Evidence-based advice processes for long-term care facilities in the COVID-19 pandemic - Aggregate report from the After-Action reviews in Georgia and Norway


European Centre for Disease Prevention and Control. Evidence-based advice processes for long-term care facilities in the COVID-19 pandemic. Stockholm: ECDC; 2023.

Aggregate report from After-Action reviews in Georgia and Norway during the emergence of the Omicron variant of concern of SARS-CoV-2

Executive summary

This report is based on the findings from two focused After-Action reviews (AARs) in Norway and Georgia that discussed the use of evidence in the advice-making process for long-term care facilities (LTCFs) during the start of the COVID-19 Omicron wave in early 2022. Both countries responded to a call for expression of interest by ECDC to participate in the project, which focused on the generation and use of the best available evidence to provide advice rather than the policymaking process. Country visits were organised to Norway in June and to Georgia in September 2022.

Norway and Georgia have quite different LTCF structures and faced the Omicron wave at different times; Norway right at the emergence of the variant at the end of 2021 and Georgia with some weeks delay in 2022. In both countries, there was a sentiment that the advice-making process was supported by the best available evidence at
the time. The interpretation of epidemiological data in real time, as well as drawing on relevant international evidence is considered key to advice-making. Social and behavioural sciences together with the lived experience of people within LTCFs were less systematically and rather insufficiently integrated into the advice-making process. Risk communication was considered a challenge in both countries.

New digital tools assisted greatly in the training and coordination of LTCF staff; however, staff burn-out was a risk at all institutional levels. A clear distinction of institutional roles and active collaboration is a key factor for a smooth response.

Learning from the crisis is essential. AARs within and across agencies are needed to amend emergency plans involving LTCFs.