Policy responses for Portugal - HSRM

Portugal


Policy responses for Portugal

1.2 Physical distancing

Following the end of the State of Emergency (18 March-2 May), the Situation of Calamity was declared by the government (https://dre.pt/application/conteudo/132883344). The government determined, like during the State of Emergency, mandatory confinement for all COVID-19 patients and all those isolated according to health authorities’ assessment is maintained. For the rest of the citizens the civic duty of home confinement applies. Besides the activities allowed during the State of Emergency, citizens can now circulate in public roads and spaces to go to libraries, fishing, or visit zoos. Additionally, stores with less than 200 sq meters are allowed to open doors, under strict measures, including assuring physical distancing of costumers and adequate cleaning and hygiene. The government has defined 1 person per 20 sq meters as the limit for maximum capacity in those stores.

The use of face masks has been made mandatory for all citizens closed public settings, including stores, public services or public transportation, unless its use is not feasible due to the nature of the activity (for example, people who need oral treatments by dentists)  (https://dre.pt/application/conteudo/132883356).

On 30 April, the government announced publicly the calendar and the conditions for lifting some containment measures (https://www.portugal.gov.pt/pt/gc22/comunicacao/documento?i=plano-de-desconfinamento). The calendar includes a number of measures in several sectors to be revised every two weeks. All sectors must adopt the necessary measures to ensure physical distancing by reducing their maximum capacity, and adequate cleaning, hygiene and ventilation.

4 May
Public transportation
- Maximum capacity of 2/3
(https://covid19.min-saude.pt/wp-content/uploads/2020/05/i026318.pdf)

Work
- Working from home is mandatory for all those who can

Business
- Local stores until 200 sq meters, including hairdressers
- Bookstores and car businesses, irrespective of the area

Public services
- Proximity public services, including finance offices, social security offices and civil registries

Culture
- Libraries and archives
(https://covid19.min-saude.pt/wp-content/uploads/2020/05/i026336.pdf)

Sport
- Open air physical activity

18 May
Business
- Stores until 400 sq meters
- Restaurants, cafes and bakeries
(https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0232020-de-08052020-pdf.aspx)

Culture
- Museums, palaces and monuments
(https://covid19.min-saude.pt/wp-content/uploads/2020/05/i026336.pdf)

Education and social sector
- Nurseries, secondary schools (for 11th and 12th grades only) and day care for people with disabilities

1 June
Work
- Working from home partially
- Reorganization of schedules

Business
- Stores larger than 400 sq meters or inside shopping malls
(https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0232020-de-08052020-pdf.aspx)

Culture
- Cinemas, theatres, concert halls
(https://covid19.min-saude.pt/wp-content/uploads/2020/05/i026336.pdf)
 
Education and social sector
- Pre-school and day care for children
(https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0252020-de-13052020-pdf.aspx; https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0242020-de-08052020-pdf.aspx)

Sport
- 1st League and Portugal coup (football), without audience (from 3 June)
- Gyms and individuals sports without proximity
(https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0302020-de-29052020-pdf.aspx)

6 June
Leisure
- Beaches
(https://covid19estamoson.gov.pt/plano-desconfinamento-medidas-gerais/desconfinamento-praias/)

Religion (from 30/31 May)
- Religious celebrations
(https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0292020-de-29052020-pdf.aspx)

Additionally, on May 4, universities restart some on-site activities and dentists are allowed to reopen their offices, under very strict rules defined by the Directorate-General of Health (https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0222020-de-01052020-pdf.aspx).

Specific legislation was approved every two weeks regarding the measures to reopen all sectors of activity, following technical meetings with public health specialists and epidemiologists, with the participation of the President, the Prime-Minister, members of the government, members of the Council of State, political parties in parliament, among others.

The epidemiological situation in the Lisbon and the Tagus Valley health region, particularly in the Metropolitan Area of Lisbon has raised concern, and specific measures were taken to delay the reopening of some activities and maintaining some restrictions (https://dre.pt/web/guest/pesquisa/-/search/134889278/details/maximized). As several outbreaks related to parties and social gatherings were identified, particularly in the Lisbon Area, the Council of Ministers declared three different situations in Continental Portugal, with effect from July 1 (https://dre.pt/web/guest/pesquisa/-/search/136788888/details/maximized):
- Situation of Alert, in most of the territory: confinement for COVID-19 patients and people under surveillance by health authorities is mandatory, drinking alcohol in the street is forbidden, and gatherings are limited to a maximum of 20 persons;
- Situation of Contingency, in the Metropolitan Area of Lisbon: same rules as the State of apply, with some additional rules, including all shops closing by 8pm (with exception of supermarkets, petrol stations, clinics, pharmacies and gyms), prohibition of selling alcohol in petrol stations, and limiting gatherings to a maximum of 10 persons;
- Situation of Calamity, in 19 parishes of 5 municipalities (https://covid19estamoson.gov.pt/plano-desconfinamento-medidas-gerais/medidas-de-mitigacao-01-07-a-14-07/): same rules as under the Contingency State, with some additional rules, including civic duty of confinement, prohibition of road markets, and limiting gatherings to a maximum of 5 persons.

The government also approved fines for those who do not respect the rules determined by this new legislation: those can range from 100 to 500 Euros for individuals and from 1,000 to 5,000 Euros for companies or establishments. The health sector, the Police and the Social Security will strengthen their cooperation in order to assure that those under mandatory confinement are following the decisions of health authorities.

A Cabinet to Suppress COVID-19 in the Lisbon and the Tagus Valley Region was created in June 9 (https://dre.pt/web/guest/pesquisa/-/search/136167763/details/maximized) with the aim of coordinating and monitoring the public health response to the active outbreaks in the Metropolitan Area of Lisbon, particularly in the municipalities of Lisbon, Loures, Amadora, Odivelas and Sintra.

As the epidemiological situation in the Lisbon and the Tagus Valley Region improved, the government lifted the situation of calamity for the 19 parishes and currently the Lisbon Metropolitan Area is under the situation of contingency, while the rest of mainland Portugal is under the situation of alert (https://dre.pt/home/-/dre/139207969/details/maximized).

and check whether other countries have some successful experiences on this regard that they could share with you.

The situation of calamity on all mainland Portugal was declared on October 14 (https://dre.pt/home/-/dre/145440403/details/maximized). The following rules were in place in mainland Portugal until October 31:
• General rule of limiting gatherings to a maximum of 5 persons, except if they belong to the same household;
• Family events (weddings, baptisms, etc.) are limited to a maximum of 50 persons;
• Corporate events should follow the rules defined by the Directorate-General of Health;
• Non-academic activities, such as student parties and celebration are forbidden.

On October 22, the Government decided on specific measures to be implement in three municipalities of the North Region, where the epidemiological situation was particularly serious. Hence, the following rules applied in Felgueiras, Lousada and Paços de Ferreira (https://dre.pt/home/-/dre/146244086/details/maximized):
• The civic duty of home confinement applies to all citizens living in those municipalities;
• Gatherings are limited to a maximum of 5 persons;
• Shops should close at 10pm;
• Working from home is mandatory, whenever it is feasible;
• Road markets are forbidden.

Upon proposal of the Social Democratic Party, the Parliament has approved the mandatory use of face mask in open public spaces, for all those older than 10 years, whenever the physical distancing recommended by health authorities (2 meters) is not possible. The proposal was approved by the Social Democratic Party, the Democratic and Social Centre, the Socialist Party (in the government) and the Party for Animals and Nature, with all remaining parties voting against it. The Law came into force on October 27 (https://dre.pt/web/guest/home/-/dre/146435561/details/maximized) and is limited for 70 days, with the possibility of being renewed upon evaluation. 

In order to avoid gatherings at cemeteries (traditionally on November 1st, people visit cemeteries in anticipation of All Souls Day), the Government also determined that citizens cannot circulate outside of the municipality where they live between 30 October and 3 November (https://dre.pt/home/-/dre/146435548/details/maximized).

Given the deterioration of the epidemiological situation and the pressure on the health system, the Council of Ministers met on October 31 in order to decide on new rules to implement (https://dre.pt/web/guest/home/-/dre/147412974/details/maximized). A number of stricter rules are applied to 121 municipalities (111 with a 14-day notification rate higher than 240 cases per 100,000 population and 10 due to their proximity with those municipalities):
• The civic duty of home confinement applies to all citizens;
• Gatherings are limited to a maximum of 5 persons;
• Shops should close at 10pm;
• Restaurants should close at 10:30pm and gatherings are limited to 6 persons per table;
• Cultural spaces should close at 10:30pm;
• Working from home is mandatory, whenever it is feasible, or lagged schedules should be implemented;
• Road markets are forbidden.

The State of Emergency was newly declared by the President (https://dre.pt/web/guest/home/-/dre/147933283/details/maximized) and approved by the Parliament on November 6. The government regulated the new State of Emergency that became effective on November 9 (https://dre.pt/pesquisa/-/search/147968348/details/maximized):
• Curfew between 11pm and 5am on weekdays and between 1pm and 5am on weekends, for the 121 municipalities with a 14-day notification rate higher than 240 cases per 100,000 population);
• Closure of commercial spaces by 10pm and restaurants and cultural spaces by 10:30pm on weekdays for the 121 municipalities with a 14-day notification rate higher than 240 cases per 100,000 population;
• Strengthening of contact tracing through mobilization of public servants and military forces;
• Allowing measurement of body temperature in accessing workplace, educational establishments, transportation and commercial, cultural or sporting spaces;
• Allowing testing for SARS-CoV-2 in healthcare facilities, nursing homes and educational establishments, as well as entering or exiting mainland Portugal and prisons and similar institutions;
• Utilization of private and social sector healthcare human resources or facilities to help in the response to the pandemic, upon fair financial compensation.
Further measures for supporting restaurants were decided on the Council of Ministers of November 12: 20% compensation for loss of revenue in the weekends of curfew (when restaurants had to close at 1pm), comparing with the average from January to October 2020.

The State of Emergency was renewed for the period between November 24 and December 8  (https://dre.pt/home/-/dre/149103950/details/maximized), maintaining the rules of the preciousprevious 2-week period and establishing new rules for the holidays of December 1st and 8th:
• Circulation between municipalities is forbidden between 11pm of November 27 and 5am of December 2, and between 11pm of December 4 and 5am of December 9;
• On Mondays November 30 and December 7: suspension of educational activities and day-off for public servants.
• Use of face mask in workplace is mandatory;
• Curfew between 11pm and 5am for the municipalities with a 14-day notification rate higher than 240 cases per 100,000 population);
• Closure of commercial spaces by 10pm and restaurants and cultural spaces by 10:30pm on weekdays for the municipalities with a 14-day notification rate higher than 240 cases per 100,000 population;
• Curfew between 11pm and 5am on weekdays and between 1pm and 5am on weekends and on holidays (December 1 and 8), for the municipalities with a 14-day notification rate higher than 480 cases per 100,000 population);
• Closure of commercial spaces by 3pm on Mondays November 30 and December 7 in the municipalities with a 14-day notification rate higher than 480 cases per 100,000 population;
• Additional measure of economic support for companies and restaurants: postponing payments of VAT and to Social Security; 20% compensation for loss of revenue in the weekends of curfew (when restaurants had to close at 1pm), comparing with the average from January to October 2020.

Finally, the State of Emergency was rewed again for the period between December 9 and 23, with additional measures foreseeing for the period between December 24 and January 7 (https://dre.pt/pesquisa/-/search/150509308/details/maximized):
• Curfew between 11pm and 5am for the municipalities with a 14-day notification rate higher than 240 cases per 100,000 population);
• Closure of commercial spaces by 10pm and restaurants and cultural spaces by 10:30pm on weekdays for the municipalities with a 14-day notification rate higher than 240 cases per 100,000 population;
• Curfew between 11pm and 5am on weekdays and between 1pm and 5am on weekends for the municipalities with a 14-day notification rate higher than 480 cases per 100,000 population);
• Special measures for Christmas:
-Circulation between municipalities will be allowed;
-Circulation in public roads is allowed for those in transit from 23 to 24;
-Circulation in public roads on Christmas night is allowed until 2am;
-Curfew by 11pm on December 26:;
-Restaurants can close by 1am on December 24 and 25; and by 3:30pm on December 26 in municipalities with a 14-day notification rate higher than 480 cases per 100,000 population;
• Special measures for New Year’s Eve:
-Circulation between municipalities will be forbidden between 12am on December 31 and 5am on January 4;
-Circulation of public roads is allowed until 2am on New Year’s Eve;
-Curfew by 11pm on January 1st;
-Restaurants can close by 1am on December 31; and by 3:30pm on January 1 in municipalities with a 14-day notification rate higher than 480 cases per 100,000 population;
-Parties with public access are forbidden.
• The government has further recommended that citizens avoid gatherings during Christmas, spending long periods with mask and avoiding closed and non-ventilated spaces.


Measures in place for New Year’s Eve were updated on December 18 (https://dre.pt/pesquisa/-/search/151904698/details/maximized):
• Circulation between municipalities will be forbidden between 12am on December 31 and 5am on January 4;
• Curfew by 11pm on December 31 and by 1pm on January 1, 2 and 3;
• Restaurants can close by 10:30pm on December 31; and by 1pm on January 1, 2 and 3 (except for take-away);
• in municipalities with a 14-day notification rate higher than 480 cases per 100,000 population;
• Parties with public access are forbidden;
• Gatherings in public roads are limited to 6 people.


The State of Emergency was further renewed, exceptionally for one week, from January 7 until January 14 (https://dre.pt/web/guest/home/-/dre/153959842/details/maximized) and the Council of Ministers has decided on new rules to be in place during that period (https://dre.pt/pesquisa/-/search/153341303/details/maximized). The government has decided to extend the curfew at 1pm on the weekend of January 9 and 10 for municipalities with more than 240 cases per 100,000 population, and to extend to all mainland Portugal the prohibition to circulate between municipalities between 11pm of January 8 and 5am of January 11, with some exceptions.

However, given the rapid worsening of the epidemiological situation since the end of December, stricter measures were implemented by the State of Emergency, which was renewed from January 15 until January 30 (https://dre.pt/pesquisa/-/search/153917314/details/maximized). The government established general duty of home confinement for the population, with similar rules to the lockdown implemented in March 2020, including work only when remote working was not possible, health care provision, acquisition of goods and services, pet walking and outdoor physical exercise (https://dre.pt/home/-/dre/153959843/details/maximized). From January 15, a few commercial spaces were closed, including restaurants (except for take away) and gyms. Remote working is mandatory if the functions allow it, without the need of agreement between employer and employee. Circulation in public roads is allowed only on January 24 to vote on the Presidential election. Education institutions remained open and religious celebrations were allowed.
 
As daily cases and deaths were rising and hospitals became under intense pressure, the government was pressured to close schools, which was implemented one week later, on January 22 (https://dre.pt/home/-/dre/154946853/details/maximized). While universities are not allowed to have presential activities, schools were not instructed to have distant learning for this period (for these two weeks, schools have been closed and the activities have been interrupted, in the same terms as a school break). Religious celebrations have been also interrupted.

After two months of lockdown, during which the State of Emergency was consecutively renewed, the Portuguese Government publicly presented the plan to reopen the activity. This happened following increasing public pressure, as the epidemiological situation significantly improved, with declining incidence, hospitalizations (including ICU) and deaths.
On 11 March, the government presented a strategy to lift lockdown measures based on a matrix of risk which included two main indicators (https://dre.pt/web/guest/home/-/dre/159432419/details/maximized) :
• 14-day cumulative incidence
• Effective reproduction number (R).
As soon as the 14-day incidence is below 120 cases per 100,000 population and the R is below 1, the strategy goes on to the next stage. If those indicators deteriorate, the strategy will suffer delay.


GENERAL RULES
• Mandatory teleworking
• Closing at 9pm on week days and 1pm on weekend and holidays
• Prohibition of circulation outside the municipality of residence on weekend 20-21 March and 26 March-5 April (Easter)

DATE & ACTIONS
15 March (level 4)
Nurseries, primary schools
Hairdressers and beauty care
Bookshops, real estate and car businesses
Libraries and archives
Stores can only attend costumers door (no clients inside)

5 April (level 3)
Schools (2nd and 3rd cycle students)
Social institutions for people with disabilities
Day Centres
Museums, monuments, palaces and art galleries
Stores up to 200 sq (on the street)
Terraces (max 4 people per group)
Low risk sport activities
Open air physical exercise up to 4 persons
Gyms (without group classes)

19 April (level 2)
High schools
Universities
In person formative activities
Cinemas, theatres and  concert halls
All stores and shopping malls
Restaurants, cafes and bakeries (max 4 people inside; max 6 people in terraces) until 10pm on weekdays and 1pm on weekends and holidays
Medium risk sport activities
Open air physical exercise up to 6 persons
Open air events with reduced capacity
Weddings and baptisms with 25% capacity

3 May (level 1)
Restaurants, cafes and bakeries (max 4 people inside; max 10 people in terraces) without restriction in schedule
All sport activities
Open air physical exercise without restriction in the number of people
Group classes in gyms
Big open air events and indoor events with reduced capacity
Weddings and baptisms with 50% capacity

The strategy applies to all mainland Portugal and the epidemiological situation will be constantly assessed. After level 1 is reached, specific measures can be taken locally, when necessary.

Physical distancing measures were first implemented in early March in Portugal, as the number of confirmed COVID-19 cases started to increase in the country. The first confirmed cases in Portugal were identified on 2 March.

Firstly, the government approved legislation on social protection of workers who had to self-isolate or assist family members in those conditions (https://dre.pt/application/conteudo/129843866; https://dre.pt/application/conteudo/130070747). This legislation was published before the closing of all educational institutions, which was announced on 12 March, with effect on 16 March. All employers were also advised to adopt telecommuting when possible, so that most workers could be sent home.

On10 March, the Directorate-General of Health recommended all mass gatherings with more than 100 participants to be postponed or cancelled, as well as all events that could not assure social distancing between participants and events with participants that come from or were visiting areas with active community transmission of COVID-19 (https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0072020-de-10032020-pdf.aspx). On that day, the government also suspended flights to and from the most affected areas in Italy (https://dre.pt/application/conteudo/130114105).

These measures were further strengthened on 13 March, when the Council of Ministers declared a “State of Alert” in the country, with effect on 16 March. Consequently, a package of measures was adopted (https://dre.pt/application/conteudo/130243053), which included:
• Banning access to restaurants or bars with dance floors;
• Restricted access to restaurants or bars up until 1/3 of maximum capacity and only until 9pm;
• Banning all school trips;
• Suspending all on-site educational activities, as well as all leisure activities and day care centres. 

Since social distancing was strongly recommended, visits to nursing homes, long-term care facilities and prisons were discouraged. The Portuguese Episcopal Conference also announced on 13 March the suspension of all religious gatherings, including liturgical celebrations and other reunions.
On 18 March, the Parliament approved the Presidential Decree declaring a State of Emergency (https://dre.pt/application/conteudo/130399862), which was followed by specific legislation approved by the government (https://dre.pt/application/conteudo/130473161). The Government Decree established mandatory confinement for all COVID-19 patients and all those isolated according to health authorities’ assessment (https://dre.pt/application/conteudo/130473161). (See also section 1.3 on Isolation and quarantine).

Additionally, those aged 70 years and older, immunocompromised patients and people with chronic conditions (including hypertension, diabetes, cardiovascular diseases, cancer or chronic respiratory diseases) are subject to a special duty of protection. The latter, can only circulate in public roads and spaces under special circumstances, namely for the acquisition of goods and services, health care provision or pet walking (https://dre.pt/application/conteudo/130473161).

For all the other citizens, besides acquiring goods and services, health care provision or pet walking, a number of exceptions are in place, including: going to work and returning home (if working from home is not possible), visiting vulnerable people who need help, volunteering, short walks, open-air physical exercise (as long as it is not collective), family reasons, judicial reasons, going to the bank or to the post office, etc. (https://dre.pt/application/conteudo/130473161).

Restaurants, pubs and cafes were ordered to close for all activities except for takeaway food sales. Supermarkets, pharmacies, bakeries, petrol stations and banks will remain open but must implement capacity restrictions.

On April 2, under the review of the State of Emergency, the government has determined that citizens cannot circulate outside of the municipality where they live between 9 and 13 April (Easter period), except for very urgent reasons (https://dre.pt/application/conteudo/131068124). The State of Emergency was further extended on 17 April, lasting until 2 May (https://dre.pt/application/conteudo/131908499), with similar restrictions being implemented during the holiday of 1st May.