The City of Helsinki has issued a statement to the Government on the “Guidelines for the controlled lifting of restrictive measures and recommendations related to the Covid-19 epidemic” document.
An overall assessment of the situation relating to the lifting of restrictions
According to the Government’s plan, decision-making on the lifting of restrictions and recommendations will be gradual and based on the epidemiological situation and an overall assessment.
The City of Helsinki considers it important that when lifting restrictions, not just individual numerical values are focused on, but the overall assessment is actually made.
As vaccination coverage increases, more important indicators than the incidence of infections are the capacity of social and health care, such as the need and prognosis of hospital and intensive care, and the ability of infection tracking and other services, as well as mortality.
The proposed incidence thresholds are quite low and based on models developed in a completely different situation. For example, vaccinations were not yet in sight at the time. Mortality from coronavirus among the elderly has also already decreased. If the incidence trend is declining, the national limit could be less than 100 / 100,000 people / 14 days and the proportion of positive test results less than two percent. In an upward trend, when considering the reinstatement of restrictions, the limits set out in the plan could still be useful.
The relaxing and lifting of restrictions on the lives of children and young people is a stronger priority
According to the Government’s plan, it is important that the lifting of restrictions first seeks to alleviate and remove restrictions on the lives and daily lives of children and young people. In the City of Helsinki’s view, however, this principle is not reflected in the concrete proposals for measures presented in the plan. It is a wrong message to first plan to open restaurant operations when children and young people do not even have access to outdoor hobby activities. On 15 April 2021, the municipalities of the Helsinki Metropolitan Area decided that outdoor activities would be opened to people 20 years old and younger as early as 19 April 2021.
In the future, the priority is for children and young people to have full access to contact education. Nationwide, there should also be a policy on enabling contact teaching for higher education students immediately. Next, hobby locations for children and young people, youth work and public spaces, such as museums, exhibition spaces and libraries, should be opened, whilst applying the necessary restrictions, including customer numbers, pre-registrations and adherence to hygiene guidelines.
The order of lifting the restrictions still requires consideration – a reverse order is not fully feasible
The notion of lifting the restrictions in a reverse order is not fully logical. Restrictions have been implemented in the order in which the tools and resources for them have become available. The opening of low-risk activities and the support of especially vulnerable groups should always be prioritised when dismantling restrictions.
For example, remote education has not been found to be particularly effective in epidemiological analyses. There have been few follow-on infections in schools, and it has been easy to reach those exposed to break chains of infection. On the other hand, experts have found restrictions on the operations of restaurants that serve alcohol to be particularly effective. Lifting these restrictions first does not align with the goals that the Government has set for itself in its plan.
Outdoor activities before indoor activities – emphasis on enabling safe physical activity
The City of Helsinki finds it important to open recreational activities related to sports and exercise in a health-secure manner as soon as possible. It would be essential to ensure sports and exercise opportunities for special groups as quickly as possible, at least in outdoor areas. Furthermore, water-based exercise is an important form of physical activity for elderly persons, disabled persons and rehabilitation patients. This type of activity has not been connected to any significant spreading of the coronavirus.
As such, adults should not be categorically barred from indoor sports facilities through the summer, and this would be especially inadvisable for children and young people. To ensure equality among children and young people, indoor hobbies should also be made possible, as many artistic hobby activities cannot be arranged outdoors.
The release of public events should be considered based on the size and nature of each event – a Covid-19 passport should also be considered
As regards public events, the City of Helsinki finds the Government’s plan to be too vague and focused on individual criteria. Moreover, the criteria proposed by the working group of the Ministry of Education and Culture, which deviate from relevant regulatory arrangements in other fields, also fails to provide the necessary clarity and predictability.
In the context of enabling public events, the size of the event and venue should be considered, along with whether the event will be organised indoors or outdoors.
Responsibly-organised small-scale events indoors and in predefined outdoor areas can be equated with the operations of restaurants, restaurant terraces or amusement parks and should, therefore, be permitted under corresponding terms and conditions. The safety measures applied to smaller-scale event activities could include limited attendance, participation based on advance registrations and tickets, designated seating or other placement arrangements, and usage of face masks.
The City of Helsinki is cooperating with the Tapahtumateollisuus ry association and operators in the events sector in order to enable event organisation in a health-secure manner. The sector already has practices that have been found effective during previous phases of the coronavirus crisis, and the field is largely committed to observing the principles of safe event organisation. For the measures to support the field to succeed, it is important that municipal operators have a clear understanding of the Government’s policies, and that the policies are prepared in cooperation with the municipalities and the event sector at large.
The City of Helsinki emphasises the importance of the event sector as a driver of vitality in large cities and finds it important to equate activities related to arts and culture more widely with trade and business.
Among fields of business, the tourism, restaurant and event sectors have suffered the most as a result of the coronavirus crisis. The institution of a Covid-19 passport could facilitate the operation of businesses and reduce unemployment among young people.
The prolonged crisis has had a negative impact on the employment of young adults, in particular. The results of the crisis will resonate for quite some time in the form of various impacts involving mental health issues and increased risk of social exclusion, especially among young demographic groups in which unemployment was already alarmingly high before the coronavirus outbreak.
A regional vaccination focus targeting the worst areas of the epidemic is justified
In the City of Helsinki’s opinion, a regional focus of vaccinations should be linked to the overall scheme of lifting restrictions, in order to ensure sufficient vaccination coverage as quickly as possible in areas where the state of the epidemic is the worst. This would also be important for improving the situation nationwide.
It is not justified to require every person in Finland who is over 70 years of age or belongs to a risk group to be vaccinated before implementing some form of regional focus. It would be far more effective to institute a decree on a regional focus immediately. Furthermore, no specific vaccine should be excluded from the focus scheme.
If implemented in an urgent and comprehensive manner, focusing the vaccines in the areas most impacted by the epidemic would save lives and reduce the load on hospitals. Experts of the Finnish Institute for Health and Welfare stress that the sooner the effective focusing of the vaccines is initiated, the higher the number of severe cases, hospitalisations and deaths that can be avoided.
The schedule for opening travel must be decided urgently – in addition to the preconditions for border security
Ensuring health security in the context of cross-border traffic has an essential impact on preventing the spreading of the epidemic and especially any new virus variants. Effective health security measures at the borders must be continued until cross-border infections no longer threaten the efforts to curb the epidemic. This principle is one that the City of Helsinki agrees with.
In practice, however, the current arrangements to ensure health security are sure to prove insufficient when the number of border crossers begins to increase as travel restrictions are lifted even partially, if not sooner. For example, the state of the epidemic in Sweden, Estonia and other Baltic countries is currently substantially worse than in Finland.
For this reason, a certificate of a recent negative test result or prior Covid-19 infection (vaccination certificate should also be required later) should be set as a precondition for entering the country as soon as possible. Alternatively, entrants to the country should at least be required to book two coronavirus tests through an electronic system. The first test should be taken immediately after crossing the border and the second one within 72 hours of the first one. Establishing a “Covid-19 passport” of this kind as a precondition for entering the country would reduce the number of people requiring testing at ports and enable testing at ports without compromising the capacity required to curb the epidemic through infection tracking and vaccination, for example. This model is critical for ensuring the health security of Finland as a whole.
The European Union’s joint Digital Green Certificate, which is currently being planned, could also be implemented to ensure cross-border health security. However, it must also be made mandatory to be effective. The Port of Helsinki is one of the busiest passenger ports in the world, which is why a model based on voluntary vaccination or testing cannot ensure health-secure entry into the country.
At the same time, the tourism industry is in urgent need of a clear plan and schedule to build its post-coronavirus future. Active sales in the sector take place up to a year before the customers’ actual trips. Without a clear and scheduled plan from the Government, alignment with EU policies and terms for health-secure entry into the country, it is practically impossible for operators in the field to make the necessary investments in their future.
The care and service deficit and the availability of social and health care professionals require measures
The prolongation of the pandemic has resulted in a continuously growing care and service deficit, which, as of yet, has only been partially rectified.
The deterioration of health and well-being will most likely result in an increased need for more robust services, if the emerging health-related challenges and demand for mental and financial support cannot be met with sufficient haste. Problems have been observed especially with regard to young people, families, child welfare and child health and maternity clinics. Early and easily-available low-threshold mental health services must be increased to prevent the escalation of crisis situations and a surge in social issues. This includes investments in schools, vocational institutions and mobilised youth work. Seniors, disabled persons and informal carers are also suffering from the prolonged pandemic and are in urgent need of services to support their coping.
Therefore, in addition to providing sufficient funding, the central government must ensure the sufficiency of health care staff especially in areas where the coronavirus situation is the most challenging (e.g. the Helsinki Metropolitan Area. The number of study places for critical professional groups must be increased as quickly as possible. Moreover, the coronavirus crisis is not the only reason for an increased demand for labour. This means that personnel structures must be diversified and workers must be utilised more flexibly than before.
Tools for preparing for possible additional waves are required in advance
The temporary provisions of the Communicable Diseases Act will remain in effect until 30 June 2021. The effective period needs to be extended in case the situation deteriorates. In addition to this, preparations must be made for the possible eventuality that any subsequent waves worsen the crisis enough to warrant instituting emergency conditions and considering restrictions on the freedom of movement. For now, we have been able to avoid the situation that emerged in the spring, wherein movement restrictions that were found necessary could not be deployed as a result of insufficient preparation.
In the event that the epidemic suddenly escalates, a sufficient range of tools and measures must be available for activation. Relevant provisions should at least be prepared but also put into effect as laws.
Instead of sector-specific and highly-focused legal solutions, it would be prudent to prepare more general regulatory arrangements that could also be used to make needs-based decisions necessitated by the pandemic with regard to restrictions and closures related to premises and private events, for example. The legal policies could determine the criteria that must be met for restriction decisions to be issued and the possible content of these decisions (e.g. hygiene requirements, distancing obligations, restrictions on customer numbers and closure of premises). The implementation authority could be maintained with the Government or granted to regional administrative authorities and municipalities. The possibility of financial compensations for losses resulting from the restrictions should be decided in the same context.
Full statement (only in Finnish):
The City of Helsinki statement on the Government document “Guidelines for the controlled lifting of restrictive measures and recommendations related to the Covid-19 epidemic.”
Photo: Jonna Pennanen.