions that were in place during the state of emergency. Only hotels and other types of accommodations have been allowed to open in strict compliance with detailed instructions, issued by the Minister of Tourism and Minister of Health. Leisure and sports facilities to the hotels, as well as outside premises of restaurants and cafés, can provide services for the guests observing all requirements for physical distancing, preventing gathering and disinfection. From May 14 onwards, assemblies are limited to 10 people in general; up to 20 people are allowed to attend wedding and funeral ceremonies. Some exemptions have been made for a traditional send-off of 12-graders, which is allowed to take place in schoolyards.

However, after several days of continued decline in newly confirmed cases some other bans have been lifted:
• from May 18, fitness centres, gyms and big shopping centres (such as malls) may restore their activities with some restrictions regarding the number of visitors and in compliance with other anti-epidemic measures. Only open-air spaces in cafés and restaurants placed in shopping centres may reopen. Indoor individual sports without spectators are allowed, as well.
• as of May 22, indoor team sports activities can be restored without spectators. Individual and team sports activities for children, both indoor and outdoor are allowed from May 26. Competitions are still barred. The Bulgarian football championship will be resumed on June 5 without an audience.
• from May 22, kindergartens and nurseries can open in strict compliance with anti-epidemic measures. Parents have to sign a declaration of informed consent and shared responsibility stating they are aware of all measures in the kindergarten, and the child enters the establishment at their request. Parents are not allowed to enter the facilities. Many kindergartens and nurseries have tested their staff for COVID-19.

Between May 25 to June 4, the Minister of Health issued several orders repealing restrictive measures introduced during the state of emergency in March:
• as of May 27, cultural and entertainment events are allowed with some restrictions regarding the number of spectators and visitors - up to 30% of the maximum indoor capacity and up to 50% outdoors or no more than 20 people for group activities such as dance classes;
• as of May 30, all kind of conferences, congresses, seminars, as well as exhibitions and fairs are permitted with attendants up to 30% of the hall’s maximum capacity;
• from June 1, indoor visits to restaurants, cafés, entertainment facilities are permitted except for discotheques and night clubs. The requirements for a distance of 1.5 meters between tables and strict disinfection measures remain in force, both for outdoor and indoor premises.
• from June 1, indoor children's and sports facilities, including those in big shopping centres, are allowed to reopen; extracurricular education and training facilities such as study halls, clubs, children’s centres may resume their activities, as well;
• as of June 2, the restrictions for a number of visitors of fitness centres, gyms and other indoor sports facilities are revoked;
• from June 5, spectators of the football championship are allowed up to 30% of the stadium’s maximum capacity;
• all kind of competitive sports events are to be resumed, initially outdoors (from June 10) and several days later indoors (from June 15). The restriction of the number of spectators will remain in place.

Due to a significant increase in newly recorded cases in the second week of June (for instance, 132 new cases on June 19), the chief state health inspector proposed the emergency epidemic situation to be continued. Based on his proposal, the government took the decision to extend the emergency epidemic situation until June 30.

The Minister of Health has released several orders that in fact further ease the imposed restrictions:
• indoor and outdoor sports events are allowed to increase the occupancy rate up to 50% of the venue's capacity with the requirement to leave one seat empty on each side of a spectator or to ensure a distance of 1.5 meters between visitors. The same 50% occupancy rate requirement applies to cultural and entertainment events, as well as to congresses, conferences, seminars and exhibitions.
• from June 15, discotheques, piano bars, night clubs may resume their activities. The requirements for a distance of 1.5 meters between tables and strict disinfection measures remain in force.
• visits to health care establishments, social services facilities and institutions for residential care are still prohibited;
• as of June 15, wearing face masks in indoor public venues is only recommendable, except for passengers in public transport, patients of health care establishments and customers of pharmacies. The requirements for a physical distance of 1.5 meters, disinfection, wearing protective devices of mouth and nose, symptoms monitoring by entry are still in place for all employers. Retail shops and offices have to ensure a physical distance of at least 1.5 meters between customers, provide hand sanitizers at the entrance and prevent gathering of many people. Keeping a physical distance of at least 1.5 meters is required in outdoor public spaces, as well.

As the number of newly registered confirmed cases continues to rise, on June 24, the Council of Ministers extended the emergency epidemic situation to July 15. Also, several transition measures were amended. For instance:
• As of June 23, wearing a face mask or other protective means in indoor public places becomes compulsory again. The rule doesn’t apply only for the costumers in restaurants and bars. Athletes and other people practicing sports indoors are excluded from this obligation, but the audience, trainers and other staff members must wear protective masks.
• The audience at sports events could be up to 50% of the standard capacity of the venue, assuring 1.5 meters distance between each individual. Besides, on soccer games, the audience is limited to 1000 people per sector.
• The 50% occupancy limit applies for discotheques, piano bars and other night clubs as well.

According to the chief state health inspector, more strict anti-epidemic measures are not necessary because the newly registered COVID-19 cases occur in clusters, and this allows the health authorities to control the spread of infection. Some local authorities have decided to place several villages and neighbourhoods under quarantine with checkpoints by entering and leaving the settlements. The requirement for mandatory wearing a face mask in public spaces is also in force in these settlements. 

With the easing of restrictive measures, a reverse trend in the spread of the epidemic has been observed. As the number of newly registered cases continues to rise, the Council of Ministers has extended the emergency epidemic situation by a month until the end of August 2020. On August 4, the ban on spectators at sports events was repealed, although some restrictions about the amount of spectators allowed as well as ensuring physical distancing remained in place.

Since June 2020, the anti-epidemic measures focused on disinfection, maintaining physical distancing and wearing protective face masks. After lifting lockdowns and easing previous restrictions, it seems that some recommended measures such as maintaining physical distancing were not being strictly adhered to. While awareness of transmission and protective measures is relatively high, many Bulgarians seemed to underestimate the risk of infection and have believed that the virus is not that dangerous. The anti-government protests and general political unrest in Bulgaria that have been taking place since mid-July 2020 have further compromised the rules for keeping physical distancing and avoiding mass gatherings. This has resulted in a significant increase in new COVID-19 cases in July and the first half of August 2020.
However, the decline in infected patients supposes that testing and tracing regimes have succeeded in suppressing some local outbreaks, and the spread of the virus has been slowed. According to the Minister of Health and the Chief Health State Inspector, imposing other restrictive measures was not necessary at that time.

By August, the Ministry of Education and Science decided to resume attendant classes for the new school year (September 15) by following strict hygienic measures (see Section 6 Transition measures: measures in other sectors). The emergency epidemic situation has been extended till September 30. In the second half of September, prompted by the increase of newly registered cases the government decided to extend the emergency epidemic situation until the end of November. An order of the Minister of Health has allowed visits to hospitals but only for relatives of terminally ill patients; visits to resident social institutions are possible with the permission of the institution's director.

The Minister of Health has released several orders, confirming the anti-epidemic measures with a focus on disinfection, physical distancing and wearing protective facemasks that were in force in August and September. Wearing facemasks or other protective device covering nose and mouth is obligatory in public transportation and indoor public places except for customers of restaurants, bars, nightclubs and gyms, as well as for indoor athletes and attendees at conferences or seminars during their speeches. In outdoor public places, the use of facemasks is recommendable. The restrictions concerning mass gathering remain in place, e.g. the requirement for ensuring 1.5-meter physical distance at sports, cultural, scientific and other public events. The number of visitors and attendees at public events cannot exceed 50% of the hall capacity. Working from home is recommendable if possible.

Sources:
Council of Ministers; http://pris.government.bg/prin/default.aspx 
For more information on protests: Bulgarian News Agency; http://www.bta.bg/en/
COVID-19 Web portal – Bulgaria; https://coronavirus.bg/bg/
Ministry of Health; https://www.mh.government.bg/bg/novini/aktualno/
Source: Ministry of Health; https://www.mh.government.bg/bg
Sources:
Ministry of Health; https://www.mh.government.bg/bg/novini/aktualno/zdravniyat-ministr-izdade-zapoved-s-koyato-pozvoly/
Ministry of Health; https://www.mh.government.bg/bg/novini/aktualno/razresheni-sa-kolektivnite-sportove-za-amatori-na-/