LTCcovid Country Profiles

Responses to 3.01. Brief summary of the overall pandemic response (not specific to Long-Term Care)

The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It was compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project moderated the entries and edited as needed. It was updated regularly until the end of 2022.

The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.

To cite this report (please note the date in which it was consulted as the contents changes over time):

Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Patel D, Pharoah D (eds.) and LTCcovid contributors.  (2022) LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science.

Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.


The first case of COVID-19 in Australia was identified on January 25, 2020, from a man who travelled from Wuhan to Melbourne. Prime Minister Scott Morrison announced the Australian Health Sector Emergency Response Plan for Novel Coronavirus on February 27 and the first economic stimulus package on March 12. By mid-March, most states and territories were in lockdown. Cases began falling across the country in April and on May 8, the government announced a three stage plan to ease lockdown restrictions. Victoria entered its second wave in late June and by October 26, it reported no new cases or deaths. COVID-19 cases have been stable nation-wide since October 2020 (sources: WHO;; Lupton, UNSW).

A report was published by the Parliament of Australia, which provides a chronological overview of the measures implemented across states and territory governments in response to the COVID-19 pandemic as well as when these measures were eased again (until June 2020). Measures included border restrictions, visiting restrictions at health sites, closure of non-essential businesses and activities, and remote learning for pupils.

A National Plan to transition Australia’s National COVID-19 response was agreed in August 2021, with transitions to less restrictive measures being triggered by the rates of vaccination, with a plan to move to a Phase C, with only very highly targeted lockdowns and re-opening of borders, once 80% of the population aged 16 and over are fully vaccinated (with two doses). It was expected that all jurisdictions in Australia would reach this threshold and enter phase C by the end of 2021.

Professor Deborah Lupton has characterised six phases in the management of COVID-19 risk in Australia:

  • – ‘A distant threat’ January 2020 to February 2020
  • – ‘The National Lockdown’ March 2020 to May 2020
  • – ‘COVID Zero’ June 2020 to January 2021
  • – ‘Vaccine Dilemmas’ February 2021 to May 2021
  • – ‘Delta Response’ June 2021 to September 2021
  • – ‘Living with COVID’ since October 2021

Since October 2021 the Government’s policy has been to ‘learn to live with COVID-19’, accepting higher case numbers, hospitalisations and deaths, particularly for people not yet fully vaccinated.

Last updated: January 9th, 2022

The first presumptive positive case of COVID-19 in British Columbia was found on January 28, 2020. The first case of community transmission was announced on March 5. On March 18, a provincial state of emergency was declared in British Columbia and by the end of March, all schools, personal service establishments, and dine-in restaurant services were closed. Health officials considered British Columbia to be successful in flattening the curve by late April and on June 24, the province entered phase 3 of its restart plan where most establishments were allowed to reopen and non-essential travel within the province resumed. A second wave of COVID-19 was declared in British Columbia on October 19 and in November, mandatory mask policies and new restrictions against social gatherings were introduced. In December, Pfizer and Moderna vaccines were approved for use in Canada. The first dose of COVID-19 vaccine in British Columbia was administered on December 15. As of January 29, 2021, 129,421 vaccine doses have been administered. Current restrictions on social gatherings, restaurant services, fitness centres, and travel have been extended indefinitely (Source:

Last updated: November 6th, 2021

The first confirmed case of COVID-19 in Denmark was diagnosed on February 27th, 2020. Early on, general recommendations were to apply spatial distancing, self-quarantine and to maintain good hygiene, especially by frequent hand washing or disinfection. However, it was (and still is) not recommended to wear a mask in public places or in situations with many people, as there was no evidence for the positive effect.

As the number of positive cases continued to grow, the authorities recommended to cancel or postpone large gatherings, initially with more than 1,000 persons, but as of March 11, just 100 persons. This meant that concerts, football matches and the like were cancelled. On March 10th, citizens were encouraged only to use public transport outside peak hours.


Denmark was one of the first countries worldwide to introduce a lockdown. This was announced on March 11th, and came into force March 13th, 2020. All persons working in non-essential functions in the public sector were ordered to stay at home for two weeks. Private employers were encouraged to ensure that their employees could work from home. All public institutions, including secondary education and universities, libraries and museums closed down. Exams were cancelled.

Also, all non-essential travel was advised against and Danes who were abroad were recommended to return home. On March 14th, the Danish borders closed apart from the transportation of goods and people with a so-called legitimate reason for entering the country. Self-quarantine for 2 weeks was recommended if a person had visited a high-risk country and for health and social care staff this was a requirement since March 3rd. Over the next days also  primary and secondary schools, child care centres, restaurants, shopping malls etc. were closed and it became illegal for more than ten persons to gather at a time in public places. On April 15th the lockdown was partly lifted as day care centres and primary schools for pupils in 0-6. grade opened up again but with more space per child and strict instructions on washing and disinfecting hands regularly. Graduating students in the upper secondary schools and at social and health care educational institutions were allowed back in school.  Over the next weeks the service industry and cultural institutions re-opened but recommendations to maintain now 1 meter’s physical distance was kept into May. In areas with less infection, public employees could return to work. At the time, there was a discussion about the reasoning behind the lock-down and whether this was taken on grounds of epidemiological evidence or rather of political concerns.

Feb 1st 2022, the far majority of restrictions were lifted in Denmark, as the first country in the EU, the reason being that more than 80% of the population had had two vaccinations. This included restrictions on nightclubs and late-night sale of alcohol.

Test strategies

The general strategies for testing have changed a number of times in Denmark, leading to some criticism for lack of transparency or evidence-based practice. The initial test strategy, introduced in early March 2020, was aimed at preventing the disease from spreading, a so-called confinement strategy. This took place by testing persons who might have been exposed to the disease, even if they did not have symptoms.

As of March 15th, 2020, the strategy changed to a mitigation strategy, targeting test measures to alleviate the consequences of the disease. Now only persons with symptoms were tested and following a referral from the GP. This led to concerns being raised such as from the WHO, which generally advised a more aggressive testing strategy. Nationally it sparked a debate that the new test strategy was a pragmatic and not a health-based decision, mainly due to a lack of testing equipment. In the period of May 1st-May 12th, the number of daily tests was fluctuating between 4-15,000.

On May 12th, 2020, a new and more aggressive testing strategy was introduced, where persons without symptoms are also to be tested. The capacity was set to 20,000 persons on a daily basis and the ambition was to increase this number over time. This would make Denmark a country with one of the highest number of tests per inhabitants.

In combination with the new testing strategy, the health authorities also introduced new and trust-based measures to confine the disease. This included a policy of encouraging those with COVID-19 to self-quarantine. The municipality must offer a place at a hospital, hotel or similar, if the person is unable to be at home. Finally, persons who have tested positive must inform other persons with whom they have been in contact with, who are then supposed to take two tests. Call centres operated by the health authorities can assist the person. Concerns were voiced that this voluntary system would not be efficient.

Over the winter 2020-2021, the mass testing strategy with free access to testing was continued. In May 2021, the test capacity peaked at 12,167 COVID-19 tests per day per 100,000 inhabitants. When society re-opened in March 2021, a negative COVID-19 test or completion of COVID-19 vaccination became compulsory for attending education, cafes and restaurants, fitness centers. Children in elementary schools were strongly urged to take biweekly COVID-19 tests, often assisted by teachers (Busk et al, 2021).

As of Sept 2022, the general recommendation is to be tested in situations only where a test result may be important for the treatment of COVID-19. However, a number of test recommendations still apply for employees and visitors to nursing homes, home care and social services with vulnerable people who are at particular risk of a serious illness in the event of infection with COVID-19 (source:


As in other countries, there was a shortage of PPE in the early phases and the health care sector was prioritised. In August 2020, wearing a mask or face shield become mandatory in public transport, and it was extended to most public places in Oct 2020. In June 2021, the requirement to wear masks in public places was phased out but reinforced in Nov 2021 along with other restrictions. Feb 1st 2022, the mask restriction was lifted for the final time.


The first vaccinations were rolled out Dec 27th, 2020. Residents in nursing homes was first on the list, followed by older people with home care, older people aged 85 and over and other vulnerable groups. Denmark uses  Pfizer/BioNTech and Moderna vaccines and vaccination is free of cost. Denmark has one of the highest levels of COVID-19 vaccination in the European Union as of the end of September 2021. 81.4% of the population has received the first vaccine, 80.0% the second, and 61.7% the third. As of Oct 1st 2022, a fourth vaccine will be offered to all persons 50 years or older. By Sept 2022 0.9% have already received the fourth vaccine (source:


Busk, P. K., Kristiansen, T. B., & Engsig-Karup, A. (2021). Assessment of the National Test Strategy on the Development of the COVID-19 Pandemic in Denmark. Epidemiologia, 2(4), 540-552.

Last updated: June 5th, 2023   Contributors: Tine Rostgaard  |  

General measures

General measures agreed between the Federal and the Länder governments include the closure of restaurants, bars, and non-essential retail outlets as well as cultural venues such as cinemas, theatres, and clubs. Wearing of masks in public (shops, transportation, workplace) is mandatory and employers and employees are urged to work from home whenever possible. An evening curfew 8pm – 5am had been in place for a while in some regions and there are restrictions in the number of people that are allowed to gather privately. The measures are being regularly revisited in meetings between the chancellor and the 16 Minister presidents. The Minister presidents have decision making power to alter some of the rules, which is why slight differences in measures can be observed across Germany. The rules also differ depending on the COVID-19 incidence (there are changes in rules even at the local level) (Lorenz-Dant, 2020; Die Bundesregierung, 2022).

Infection prevention bill

On April 23, 2021, a new infection prevention bill was enacted. The aim of the bill is to unify COVID-19 related measures across the country depending on local incidence levels (Bundesministerium für Gesundheit, 2021).


Bundesministerium für Gesundheit (2021) Fragen und Antworten zum 4. Bevölkerungsschutzgesetz. Available at: 6 February 2022).

Die Bundesregierung (2022) Corona-Regelungen: Das haben Bund und Länder vereinbart. Available at: (Accessed 3 February 2022).

Die Bundesregierung (2021) Bund-Länder-Beschluss: Öffnungsperspektive in fünf Schritten. Available at: (Accessed 6 February 2022).

Lorenz-Dant, K. (2020) Germany and the COVID-19 long-term care situation. LTCcovid, International Long Term Care Policy Network, CPEC-LSE, 26 May 2020. Available at: (Accessed 3 February 2022)

Robert Koch Institut (2021b) Bericht zu Virusvarianten von SARS-CoV-2 in Deutschland, insbesondere zur Variant of Concern (VOC) B.1.1.7. Available at: (Accessed 6 February 2022).

Last updated: February 12th, 2022

Following the experience with the SARS epidemic (2003), the government quickly imposed strict policies and guidelines in community and long-term care facilities. Already in late January 2020, the Social Welfare Department provided the first COVID-19 guideline ‘for special arrangements for publicly funded welfare services’. In addition to daily updates regarding its public services arrangements, the government also offers ‘helplines for daily necessities and/or food’ for people confined at home (Source:

In July 2020, with the development of a third wave, containment measures across society were escalated. This included screening and quarantine for foreign domestic workers entering Hong Kong, orderly return of travellers from higher-risk countries, mandatory COVID-19 testing and medical surveillance for crew members of aircrafts and vessels, tightening of social distancing measures, limiting of the number of people in restaurants and entertainment venues, and suspension of visits to LTC facilities, rehabilitation centres, and non-acute hospitals (Source:

Last updated: September 8th, 2021

Iceland began lifting its COVID-19 restrictions in June 2021. Even before that, from May 2021, the country’s international borders were open to travellers from selected regions meeting negative tests and (from 1 July) vaccination requirements. For travellers with close relatives in Iceland, a negative test is required within two days of entering the country.

In November 2021 the restrictions in place were:

  • The maximum number of people allowed in the same location is 50 (with certain restrictions) – in public and private locations, both indoors and outdoors. Restrictions on numbers and social distancing rules do not apply to children born in or after 2016.
  • Up to 500 people may attend an organised event if additional conditions are met – namely:
    • negative rapid antigen tests for all, taken less than 48 hours ago;
    • one-metre distancing rule except when seated;
    • all guests registered; and
    • face masks obligatory.


Directorate of Health. (October 2021). COVID-19 instructions for outdoor and indoor areas. Retrieved from

Low LF, Feil C, Iciaszczyk N, Sinha S, Verbeek H, Backhaus R, Fadnes Jacobsen F, Hulda Tómasdóttir Þ, Ayalon L, Dixon J and Comas-Herrera. (2021) Care home visitor policies: a rapid global scan of current strategies in countries with high vaccination rates. International Public Policy Observatory and

Last updated: November 29th, 2021

A National Action Plan in response to COVID-19 was issued in March 2020. One of the aims is to ‘maintain […] critical and ongoing services for essential patient care’. This also captures long-term care services for different groups of people with needs for care and support. There is also a specific point on ‘Caring for our people who are ‘At Risk’ or vulnerable’.

By March 2020, additional public health restrictions emphasising the importance of people staying at home were published.

Last updated: September 7th, 2021

The pandemic was maintained at reasonably low levels of infection in Israel between February 21 (first case detected) and September 2020, with an effective first lockdown easing by May. In September, the first major wave coinciding with the Jewish High Holidays resulted in a second lockdown. This wave peaked at 6,276 cases on September 27. In tandem with a record-breaking vaccination campaign rollout, a second wave began in mid-December. The daily number of cases peaked at 8,624 on January 17, 2021, with the majority of cases due to a new, more virulent strain (Source: CGD)

As of November 24th 2021, a total of 8,178 people died due to COVID-19. However, due to massive vaccination, there are currently (November 2021) only 6,505 individuals defined as active COVID-19 patients, and 124 defined as severely ill. As of November 23rd 2021, only 603 new cases were identified.

The Israeli Ministry of Health was charged with leading the Government’s pandemic response, with publishing both weekly and daily press releases starting January 24, 2020. Lockdown measures were implemented the second week of March, which proved effective in terms of minimizing the rate of infection. According to the Government Stringency Index produced by the Oxford COVID-19 Government Response Tracker, the Israeli Government’s policies (e.g., stay at home orders, business closures) were most stringent in April at a score of 95 (when rates were low). In the first and second wave, the index measures were at 85 (with a significant drop to a score of 40 and a reopening of society in November 2020) (Source: Our World in Data).


Last updated: December 5th, 2021   Contributors: Shoshana Lauter  |  LIAT AYALON  |  

After the first two Covid-related cases in Italy were registered and confirmed in Rome on the 21st of January 2020, the Italian government suspended flights to China and declared a six-months state of emergency throughout the national territory with immediate effect on 31st of January 2020. At the same time, the Italian Council of Ministers appointed the head of the Civil Protection as Special Commissioner for the Covid-19 emergency. In the following days and weeks, additional regulations opened the possibility for the central government as well as other administrative levels (regions, cities etc.), in case of absolute need and urgency, to adopt stricter containment measures in order to manage the epidemiological emergency. At the end of February the first cases and deceased were registered in small towns in Northern Italy (Codogno, Vo’) that were placed under stricter quarantine(schools closed, public events cancelled, commercial activities closed etc.); on February 22rd carnival celebrations and some soccer matches were cancelled. On 1st of March, a Ministerial Decree established that the Italian national territory was divided in three areas: (i) Red zones (composed of Northern Italy municipalities that registered a certain level of COVID-19 cases where the population was in lockdown); (ii) Yellow zones (composed of regions of Lombardy, Veneto and Emilia-Romagna where certain activities were closed – schools, theatres – but people still had the liberty of limited movements); (iii) the rest of the nation where both safety and prevention measures were advertised but no further limitations were put in practice. On March 8th the government approved a decree to lockdown the entire region of Lombardy (and 14 other neighbouring provinces) establishing “the impossibility to move into and out of these areas” – with only few exceptions. Just a day later, on the evening of 9th of March, the government extended the Lombardy quarantine measures to the entire country. This national lockdown was expended several times until the 3rd May (Galeazzi et al., 2020).

If containment measures and lockdown were enforced by the central government, the same cannot be said for provisions detailing how the health sector and the LTC should respond to the COVID-19 crisis. In Italy, in fact, the health sector management and legislation fall within the competence of the Regional level; hence, especially during March and April all Italian Regions have adopted, at different times, plans, norms and decrees for managing the crisis.


Galeazzi, A., Cinelli, M., Bonaccorsi, G., Pierri, F., Schmidt, A. L., Scala, A., … & Quattrociocchi, W. (2021). Human mobility in response to COVID-19 in France, Italy and UK. Scientific Reports11(1), 1-10

Last updated: November 23rd, 2021   Contributors: Elisabetta Notarnicola  |  Eleonora Perobelli  |  

Most of the early attention on Japan was focused on the Diamond Princess cruise ship: people on board started a 2 week quarantine on February 5, 2020 (Source:

A published article gives an account of the different measures implemented in Japan during the COVID-19 pandemic.

Last updated: September 8th, 2021

A comprehensive preparedness plan was developed by the Ministry of Health (MOH) in Malaysia during the very early days of the pandemic; before the first case in the nation had been identified. The main components of this plan included screening at ports of entry, designating hospitals and clinics as either treatment or sampling centres, and empowering the public health surveillance system (Hashim et al., 2021).

In March 2020, when the first community case was identified and cases in Malaysia subsequently began to increase, the Malaysian government introduced the Movement Control Order (MCO) in an attempt to mitigate spread of the virus. This order was extended and/or amended several times (e.g., the Recovery Movement Control Order) in the following months, until June 2021 when the National Recovery Plan (NRP) – a four-phase plan to steer the nation out of the pandemic – was put into effect (Jamaluddin et al., 2022). The MCOs involved the closing of local or community borders and strict enforcement of the prohibition of movement between areas, and its initial implementation was followed by a drop in the number of daily cases reported within two weeks (Ang et al., 2021).

Malaysia achieved successful delivery of medical services and COVID-19-related physical and digital infrastructure (such as mobile apps for track-and-trace) through a centralised coordination council which was made up of multiple ministries, to whom the Ministry of Health provided advice and updates on the pandemic, and collaborations with the general public, NGOs, and other states. Aside from the various national lockdowns, Malaysia adopted a targeted screening approach to monitor individuals who had been identified as high-risk (such as those who had travelled), and had hospital and non-hospital quarantine systems to manage active COVID-19 cases. These were organised according to the disease severity and risk of infection (Ang et al., 2021). The MOH distributed the National Guidelines on COVID-19 Management (aimed at assisting frontline staff and also available online) in every step of their management of COVID-19 cases. These guidelines were continuously updated throughout the trajectory of the pandemic (Hashim et al., 2021).


Ang ZY, Cheah KY, Shakirah MS, Fun WH, Anis-Syakira J, Kong YL, Sararaks S. Malaysia’s Health Systems Response to COVID-19. Int J Environ Res Public Health. 2021 Oct 22;18(21):11109. doi: 10.3390/ijerph182111109. PMID: 34769629; PMCID: PMC8583455.

Hashim, J. H., Adman, M. A., Hashim, Z., Mohd Radi, M. F., & Kwan, S. C. (2021). COVID-19 Epidemic in Malaysia: Epidemic Progression, Challenges, and Response. Frontiers in Public Health, 9, 247.

Jamaluddin, F., Sheikh Dawood, S. R., Ramli, M. W., & Mohd Som, S. H. (2022). Bouncing back from the pandemic? A psychosocial analysis of older adults in urban areas of Malaysia. Http://Www.Editorialmanager.Com/Cogenthumanities, 9(1).

Last updated: February 17th, 2022   Contributors: Daisy Pharoah  |  

During the first wave of the pandemic, southern regions of the Netherlands were hardest hit, with Carnival celebrations being one of the main accelerators. The second wave started in September 2020 and by November was most pronounced in the west, including in the large urban centres Rotterdam, the Hague, and Amsterdam. The Dutch government introduced an “intelligent lockdown” during the first wave. A regional approach was attempted at the beginning of the second wave, but was abandoned by mid-October 2020, when the government introduced a second lockdown, with similar rules like the first (Source: A published paper describes the economic and public health interventions during the first wave. An overview of measures to reduce community transmission, such as an overnight curfew, have been published online.

Last updated: September 8th, 2021

Since 25 September 2021, there have been no national COVID-19 restrictions in Norway. Since 6 October, all national borders were open, with no particular COVID controls in place. However, from 26 November, some entry restrictions have been reintroduced – namely, the duty of all travellers entering the country to:

  • register their entry at the border;
  • produce evidence of a negative Coronavirus test if they have no valid COVID-19 certificate; and
  • subject themselves to testing if they are neither fully vaccinated nor have had a COVID-19 infection during the previous six months.

Other possible national restrictions are being debated, but have not been announced as of 24 November.


Low LF, Feil C, Iciaszczyk N, Sinha S, Verbeek H, Backhaus R, Fadnes Jacobsen F, Hulda Tómasdóttir Þ, Ayalon L, Dixon J and Comas-Herrera. (2021) Care home visitor policies: a rapid global scan of current strategies in countries with high vaccination rates. International Public Policy Observatory and


Last updated: November 29th, 2021

General measures introduced to manage the pandemic include early adoption of extensive testing and contact tracing, low cost tests and treatments covered by the health system, social distancing, and immigration control (Source:

The government plan to implement mass vaccination of key groups starting February 2021 (Source: Laws introduced after earlier public health shocks (Sars in 2003 and Mers in 2015) allow the Korea Disease Control & Prevention Agency to access phone data, credit card records, and CCTV footage to trace people’s movements.

Last updated: September 7th, 2021

Singapore has put in place a multi-pronged strategy with an emphasis on epidemiological surveillance, case finding, testing, mandatory reporting, contact tracing and containment.

There is a strict isolation policy for people who test positive. If they are clinically unwell  according to a set clinical protocol, they are hospitalised. If they are clinically well are housed and cared for in designated community isolation facilities. These community facilities include hotels, army barracks, stadiums, and exhibition halls which have been repurposed. Clinically well individuals are closely monitored by designated healthcare professionals at these facilities.

Extensive contact tracings done for all positive cases, in April 2020 there were more than 1,300 Singapore Armed Forces personnel and civilians deployed to contact tracing. This is complemented with the use of technology.

The country has a Disease Outbreak Response System Condition (DORSCON) framework. The severity of an outbreak and associated actions are highlighted through a colour-coded system


Last updated: November 2nd, 2021

The overall Public Health response to COVID-19 in Sweden was based on a tradition of voluntary measures that emphasize individual responsibility and mutual trust. Recommendations included staying at home if presenting with symptoms, good hygiene, physical distancing, and avoiding unnecessary travel. People aged 70 or over were asked to avoid all close contacts and to stay away from places where people gathered. There were some legally binding rules including a ban large public gatherings, distance learning in secondary schools and universities and restrictions on visiting in care homes (Szebehely, 2020 and Kavaliunas et al., 2020).

Despite the government stressing the importance of protecting older people, initially there were no specific measures for care home residents (see section 3.00).


Kavaliunas, A., Ocaya, P., Mumper, J., Lindfeldt, I., & Kyhlstedt, M. (2020). Swedish policy analysis for Covid-19. Health policy and technology, 9(4), 598–612.

Szebehely M (2020) The impact of COVID-19 on long-term care in Sweden., Long-Term Care Policy Network, CPEC-LSE, 22 July 2020.

Last updated: February 13th, 2022

Thailand experienced the first wave of COVID-19 during March and April 2020, prompting the government to declare a nationwide emergency curfew on the 25th March 2020. Even if the government relaxed the measures after the first COVID-19 outbreak was declared to be under control in May 2020, most Thai people have continued to practice social distancing (Srifuengfung et al., 2021).


Srifuengfung, M., Thana-Udom, K., Ratta-Apha, W., Chulakadabba, S., Sanguanpanich, N., & Viravan, N. (2021). Impact of the COVID-19 pandemic on older adults living in long-term care centers in Thailand, and risk factors for post-traumatic stress, depression, and anxiety. Journal of Affective Disorders, 295, 353–365.

Last updated: January 14th, 2022

The government imposted a curfew on people aged 65 and older, as of 22nd March 2020. This became became a partial curfew on the 1st of June 2020, when infection rates had started to decrease. The hours that people were authorised to go out varied according by region and changed according to infection rates. As of 22nd November 2020, individuals aged 65?years and over have been allowed to go out between 10:00–13:00?hours (Arpacioglu et al., 2021).


Arpacioglu S, Yalçin M, Türkmenoglu F, Ünübol B, Çelebi Çakiroglu O. Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey. Psychogeriatrics. 2021 Nov;21(6):881-891. doi: 10.1111/psyg.12762.

Last updated: January 12th, 2022

In response to the COVID-19, the Government have introduced various public health and economic measures in England to mitigate the impact of the pandemic.

The first wave and first lockdown (January -September 2020)

The first cases of COVID-19 were discovered in January 2020, as a result, in late January and February, the government issued advice for travellers coming from affected countries and contact tracing was introduced. As the COVID-19 spread across England, the government introduced further public restrictions, but it was not until 23rd of March 2020 when the first lockdown was announced, which lasted between March and April 2020. The Coronavirus Act 2020, came into force on the 25th of March 2020 and it granted the devolved governments (England, Wales, Scotland and Northern Ireland) emergency powers (e.g. to suspend public gatherings, order businesses to close, mandate social distancing, close educational institutions etc) and it gave powers to the police to enforce these measures.  Simultaneously, it was announced that economic support has been provided to businesses which suffered due to restrictions and to furlough employees to mitigate the economic impact of the lockdown. The national restrictions introduced during first lockdown were gradually lifted between April  and September 2020, and people were urged to go back to work in offices and restaurants; however regional measures (lockdowns) were introduced due to rises in Covid cases in specific regions (Source: Coronavirus (COVID-19): guidance and support – GOV.UK).

Further waves and lockdowns (October- January 2020)

By the end of September 2020 cases were drastically increasing and on 14 October 2020, the government introduced a three-tier approach to containing the virus across England. In the new approach, restrictions varied locally according to defined tiers (tier 1 restrictions were referred to as ‘Local COVID Alert Level Medium’,  tier 2 as ‘Local COVID Alert Level High’ and tier 3 ‘Local COVID Alert Level Very High’) (Source: Coronavirus, Local COVID-19 Alert Level). As cases continued to rise, a 4-week national lockdown was announced commencing on Nov 5, 2020 (Source: The UK needs a sustainable strategy for COVID-19). A new enhanced tier system was announced in November, which was to be applied following the end of the second lockdown on 2 December.  Following a discovery of a new COVID strain, England entered another national lockdown on the 5th of January 2021.

Vaccination and lifting of national lockdowns

The vaccination programme started in December 2020 and as it expanded, most restrictions were lifted in England on 19 July 2021. Following the discovery and spread of the Omicron variant, in December 2021, government advised people to work from home advice and mandatory face masks in certain settings were introduced.

Living with COVID- 19 (February 2022)

On the 21st February 2022 the government announced that all COVID regulations, including those that mandate lockdown and require people to self-isolate if they test positive, will be removed from the 24th of February, 2022. The plan is outlined in the “Living with Covid 19” report.  Although those who test positive and their close contacts (including those who are unvaccinated) will no longer be required by law to self-isolate, the advise still is to isolate for five days and avoid contact with vulnerable people. Financial support for people who are self-isolating will also come to an end, although statutory support due to illness will be available. From April 1, when the general public will no longer be able to access free COVID-19 tests (Source: Living with Covid 19).

Last updated: March 24th, 2022   Contributors: Joanna Marczak  |  

First wave and lockdown

On the 1st March 2020, the first positive case of COVID-19 was confirmed in Scotland. Two days later, the UK Government announced its Coronavirus Action Plan; a four staged collective approach for the UK to contain and respond to the spread of the virus. The main advice given to the public at this stage was to wash their hands regularly with soap and water, for at least 20 seconds.

In the following months, a series of recommendations and guidance on isolating, social distancing and event closures were followed by the formal placement of the NHS on an emergency footing and eventually orders were enacted to ask all Scots to stay at home, as the UK entered lockdown on the 24th March 2020. School closures followed. Towards the end of May, the Scottish Government published its Routemap through the pandemic, outlining a five-phased approach to varying

Between May and July Scotland moved through Phases 1 to 3 of the Routemap. The test and protect scheme was rolled out from 28th May and the new contact tracing app was developed. By August, COVID-19 cases were increasing in certain parts of Scotland and localised restrictions were brought into place. On the 20th August 2020, the Scottish Government announced that Scotland would remain in Phase 3 and they set out updated dates for further changes.

Throughout September more localised restrictions were implemented as cases continued to spread and by November 2nd the new five-level strategic framework indicating varying levels of restrictions that would be required depending on the level of transmission of the virus came into effect.


The roll-out of the vaccination programme was announced in December with care home residents, their carers and frontline health care workers being vaccinated first. The over 80s would follow, along with other groups identified as being at risk of serious harm and death from the virus. By the 15th May, 66.6% of eligible Scots had received their first dose of the COVID-19 vaccination.

Second lockdown

Further restrictions were introduced over the festive period and on 5th January mainland Scotland entered its second lockdown. All travel corridors were suspended from 18th January. At this point, the roll out of the vaccination programme was well under way and by 17th March, 44% of the adult population had received their first dose of the vaccine.

The second national lockdown would remain until restrictions began to be eased from 2nd April. From the 26th April, free lateral flow test kits were to be made available to anyone in Scotland without symptoms and Scots were encouraged to test themselves twice weekly.

Level 0 and booster vaccinations

Due to the success of the vaccination roll out, on the 19th July 2021, the whole of Scotland entered level 0. Up until November 2021, the focus of the Scottish Government has been continuing to administer vaccines, including the roll out of booster vaccinations (Source:

Last updated: March 24th, 2022   Contributors: Jenni Burton  |  David Henderson  |  David Bell  |  Elizabeth Lemmon  |  

The United States has been the country hit hardest by the pandemic per capita. Public health responses have primarily been delineated by state and local government, but general stay-at-home and mask-wearing orders have been in place across the country since March 2020 (Source:

Last updated: September 8th, 2021

By the end of 2020, Vietnam had emerged as one of the few countries to effectively contain COVID-19, having gained epidemic response experience as one of the first countries in the world to successfully eliminate SARS in 2003. Vietnam had therefore made invaluable investments into its public health infrastructure prior to the current pandemic, including a national public surveillance system, a national public emergency operations centre (PHEOC), and four regional operations centres. These were all used to successfully manage the spread of COVID-19 immediately after the first outbreak (Thi Mai Oanh et al., 2021).

This experience also meant that the government was able to make quick decisions in response to the outbreak in the first wave. This included an immediate nationwide lockdown, limiting international flights, and shutting its borders. The aggressive contact tracing, testing, and quarantining of anyone who had been within three degrees of separation of any positive case, as outlined in section 2.01, also ensured that no potential cases could go undetected. Communications with the public were consistent and went out through a vast array of sources throughout the pandemic, with timely updates on the details of new cases and details of the actions being taken. A hard stance was also taken against fake news and the spreading of disinformation on social media (Thi Mai Oanh et al., 2021).


Thi Mai Oanh, T., Khanh Phuong, N., & Anh Tuan, K. (2021). Sustainability and Resilience in the Vietnamese Health System Sustainability and Resilience in the Vietnamese Health System Sustainability and Resilience in the Vietnamese Health System.

Last updated: December 30th, 2021   Contributors: Daisy Pharoah  |  

Contributors to the LTCcovid Living International Report, so far:

Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Erica BreuerJorge Browne Salas, Jenni Burton, William Byrd, Sara CharlesworthAdelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin HämelNina Hemmings, David Henderson, Kathryn Hinsliff-Smith, Iva Holmerova, Stefania Ilinca, Hongsoo Kim, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’DonovanCamille Oung, Disha Patel, Martina Paulikova, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. SchmidtAgnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jae Yoon Yi, Jessica J. Yu

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.