Policy responses for Finland - HSRM

Finland


Policy responses for Finland

1. Preventing transmission

The section on PREVENTING TRANSMISSION includes information on key public health measures that aim to prevent the further spread of the disease. It details how countries are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak.

1.1 Health communication

Health communication is the main task of the Finnish Institute for Health and Welfare (THL) and the Ministry of Social Affairs and Health (MSAH) at the national level. However, several Ministries, national research and expert organisations and local and regional public health authorities also participate in communication activities. The Government held press conferences several times a week with key Ministers and the Prime Minister present during the first weeks of the epidemic. Towards the end of April and May the press conferences have been held every time there have been new decisions made.

THL has given general advice on hand hygiene, physical distancing and respiratory etiquette with printable instructions and videos for travellers and the general public. They have also advertised widely on the TV, public transport, and in public places. THL has also produced materials for use by public health officials functioning at national and local level. THL updates its website daily which has a Q&A section and general information about the disease, prevention and care for the public, health care professionals as well as for the media (1).

MSAH, Prime Minister’s Office and other ministries have their own web pages for coronavirus information. Local authorities, i.e. municipalities, and hospital districts are responsible for communication and advice in their communities and regions on the local situation.

In addition to official sources, Finland has also defined social media as a critical operator and has invited social media influencers to participate in disseminating timely and accurate information on social media. (2).

In early April, the MSAH and THL jointly prepared a COVID-19 information letter that was delivered by post to each Finnish household. 

On 14th April, the director of THL recommended via media the use of fabric face masks in public places, however neither THL nor MSAH has not issued a formal advice on the matter. On April 18 2020 THL and MSAH stated that they do not recommend using fabric face masks (4).

On April 15th 2020 THL stated that hygiene measures could be further enhanced, for example by improving the possibility for hand disinfection in public spaces. THL stated that hand sanitizer should be available everywhere where hand washing is not possible (e.g. at the doors and within the facilities of shopping centres, near doors and checkout points in stores, in toilet facilities at transport hubs such as stations and terminals, and in public transport). (3) 
COVID-19 infections began to increase in April sharply among Somali speakers in Helsinki. The City of Helsinki revealed on April 14 that 1.8 per cent of the entire Somali-speaking population in Helsinki had the infection, while the corresponding share across all residents of Helsinki is 0.2%. (6) Somali community spokesperson responded that revelation of the information was done in a way which stigmatized the Somali community. (6)

On April17 2020 the Government launched Finland forward (Suomi toimii) -campaign which is a multi-agency project, led by the Prime Minister’s Office. It is working to support day-to-day crisis communications. Its main form of action is putting together communications and sharing information. A number of NGOs and other organisations, such as Save the Children, Finnish Red Cross, Mieli Mental Health Finland, Unicef, have joined the campaign. The campaign aims at supporting psychological resilience to crisis during and after the emergency situation, building trust and strengthen people’s sense of belonging and belief in the future, providing reliable information and tools for dealing with the emotions and uncertainty caused by the crisis, and demonstrating the importance and value of joint action and all forms of assistance. (8)

On 24th April 2020 the government organized a press conference for the country’s children. This was broadcast on newspaper websites and the national broadcaster. Children had been asked to prepare questions that they could ask online. The questions ranged from how dangerous COVID was and when children could get back to school. The event was well received by both parents and children. (7)

On 15th of May the Prime Minister held briefing on the “hybrid strategy” and the models and indicators used to monitor the progress of the COVID-19 situation. At the event also the Director of Strategic Affairs from the MSAH and the Chief Physician from THL reported on the indicators and forecasts used in assessing the COVID-19 situation. (9)

Following the demands from the public, the government has engaged in more open communication in terms of the Covid-19 situation. On 11th May, THL held a webinar on the models used for predicting epidemic progress and its effects. On 15th May, THL held a webinar on testing. THL has also announced that MSAH has a group following the situation nationally and regionally. The current situation update was published for the first time on 15th May with a follow up report on 20th of May (9). This reporting is more extensive including both national and regional data as well as weekly estimates of national R0. It is a response to requests of sharing of more data and information to researchers and the public.

THL has updated its guidelines on how older people can protect themselves against the coronavirus disease. The Government held a briefing on 20th May which focused on the wellbeing of older people, especially those over 70 years of age, and on the new guidelines. The updated guidelines draw particular attention to ways in which elderly people can safely have contact with their family and close friends and maintain their wellbeing and functional capacity under emergency conditions.(10)

On 28 May the MSAH and THL gave a briefing on epidemiological assessment, disease situation and health system capacity.

On 29 May the results of a report on the use of face coverings in the community to prevent the spread of COVID-19 was published. A systematic literature review was prepared for the MSAH by Summaryx Oy, a non-profit corporation. According to the review, there is very little evidence available on the effectiveness of face coverings in the community in preventing the spread of COVID-19. The report concluded that the effect of the use of face coverings on the spread of respiratory infections among the population is minor or non-existent and that the primary means of preventing the spread of COVID-19 are avoiding close contact with others, good coughing and sneezing hygiene and washing hands. (11). This finding sparked discussion regarding the ordered review, and the parameters set for the review as it mainly examined randomized controlled trials, which was viewed by many as too limited for determining a true effect. On 1 June 2020, the government was also handed a report by the science panel, which in contrast to the review, recommended the use of masks particularly in high risk situations (12). On June 3, the government did not recommend the use of facemasks for the general public, but advised that it would be possible to use these in high risk situations (e.g. public transport and other closed spaces). (13).

On 13 August THL issued a regional advisory for the use of facemasks depending on epidemiological criteria, in many regions of the country. The advisory suggested that facemasks should be used in situations where physical distancing was not possible, specifically in public transport. (14)

On 24 September THL recommended the use of face coverings also for secondary education facilities (universities and trade schools) in areas where COVID-19 is spreading. Face coverings recommendations varied in the country according to the epidemiological stage of each region, and the recommendations were formally made by hospital districts. On 8 October THL recommended face coverings use in public spaces in the entire country.

Generally, the use of face coverings in the country is deemed lower than what would be necessary to curb the epidemic. The health communication in terms of face coverings has been criticized as confusing by the public, and experts have argued that THL and MSAH hesitancy from advising against and advising for face coverings, and independent researchers’ arguments against this have caused for less than optimal face coverings use among the public.

In October and November 2020 areas within the acceleration phase of the epidemic are recommending face masks for the public in public places. In addition, on 9th November the City of Helsinki announced that staff in primary and secondary schools in the capital region should wear masks (15).

On 19th November, the Government and THL launched “Five tips to tackle COVID-19” campaign to encourage a joint nationwide effort to adhere to the most crucial recommendations to prevent the spreading of the virus. The campaign emphasizes taking care of oneself and then others by going to test and isolating when symptoms occur, by keeping distance (1-2 meters) and practicing appropriate hand and coughing hygiene, wearing mask when keeping distance is not possible, and by downloading Koronavilkku-app. Various celebrities took part in the campaign which has been visible in various media. One part of the campaign is targeted to younger population. (16)

MSAH and THL have held weekly press-briefings on the COVID-19 situation throughout the autumn. The epidemic situation reports are available online. (26) However, as the COVID-19 infection rates have risen throughout the country, the government held a meeting on 25th November to discuss further measures that may need to be taken if the situation gets worse. The following day, on 26th November the Prime Minister, the Minister of Social Affairs and Health, representatives from THL, chief medical officer all participated in a press briefing on 26th November to discuss the results of the Government meeting. (19)

During November and December 2020 THL, Fimea and the Government have disseminated information on COVID-19 vaccination and vaccination strategy. Moreover, THL published a survey investigating the Finnish population’s willingness to take the COVID-19 vaccine and the results tell that 64% of the population are willing to take the vaccine if it is available and recommended to take (20). In addition, the President and Prime Minister announced in the media that they will take the vaccine when it is available.

THL gave holiday season guidelines, which emphasize the importance of already existing recommendations to carry out protective measures such as social distancing and good hand and coughing hygiene. Holiday season is recommended to spend with household family members. In the case of including other people to the festivities, participants should be limited to less than ten people and protective measures should be ensured. (21)

On 21 of December THL held a public webinar on COVID-19 vaccinations. In the webinar THL experts also answered the questions sent in by the audience.

THL has updated the mask recommendation for citizens according to the recommendation of WHO. From Jan 8, 2021 the use of mask is recommended for everybody over the age of 12, including recommendation for masks to be used in school from sixth grade onwards. (22) According to the report of the Finnish Institute of Occupational Health, wider use of FFP class respiratory protectors is not recommended in Finland at the moment. Respiratory protectors of FFP2 class should be reserved for people who need effective protection in their work. (24)

On 20th of January THL changed its recommendations on the use of face masks and on keeping  distance to others because of the mutated corona virus variants. THL now recommends that face masks are used in public transportation, inside public spaces (e.g. shops, malls, libraries), workplaces and at schools (pupils over 12 years old) even when it is possible to maintain distancing. Previously the recommendation included situations where distancing was impossible. THL also recommends that the safe distance to others should be over 2 m because the new virus variants are more infectious. (23.)

On 9th of February THL held a public webinar on alternative possibilities about the spread of COVID-19 variants and the effects of COVID-19 vaccinations. THL also published a webpage for the information on COVID-19 variants (28). On Feb 11 THL held a public online event on corona vaccinations. Topics of the event were the updated information on the different corona vaccines, the vaccination order and organisation of vaccinations. Public had an opportunity to ask questions during the event.(26) The Ministry of Social Affairs, the Finnish Institute of Occupational Health, and the Centre of Occupational Safety and Regional State Administrative Agencies have held open webinars on COVID-19 risk management at work environments. (30)

In terms of winter holidays, THL recommendation is to spend them close to home and with the closest friends and family. Travelling and crowds should be avoided, and in case of a need to travel the epidemic situation should be taken into consideration.(27)

Weekly press-briefings by MSAH and THL on the national COVID-19 situation have continued throughout the winter with representatives from relevant ministries and organizations such as Fimea. Links to recordings and situation reports are available in the webpage of MSAH (26) In addition, press-briefings (live and recorded formats) from some regional authorities have been accessible through newspapers web pages and the national broadcasting company YLE.

From March 11 forward the state-owned train company VR requires the passengers over 12 years of age to use a face mask in long-distance and commuter trains unless unable to wear a face mask for a health-related reason. Passengers do not need to prove to have a health-related reason (33) Also, several regional public transport operators demand now the use of face masks with the same conditions.

The government held an COVID-19 information event for students on 2nd March 2021 addressing the impact of the pandemic on students' studies, well-being and prospects for the future. Present were the Prime Minister, the Minister of Education, the Minister of Science and Culture, the Permanent Secretary of the Ministry of Education and Culture, and the Executive Director of the Confederation of Mental Health. Students had a possibility to pose questions via video conference connection. The event was streamed in the Youtube channel of the Government and also in YLE.

In April 2021 the cities of Helsinki, Espoo and Vantaa in cooperation with THL and HUS launched a social media campaign targeted to young adults due to the increased transmissions and the number of serious illness among this age group. The campaign includes an Instagram live event focusing on the mental health effects of the pandemic. Adolescent mental health specialist answered questions with social media influencer during the event. Campaign is to spur everyone on to endure amidst a difficult epidemic situation and to adhere to social distancing. (31)

THL gave recommendations to spend Easter holiday with one’s family at home. In the case of travelling outside one’s local area, it is recommended to check the instructions issued by the local authorities for the destination area and the restrictions in force. (32)

THL held two open webinars on corona vaccines and their safety, one on 15th and another on 29th of April. The public had an opportunity to send questions beforehand to the specialist of THL. (33, 34) THL held also a webinar on April 16th regarding different COVID-19 epidemic scenarios for the spring and early summer. (35) THL has continued organizing webinars on corona vaccines (37) and also some regional authorities have organized their own open webinars with topics related to COVID-19 (38)

Joint campaign of the Prime Minister’s Office, THL, the Ministry of Interior and the police calls on people to celebrate Vappu (1st of May) safely and taking into consideration the COVID-19 restrictions. The #OmassaKuplassa and #VappuAtHome campaign’s main objective is to prevent a surge in COVID-19 infections in connection with 1st of May, which is usually widely celebrated in Finland. The campaign is visible in the social media channels of various organisations the week leading to 1st of May 2021. (36)