Policy responses for Poland - HSRM

Poland


Policy responses for Poland

5. Governance

5.1 Governance

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.

MEASURES INTRODUCED IN 2020
 
JANUARY-MAY:

Poland has existing legislation on combating infections and infectious diseases in humans (here referred to in shortened form as the Infections Diseases Act, 2008), which delineates the status of a national epidemic. Therefore, under this legislation, national lockdown and self-isolation measures were able to be legally introduced and additional financing for the health care system - for testing and infectious diseases treatment - were activated (see Sections 1 and 4). The rules of conduct during the COVID-19 epidemic were announced by the Chief Sanitary Inspectorate. They are recommendations aimed at limiting virus transmission. Restrictive measures are being eased from 20 April (see additional information on ‘Transition measures: Social distancing’).
 
The first case of COVID-19 was detected in Poland on 4th March. A state of ‘epidemic emergency’ was announced on 12 March, followed by the higher-level ‘state of epidemic’ on 25 March. Under these legal declarations, school and university closures were implemented from 12 March, with the closures of non-essential shops and recreational facilities and other physical distancing and stay at home rules following the day after (see Section 1.2). The lockdown measures will continue until 26 April 2020, when they will be reviewed.
 
Despite the declaration of the state of epidemic emergency, presidential elections (which were due on 10th May) were not officially postponed and the government proceeded to organise lockdown-compliant elections via a postal poll. This led to a split within the government. Eventually, on 10 May, the National Electoral Commission (the authority responsible for organising elections in Poland) declared that presidential elections could not be held and it is currently unclear when it will take place. It is possible that a new president will not yet have been elected when the current presidential term ends on the 6th of August.
 
On 29 March the Government introduced specific legislation containing targeted solutions for the prevention and mitigation of COVID-19 and for the deployment of needed physical and workforce resources.   This has included the implementation of maximum prices for medicinal products, medical devices and foods for particular nutritional uses.
 
The main actor in health care system is the Minister of Health who is chiefly responsible for managing health policies and health care during the COVID-19 pandemic. The Minister took the decision to designate 19 entities as single-infection hospitals and recommend national lockdown measures (as a member of the Ministers’ Council). The Ministry of Health coordinates testing, health communication and information streaming as well as daily press briefings. It also cooperates with other ministries e.g. Education, Internal Affairs, Science and Higher Education on the design and implementation of measures in other sectors (see Section 6).
 
While the Ministry of Health is responsible for ensuring the supply of required medical and protective equipment it is also supported by the self-governing provinces (voivideships), which have been given more operational powers to implement measures, as well as by municipalities and district governments (see Sections 2.1 and 2.2). All of these meso and local level governments have been active in collecting funds for the purchase of ventilators, masks and gloves for hospitals. The Ministry of Health and the Chief Sanitary Inspectorate are responsible for reporting the number of infected cases and deaths to international institutions. These data come from hospital facilities.
 
Cases detection is the responsibility of the Chief Sanitary Inspectorate. People displaying symptoms, are required to report to their local sanitary and epidemiological units (and not to hospital emergency departments). The Chief Sanitary Inspector or a voivodeship sanitary inspector has the power to request information, take specific preventive or control measures and make relevant decisions under their jurisdiction regarding the distribution of medicines, medical devices and personal protective equipment.
 
In the second week of May, the Silesian voivodeship led with the number of new coronavirus infections, with close to 4,000 cases recorded there (https://wiadomosci.onet.pl/slask/koronawirus-slask-w-centrum-epidemii/jt2nmw4). One of the contributing factors was an outbreak in the mining industry: on one day (12 May) 173 miners from in Bytom, Katowice and Pawłowice were confirmed to have the infection. As a result, the Chief Sanitary Inspector announced the start of a large screening campaign in five Silesian mines. So far, 10,000 miners have been tested. The results will be known in the coming days.
 
In order to facilitate the faster supply of medical equipment to hospitals the government has introduced a simplified public procurement procedure, where the usual provisions of the Public Procurement Act (2004) do not apply (in the context of infectious disease mitigation efforts and public health protection). In addition, Polish scientists are working to develop double-ventilators (which will ventilate two people simultaneously).
 
Sources:
Ustawa z dnia 5 grudnia 2008 r. o zapobieganiu oraz zwalczaniu zakażeń i chorób zakaźnych u ludzi. Dz. U. 2008 Nr 234 poz. 1570.
USTAWA z dnia 2 marca 2020 r.o szczególnych rozwiązaniach związanych z zapobieganiem, przeciwdziałaniem i zwalczaniem COVID-19, innych chorób zakaźnych oraz wywołanych nimi sytuacji kryzysowych. Poz
https://polskatimes.pl/dwuosobowy-respirator-moze-uratowac-zycie-chorych-na-koronawirusa-to-polski-wynalazek/ga/c1-14876135/zd/42668537. [online access:30.03.2020]
https://www.politykazdrowotna.com/57474,gis-dekalog-bezpiecznego-zachowania-podczas-epidemii-koronawirusa. [access online: 17.04.2020]
https://www.wprost.pl/polityka/10312593/jaroslaw-gowin-podaje-sie-do-dymisji.html
https://www.rp.pl/Wybory-prezydenckie-2020/200509579-PILNE-Korespondencyjne-wybory-prezydenckie---ustawa-uchwalona.html
https://wybory.gov.pl/prezydent2020/pl/aktualnosci/37893
https://wybory.gov.pl/prezydent2020/statics/prezydent_2020_uchwaly/uploaded_files/1589173994_uchwala-nr-129.pdf
http://isip.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200000827
http://isip.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200000695
https://polskatimes.pl/kiedy-odbeda-sie-wybory-prezydenckie-2020-opozycja-nie-chce-wyborow-28-czerwca-glosowanie-w-lipcu-albo-dopiero-po-6-sierpnia/ar/c1-14993675 [access online 31.05.2020]
 
JULY:
 
In connection with the second round of presidential elections, the Minister of Health issued provisions regarding sanitary rules during voting. The provisions stipulate that the following groups will have priority access to the voting stations: persons over 60 years of age; pregnant women; persons with a child up to 3 years old; persons with a disability certificate, a certificate of need for special education, or persons who due to health reasons cannot move on their own.
 
Sources:
Rozporządzenie Ministra Zdrowia z dnia 6 lipca 2020 r. zmieniające rozporządzenie w sprawie wykazu środków ochrony osobistej związanej ze zwalczaniem epidemii COVID-19 dla członków obwodowych komisji wyborczych oraz szczegółowych zasad bezpieczeństwa sanitarnego w lokalu wyborczym. Poz. 1207.  http://isap.sejm.gov.pl/isap.nsf/download.xsp/WDU20200001207/O/D20201207.pdf. [access online: 13.07.2020].
 
AUGUST:
 
Due to the increasing number of cases emerging each day, the government decided to designate areas with an increased number of infections as yellow or red zones (see ‘Transition measures: physical distancing’). There are more restrictions in these places compared to other areas in the country. Limits apply to events such as:  congresses and fairs; sports competitions, matches, races; concerts, performances, cultural events; cinemas; restaurants; amusement parks; hotels; swimming pools and aquaparks; fitness clubs; participation in church masses; gatherings; spas.
 
In the last two months, the largest number of infections was recorded among miners and people attending weddings. Consequently, the spread of the virus has been reduced through actions such as shutting down the mines. There are also restrictions on the number of people who can participate in weddings (up to 100 people in YELLOW ZONES, and up to 50 people in RED ZONES).
 
Source:
https://pacjent.goc.pl/aktualanosci/trzy-kolory-bezpieczenstwa [access online: 28.08.2020].

SEPTEMBER:

A dedicated monitoring and forecasting team has been operating at the Ministry of Health since September 2020. Its purpose is to exchange experiences and compare data from various classes of epidemiological models and approaches to epidemiological forecasting. It is composed of representatives of public institutions (the Ministry of Health, the Chief Sanitary Inspectorate, the National Institute of Public Health - the National Institute of Hygiene, the Central Statistical Institute, the Agency for Health Technology Assessment and Tariff System and the e-Health Centre) and expert and research teams.  The main tasks of the team include sharing data with research teams, preparing weekly short- and medium-term forecasts of epidemic development (morbidity, mortality, testing, etc.), as well as preparing variant forecasts. They constitute the basis for decision-making by the Government Crisis Management Team. This allows the government to react on an ongoing basis to the current epidemiological situation and various scenarios.

Source:
https://www.gov.pl/web/koronawirus/zespol-ministra-zdrowia-do-spraw-monitorowania-i-prognoz. [accessed online: 06.02.2021]
 
OCTOBER:
 
Compared to the initial phase of the pandemic, when the majority of infections were recorded in the Śląskie Voivodeship, the majority of infections are now are recorded in the Małopolskie and Mazowieckie voivodships, where the largest cities - Cracow and Warsaw – are located. Also the largest number of poviats in the yellow and red zones are located in these voivodships.
 
Source:
https://twitter.com/MZ_GOV_PL/status/1313033783306792962. [Accessed online: 05.10.2020]
 
Given the fast-changing epidemiological situation, the government reacts on an ongoing basis and introduces new safety rules. The priority is to counteract the spread of the virus. From Saturday, October 24, red zone restrictions will apply to the entire territory of Poland. Changes will include: remote schooling for grades 4-8 of primary schools; obligation for people under the age of 16 under to be accompanied by a parent or guardian when outside; as well as restrictions on the operation of restaurants, sanatoriums and the organization of events, meetings and gatherings. The government is also launching the Solidarity Corps of Support for Seniors – a special programme designed to coordinate assistance to older people, both at the central and local levels.

The government recommends that people over 70 years of age limit their movements, with the exception of fulfilling professional activities, meeting their daily basic needs or participation in holy mass or religious rites.

Source: https://www.gov.pl/web/koronawirus/cala-polska-w-czerwonej-strefie-kolejne-zasady-bezpieczenstwa-oraz-solidarnosciowy-korpus-wsparcia-seniorow. [Accessed online: 29.10.2020].

NOVEMBER:

Changes have been introduced as part of the efforts to digitalize the State Sanitary Inspection. There is now a nationwide helpline through which the Sanitary Inspection can be contacted. The obligation to issue decisions in paper form has been abolished. Inspection’s staff no longer call people to inform them that they need to isolate or quarantine. Instead, this is now automated and performed by a machine.

New equipment has been purchased for the purpose of fighting the pandemic, including 9,000 laptops with full software, 4,000 mobile phones with Internet access and 4,000 modern landline phones. The work of the inspection is supported by state treasury companies, WOT soldiers and students.

Thanks to the integration of the Sanitary Inspection with the Social Insurance Institution, employees do not need to provide certificates of quarantine to their employers. Infected persons can also report contacts by completing a special form, without waiting to be contacted by the Department of Health.

Sources:
https://www.gov.pl/web/gov/zglos-kwarantanne. [access online: 17.11.2020].
https://twitter.com/GIS_gov/status/1326458676434046976. {access online: 17.11.2020]

DECEMBER:

The Chief Sanitary Inspectorate indicated that there were differences in reporting on the number of COVID-19 infections between the electronic system of reporting and other sources. The identified discrepancies did not significantly affect the assessment of the epidemiological situation. The main reasons for this situation that have been identified include:
• delays in reporting the results to the Sanitary Inspection by the laboratories
• different sources of data acquisition and the need for their verification
• different purposes of the collected data (e.g. infection statistics, tracing epidemiological outbreaks, including identification of infection sources);
• interruption in the functioning of the sanitary and epidemiological stations caused by isolation or quarantine of employees (periodically approx. 20% of the staff excluded from work).

From November 24, epidemiological data recording tools will be unified. Identified cases that have not been properly reported so far will be added to the total number of "positive results" on November 24.

Source:
https://www.termedia.pl/koronawirus/Tysiac-lekarzy-z-zagranicy-do-walki-z-COVID-19,40174.html. [accessed online: 10.12.2020]