- The National Security Council (NSC) is a federal body consisting essentially of the Prime Minister and the Deputy Prime Ministers. In the context of the crisis, this body was extended to include the Ministers-President of the Regions and Communities. This collegial body took the policy decisions for the management of the crisis at the start of the pandemic.
- The Consultative Committee is a committee on which all governments and their Ministers-President – at federal, community and regional level – have a seat. Since the formation of the De Croo government (01/10/2020), the decisions concerning the COVID-19 pandemic have been taken here.
- The Interministerial Conference (IMC) on Public Health (see below).
- The Federal Coordination Committee (COFECO) is chaired by the National Crisis Center and is responsible for preparing the policy decisions of the Consultative Committee at strategic level, and for coordinating the implementation.
- The Governmental Corona Commission is responsible, among other things, for coordinating the communication between the federal government and the federated states as regards health policy. The Commission had to maintain relations with experts and social partners. In addition, the Commission was competent for formulating proposals for reforming the various consultation structures and thus simplifying the fight against the crisis. Finally, the Commission had to acquire new insights about the virus with a structured approach, and monitor the social, economic and societal impact of the measures taken. In this way, the Commission provided support for policy decisions and their implementation. The Commission’s task was ended on 8 April 2022.
- The Risk Assessment Group (RAG) analyses the risk to the population based on epidemiological and scientific data. The group is chaired by Sciensano and consists of experts from Sciensano, the federal and the regional health authorities, among others. Since November 2020, this body has taken over the remit of Celeval (see below) with regard to analysing epidemiological risks, and until 1 April submitted its opinions to the Governmental Corona Commission.
- The Risk Management Group (RMG) takes measures to protect public health based on the advice of the RAG. This group is chaired by the FPS Health, Food Chain Safety and Environment (FPS-HSFCE) and consists of representatives of the health authorities, both federal and federated. As an extension of this, the Hospital Transport & Surge Capacity Committee and the Primary & Outpatient Care Capacity Committee were set up (see below).
- The Scientific Committee Coronavirus provides scientific advice on the evolution of the virus.
- The ‘Evaluation unit’ (Celeval) consisted of various experts who initially combined the advice of the RAG, the RMG and the Scientific Committee. On this basis, the unit advised the authorities on measures to be taken to stop the spread of the COVID-19 virus. At the end of August 2020, the composition of Celeval was expanded to include experts from various sectors, and the unit took over the task of the GEES (see below). The Evaluation unit was dissolved at the end of November 2020. On the one hand, Celeval’s remit was transferred to the RAG and the FPS-HSFCE. On the other hand, it was decided to set up ad-hoc advisory groups for specific advice or strategic policy questions, since this exceeds the RAG’s remit.
- The ‘Group of Experts tasked with the Exit Strategy’ (GEES) was a group of 10 experts tasked with providing advice to restart public and economic life after the first wave and stop the spread of the COVID-19 virus. This group was wound down in August 2020.
- The ‘Expert Committee on Management Strategy’ or ‘Group of Experts for the COVID-19 Management Strategy’ (GEMS) was set up in December 2020 as the successor to Celeval and GEES, and provides advice on the crisis management measures. Together with the Governmental Corona Commission, they ended their activities on 8 April 2022.
Various crisis units were set up to operationalise the crisis management:
- The Operational unit is coordinated by the National Crisis Center (NCCN). This unit is responsible for alerting the various crisis units, monitors their operations and also has the objective of facilitating the flow of information between the various authorities involved.
- The Socio-economic unit provides advice on the socio-economic impact of the measures taken or to be taken.
- The ‘Economic Risk Management Group’ (ERMG) is responsible for managing the economic and macro-economic risks relating to the spread of the COVID-19 virus in Belgium.
- The Information unit (INFOCEL) is co-chaired by the FPS-HSFCE and the NCCN. This unit is responsible for consistent communication to the public with regard to the pandemic.
- The Legal units are responsible for drafting legal texts and answers to numerous legal questions raised in the context of this complex crisis management.
- The International unit is responsible for a smooth flow of information between the equivalent authorities on crisis management within Europe.
- In addition, various task forces were set up on specific topics (e.g. regarding testing, vaccination, personal protective equipment, data (e.g. data technology against coronavirus) to fight the pandemic.
In this report, we opted to take a closer look at the operations of four consultative bodies:
HOSPITAL & TRANSPORT SURGE CAPACITY COMITÉ
The Hospital & Transport Surge Capacity Committee (HTSC Committee) is tasked, on the one hand, with monitoring the number and nature of COVID-19 patients in general hospitals and university hospitals. On the other hand, the Committee needs to address issues of capacity and flow of patients in hospitals. The Committee also oversees the organisation of (non-)urgent transport for patients. The members of the Committee formulate advice on the aforementioned subjects to the RMG. Among other things, the HTSC Committee drew up a phasing plan to ensure sufficient hospital beds and resources within hospitals for patients with COVID-19. It also drew up a distribution plan for patients and conducted analyses in the context of postponing non-essential care. The Committee is coordinated by the Directorate-General Healthcare of the FPS-HSFCE. The Committee focuses on inter-federal cooperation to provide streamlined communication and approaches.
In the spring of 2022, the HTSC Committee saw the number of hospitalisations of COVID-19 patients in intensive care and nursing units decrease further. The distribution plan could therefore be phased out. The Committee found that during the pandemic hospitals got organised to treat COVID-19 patients. If necessary, problems will be anticipated in due time. The members of the Committee are of the opinion that hospitals can take on greater responsibility in the organisation of COVID-19 care at their institution and within their network. If desired, the hospital can turn to the phasing plan to ensure that it always keeps sufficient beds and resources available for COVID-19 patients.
The Committee, in addition to its task of monitoring the occupancy rate for COVID-19 patients within the general and university hospitals, has taken on an additional task. Shortly after the start of the war in Ukraine, a European evacuation mechanism was established for patients needing care. Given (i) the interfederal cooperation, (ii) the representation of the hospitals by the umbrella organisations, and (iii) the contacts with professional associations through an extensive network, the HTSC Committee is the ideal platform to map the care offer. In the meantime, this has ensured the smooth repatriation and hospitalisation of various Ukrainian patients.
Find out more about the HTSC Committee: consultativebodies.health.belgium.be
PRIMARY & OUTPATIENT CARE SURGE CAPACITY COMITÉ
The Primary & Outpatient Care Surge Capacity Committee (POCSC Committee) was set up at the request of the RMG to complement the work of the HTSC Committee. To relieve hospitals as much as possible, the optimal organisation of primary care was essential. The POCSC Committee examines the organisation and availability of care outside the hospital and transmits its advice to the RMG. The federal government, the various regional authorities and representatives of general practitioners form the basis of this Committee. Depending on the topics to be discussed, representatives from home care, hospitals, residential facilities or associations working on behalf of the most disadvantaged are involved. The Committee must ensure that primary care, hospital care and new forms of care (e.g. telemonitoring, triage centres) are coordinated and appropriate.
Over the past two years, various matters have been dealt with, including:
- the organisation of testing in schools and companies;
- the reduction of the high workload for general practitioners;
- explanation of the financing of the alternative centres (‘test villages’);
- advice on the testing strategy to take some of the load from primary health care, for example by testing only symptomatic patients.
OUTBREAK MANAGEMENT GROUP (OMG)
At the request of the RMG, the Outbreak Management Group (OMG) was set up on 23 March 2020. This working group formulated advice on how to handle the COVID-19 measures and contamination in residential organisations, such as assisted living facilities, institutions for people with a disability and reception centres for migrants.
The first objective of this working group was to make a joint analysis of the situation in the aforementioned institutions based on the various data available within the regional authorities. The second objective was to support the regional authorities in elaborating the decisions taken at the National Security Council or subsequently the Consultative Committee. These decisions needed to be translated into the context of residential institutions, and especially assisted living facilities, as these were the most affected. Among other things, the OMG formulated advice on the following questions: ‘How should the limited available protection equipment be used?’, ‘How can the limited number of staff be deployed?’, ‘Why and in what way can one or more people be isolated from other people?’. This advice led to ‘mobile teams’ being set up, consisting of healthcare professionals, who assist the residential institutions with advice and identify the strengths and development points of an organisation. The aim is to support them in preparing for new waves of infection.
In October 2020, it was decided to wind down the OMG, as the cooperation had enabled the regional authorities to organise themselves autonomously and efficiently to respond to the pandemic in residential institutions. The positive collaboration of the OMG led to a pilot project being set up called the Hospital Outbreak Support Team (see chapter on ‘Quality’).
INTERMINISTERIAL CONFERENCE ON PUBLIC HEALTH
The Interministerial Conference (IMC) on Public Health is a consultative and decision-making body involving all competent ministers for public health in our country. The IMC’s main objective is to ensure and encourage consultation and cooperation between the federal government and the federated states.
The IMC continued its coordinating role and the validation of the measures taken in the context of health unabated. During various consultation moments, they share information and take decisions on the following subjects:
- the evolution of the pandemic and the state of affairs of the vaccination campaign;
- the strategy on pandemic management (to be able to guarantee better preparedness for a possible future crisis);
- the development of a mid/long-term strategy on testing and detecting infections, as well as isolation and quarantine measures.
To find out more about the remit of the Interministerial Conference on Public Health: consultativebodies.health.belgium.be