LTCcovid Country Profiles

Responses to 4.11. Reforms to improve the pandemic and emergency preparedness of the Long-Term Care sector

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.



Beliefs by LTC staff about improved pandemic preparedness

A study carried out in Sweden, Italy, Germany and the United Kingdom investigating LTC staff learning of new knowledge and skills during the pandemic and their beliefs for changes in the future showed that care staff reported significant learning, despite the disruptive nature of events. Staff also held a strong belief that digital technologies and clinical protocols for care would be increasingly used in the future, leading to improved care, but expressed concern about the poor public image of the sector and its inability to attract staff. They also reported low expectations about increased collaboration between professionals from different organisations (Malmgren Fänge et al, 2022).


Malmgren Fänge A, Christensen J, Backhouse T, Kenkmann A, Killett A, Fisher O, Chiatti C, Lethin C. (2022) Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom. Healthcare; 10(2):306.

International reports and sources

EU report on LTC (2021) highlights some recent reforms related to pandemic preparedness in Member States.

Prior to the World Health Organization declaring a pandemic on 11 March,  Danish politicians quickly amended the national Epidemic Act, which had not been updated since the 1970s. Consequently, the decision-making authority which previously was in the hand of local epidemic commissions is now centralized within the government. The newly centralised authority, the Epidemic Comission, is primarily comprised of Danish prime minister and various Ministry representatives and experts from the Danish Health Authority, the Danish Patient Safety Authority, and virologists at Statens Serum Institut (SSI). This authority alone now has the power to make evidence-based decisions regarding public health and safety in relation to pandemic (source: Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (

Last updated: May 25th, 2023

The country aims to focus research on pandemic-related issues (source: Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (

Last updated: November 9th, 2021

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.