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.
Georgia has implemented a multisectoral response led by the Prime Minister and coordinated by the Ministry of Internally Displaced Persons from Occupied Territories, Labour, Health and Social Affairs. On 23 January 2020, the Prime Minister set up the Interagency Coordination Council to respond efficiently to the outbreak. The Georgian response to the COVID-19 outbreak started on 25 January 2020, when emergency medical teams equipped with C-level Personal Protective Equipment (PPE) and remote thermometers, were placed at seven key points of entry. This was seen as part of Georgia’s responsibilities as a party to the International Health Regulations, guided by the recommendations of WHO and the ECDC.
Decree of the Government of Georgia #164 dated 28 January 2020 on “Approval of Measures to Prevent the Possible Spread of the New Coronavirus in Georgia and Approval of an Emergency Response Plan for Cases Caused by COVID-19” was adopted (amended on February 26, with Decree #377). The Plan includes the following measures to respond to a case of coronavirus disease:
o Disease detection, identification, validation and risk assessment;
o Laboratory testing;
o Notification of responsible bodies;
o Epidemiological surveillance / response action;
o Informing the public about the risks associated with coronavirus disease, elimination / mitigation of the effects and getting out of the situation
The strategic objectives of the Plan are:
• Country preparedness for expected threats in case the disease is imported;
• Measures to prevent or reduce the effects of imported and local transmission;
• Support efforts to meet international regulations (WHO) to stop, slow down, restrict and report the outbreak of COVID-19;
• Mobilizing health care systems for the treatment and assistance of patients with COVID-19 through continuing provision of essential health services to the population;
• Continuous provision of public information and media engagement.
The national response is led by the Ministry of Internally Displaced Persons from Occupied Territories, Labour, Health and Social Affairs, the NCDC, and the Emergency Situations Coordination and Urgent Assistance Centre. These bodies are responsible for the implementation of the Plan in compliance with International Health Regulations: coordinating surveillance, communications, international reporting and testing. Sectoral action plans have been developed. As of 6 March, they have assessed the capacity of health facilities and identified strategic stocks: capacity of infectious disease profile clinics; adult and children's emergency beds, artificial respiration devices/ventilators, isolated wards, personal protective equipment, medical masks, medical gloves, hand and surface sanitizer solutions, etc.
At the NCDC an Incident Management Team was established. To strengthen preparedness and identify gaps, a multi sectoral tabletop exercise was conducted by the NCDC with participation of all stakeholders in Tbilisi and Batumi.
The significant outbreak in Mestia Municipality that lead to the enforcement of restrictions including quarantine measures for local inhabitants and tourists in the area was a major response that included law enforcement agencies. A regional command centre was put together to assist the local population and ensure coordination among various agencies.
On the 14 July 2020, the Georgian parliament amended the Public Health Law to allow the government to impose movement, labour, migration, economic and other restrictions without the declaration of a state of emergency, that is without the approval of the legislative body until the end of the year. A bill which was passed in May 2020 allowed the government to use the right only temporarily - until 15 July 2020, if the epidemiological situation required such a response.
The Government of Georgia has launched a large-scale study on the management of COVID-19 and the impact of the pandemic with the help of international partners. The independent study will examine the social impact of the crisis, human rights, and legal issues, as well as the stability of state institutions. The actions of the government in the process of managing the state of emergency and the pandemic, the existing challenges, and the impact of COVID-19 on the vulnerable population of Georgia will also be assessed. Recommendations will also be developed to ensure that state institutions are better prepared in the event of recurring crises.
With the worsening epidemiological situation in October 2020, the Inter-Agency Coordination Council Meetings will be held and led by the Prime Minister of Georgia on a daily basis.
On 2 December, the Inter-Agency Coordination Council began preparations for the vaccination stage with the establishment of a special task force for the effective roll out with the engagement of all relevant institutions. Planning will cover the timely import of vaccines as well as the execution of all the preliminary preparation works both in terms of infrastructure and logistics to make sure that the country gets ready to start the vaccination process.
Georgia is expected to receive the coronavirus vaccine either in March or April 2021 via the COVID-19 Vaccines Global Access Facility (Covax). Georgia will be able to choose between the vaccines approved by the World Health Organization. So far 1,400,000 doses (to vaccinate 70,000 people) have been ordered at a cost of 17 million USD. Georgia had already paid over four million dollars to be able to choose between the approved vaccines. Only WHO approved vaccines will be imported into the country.
As of 9 February, a National COVID-19 Vaccination Plan has been drafted, and human resources capacity strengthening has begun. 110 personnel at the regional public health centres and in the Hospital sector will be trained by NCDC in practical immunization, on cold chain and logistics, interpersonal and crisis communication for COVID-19 vaccines.
Georgia will receive the first batch of vaccine doses via Covax in March and vaccination will start with the AstraZeneca vaccine in Georgia. The Covax platform has offered Georgia the new American vaccine from Johnson & Johnson in addition to AstraZeneca and the promised 29,250 doses of the Pfizer vaccine will soon be received, again via the Covax platform.
The Georgian government has plans to vaccinate 60 per cent of the country's population of 3.7 million people this year.