What we have learned internationally from 1.5 years of COVID-19

Over the past year Vilans has closely followed the coronavirus measures taken by governments of eight countries (Belgium – Flanders, Denmark, Germany – North Rhine-Westphalia, France, Norway, United Kingdom – England, Sweden and the Netherlands). The aim is to better deal with the virus and its consequences, especially for clients, caregivers and informal carers in long-term care. Now that we appear to be in calmer waters, it is time for reflection. What lessons can we learn from the countries around us?

In this report, we focus on vaccination status and strategies, current testing policies, the impact on visitor arrangements, preparations for a possible ‘fourth wave’ and financial compensation. 

In all participating countries, vaccination policies in long-term care were highly effective in reducing corona deaths. Vaccination strategies differed somewhat from country to country, but overall, the oldest and most vulnerable were highest on the vaccination priority list.
People in nursing homes have almost all been vaccinated and the number of new infections was zero in the Netherlands at the time of writing. The virus has all but disappeared within residential facilities.

Vaccinating personnel

Although there is also a high willingness among healthcare personnel to be vaccinated, everyone is free to refuse the vaccine. If staff choose not to be vaccinated, testing requirements vary by country. There is currently a debate over whether or not vaccination should be mandatory for certain healthcare personnel. In this regard, England is the first country that will make vaccination mandatory for healthcare professionals.

Similar measures; different outcomes

Although the measures in these countries are and were fairly similar, the outcomes vary from country to country. It also depends on how a society, i.e., the population and the health care system, has dealt with the measures.

Listening to the individual

The report also revealed that, in almost all countries, the opinions of staff, patients and their families, as well as people who lived independently and their unpaid carers, were not taken enough into account during this crisis, especially at the beginning.
On the other hand, the pandemic has shown strengths that can guide us in the development of long-term care. The resilience of services, staff and patients, as well as governments at all levels, was astounding.

Ability to vaccinate on a large scale, improved (high quality) testing facilities, contingency plans/disaster plans for limiting infections (also for other infections), scaling up skills, building extra manpower, resources and buildings, collaborative networks, and engaging researchers in rapid data collection, have all been evident in this crisis. The question now is how sustainable the knowledge gained will be and whether there is sufficient basis for further improvement.

Questions for the future

Now that we are in calmer waters and have time to reflect, questions also arise about how we should and can deal with certain issues in the future. Issues such as:

  • Balance between survival and quality of life.
  • Mandatory or voluntary vaccination.
  • Privacy and compensation measures for residents and patients in long-term care.
  • Balance between health and overburdened caregivers.

It will remain critical to continue to monitor long-term care through an international network in order to maintain a sustainable, accessible and quality long-term care sector.

10 Tips from France

  1. Fight against the virus without forgetting the wishes of the individual
  2. Most important is the information, expression and free choice of the
    residents as much as possible
  3. Preserve contact and trust with the families
  4. Reduce to the maximum – constraints and restrictions of freedom
  5. Take into account the specificities of people with neurocognitive disorders
  6. Support the dying, honour the dead, take care of the mourners
  7. Support the colleagues, take care of the team
  8. Make decisions based on knowledge, and with consensus
  9. Take responsibility in an anxious and uncertain context
  10. Preserve a space for thought and pay attention to the ethical question at the
Contact for this project:

Director Strategy and Development