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.
The national response to the epidemic was carried out in collaboration with all stakeholders at the national level (Government, health care institutions, health actors, etc.). This response also had to take into account the policies implemented in France and Italy, due to the proximity of the territories and the many interrelationships at the health, economic and circulating population levels.
The management of the health crisis went through three major phases. A first phase of prevention, started at the end of February 2020, during which the Government of Monaco tried to prevent the virus from coming in the national territory by asking people returning from high-risk areas to remain in quarantine for fourteen days.
With the progression of the epidemic in neighboring countries, the Principality entered a second phase: containment, decided on 14 March 2020 by the Government of Monaco, on the instructions of H.S.H. the Sovereign Prince. Public places that were not deemed essential to the life of the country, nurseries and schools, public gardens and playgrounds, etc. were successively closed. Confinement was extended until 15 April 2020 and then again until 3 May 2020, while the Government carried out extensive disinfection operations in public areas.
The third phase of post-lockdown restart began on 4th May 2020 and provides for the gradual reopening of places open to the public, in compliance with ten basic health measures. The month of June will mark a new phase of post lockdown restart, with the reopening of bars and restaurants, as well as certain sports and cultural facilities (from 2 June 2020), followed by nurseries and day-care centers (from 8 June 2020).
In order to deal with the health crisis, the Principality has adopted emergency legislation. Laws n° 1.485 and 1.486 of 9th April 2020 suspended administrative and procedural deadlines during the containment period, and Budget Law n° 1.487 assessed the impact of the crisis on the State budget. Law No. 1.488 of 11 May 2020 on labour law measures made the use of telework compulsory in jobs that allow it and prohibited unfair dismissals. Health and economic measures were taken by ministerial decisions on the basis of Article 65 of Sovereign Order 6.387 of 9 May 2017 on the implementation of the International Health Regulations (we can quote: the Ministerial Decision of 22 March 2020 temporarily restricting night travel in order to combat the spread of the COVID 19 virus; the Ministerial Decision of 1 April 2020 on the adoption of suitable working conditions for employees, civil servants, State or local authority officials in the Principality with regard to the risks of potential infection by the SARS-CoV-2 virus; and the Ministerial Decision of 14 May 2020 amending the Ministerial Decision of 28 April 2020 introducing exceptional measures in the context of the gradual resumption of activities to combat the COVID-19 epidemic).
In a spirit of national unity, a committee has been set up to ensure the collaboration of Institutions in the management of the crisis: the Joint Monitoring Committee covid-19, which regularly brings together representatives of the Princely Government and a delegation of elected members of the National Council.