HEALTH SYSTEM RESPONSES TO

COVID-19 IN OECD COUNTRIESWebinar: COVID-19 MANAGEMENT STRATEGY IN LITHUANIAWednesday 3rd June

Frederico GuanaisDeputy Head of the OECD Health Division

The evolution of the reproduction number (Rt),

or why we all need to remain vigilant

Real-Time Estimates of the Effective Reproduction Rate (Rt) of COVID-19

0

1

2

3

4

5

6

7

8

21-Feb 28-Feb 6-Mar 13-Mar 20-Mar 27-Mar 3-Apr 10-Apr 17-Apr 24-Apr 1-May 8-May 15-May 22-May 29-May

Lithuania South Korea Italy Mexico

Source: Data from Arroyo Marioli et al (2020), Tracking R of COVID-19: A New Real-Time Estimation Using the Kalman Filter. http://trackingr-env.eba-9muars8y.us-east-2.elasticbeanstalk.com/ Accessed 3 June 2020

1.751.260.880.58

AUS

AUT

BEL

CAN

CHL

CZE

DNK

EST

FIN

FRA

DEU

GRC

HUN

ISL

IRL

ISRITA

JPN

KOR

LVA

LTU

LUX

MEX

NLDNZL

NOR

POL

PRT

SVK

SVN

ESP

SWE

CHE

TUR

GBR

USA

0

2

4

6

8

10

12

14

16

18

1,5 2,0 2,5 3,0 3,5 4,0 4,5 5,0 5,5 6,0 6,5Practising doctors per 1 000 population

OECD

Practising nurses per 1 000 population

Doctors low

Nurses low

Doctors low

Nurses highDoctors high

Nurses high

Doctors high

Nurses lowOECD average: 3.5

OECD average: 8.8

Lithuania was well-placed to respond to COVID-19:

More doctors, slightly fewer nurses than most countries

Source: OECD (2020). Beyond containment: Health systems responses to COVID-19 in the OECD. https://oe.cd/31K

Number of doctors and nurses in OECD countries, 2017 (or nearest year)

Lithuania was well-placed to respond to COVID-19:

4th highest availability of acute care hospital beds in OECD

7,8

7,1

6,0

5,5

5,5

5,0

4,9

4,9

4,3

4,2

4,1

3,8

3,7

3,6

3,6

3,5

3,3

3,3

3,2

3,1

2,9

2,8

2,8

2,8

2,7

2,6

2,5

2,5

2,4

2,4

2,2

2,0

2,0

2,0

1

2

3

4

5

6

7

8

Per 1 000 population

94.9

93.3

91.6

84.3

82.0

81.8

80.7

79.8

79.1

78.9

75.6

75.5

75.3

75.2

74.0

73.8

73.2

71.1

70.7

70.4

70.1

69.5

68.0

67.8

66.8

65.5

65.4

64.0

61.6

50

60

70

80

90

1002000 2017

%

Acute care hospital beds in OECD countries,

2017 (or nearest year)

Occupancy rate of acute care beds in OECD countries,

2000 and 2017 (or nearest year)

Source: OECD (2020). Beyond containment: Health systems responses to COVID-19 in the OECD. https://oe.cd/31K

Lithuania’s effective test, track, and trace response:

Extensive and consistent testing

Notes: 1. People or cases tested. 2. Tests performed or samples tested. 3. Units of test unclear or inconsistent. Differences exist as to whether figures include tests, or individuals tested; whether they include all lab tests (public and

private) or not; on how regularly data is updated by each country; and other aspects. Date of testing data shown in the graph varies between 20 May and 1 June2020. Source: Our World in Data. https://ourworldindata.org/covid-testing

accessed 2 June 2020.

1,8

2,3 6,

517

,518

,019

,520

,4 23,7

24,6

24,6 31

,331

,631

,633

,4 38,0 41

,4 44,8

45,3

46,1

47,2

49,3

50,2

51,2 54

,2 57,0

58,2

58,3

60,3

60,7 63

,464

,766

,078

,091

,311

2,0 12

0,5 17

9,0

0

20

40

60

80

100

120

140Tests per 1 000 population

0,02

1

0,02

5 0,18

0

0,23

6

0,23

7

0,24

2

0,27

0

0,28

6

0,33

7

0,35

7

0,36

4

0,41

0

0,42

0

0,42

1

0,47

5

0,49

4

0,49

8

0,51

1

0,58

8

0,61

4

0,64

2

0,64

8

0,70

8

0,70

9

0,79

9

0,85

4

0,86

5

0,87

3

0,91

9

0,95

8

0,96

2 1,13

9 1,31

8

1,40

6

1,41

8

1,62

2 1,80

5

2,30

8

0,0

1,0

2,0

3,0Tests per 1 000 population

Diagnostic testing for COVID-19 in OECD

countries, cumulative total

Diagnostic testing for COVID-19 in OECD countries, daily

(3-day rolling average)

The things to watch closely: COVID-19 imposes a double

burden on people with chronic conditions12

.1

15.6

23.2

23.6

23.7

25.2

25.9

27.0

27.5

27.7

29.2

29.4

30.0

30.3

30.7

30.8

31.3

33.2

33.6

34.5

36.7

37.0

38.5

40.5

40.9

42.2

48.1

49.4

0

10

20

30

40

50

60

70

80

%

Total 15-64 65+

1/3 of the population live

with 2 or more chronic

conditions

People living with 2 or more chronic diseases, 2014

Source: EHIS-2 2014 and other national health surveys.

Things to watch closely: Opportunities for improvements in

primary health care

42

43 45 52 59 62 66

73

74 77 78 79

96 96 98 102

108

117

119

119

129

139

144

148

151

156

162

165

170 20

9

210

218

219

222 24

5

249

0

50

100

150

200

250

300

350

400

2012 2017Age-sex standardised rates per 100 000 population

Diabetes hospital admissions in adults, 2012

and 2017 (or nearest year)

Trends in hospital admission in adults, selected countries 2007-2017 (or nearest year)

Source: OECD (2019) Health at a Glance 2019. OECD indicators.

→ http://oe.cd/PHC

• France: online bookings for GPs fell 44% and specialist care by 71%

• United Kingdom: emergency rooms visits decreased by 29%

• United States: visits to ambulatory care declined nearly 60% in mid-March(Source: https://sante.lefigaro.fr/article/coronavirus-l-inquietante-baisse-des-consultations-medicales-en-ville/; ; https://www.commonwealthfund.org/publications/2020/apr/impact-covid-19-outpatient-visits‘https://www.bmj.com/content/369/bmj.m1607)

• Scaled-up Telemedicine

• Scaled-up non-resource-intensive interventions that encourage self-management

• Developed guidelines to protect vulnerable populations (France)

• Expanded ‘hospital at home programs’ (Australia, Italy, New Zealand and UK)

Across the OECD, COVID-19 has disrupted the

continuity of care prompting countries to react

In response, countries have:

How are countries using telemedicine now?

Expanded provider payment

e.g. Estonia, Slovak Republic, Poland, Japan,

Belgium, US, Ireland, France, Australia

New guidelines and regulations

e.g. Belgium, France, US, Japan

New services and platforms

e.g. Slovak Republic, Greece, Israel,

Turkey, Luxembourg, Brazil, Chile, Spain

New legislation allowing use

e.g. Costa Rica, Peru, Estonia, Poland

High-level political encouragement

e.g. Switzerland, UK, France, US

Image of coronavirus: Alissa Eckert, Dan Higgins/CDC

SARS-CoV-2

See http://www.oecd.org/health/COVID19-OECD-Health-System-Response-Tracker.xlsx for more

The impact of COVID-19 on mental health and

wellbeing

COVID-19 presents a risk to mental health and

wellbeing for:

• Front line workers

• Mental health service users

• General population

• Phone and online support services for the

general population (10 OECD countries)

• Dedicated psychosocial support for

healthcare workers over the phone, online

or in person (e.g. FRA, IRE, UK)

Source: Sciencano (2020), ENQUÊTE DE SANTÉ COVID-19 : QUELQUES RÉSULTATS PRÉLIMINAIRES, Sciensano, Brussels, https://www.sciensano.be/sites/www.wiv-isp.be/files/report_final_fr.pdf (accessed on 30 April 2020).

The impact has been more significant for those with

less secure employment and who are less-able to continue working

In response, countries are offering:

Education

Status

Employment

Status

Working during

confinement

Teleworking

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Secondaryor less

Highereducation

Employed Unemployed Disability Continuedworking

Temporarysuspension

Able totelework

Not able totelework

Prevalence of anxiety Prevalence of depression

Thank you

@fredguanais

frederico.GUANAIS@oecd.org

www.oecd.org/coronavirus/en/#policy-responses

• Testing for COVID-19: A way to lift confinement

restrictions

• Beyond Containment: Health systems responses to

COVID-19 in the OECD

• Supporting livelihoods during the COVID-19 crisis

• Supporting people and companies to deal with the

COVID-19 virus

• Migrant doctors and nurses in COVID-19 crisis

• VET in a time of crisis:

• Public employment services on the frontline for

jobseekers, workers and employers

• Children and COVID-19

• Women at the core of the fight against COVID-19 crisis