Ready for the Next Crisis? Investing in Health System Resilience

Annex A. OECD Resilience of Health Systems Questionnaire 2022

Participants in the OECD Resilience of Health Systems Questionnaire 2022

The OECD Resilience of Health Systems Questionnaire 2022 was sent to OECD countries on 3 December 2021, and responses were accepted until April 2022.

The Questionnaire was responded to by 26 countries. Responses were received from: Australia; Austria; Belgium; Canada; Costa Rica; Czech Republic; Finland; France; Germany; Greece; Ireland; Israel; Italy; Japan; Korea; Latvia; Lithuania; Mexico; Portugal; Slovenia; Spain; Switzerland; Türkiye, United Kingdom and United States. Luxembourg responded by completing several modules of the Questionnaire as part of the OECD’s Evaluation of its COVID-19 response (OECD, 2022[1]).

Content of the OECD Resilience of Health Systems Questionnaire 2022

This questionnaire is designed to collect information from OECD countries on policy responses to the COVID-19 pandemic and efforts to increase the resilience of health systems. The information collected will support shared learning on the resilience of health systems. The work based on this information will be presented to the OECD Health Committee in June 2022 and then released as an OECD publication later in 2022. An outline of the work was discussed in June 2021 by the Health Committee [DESLA/HEA(2021)5].

The questionnaire is organised into sections, each focusing on a specific area (see table below). If it helps to communicate the information, please include URLs and links as appropriate. The questionnaire has check boxes and areas for text. The grey highlighted areas mark where you are invited to include comments. Important areas such as digital infrastructure have been captured in other surveys and are not replicated here. Other issues that are core to this project, notably on paying for global public goods, are not included in this questionnaire as information is being collected through other methods.

If time does not permit you to answer all the sections, we would be grateful for as many responses as possible.

 

Section	Focus of the questions
1. Workforce	Short term mobilisation, protecting workers’ health and long-term workforce plans.
2. Continuity of care	Primary health care changes and maintaining care for non-COVID patients.
3. Waiting time	Managing the impact of deferred and delayed care.
4. Critical care surge	Modelling the requirement for critical care resources and system level changes to improve use of critical care resources.
5. Essential products/supply chains	Challenges in obtaining products and how your country assured quality or certification when diversifying supply chains.
6. Mental health	Monitoring mental health and service use. Changes in capacity and in crisis preparation.
7. Long-term care	Impact of the COVID-19 pandemic on long term care.
8. Containment and mitigation	Prior pandemic preparedness, public health responses to the pandemic and suggestions for the future.
9. Investing in core public health functions	Understanding the impact of the pandemic on other core public health functions with the goal of enhancing resilience over the medium-long term.

Please send completed questionnaires to [e-mail]. Your response by 31 January 2022 would be greatly appreciated.

If you would like to discuss any aspect of the questionnaire or the project, please contact the secretariat via Philip Haywood at [e-mail]

Contact persons

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Glossary of terms used in this questionnaire

 

Term	Explanation
Contingency critical care surge	A surge in critical care that is not consistent with daily practices but has minimal impact on usual patient care (contrast with a crisis critical care surge).
Crisis critical care surge	A surge in critical care that is not consistent with usual standards of care, but rather the best possible care is given the circumstances (contrast with a contingency critical care surge).
Intensive care units (ICU)	An ICU is an organised system for the provision of care to critically ill patients that provides intensive and specialised medical and nursing care, and an enhanced capacity for monitoring. Countries may have their own systems for defining and categorising ICUs and ICU beds.
One Health	The One Health approach recognises that many of the antimicrobial threats to human health are the same as those afflicting the health of animals and plants that share the same ecosystem. It underscores the importance of pairing policies in the human health sector with those that are targeting the drivers of antimicrobial resistance in the animal and plant populations, agricultural production, food safety and security, and the environment sectors.
Primary care worker	Primary care workers go beyond primary care physicians or general practitioners to encompass other health professionals such as nurses, auxiliaries, pharmacists, and community health workers.
Resilience	The ability of a system (such as the health system) to recover from and adapt to shocks or stresses.

Section 1: Planning and investing in the health workforce

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Mobilising the workforce quickly during the pandemic
Question 1.1. Was or is your country dealing with a problematic health workforce shortage during the COVID-19 pandemic? ☐ Yes ☐ No
On a scale of 1 (Low) to 5 (High), please indicate the impact of the health workforce shortage in dealing with the COVID-19 pandemic: ☐1 (low) ☐2 (low-medium) ☐3 (medium) ☐4 (medium-high) ☐5 (high)
Question 1.2. Which categories of health and long-term care workers were particularly in short supply during the COVID-19 pandemic? Check all that apply
☐ Doctors (physicians)	☐ Intensive care unit (ICU) specialists ☐ Hospital emergency unit specialists ☐ General practitioners (GPs)/ Family Doctors ☐ Other: (please specify)
☐ Nurses	☐ Intensive care unit (ICU) nurses ☐ Hospital nurses in general ☐ Nurses working in long-term care facilities ☐ Other: (please specify)
☐ Health care assistants/nursing aids	☐ Health care assistants/nursing aids in hospitals ☐ Health care assistants/nursing aids in long-term care facilities ☐ Other: (please specify)
Question 1.3. What policies were put in place to address any shortages of health workers during the peaks of the COVID-19 pandemic and to quickly mobilise additional staff? Check all that apply ☐ Prolong working hours (overtime) ☐ Increase workload (e.g., more ICU beds per ICU nurse) ☐ Provide rapid training in key clinical areas (e.g., intensive care, primary health care) ☐ Mobilise medical and nursing students ☐ Call on retired doctors and nurses to return to practice (part-time or full-time) ☐ Rely on national reserves of health professionals (pre-existing before the pandemic or established in response to the pandemic) ☐ Reallocate health workers to localities/facilities with greater needs ☐ Reallocate health staff to key clinical areas (e.g., intensive care) and reduce activities in non-COVID clinical areas ☐ Reorganise clinical teams to spread expertise ☐ Accelerate the recognition of qualifications of foreign-trained doctors and nurses already in the country ☐ Recruit doctors and nurses from other countries ☐ Other: (please specify)
Question 1.4. What are the three key lessons learned from the pandemic for health workforce policies? Please consider which innovations should be maintained to ensure resilient health systems and provide useful examples from your country
Please briefly describe the three key lessons in this box 1. 2. 3. Examples:
Protecting the health and well-being of workers
Question 1.5. Does your country or an organisation in your country currently conduct a survey to assess health worker safety and/or well-being? ☐ Yes, nationally ☐ Yes, regionally ☐ Yes, on the level of individual providers ☐ No, but one is in development ☐ Other: (please specify)       ☐ No
Please briefly describe and/or provide a link to relevant documentation.
Question 1.6. Did your country provide specific psychological support for health and care workers during acute phases of the pandemic (beyond services that are routinely available to the public)? Select all that apply: ☐ Access to apps or web-based support sites ☐ Access to free phone line ☐ Access to a consultation with a specialist (psychologist or other mental health care worker) ☐ Other: (please specify)       ☐ No
Please briefly describe and/or provide a link to relevant documentation.
Did your country provide additional psychological support services for primary care or long-term care workers during the COVID crisis? ☐ Yes ☐ No
If yes, please briefly describe and/or provide a link to relevant documentation.
Did your country provide additional psychological support services for staff in hospital COVID wards, critical care, and intensive care units? ☐ Yes ☐ No
If yes, please briefly describe and/or provide a link to relevant documentation.
Question 1.7. Has your country provided additional guidelines or training on personal protective equipment (PPE), infection control, patient triage, or mental well-being for general practice (including primary care physicians, nurses, auxiliaries, or community health agents in facilities and those home-based)? Check all that apply ☐ Yes, guidelines on PPE ☐ Yes, training on PPE ☐ Yes, guidelines on infection control ☐ Yes, training on infection control ☐ Yes, guidelines on patient triage ☐ Yes, training on patient triage ☐ Yes, guidelines on other safety procedures (please specify below) ☐ Yes, training on other safety procedures (please specify below) ☐ Yes, guidelines on mental well-being ☐ Yes, training on mental well-being ☐ No
Please briefly describe and/or provide a link to relevant documentation.
Persistent health workforce shortages
Question 1.8. What are the policies in place to address any persistent physician supply problems after the pandemic? Check all that apply ☐ Increase in training capacity ☐ Prolong working time for physicians (e.g., incentives for postponing retirement) ☐ Targeted immigration policy (to attract more physicians) ☐ Incentives to increase the attractiveness of general medicine (financial and non-financial) ☐ Incentives to increase the attractiveness of specialties where shortages exist or are expected (financial and non-financial) ☐ Introduction or expansion of non-physician practitioner roles (e.g., nurse practitioner) ☐ Financial incentives to correct perceived geographic maldistribution ☐ Other (please specify)       ☐ No policy
Please use this box to supply any additional comments or clarifications for this question
Question 1.9. What are the policies in place to address any persistent nurse supply problems after the pandemic? Check all that apply ☐ Increase in training capacity ☐ Increase in pay rates (salaries) to increase recruitment and retention ☐ Improve other aspects (non-financial) of working conditions of nurses (e.g., working time) ☐ Provide incentives to prolong working time for nurses (e.g., incentives for postponing retirement) ☐ Introduce or expand targeted immigration policy (to attract more nurses) ☐ Introduce or expand more advanced roles for nurses (e.g., nurse practitioners) ☐ Other (please specify)       ☐ No policy
Please use this box to supply any additional comments or clarifications for this question
Question 1.10. What are the policies in place to address any persistent shortages of long-term care workers after the pandemic? Check all that apply ☐ Increase in training capacity ☐ Increase in pay rates (salaries) to increase recruitment and retention ☐ Improve other aspects (non-financial) of working conditions of nurses (e.g., working time) ☐ Provide incentives to prolong working time for long-term care workers (e.g., incentives for postponing retirement) ☐ Introduce or expand targeted immigration policy (to attract more long-term care workers) ☐ Other (please specify)       ☐ No policy
Question 1.11. Are limits set for the number of students accessing undergraduate medical education? ☐ Yes, there are limits only in the form of quotas on the number of students admitted at university level ☐ Yes, there are limits only in the form of budget or capacity constraints ☐ Yes, there are limits in the form of quotas on the number of students admitted and of budget or capacity constraints ☐ No, there are no limits
If yes, please indicate who sets these limits. ☐ Central government ☐ Local levels of government ☐ Universities ☐ Other: (please specify)
Have any changes occurred since 2020 in the number of students accessing undergraduate medical education? ☐ Yes ☐ No
If yes, please indicate if the number: ☐ Increased ☐ Decreased
Were these changes related at least partly to the COVID-19 pandemic? ☐ Yes, these changes were presented as a response to the COVID-19 pandemic ☐ No, these changes were already planned before the COVID-19 pandemic or unrelated
Please use this box to supply any additional comments or clarifications for this question
Question 1.12. Are limits set for the number of students accessing post-graduate medical training (i.e., medical specialisation)? ☐ Yes, there are limits only in the form of quotas on the number admitted for post-graduate training ☐ Yes, there are limits only in the form of budget or capacity constraints ☐ Yes, there are limits in the form of quotas on the number of students admitted and of budget or capacity constraints ☐ No, there are no limits, all medical students are provided a post-graduate training opportunity
If yes, please indicate who sets these limits. ☐ Central government ☐ Local levels of government ☐ Universities ☐ Other: (please specify)
Have any changes occurred since 2020 in the number of students accessing postgraduate medical education (i.e., medical specialisation)? ☐ Yes ☐ No
If yes, please indicate if the number: ☐ Increased ☐ Decreased
Were these changes related at least partly to the COVID-19 pandemic? ☐ Yes, these changes were presented as a response to the COVID-19 pandemic ☐ No, these changes were already planned before the COVID-19 pandemic or unrelated
Please use this box to supply any additional comments or clarifications for this question
Question 1.13. Is there any limit for entry into nursing education? ☐ Yes, there are limits only in the form of quotas on the number of students admitted ☐ Yes, there are limits only in the form of budget or capacity constraints ☐ Yes, there are limits in the form of quotas on the number of students admitted and of budget or capacity constraints ☐ No, there are no limits.
If yes, please indicate who sets these limits. ☐ Central government ☐ Local levels of government ☐ Universities ☐ Other: (please specify)
Have any major changes in nursing student intake occurred since 2020? ☐ Yes ☐ No
If yes, please indicate if the number: ☐ Increased ☐ Decreased
Please use this box to supply any additional comments or clarifications for this question
Were these changes related at least partly to the COVID-19 pandemic? ☐ Yes, these changes were presented as a response to the COVID-19 pandemic ☐ No, these changes were already planned before the COVID-19 pandemic or unrelated

Section 2: Maintaining continuity of care for all

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Question 2.1. Has your country implemented measures to recruit additional workers to provide primary health care or expand the role of available primary health care workers to address the peak in demand or maintain care continuity for all non-COVID patients? Check all that apply ☐ Yes, non-health workers (e.g., post-office-workers, firefighters, etc.) have been provided training to provide COVID-19 related care (vaccination, testing) ☐ Yes, pharmacy workers have had an expanded role ☐ Yes, nurses have had an expanded role ☐ Yes, other health workers have had an expanded role (e.g., nursing assistant, midwife, physiotherapist, etc.) ☐ Yes, (please specify)       Please specify, and provide example(s) in the box below?
Please briefly describe and/or provide a link to relevant documentation.
Question 2.2. Has your country introduced new service delivery models in primary health care since the start of the pandemic to maintain care continuity for non-COVID-19 patients? Please indicate new in-person services (such as the deployment of multidisciplinary team practices, or the development of hospital-based programmes), digital health as well as services integrating in-person services and digital health solutions. ☐ Yes ☐ No
Please briefly describe best examples and/or provide a link to relevant documentation.
Question 2.3. Has your country introduced new models to pay for primary health care services to maintain care continuity for non-COVID-19 patients since the start of the pandemic? Check all that apply.
	Incremental changes introduced to existing payment models	New payment model introduced
Yes, additional amounts in salary or additional fee-for-services	☐	☐
Yes, capitation or bundled payment	☐	☐
Yes, pay-for-performance	☐	☐
Yes, payment for coordination with hospital, outpatient care or long-term care	☐	☐
No	☐	☐
Other (please specify)	☐	☐
Please briefly describe and/or provide a link to relevant documentation.
Question 2.4. Does your country have digital booking systems for COVID-19 related services? (i.e., centralised systems to allow people to access services) Check all that apply ☐ Yes, for vaccination ☐ Yes, for testing ☐ Yes, for seeing a primary care provider [for a consultation or prescription renewal] ☐ Yes, other (please specify)       ☐ No
Please briefly describe and/or provide a link to relevant documentation.
Question 2.5. Are any of the following databases for COVID-19 related services linked to national primary health care datasets? Check all that apply ☐ Vaccination registry ☐ Laboratory results ☐ COVID-19 related hospital stays ☐ Digital sick leave forms ☐ Prescriptions ☐ COVID-19 Certificates (Vaccination certificates or health passes) ☐ Patient accessible portals for health information ☐ Patient accessible portals for administrative information (managing contact and demographic information, beneficiaries, etc.) ☐ Patient accessible portals for managing contact with the health system (e.g., schedule consultations/exams in primary health care or specialist care, etc.)
Please briefly describe and/or provide a link to relevant documentation.
Question 2.6. Do primary health care facilities in your country have the functionality to identify, track and/or contact specific priority populations? This data may be used, for example, for targeted follow-up for services (vaccination, routine follow up for chronic care), communication (education for self-management, outreach to high-risk groups) or monitoring of outcomes for particular groups. Check all that apply ☐ Economically deprived ☐ Elderly ☐ Those with routine health needs. Please specify which specific populations       ☐ Those recently released from hospital care ☐ Children ☐ Pregnant women ☐ Other: (please specify)
Please briefly describe and/or provide a link to relevant documentation.
Question 2.7. Does your primary health care system have any of the following enhanced capacities to reach out to priority populations since the start of the pandemic? Check all that apply ☐ Mobile primary health care units/teams ☐ Temporary health clinics for COVID-19 related health needs (testing/vaccination) in public spaces (e.g., libraries, town-halls, schools, conference centres, gymnasiums) ☐ Temporary health clinics for those with chronic care needs in public spaces (e.g., libraries, town-halls, schools, conference centres, gymnasiums) ☐ Home visits for vaccinations ☐ Home visits or digital health consultations for those with chronic care needs ☐ Manage coordination with acute care or long-term care to treat those with chronic care needs ☐ Text-reminders to schedule care ☐ Data sharing with outpatient specialist or acute care ☐ Changes in referral policies between primary health care and social/long-term care, hospital care and end-of-life care ☐ Other: (please specify)
Please briefly describe and/or provide a link to relevant documentation.
Question 2.8. Has your country been using digital health (e.g., teleconsultation, health apps, telemonitoring platform, chatbots) in primary health care to ensure continuity of care to all and better integration with the rest of the health system? ☐ Yes, existing digital health platforms were used ☐ Yes, new digital health platforms have been developed ☐ No
Please briefly describe and provide a link to relevant documentation.
Question 2.9. To what extent have non-physician primary health care workers (such as nurses, pharmacists, community health workers and auxiliaries) undertaken the following COVID-19 related services? ☐ Tracing and tracking of COVID-19 cases ☐ Vaccination ☐ Following up on information reported from public health systems ☐ Providing surveillance data to public health monitoring system ☐ Care for non-acute COVID-19 cases ☐ Other: (please specify)
Please briefly describe and/or provide a link to relevant documentation.

Section 3: Managing waiting times

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Question 3.1 In your country, have waiting times for elective (non-emergency) care become a more prominent health policy issue on which government(s) have taken or are planning to take actions following the COVID-19 pandemic? ☐ Yes ☐ No

On a scale of 1 (Low) to 5 (High), please indicate the level of priority given to waiting time and delayed care issues in your country following the COVID-19 pandemic: ☐1 (low) ☐2 (low-medium) ☐3 (medium) ☐4 (medium-high) ☐5 (high)

Question 3.2. Has your country created a national plan for addressing care backlogs that may have been caused by reduced provision of care during the COVID-19 pandemic? ☐ Yes, a national plan exits ☐ Yes, a national plan is in development ☐ No

Please briefly describe and/or provide a link to relevant documentation.

Question 3.3. How do you expect the waiting times for elective (non-emergency) treatments to evolve over the next few years? How long is it expected to take to deal with any backlog in treatments (e.g., postponed elective surgery, postponed cancer treatments)?

Please briefly describe the expectations about waiting times in this box and provide any study or relevant documentation

Question 3.4. Did your country have any predefined targets relating to waiting times or maximum waiting time norms or guarantees before the COVID-19 pandemic? ☐ Yes ☐ No

If yes, were these waiting times targets or guarantees maintained or temporarily suspended during the COVID-19 pandemic? ☐ Waiting times targets or guarantees were maintained ☐ Waiting times targets or guarantees were temporarily suspended (please specify in which clinical areas)

Please add additional relevant information about the measures taken in this box

Question 3.5. Has there been any new national strategy or specific policy introduced or planned to reduce waiting times and waiting lists for elective (non-emergency) care in your country following the COVID-19 pandemic? ☐ Yes ☐ No

If yes, please provide the title of the strategy or policy, the date of publication and any link to the document.

Please use this box to give the details, links, objectives, and actions of any policy. Please provide relevant links.

Does the strategy or policy involve any of the following elements to increase the volume of elective care? Please check all that apply. ☐ Additional funding for health care providers ☐ Expand health workforce (e.g., doctors, nurses, etc.) ☐ Extend working hours of health workforce ☐ Better use of capacity or operating theatres ☐ Involvement of additional providers (e.g., private providers to treat publicly funded patients) ☐ Digital consultations ☐ Other: (please specify)

Please use this box to provide additional information about these policies, if available

Question 3.6 Have any new policies been put in place to ensure that patients on the waiting lists are prioritised appropriately? Please refer to any new prioritisation policy, the corresponding criteria (e.g., condition likely to deteriorate, pain while waiting, mortality risk, etc.) and how these have been implemented (e.g., in the form of guidelines).

Please use this box to briefly describe new prioritisation policies

Question 3.7 If available, please provide any evidence of the impact of the above policies on waiting times (and add a link to any relevant documentation).

Please use this box to briefly describe the evidence on the above policies

Question 3.8 What lessons have been learned so far from policies to deal with waiting times during the COVID-19 pandemic that could be used to make health systems more resilient to future (unpredictable) public health crises?

Please use this box to outline the lessons learned.

Section 4: Implementing critical care surge capacity

This section is about the forecasting of demand or modelling used to identify the required critical care resources. It also seeks information about the health system level changes associated with the critical care surge that occurred during the pandemic. Some questions associated with the critical care staffing workforce were asked in Section 1 (Workforce). Please provide the name, affiliation, and email address of the best person to contact about the implementation and planning of surge capacity in your country for a case study or focus group.

 

Name:
Position:
Organisation:
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Further discussion	Does your country wish to be involved in a case study or focus group? ☐ Yes ☐ No

 

Modelling of critical care requirements
Question 4.1. Was forecasting or modelling used to plan for the demand for critical care and hospital resources? ☐ Yes ☐ No Please describe what modelling of the demand for critical care and hospital resources was undertaken to aid management of the critical care surge in the COVID-19 pandemic?
Please use this box to briefly describe the forecasting or modelling. For example, regional or national level, based on epidemiological forecasting or trends of current usage etc., modelling occupancy and staff requirements etc. Include URLs or documents as appropriate.
Please comment on the most critical shortages that the forecasting or modelling identified during the COVID-19 pandemic.
Please use this box to outline the crucial shortage identified by the forecasting or modelling. For example, the key shortage was trained ICU nursing staff or ventilators.
On a scale of 1 (not useful) to 5 (very useful), please indicate the level of usefulness to your country in modelling the demand for critical care and hospital resources. That is, was the modelling useful? ☐ 1 (not useful) ☐ 2 (slightly useful) ☐ 3 (moderately useful) ☐ 4 (useful) ☐ 5 (very useful)
Please describe how the forecasting or modelling aided decision making in the health system.
Please use this box to describe how it aided decision making. For example, improved planning and proactive staff recruitment, consideration of physical distancing restrictions, stockpiles etc.
Please comment on what would be useful to include in the future modelling of critical care based on your experiences during the COVID-19 pandemic?
Please use this box identify what would be useful to include in future modelling. For example, key shortages not identified by the modelling.
Question 4.2. Please describe what long term improvements or changes to the forecasting or modelling of critical care demand and capacity were made or are planned to follow the COVID-19 pandemic?
Please use this box to describe the improvements. For example, national centres of excellence, improved data, wider distribution etc.
Question 4.3. What are the expected benefits for the health care system of making these long-term changes?
Please use this box to describe the expected benefits for the health care system of the forecasting or modelling improvements. For example, changes in long term workforce and ICU planning.
Changes to the health system for a crisis critical care surge
Question 4.4. Did you country experience a crisis critical care surge? (A crisis critical care surge is when usual standards of care cannot be maintained, but rather the best possible care is provided given the circumstances) ☐ Yes ☐ No Whether or not your country experienced a crisis critical care surge, what systems level changes were implemented?
Systems level changes	Yes	No
Organisation of facilities into larger networks	☐	☐
Integration of public and private providers into the same network	☐	☐
Implementation of national or regional real-time data on available and used resources	☐	☐
Development of crisis surge triage protocols for treatment and use of scarce resources	☐	☐
Temporary facilities for admitting and treating patients requiring hospitalisation, e.g., mobile hospitals or hotels	☐	☐
Most important systems level policies
Question 4.5 What were the three most important systems level policies that were implemented or already in place to ensure that critical care resources were used more effectively and efficiently?
Please use this box to outline the three most important systems level policies or changes 1. 2. 3.

Section 5: Securing essential medical products

This section is about understanding the major challenges in securing essential medical products from the perspective of the health system. We ask about “the most important product” to ensure a narrow focus on the most useful policies for the international community. Please provide the name, affiliation, and email address of the best person to contact about the supply chain challenges in your country’s health system for a case study or focus group.

 

Name:
Position:
Organisation:
E-mail address
Further discussion	Does your country wish to be involved in a case study or focus group? ☐ Yes ☐ No

 

Question 5.1. Did your country experience supply chain disruptions of essential medical products during the pandemic? ☐ Yes ☐ No
If “No”, please describe the most effective policies that were used to avoid supply chain disruptions.
Please use this box to describe the most effective policies your country used to avoid supply chain disruptions
Question 5.2. What medical products were the most difficult to obtain due to supply chain disruptions during the pandemic? Please indicate in the table below whether each of the listed products experienced a supply chain problem, experienced a problem but it got resolved, or was not a substantial problem. Please add additional products in the “other” row, if not listed and important.
Product	It was a problem throughout the pandemic	It was a problem, but it was resolved	It was not a substantial problem
Ventilators and other ventilation related products	☐	☐	☐
Personal Protective Equipment (PPE)	☐	☐	☐
Testing materials (laboratory reagents, testing devices etc.)	☐	☐	☐
Oxygen	☐	☐	☐
Vaccines	☐	☐	☐
Disinfectants and Sanitizers	☐	☐	☐
Portable monitoring equipment (e.g., thermometer or pulse oximetry)	☐	☐	☐
Other: (please specify)	☐	☐	☐
Out of the medical products listed in the previous table, which were you most concerned about obtaining due to supply chain issues during the pandemic? Please specify one.
Use this box to specify the product you were most concerned about
Question 5.3. Was your supply chain for the medical product that you were most concerned about visible to the health system? (Supply chain visibility can be described as knowledge of suppliers, the suppliers of suppliers, supply chain mechanics and logistics) ☐ Yes ☐ No
Please describe the main location of the disruption in the supply chain. For example, manufacturing or transportation? Was the disruption domestic, international or both?
Please use this box to describe the main location of the disruption in the supply chain. If it was unknown or not visible, then please indicate
Diversification of supply chains
Diversification of supply chains was a common and important strategy following supply chain disruption during the COVID-19 pandemic. Question 5.5. If your country experienced an interrupted supply for the medical product that you were most concerned about, were you able to substitute by switching to: a different supplier, a different product with similar action, combining multiple components or a different strategy?
Use this box to discuss how you diversified. If you were unable to diversify, please indicate that.
How did your country assure the quality of the product you were most concerned about after your supply chain diversification?
Use this box to briefly discuss how you assured the quality of supply chain diversification. For example, did you facilitate technology diffusion from existing suppliers to new suppliers? Did you produce guidelines for new suppliers?
Proposed long-term changes to supply chains
Question 5.6. Please describe the main intended changes to supply chains for medical products for the medium-long term (i.e., for the next five years)
Use this box to outline the main intended changes to supply chains

Section 6: Strengthening and managing mental health

Please provide the name, affiliation, and email address of the person who completed the information about strengthening and managing mental health.

 

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Question 6.1. Has your country undertaken any mental health prevalence surveys during the COVID-19 crisis (2020 – 2021)?

Please provide link(s) to relevant survey(s).

Question 6.2. Did your country introduce any emergency mental health support measures for the public during the COVID-19 pandemic? Please only indicate new or emergency services and support. Please note that mental health supports for health and care workers are enquired about in question 1.6.

☐ New phone support lines ☐ New online information, e.g., on staying mentally healthy during the pandemic ☐ New or temporary mental health services or service entitlement, e.g., access to psychological therapies ☐ Other: (please specify)

Please use this box to briefly describe and/or provide an information link to relevant documentation on new or emergency mental health services and support.

Question 6.3. Has your country tracked the impact of COVID-19 on mental health service use and delivery? For example, monthly referral rates to mental health services, rate of delivery of telemedicine mental health services, waiting times for mental health services.

Please briefly describe and/or provide a link to relevant documentation.

Question 6.4. Has your country permanently increased mental health support or capacity since the start of the crisis? For example, increase in mental health funding, introduction of new services. Please note there is a question of training, including mental health training, in question 1.7

Please briefly describe and/or provide a link to relevant documentation.

Question 6.5. In your country, are mental health considerations included in routine crisis preparedness and planning approaches? For example, does your country have a mental health crisis response blueprint, are mental health impacts of crisis containment measures routinely considered, or are mental health considerations included in crisis preparedness exercises?

Please briefly describe and/or provide a link to relevant documentation.

Section 7: Strengthening long-term care

Please provide the name, affiliation, and email address of the person who completed the information about strengthening and managing mental health.

 

Name:
Position:
Organisation:
E-mail address

 

Question 7.1. Were long-term care workers required to be vaccinated in your country? ☐ Yes ☐ No

Please briefly describe or provide a link to the relevant policies developed for vaccination among the long-term care workforce.

Question 7.2. Are there testing requirements in place for long-term care workers in your country? ☐ Yes ☐ No

Please briefly describe or provide a link to the relevant policies developed for testing among the long-term care workforce.

Question 7.3. In your country, to what extent are low COVID-19 vaccination rates among the long-term care workforce an issue? ☐ 1. Not a concern at all ☐ 2. Something of a concern ☐ 3. A moderate concern ☐ 4. A significant concern ☐ 5. Among the most important issues hampering the COVID-19 response

Question 7.4. Does your country have information on the proportion of the long-term care workforce that has been vaccinated? ☐ Yes ☐ No If yes, please provide the percentage at a given date      % at       date

Question 7.5. Was additional financing for long-term care made available during the COVID-19 pandemic? ☐ Yes ☐ No

Please briefly describe or provide link to relevant information, including how much funding was made available and how it was used

Question 7.6. Have any changes occurred since the COVID-19 pandemic in the turnover of long-term care workers? ☐ Yes ☐ No If yes, please indicate if turnover: ☐ increased or ☐ decreased

Please provide any additional comments or clarifications for this question.

Question 7.7. Were additional measures undertaken to recruit additional long-term care workers during the pandemic sufficient to address shortages? ☐ N/A – no additional measures undertaken ☐ No – measures did not make up for pre-existing shortages of long-term care workers ☐ No – measures did not make up for shortages of long-term care workers caused by the pandemic ☐ Yes – measures were undertaken and were sufficient

Please briefly describe or provide a link to relevant information

Question 7.8. In addition to policies to recruit additional long-term care workers, did your country adopt any policies during the pandemic to address worker shortages by increasing the responsibilities and workload of existing long-term care workers? ☐ Yes ☐ No

Please briefly describe or provide a link to relevant information

Question 7.9. Has COVID-19 negatively impacted recipients of long-term care and the delivery of long-term care? Please check all that apply ☐ Delays in accessing long-term care services or care packages ☐ Physical or mental impact of COVID-19 and containment policies among long-term care residents ☐ People living with dementia or cognitive impairment ☐ Other impacts, and if, so please elaborate

Question 7.10. Has there been an impact of COVID-19 on the delivery of palliative and end-of-life care? Please check all that apply ☐ Difficulties in accessing pain management ☐ Delays in palliative care consultation ☐ Delays in hospice transfer

Question 7.11. Has your country tracked the impact of COVID-19 on where people are receiving long-term care? Is there any evidence that the setting for long-term care has changed? ☐ No ☐ Yes – more people than expected are being removed from institutional care ☐ Yes – fewer people than expected are being removed from institutional care

Section 8: Pandemic preparation, containment, and mitigation strategies

Please provide the name, affiliation, and email address of the person who completed the information about pandemic preparation, containment, and mitigation strategies.

 

Name:
Position:
Organisation:
E-mail address

 

Question 8.1. Did your country have a pandemic preparedness plan before the COVID-19 pandemic or January 2020? ☐ Yes ☐ No

8.1.1. If yes, please choose the reason why your country had this plan. Please check all that apply. ☐ World Health Organization (WHO) or another international organisation’s recommendation ☐ Based on domestic experience of an emerging infectious disease (EID) outbreak ☐ Based on domestic experience of the H1N1(2009) pandemic ☐ Based on an EID outbreak in another country or neighbouring countries ☐ National/political drive/decision for any reason ☐ Other: (please specify)

Please offer relevant background or a link to your country’s pandemic preparedness plan enactment

Please use this box to include additional details.

8.1.2. If yes, please select what components and strategies are included in the plan. Please check all that apply. ☐ Testing & laboratory preparedness ☐ Surveillance & reporting ☐ Case investigation & tracing/tracking ☐ Case isolation protocol and logistics ☐ Hospital and/or other isolation facilities recruitment and allocation ☐ Respirator and other medical equipment supply strategies ☐ Medical care continuity plan for non-pandemic disease patients ☐ Infection prevention and control (IPC) measure training and education for healthcare professionals and/or members of the public ☐ Additional human resources recruited during the pandemic ☐ Human resource training and education before and/or during pandemic ☐ Personal protection equipment (PPE) production and/or trade ☐ PPE procurement & logistics ☐ Vaccine and other medication stockpile ☐ Vaccine and other medication emergent approval process ☐ Vaccine and other medication logistics during the pandemic ☐ Vaccine and other medication research and development ☐ Social/Physical distancing measures and implementation ☐ Psychological support for pandemic cases (see mental health section) ☐ Psychological support for the public (see mental health section) ☐ Financial aid and/or support plans ☐ Social support strategies ☐ Emergency operational government system or organisation ☐ Role of ministries other than the ministry of health ☐ Managing death care services and the handling of dead bodies ☐ Managing information and data infrastructure ☐ Sharing information and statistics ☐ Managing privacy & ethics issues ☐ Engaging civil society ☐ Risk communication ☐ Border control measures ☐ International cooperation strategy ☐ Research for emerging virus characteristics and its surveillance ☐ Research for pharmaceutical interventions (PI) including vaccine and medicine ☐ Research for non-pharmaceutical interventions (NPI) including social distancing strategies ☐ Other: (please specify)

Please describe any further additions regarding the composition and components of your country’s pandemic preparedness plan

Please use this box to describe additional details of the pandemic preparedness plan.

Question 8.2. Does your country have an external evaluation of your pandemic preparedness plan or your response capacity for pandemics that was prepared prior to COVID-19? ☐ Yes ☐ No

8.2.1. If yes, describe when it was and whether it was helpful in your country’s COVID-19 pandemic response

Please use this box to describe when your plan was evaluated and whether this was helpful.

8.2.2. Whether yes or no for 8.2., did your country do any internal or external evaluation of your national response during the COVID-19 pandemic? ☐ Yes ☐ No

8.2.3. If yes for 8.2.2., describe when it was and share your experience with the result (e.g., link to final report etc.)

Please use this box to describe to share your experience

Question 8.3. Did your country have an annual budget dedicated to pandemic preparedness before 2020? ☐ Yes ☐ No

8.3.1. If yes, give the annual budget amount from 2015 to 2019, as applicable, and advise whether it increased or decreased during this time period.

Please use this box to describe your annual budget for pandemic preparedness

8.3.2. Whether yes or no for 8.3., has your country now established or increased its annual budget for pandemic preparedness? If yes, please give the budget amount and describe what it consists of.

Please use this box to describe your new budget for pandemic preparedness

Question 8.4. What top three challenges and opportunities were revealed for your country’s pandemic preparedness plan as a result of COVID-19? What are your country’s future priorities for pandemic preparedness?

● (Challenges) ● (Opportunities) ● (Next steps/future priorities)

8.5. Did your country do any simulation/modelling to estimate the impact of the non-pharmaceutical interventions (NPIs) including lockdown measures, “stay-at-home” orders, school closures, public space closures, gathering/event cancellations and/or other COVID-19 response policies? ☐ Yes ☐ No

If yes, please describe to what extent that simulation/modelling has been used and whether it was useful to implement/adapt the policies. If there are any available reports, please share the files or the links.

Please use this box to discuss the simulation/modelling.

Question 8.6. Did your country respond to the COVID-19 pandemic through a whole of government approach? ☐ Yes ☐ No

8.6.1. If yes, please provide your national level governmental response structure and key decision-making process during the COVID-19 pandemic. (Please specify if there is a special agency dedicated for public health emergency preparedness and response at the national level)

Please use this box to briefly respond to the above question.

8.6.2. Please describe how your local governments/health authorities had a key role in the whole of society response scheme.

Please use this box to briefly respond to the above question.

Question 8.7. Beyond the development of vaccines and other COVID-19 tools, has there been any example of good practice public-private partnerships in managing the COVID-19 response? ☐ Yes ☐ No

If yes, please share your country’s examples (e.g., development and distribution of essential equipment, organising healthcare, supporting social care services, development of testing and/or tracing/tracking process technology, data collection and processing etc.)

Please use this box to briefly respond to the above question.

Question 8.8. Were there crisis communication strategies already in place that were used during the pandemic? ☐ Yes ☐ No

Please describe these crisis communication strategies.

Please use this box to briefly respond to the above question.

Question 8.9. Has your country engaged with social media companies or news media to deal with mis- and dis-information during the pandemic? Please tick all that apply. ☐ Yes, Direct engagement with social media companies ☐ Yes, Direct engagement with news media ☐ No

If yes, did this engagement begin during the pandemic, or was it part of ongoing efforts to combat mis- and dis-information? ☐ Engagement with social media began during the pandemic; or ☐ Engagement with social media predated the pandemic. ☐ Engagement with news media began during the pandemic; or ☐ Engagement with news media predated the pandemic.

Please use this box to briefly provide further information and/or a link to relevant documentation.

Question 8.10. Has your country established a system of communication to respond to the population´s concerns and questions about vaccines? ☐ Yes, a system of communication exists ☐ Yes, a system of communication is in development ☐ No If so, who is responsible for this communication, and what are the means of supporting the communication?

Please briefly describe and/or provide a link to relevant documentation.

Question 8.11. Did your country include citizen or patient participation in key COVID-19 taskforces or decision-making groups involved in your government’s response? ☐ Yes ☐ No

If yes, please briefly describe and/or provide a link to relevant documentation

Please use this box to briefly describe the issues.

Section 9: Investing in core public health functions

The COVID-19 pandemic has been documented to impact efforts to tackle antimicrobial resistance (AMR). This section aims to gather information on the extent to which the pandemic may have interfered with the implementation of national action plans to tackle AMR, as well as the measures that were put in place to mitigate the adverse effects. Please provide the name, affiliation, and email address of the best person to contact in the event of further questions or clarifications.

 

Name:
Job Title:
Organisation:
E-mail address

 

Question 9.1. Which types of activities highlighted in the national action plan on antimicrobial resistance have been adversely impacted by the COVID-19 pandemic? Please check all that apply. ☐ Activities to improve awareness and understanding of antimicrobial resistance in the public (e.g., social media campaigns) ☐ Educational programs for antibiotic prescribers ☐ Health workers’ compliance with the existing hand hygiene guidelines and programs in health facilities (e.g., WHO’s 5 moments for hand hygiene model) ☐ Health workers’ compliance with the existing environmental hygiene programs and guidelines in health facilities (e.g., decontamination, disinfection, cleaning and sterilisation of the environment and equipment, safe disposal of items that have potentially come into contact with infected patients) ☐ Rapid testing of patients to determine whether they have viral or bacterial infections ☐ Audits of antibiotic prescribing behaviours in health care facilities ☐ Surveillance and reporting of antimicrobial consumption in healthcare facilities ☐ Surveillance of antimicrobial resistance through involvement of multiple sectors in line with the One Health approach ☐ Vaccination campaigns for non-COVID related diseases (e.g., childhood diseases, influenza) ☐ Other: (please specify)

Question 9.2. What mitigation measures have been put in place to ensure the implementation of the national action plan on antimicrobial resistance is not adversely impacted by the COVID-19 pandemic?

Please provide short answers in this box

Please send your responses by 31 January 2022 to the OECD Secretariat via [e-mail]

References

[1] OECD (2022), Evaluation of Luxembourg’s COVID-19 Response, OECD Publishing, Paris, https://doi.org/10.1787/2c78c89f-en.