Policy responses for Finland - HSRM

Finland


Policy responses for Finland

1.2 Physical distancing

On 24 August the MSAH issued guidance to regional state administrative agencies limiting gatherings to 50 people, and beyond that strictly following physical distancing guidance. The regional state administrative agencies then issued this guidance to be effective. Following the announcement of the guidance, the MSAH reported that there was a spelling mistake in their guidance letter, and the guidance was intended to recommend limiting gatherings from 500 people upwards. On 26 August, after deliberation, the Regional State Administrative Agencies, however, informed the public that regardless of the mistake in the MSAH guidance letter, their guidance will limit gatherings to 50 people. More participants to events can be taken if guidance on physical distancing and hygiene is followed.

Schools have continued under cities, local government and the Regional State Administrative Agencies’ guidance with local temporary closure and move to distance teaching as well as partial moves to distance teaching. For example in Helsinki temporary closures have been applied as well as maintaining schools partially open. School lunches will be provided for students in distance learning with food packages for those in quarantine (12).
On 29 September, the Government decided on temporary restrictions to the opening hours and alcohol sales hours of food and beverage businesses for the month of October: the latter must be closed between 1-4am, while alcohol sales must be closed from midnight until 9am. (14)
On September 30, due to worsening epidemiological situation the Government used Communicable Diseases Act to temporarily limit the daily closing time of restaurants and nightclubs to 1 am. Also, the restaurants were restricted to fill only half of their existing maximum capacity. These limitations would apply until October 30. On October 9, the local acceleration of the epidemic resulted in tightening of the limitation for closing time to 23 p.m. within six regions (31). The restaurant industry has strongly objected against these limitations. Regional State Administrative Agencies began also inspecting restaurants and nightclubs in which customers had been in a high risk for COVID-19. These inspections aimed to confirm if the preventive measures of these service providers were organized according to the Communicable Diseases Act.
On 23 October, the Government adopted a resolution on national and regional recommendations to help prevent the spread of the coronavirus. The recommendations take into account the most recent assessment of the epidemiological situation. The Government’s policies and recommendations are not legally binding but the local and regional authorities as well as private organisations. The resolution included the following recommendations (32):
• National recommendation to work remotely:  the Government recommends that employees in the public sector work remotely as extensively as possible if their duties so allow.  The Government also recommends that private sector employers adopt similar extensive remote work practices. Employers are responsible for assessing how best to coordinate remote and on-site work at their workplaces. Employers should also promote work arrangements that reduce close contacts and other risk factors for employees. The national recommendation on remote work will remain in force until further notice. The validity of the recommendation will be reassessed by 31 December 2020.
• Government recommendations for regions:
o In regions where the epidemic is at the base level, the Government recommends that all public events and leisure activities with more than 50 participants be arranged in a way that takes into account the guidelines from the Finnish Institute for Health and Welfare (THL) and the Ministry of Education and Culture on hygiene recommendations and safe distances.
o In the acceleration phase of the epidemic, the Government recommends issuing a regional or local recommendation to avoid holding private events with more than 20 persons. All public events must be arranged in compliance with the guidelines issued by the Finnish Institute for Health and Welfare and the Ministry of Education and Culture. The number of persons at public events held in indoor spaces is restricted to half the normal capacity. When using public spaces, arrangements must be made to ensure that participants and parties can avoid close contact with one another in practice. In addition, the number of customers permitted in indoor spaces is restricted by half. Due to the restrictions on the use of spaces, it is recommended that indoor group leisure activities for adults be suspended in situations where there is a high risk of infection. All group leisure activities must be arranged so that participants and parties can avoid close contact with one another in practice. The Government also recommends that higher education institutions switch to distance education, taking into account the need for essential contact teaching.
o In the community transmission phase, the Government recommends issuing a regional or local recommendation to avoid holding private events with more than 10 persons. If necessary, public events may be prohibited altogether. The Government also recommends suspending group leisure activities altogether if this is necessary due to the restrictions on the use of spaces. However, careful discretion should be used when considering whether to suspend children’s hobbies. If necessary, public spaces may be closed altogether, taking into account the nature of their use. As a last resort, the Government recommends that upper secondary schools switch to distance learning, taking into account the need for essential contact teaching.

The restrictions concerning the activities of food and beverage service businesses, namely restaurants, bars and cafes, were temporarily added to the Communicable Diseases Act, under section 58a, in May (see above in this section). The validity of the Act on Temporarily Amending the Communicable Diseases Act and the temporary section was extended from 1 November 2020 to 28 February 2021. Without the extension, the Act would have ceased to be valid after October. That is, the current requirements for food and beverage service businesses concerning guidance, hygiene practices and safe distances in customer seating will remain unchanged. Similarly, food and beverage service businesses are still subject to the existing obligations concerning the planning of their activities. Under the Act, the restrictions must be necessary to prevent the spread of a generally hazardous communicable disease in each area and in such food and beverage service establishments that the restrictions concern. What is new in the Act is that the restrictions on opening hours do not apply to food and beverage service businesses on vessels and aircraft that operate between Finland and other countries or abroad or to food and beverage service businesses that operate at distributions stations for liquid fuels. (33)

On 29 October 2020 the Government also decided to impose temporary restrictions on the activities of food and beverage service businesses as of 1 November 2020 (34). The decree was adopted under the new temporary provisions of the Communicable Diseases Act and will remain in force until 15 December 2020. In short, the decree elaborates on the restrictions on the amount of customer seating in food and beverage service businesses and on opening hours and hours when alcohol can be served. What is notable is that the decree takes into account the regional variation in the epidemic situation and in that sense allows flexibility for regions.
• Number of customers: in the regions that are in the acceleration or community transmission phase of the epidemic, the amount of customer seating in businesses that primarily serve alcoholic beverages is now restricted to half the normal capacity. These businesses typically include pubs, bars and nightclubs. For other food and beverage service businesses in the above-mentioned regions, the amount of customer seating is restricted to three quarters of the normal amount. These businesses typically include restaurants, cafes, fast food restaurants and pizzerias. In the regions in which the epidemic situation is at the base level the number of customer seats is not restricted.
• Serving alcohol: in the regions which are currently in the acceleration or community transmission phase of the epidemic, businesses must stop serving alcoholic beverages by 22.00 at the latest. All food and beverage service businesses in regions in the community transmission phase must be closed by 23.00 at the latest. In the regions that are in the acceleration phase businesses that primarily serve alcoholic beverages must also be closed at 23.00, but other food and beverage service businesses may remain open until 24.00. Businesses in the regions that are at the base level of the epidemic must stop serving alcohol by 24.00 at the latest and those businesses that primarily serve alcoholic beverage must close by 1.00 at the latest. In the regions that are at the base level other food and beverage service businesses may be open round the clock.

Initially the decree added flexibility to the restrictions on the opening hours of food and beverage service businesses so that businesses subject to the restrictions could  reopen one hour after closing. This meant that in line with the decree, a business that had stopped serving alcoholic beverages at 24.00 and had to  close at 1.00 but could reopen as  “night café" starting at 2.00, for example.  However, due to continuation of night life in the night cafes the government gave an additional decree which now allows reopening at 5 am and serving alcohol may start at 7 am. (20)

On 9th November THL released guidelines for the winter festive season urging people to take into consideration the possible updates on national and local recommendations and restrictions when planning the festivities. However, the guidelines recommend limiting the physical participants to less than ten people and to provide a possibility to attend remotely. (15)

Towards the end of November 2020, the COVID-19 situation has worsened almost throughout Finland but particularly in the Greater Helsinki area and the Hospital District of Helsinki and Uusimaa. New restrictions and recommendations have already been introduced and will be introduced not only in the Hospital District of Helsinki and Uusimaa but also elsewhere in the country. (16.)

During the period of 16–22 November, the number of cases increased sharply, and new infections were reported in all hospital districts. The majority of new cases were reported in the Hospital District of Helsinki and Uusimaa where the number of infections has been the highest since the epidemic started.

In addition to the Hospital District of Helsinki and Uusimaa, the Päijät-Häme Hospital District has reported having entered the community transmission phase of the epidemic. The Hospital Districts of Kanta-Häme, Kymenlaakso, Länsi-Pohja, Pirkanmaa, North Ostrobothnia, Vaasa and Southwest Finland and the Åland Islands are in the acceleration phase. The remaining 11 hospital districts are at a stable level, but there are individual cities and towns situated in some of these hospital districts that have entered the acceleration phase. These are Alajärvi and Soini, Kronoby, Joensuu, Rauma and Pori. (16.)

In the area of the Helsinki Uusimaa Hospital District, which has been the epidemic center throughout the pandemic, several restrictions were put in place first as of 23rd November and later also as of 30th November. On 27th of January the corona coordination group decided on the adjustments (some relaxation) for children’s and adolescents’ leisure activities in municipal facilities (see below). The decisions on the restrictions are made by either municipalities or Regional State Administrative Agency (depending on the restriction) and they are based on the regional COVID-19 coordination group with representation from municipalities, hospital district, THL and Regional State Administrative Agency. The restrictions recommended are in-line with the Government’s recommendations of the restrictive measures that should be put in place in the community transmission phase (see above). In Helsinki Uusimaa hospital district, the regional recommendations include the following (17):

Use of face mask for everyone aged over 15 years is recommended:
• in public transportation, and in taxis for both the driver and the passengers
• in public spaces and events
• in private spaces (shops, banks etc.)
• in secondary education, universities and youth centers 
• in hobbies
• in workplaces when safe distances, rotated room usage or other hygiene and safety arrangements are not possible
• social welfare and healthcare personnel in work with patients and clients

Additionally, use of face mask is recommended for staff and pupils in upper comprehensive schools (yläkoulu). Use of face masks or shields is recommended for staff in daycare centers and lower comprehensive schools (alakoulu). The use of face masks is recommended for everyone aged over 12 years since Jan 14, 2020.

Remote work and use of masks recommended at the workplace
Employers are recommended to organize remote work in all tasks that can be carried out remotely even temporarily. If working remotely is not possible, employers are recommended to instruct employees to wear face masks in all working spaces even when maintaining safe distances is possible. Workplaces should stagger lunch and coffee breaks.

Private events:
It is recommended that no private events are held. Private events also include family gatherings. However, small memorial services (of 10 people at most) are excluded and can be held.

Restrictions on visiting social welfare and healthcare units, including units that provide 24-hour-care:
• Meeting visitors outdoors is recommended, if possible.
• The number of visitors indoors and the duration of visits has been restricted. These restrictions are monitored. Visits to shared facilities are not permitted.

Public events:
All indoor and outdoor public events are prohibited by decision of the Regional State Administrative Agency.

Public spaces:
All municipality-run facilities open to the public will be closed with the exception of securing the right to access essential public services. It is recommended that private providers also close their similar sports and leisure facilities.

Leisure group activities:
• All municipality-run leisure group activities for adults (over 18-year-olds) are suspended by municipal decision. If possible, these group activities may continue online. It is recommended that private service providers follow the same restrictions.
• Leisure group activities for children under the age of 12 may continue at the municipality's discretion. Careful consideration should be taken when deciding on the continuation of leisure group activities for 12- to 17-year-old adolescents.
• Indoor leisure group activities for children are suspended as well. Already scheduled outdoor leisure group activities for under 20-year-olds may continue.
• On 27th of January the corona coordination group decided that the leisure group activities of children under 20 years old can resume from 1st February in the public facilities. The decision was strongly criticised for instance by the Prime Minister and also by Helsinki Uusimaa hospital district. The decision was justified by growing social and mental health problems among the children and the adolescent. (26)

Organizing education:
Municipalities will decide if high schools, vocational schools, non-formal adult education (for over 15-year-olds), polytechnics, and universities shall move classes online.

High schools and vocational schools moved to distance education Dec 3, 2020. Contact teaching is offered to students with special education or developmental disabilities as well as for students who need individual support for different reasons. (24) In addition, a possibility for contact teaching is offered also to the final year students at upper secondary school to enable to preparation for the matriculation exam (A-levels), since the electronic system used in the exam can be only used in school facilities. Final year students are recommended to carry out voluntary quarantine for two weeks before the participation to the matriculation exams starting on March 16. (25)

On 18th of February 2021 the corona coordination group in the Capital region announced that upper secondary education in the region will transfer from distance education to limited contact teaching on 1 March 2021. This means that that for certain years no more than half of students may attend classroom in person, and groups will alternate between distance and contact teaching. Group sizes will be regulated to ensure that students can maintain a safe distance. On the contrary all upper secondary school students who are participating in this spring’s matriculation exams will switch to distance learning on 1 March 2021 to minimise the infection spread in this group in the runup to the exams. The region’s vocational education institutions will have one-third of the students attend in-person at a time, to ensure social distancing. This smaller ratio is due to the wider age range among vocational education students. (32) The decision was opposed by the THL and Helsinki Uusimaa Hospital District, as well as members of the coordination group. Later, on 21st of February, also the Prime Minister criticised the decision made by the municipalities.   However, the municipalities have the authority to make the decision. According to the representatives of the municipalities, the decision was based on the evaluations of the harms caused by prolonged distance learning for the students both in terms of their wellbeing and the learning outcomes.

Restaurants and bars in Uusimaa region are restricted by a government degree: Restaurants and other food and beverage service businesses in the region of Uusimaa, which is now in the community transmission phase, will be subject to tighter restrictions than the other regions in Finland. The government decree on the matter will enter into force on 26 November at 00.00. The decree will address the activities of night cafes by restricting their opening hours. In future, food and beverage service businesses may, after closing, reopen their doors at 5.00 at the earliest (before they had to be closed for an hour before reopening) and stay open until 23.00. The restrictions on opening hours will not, however, apply to food and beverage service businesses operating in connection with service stations. All food and beverage service businesses in Uusimaa must stop serving alcohol by 22.00 as before. The number of customer seats in restaurants that primarily serve alcoholic beverages will continue to be restricted to half the normal total. Restaurants serving food would be allowed to seat 75 per cent of their normal number of customers. (18.)

On 18th of February THL and MSAH stated that the epidemiological situation is characterised by great and rapidly changing regional differences. Especially in Uusimaa, the situation has deteriorated further. Between 1 and 14 February, the incidence of new cases during the 14-day period was 186 per 100,000 inhabitants in the Hospital District of Helsinki and Uusimaa, while in the whole country it was 91 per 100,000 inhabitants. In some places in the Greater Helsinki area, there is a backlog in tracing contacts of COVID-19 cases. Over the past four weeks, the incidence of new cases in a 14-day period was also more than 100 per 100,000 inhabitants in the Hospital Districts of Southwest Finland, Central Finland, Vaasa and East Savo. (34) On 18th of February the representative of THL stated – in the weekly press conference – that THL would suggest that in Uusimaa all the bars and restaurants would be closed in order to mitigate the epidemic. THL also stated that people should not travel over the winter holidays which started on 19th of February in the Capital region. The statement was criticized both by the Government and the media – not because of the content but because of the lack of coordination with other authorities. (33)

Restrictions on food and beverage service businesses in regions in acceleration phase remain unchanged. The restrictions on food and beverage service businesses operating in Southwest Finland, Pirkanmaa, Kanta-Häme and Ostrobothnia will remain unchanged as from 26 November. All food and beverage service businesses in these regions will be allowed to serve alcohol between 7.00 and 22.00. Restaurants that primarily serve alcoholic beverages may be open between 24 and 23, and they will be allowed to seat half of their normal number of customers. Other restaurants may be open between 01.00 and 24.00 and seat 75 per cent of their normal number of customers. (18.)

On 2nd of December due to the accelerated epidemic situation in the whole country, THL published a national recommendation to limit participants in public events and gatherings to less than 50 people. This recommendation also applies to regions in the base level of the epidemic. (19) On 10th of December the restrictions for restaurants and bars were prolonged until 28th February 2021 (21). Application of tighter restrictions vary by the regional acceleration of the epidemic. Tightest restrictions for community transmission phase (described above) are now (early Jan 2021) applied in Uusimaa, Southwest Finland, Kanta-Häme, Päijät-Häme, Kymenlaakso and North Ostrobothnia. Moderate restrictions for acceleration phase are now applied in regions of Satakunta, Pirkanmaa, South Karelia, North Karelia, Central Finland, South Ostrobothnia, Ostrobothnia, Central Ostrobothnia, Kainuu and Lapland – as well as in the Hospital District of South Savo.

On 4th of February 2021 the restrictions for restaurants and bars were proposed to be extended until 30th of June (32). Moreover, the tightest restrictions for community transmission phase were extended also on Ostrobothnia. The restrictions for restaurant and bars were extended until 30th of June after the Parliament adopted the government proposal of Feb 4th 2021 for temporarily amending the Communicable Disease Act. (41) In addition, the government issued a new decree on ensuring distancing measures in restaurants and bars. Customers need to be guided to their seats and given instructions how to move in the premises, for example how to access the toilets and washing facilities and how to collect their takeaway orders. The decree entered fully into force on Mar 5th 2021 and remains in force until June 30th. The regional restrictions on the numbers of customers, and the licencing and opening hours remains unchanged, and only the restriction levels for the regions have been updated according to their epidemic situation. (42) On Mar 11th the Government further amended this decree (56). With this amendment, the restrictions that previously applied to regions in the community transmission phase of the epidemic would be temporarily introduced also to areas in the baseline and acceleration phases (between Mar 13th–28th). Thus, in regions where restaurants are allowed to remain open (Kainuu, North Karelia, Central Ostrobothnia and North Savo) the amount of customer seating in restaurants will be restricted: to 50% in those that primarily serve alcoholic beverages – and up to 75% in other restaurants. Moreover, restaurants in these regions may serve alcoholic beverages until 22.00 and may be open between 5.00 and 23.00.

Attitudes towards the usage of face masks and physical distancing: On 14th December Helsinki Uusimaa hospital district presented results of a survey, which found that though 92% of population considers tighter restrictions necessary, still approximately 60% have met their friend or relatives just recently. Only approximately fifth have avoided all social occasions. While nine out of ten respondents use face masks in public transportation, only three fourths apply them either in work or in studies. This proportion is even smaller among hobbies, where only every other respondent applies mask (22).

The national recommendation to work remotely was reviewed by the Ministry of Social Affairs and Health and the Ministry of Finance in December 2020 and extended until further notice or until next assessment by 30 June 2021. (23)

On  20th January 2021, five hospital districts, including Helsinki and Uusimaa, Kymenlaakso, Päijät-Häme, Kanta-Häme and South-West Finland, are in the spreading phase of the epidemic. In the acceleration phase are the hospital districts of South Karelia, Pirkanmaa, Central Finland, South Ostrobothnia, Vaasa, Pohjois-Savo, North Karelia, North Ostrobothnia, Kainuu and Länsi-Pohja as well as the Åland Islands. The remaining five hospital districts are on the stable level of the pandemic, nevertheless individual cities or municipalities might be defined to be on different level than the rest of the region. (26)
 
The City of Jyväskylä declared moving to the spreading stage on Jan 31 due to growing COVID-19 incidence. During week 4, 240 new cases were identified, and more than 1300 people were ordered to quarantine. The positive test rate was 7.3% and incidence rate 160/100 000 habitants during the previous two weeks.  Initially the chains of infection were linked to students’ celebration in a restaurant and a gym, and later cases were identified among several leisure activity groups for under 18-year-olds. (28) To stop the spreading of the disease many new measures were implemented: 
• Targeted low threshold testing for students in mobile test facilities. No referral needed. (30)
• Distant education in middle school in the first week of February
• Facilities for young people are closed during the first week of February
• Museums and libraries are closed for the first two weeks of February
• Leisure activities for under 18-years-old in city premises suspended for the first two weeks of February
• City administrated swimming halls and gyms are closed, and group exercise classes and public outdoor skating hours are suspended until 28th February. 

In addition, the city recommends leisure activity service providers to restrict services, activities and trainings for children and young people until Feb 14 and for adults until Feb 28. People are recommended to exercise outdoors and maintain physical distancing. (29) Genetic sequencing confirmed that the virus causing the rapid increase in cases was not a mutated COVID-19 variant. (31) 

On February 19- 24, 2021 the Regional Administrative Agencies decided to continue restrictions on mass gathering in several hospital districts. The Regional Agencies are making decisions separately which explains the differences in the details of the decisions.  In the Kanta-Häme, Päijät-Häme and Kymenlaakso district all public gatherings of over 10 persons are forbidden out- and indoors; in the Etelä-Karjala the maximum size of gatherings remained at 20 persons. The decisions were supposed to be in force until March 31, 2021. (35) For three hospital districts, the Regional Administrative Agencies decided to tighten the restrictions on assembly.  In the Lapland district, the maximum size of gatherings is 20 persons (in force until March 21), in the Satakunta 10 persons (in force until March 19) and in the Helsinki and Uusimaa 6 persons (in force until March 14). For the Helsinki and Uusimaa Hospital District, the Regional Administrative Agency also decided to apply the provision of the amended Communicable Disease Act allowing the Agency to request companies, entrepreneurs and other public and private actors to secure factual possibilities for physical distancing for their clients and audience and to prepare written plans on how close contacts are avoided in their premises. The order was decided to be in force until March 14. (36, 37, 38, 39)The request was extendend to Etelä-Karjala, Kanta-Häme, Päijät-Häme (in force until March 31), South Savo (in force until March 15), Lapland (in force until March 28), Southwest Finland (in force until April 5) and Pirkanmaa (in force until March 31)(53,54,55,49,47)

During the first weeks of March due to the accelerated epidemic situation and guidance from the Government, the Regional Administrative Agencies have extended the gathering restriction of maximum of six people to the whole area of southern Finland (in force until March 31), to South and East-Savo hospital districts (in force until March 31), Lapland (in force until March 28), Southwest Finland (in force until March 26),  Pirkanmaa and Vaasa (in force until March 31) and in North Finland (in force until March 31) (43, 44, 45, 46, 47, 48) In addition by Regional Administrative Agencies’ decisions upper comprehensive schools move to distance education until March 28 in Southern Finland, East and South Savo, Southwest Finland and the hospital districts of Vaasa and Pirkanmaa(43, 49, 50, 51) Regional Administrative agencies decided to extend the order to close public and private sector facilities for more than 10 people such as sports facilities or shopping centres’ public areas, to the entire Helsinki and Uusimaa Hospital district until March 14 and in Southwest Finland until March 28 (52, 49)

THL in cooperation with the Matriculation Examination Board has given guidelines on how students set in quarantine can participate in the matriculation exam. Only asymptomatic quarantined students, who have been tested prior to that exam and received a negative test result may participate in the exam with special arrangements including separate exam facilities and supervisors. The schools need to organize the special arrangements in cooperation with the local infectious disease units and according to the epidemic situation. Nevertheless, it is not obligatory to arrange them and primarily the quarantined students are recommended to cancel their enrolment to the exams and participate at the next time of qualification. (40) On Mar 12th Helsinki University Hospital promised both prioritisation and rapid analysis of Covid-19 tests of those high school students who are about to participate in matriculation exams. (57)


The government does not give recommendations on educational arrangements for the time being. Decisions on distance learning will be made by regional authorities, e.g. the regional authorities have decided to continue distance learning for upper grades of comprehensive school until April 4th in Southern Finland and Pirkanmaa. (58-60)

The Finnish Transport and Communications Agency Traficom issued decisions on limiting the maximum permitted number of passengers in public transport. The number of passengers in public transportation will be restricted to half the normal maximum capacity in the Helsinki and Uusimaa Hospital district and in the Southwest Finland Hospital district. The restrictions are respectively in force from March 27 to April 25 and March 25 to April 23 (61,62)

Amendments to the Communicable Disease Act enable secure use of sport facilities, public saunas, swimming pools and spas, dance venues and choral singing and amateur theatre facilities, amusement and theme parks, indoor play parks and indoor play areas, as well as public lounges in shopping centres excluding retail commercial areas and the facilities used to provide services, as well as the passage to them. The amendments entered into force March 31 and will be valid until 30 June 2021.(63)

The Government amended the decree restricting the activities of restaurants and other food and beverage services. The amendment to the decree entered into force on April 19, 2021, after the temporary closure of restaurants and bars ended. The regional restrictions will be amended weekly according to the prevalent epidemiological situation. The strictest restrictions are implemented in areas worst affected by the epidemic. In those regions restaurants that primarily serve alcoholic beverages can be open between 5 am to 6 pm and alcohol can be served between 7 am and 5 pm. In addition, the amount of customer seating indoors is restricted to one third of the normal number of seats. Other restaurants can be open from 5 am to 7 pm and serve alcohol between 7 am to 5 pm and number of customer seating indoors is restricted to half the normal capacity. Customers have to stay seated. The restrictions on opening hours do not apply to takeaway sales, sales on vessels and aircraft, and petrol stations. (64)

In May 2021 government launches a national digital COVID-19 vaccination certificate compatible with the proposed EU model. It can be used when crossing the border to the EU Member State that accepts it as a proof of COVID-19 vaccination even before the Digital Green Certificate of the EU is implemented. The national certificate would be available in the national patient records portal My Kanta Pages and will be introduced in stages. First the certificate would inform that the person has received COVID-19 vaccine, but later similar certificates could be available to prove a negative test result and a recovery from COVID-19. The national certificate ensures consistent COVID-19 testing status regardless of the test provider. 
Preparations and modifications to the patient data systems and My Kanta Pages have been made to enable the transfer of vaccination data certificate. The certificate is free of charge and can be showed on mobile device or printed out. A paper version can be requested from the provider of vaccine or test (65, 66). 

On 22nd April the Government met to update what is seen so far as generally successful Finland’s coronavirus strategy. Therefore the Government suggested that Finland can transfer gradually to a “hybrid strategy”, referring to a move from extensive restrictive measures to enhanced management of the epidemic. Alongside the controlled dismantling of restrictive measures, Finland’s strategy focuses on testing, tracing, isolating and treating. The idea is that the progress of the disease can be impeded through extensive testing, contact tracing of identified infections and chains of transmission, isolating those who are ill and quarantining those who have been exposed. As part of the strategy, the Government is continuing with preparations to introduce a mobile application for use in the management of the epidemic. A precondition is that the application must be voluntary and must ensure privacy protection. (5) For the purpose of exit strategy measures and mitigation of impacts government invited a science panel consisting of expertise in a number of fields from Finnish Universities and research institutes, including on children, schools, economic and environmental policy (6). While the wide range of expertise was welcomed, it was noted that it lacked expertise on aging and gerontology.

On 29 April 2020, the Government decided to lift the restrictions on early childhood education and care and those on primary and lower secondary education. Contact teaching in early childhood education and care as well as primary and lower secondary education will resume on 14 May. (7)

On 4th May in its meeting the Government decided on the following measures to lift the restrictions. These were also adopted in the form of resolution on 6th May 2020.

Immediately as of 4th May 2020:
- Borrowing of books and other material from libraries
As of 14th May 2020:
- Outdoor recreational facilities will be opened as of 14 May, subject to the restrictions on gatherings.
- Primary schools and early childhood education facilities
As of 1st June 2020:
- Opening of restaurants (gradually and provided that this is supported by the effects of lifting the current restrictions and by the subsequent general epidemiological assessment)
- Sports competitions and series can be resumed with special arrangements
- Opening public indoor premises: national and municipal museums, theatres, the National Opera, cultural venues, libraries, mobile libraries, services for customers and researchers at the National Archives, hobby and leisure centres, swimming pools and other sports facilities, youth centres, clubs, organisations’ meeting rooms, day care services for the elderly, rehabilitative work facilities and workshops.
- Restrictions on gatherings are eased from 10 to a maximum of 50 persons.

The Government recommends that higher education institutions and secondary level schools continue distance teaching until the end of the semester. The recommendation on working from home is also continued. Residents aged over 70 years are advised to continue avoiding physical contacts. Also, the restrictions concerning visits to health and social care units will remain in force. On 6th May new advice was issued by MSAH regarding social distancing of over 70. While quarantine-like arrangements are recommended, those over 70 can meet their families and friends including grandchildren outside with a 2 metre distance.

After lifting the first restrictions, on 18th May, a few primary schools and early childhood education units in Helsinki-Uusimaa region reported single confirmed COVID-19 cases with several dozens exposed.

On 11 June 2020 the Government made further specifications to its policy on organising major outdoor events as of 1 July. The number of attendees at public events in enclosed outdoor spaces is still restricted to 500 until 31 July 2020. However, the permitted number of attendees may be exceeded in certain cases. For outdoor events where there are several sections or demarcated areas intended for audiences, a total audience of more than 500 persons may be permitted starting on 1 July with special separation arrangements. This requires that the event attendees can be placed in their own seating areas or viewing sections, each of which has a maximum capacity of 500 persons. Safety must be ensured in each viewing section or area by limiting the number of visitors in order to ensure safe distances and by providing hygiene instructions in line with the restrictions that entered into force on 1 June. (8)

On 17 June 2020 the Government agreed on further easing on restrictive measures (9).
• Large events: The Government recommends that as of 1 August 2020, without any significant setbacks in the epidemiological situation, events with more than 500 persons may be organised in both indoor and outdoor spaces. However, precautions concerning hygiene and physical distance need to be taken care of by the event organisers by for instance limiting the number of visitors. The Regional State Administrative Agencies will make decisions on the matter in July for a maximum of one month at a time. If the epidemiological situation so allows, all restrictions concerning the organising of events can be lifted in which case all indoor and outdoor events would be permitted without restrictions on the number of attendees.
• Easing the temporary restrictions on the operations of food and beverage service businesses The Government will issue a decree on the matter on 18 June. The restrictions are based on the Communicable Diseases Act. The Government agreed that the restrictions on food and beverage service businesses would be lifted as of 13 July. Even then, however, a seat must be reserved for each customer.
o As of 22 June 2020, the decree would be amended so that food and beverage service businesses can open at 4.00 and must close by 2.00.
o Alcohol sales can start at 9.00 at the earliest and must stop at 1.00 at the latest.
o Buffets would be permitted.
o Three quarters of the number of persons permitted in the serving licence or building plan could be present in the indoor premises.
o All customers would still need to have their own seat.
o Food and beverage service businesses should arrange their indoor and outdoor furniture and serving practices so that customers would not be exposed to the spread of COVID-19. In particular, food and beverage service businesses should make sure that there would be no unnecessary congestion in their premises and that customers and parties could enter the premises while maintaining a safe distance from one another.
o Food and beverage service businesses should ensure that customers can wash or sanitise their hands upon arrival.  Food and beverage service businesses should have visible instructions on handwashing, maintaining safe distances and other practices in place to prevent the spread of COVID-19.
• Dismantling the recommendation to avoid visits to hospitals.
o The lifting of the restriction concerns persons receiving hospital treatment in both specialised and primary healthcare.
• Units providing 24-hour care and treatment must provide their older clients and others belonging to risk groups with the opportunity to meet their loved ones safely, for example by ensuring adequate protection in an outdoor location or by arranging separate, protected meeting facilities. However, the Government recommends that access to the customer premises of units providing 24-hour care remain limited to the staff of the unit.
On June 23, based on the improved epidemiological situation the Government decided to lift the recommendation for persons over 70 to avoid physical contacts. However, the Government still continued to advice to take a cautious approach using individual discretion in close contacts and taking the overall situation and the individual risk factors into account. The Government also stated that its recommendation on extensive remote work would end on August 1. (10)

On August 1, the regulation issued by the Regional State Administrative Agencies on organising indoor and enclosed outdoor public events and meetings with more than 500 attendees was lifted as planned. At the same time, the Government’s recommendation on extensive remote work ended. (11)

Physical distancing was first based on recommendations and general advice. As the situation evolved the Government has also taken more strict measures to stop the spread of the virus.

Many municipalities took measures within their powers before state decisions, for example in testing or service restrictions.

Regulated by the Communicable Disease Act (2016), local school closures were applied in early March, before the formal closure of schools nationally took place March 17th 2020. Prior to that, classes or entire schools were closed when teachers or students were found to be infected.

On March 12th 2020 the Regional State Administrative Agencies (RSAAs) got and advice from the Government to ban meetings with over 500 people. Further, on March 16th 2020 the Government decided on additional measures to address the coronavirus outbreak in Finland, which took force on 18 of March 2020.(1) These included the following:

- The premises of schools, educational institutions, universities and universities of applied sciences as well as other education institutes were closed and contact teaching was suspended. As an exception, however, pre-primary education organised in schools and contact teaching for grades 1–3 continued for the children of parents working in sectors critical to the functioning of society or pupils requiring additional support. Parents and guardians who are able to arrange childcare at home were requested to do so. While contact teaching was suspended the government expected that teaching across all educational institutions should be organised in alternative ways, such as with distance learning and self-learning. Matriculation examinations (final exams for upper secondary school) were carried out by 23 March 2020 according to the condensed schedule. According to the Ministry of Education in late March, 84 % of children in pre-primary education, 93 % of pupils in grades 1–3 and 91 % of pupils with decision on special-needs support did not participate in contact teaching in schools.

- All national and municipal sports and cultural facilities (including museums, libraries, swimming pools, youth centres and clubs) as well as day care services for the elderly, rehabilitative work facilities and workshops were closed. This applied to private and third-sector operators and religious communities also. In April the Ministry of Education and Culture clarified that, for example, outdoor sports facilities should not be closed on the basis of the Government decision.

- Visits to housing services for the elderly and other at-risk groups were prohibited. Visitors were banned from care institutions, health care units and hospitals. Asymptomatic family members of children and critically ill individuals, family members of those in hospice care and spouses or support persons in the maternity ward are permitted to visit patients on a case-by-case basis.

- Public-sector employees were instructed to work from home if their duties allow. Several private employers gave instructions for distance working earlier than the public sector. The COVID-19 epidemic was included in guidance from Confederation of Finnish Industries, for example,  recommending that workers should be allowed to stay away from work on their own announcement (2) during the epidemic, a policy which was opposed before by employer organisations. Tampere University became the first University to implement a policy advising working from home on 11th of March after positive COVID-19 cases were identified from University campuses.

- General guidance was issued that persons over 70 years of age must refrain from contact with other persons to the extent possible (quarantine-like conditions), excepting the members of parliament, the state leadership and elected officials in local government. After the restrictions have been at place for a month a discussion on whether it is justified to issue restrictions based on person’s age has emerged. A number of gerontologists and social policy experts have problematised the strict age-limits and called for more tailor-made restrictions. It has also been raised that the restrictions should have solid regulatory based. 

- Public events and gatherings with more than 10 people were banned and the public was strongly advised for not spending unnecessary time in public places. The authorities have allowed gatherings of specific groups, such as Alcoholics Anonymous, if deemed critical for functioning of the associations.

On March 30, the government extended the measures announced on March 16 until May 13 2020. In addition, they stated that preparations will be made for extending the exceptional arrangements in education until the end of term, if this is deemed necessary for containing the epidemic.(3)

The extensions included that all restaurants must be closed as of April 4 2020. The restrictions apply to all restaurant operations except for preparing food for take away and for delivery by food couriers. These restrictions will remain in place until May 31.(3)

On April 9 the Finnish universities announced that due to the coronavirus situation, organising traditional entrance examinations is not possible without compromising the safety of those involved. The universities disseminated information on the changed admission procedures at the end of April, and increased the ratio of students admitted on certificates alone, reducing numbers of people attending admission tests. Similarly, universities of applied sciences across the country have decided that their entrance examinations in Spring 2020 are organised online. (4)

On April 22 the Government decided that public events and gatherings of more than 500 people should continue to be banned until at least 31 July. As far as events in late summer and early autumn are concerned, an assessment will be made no later than the start of June.