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Deficient stockpile of personal protective equipment during the COVID-19 pandemic

When the pandemic broke out, the regions and municipalities did not have sufficient personal protective equipment. To address the situation, the Government adopted several measures, but the actions were delayed, in part due to a lack of preparation and cooperation.

Healthcare staff adjust protective equipment, mouth guards and visors.

Photo: Jeppe Gustafsson/TT

The Swedish National Audit Office (NAO) has audited central government efforts to secure supplies of personal protective equipment during the COVID-19 pandemic. The audit shows that these efforts were not conducted effectively.

The deficiencies in the regions’ and municipalities’ supply preparedness were present before the pandemic and had been pointed out a number of times. It is true that the Government had decided on several inquiries, but the Swedish NAO’s assessment is that the Government and the agencies responsible should have done more to address these shortcomings.

“The Government and agencies responsible have neither made clear demands on emergency reserves nor offered guidance on how they should be established,” says Auditor General Helena Lindberg.

When Sweden suffered from extensive spread of disease, a national effort was launched to secure availability. In February 2020, the National Board of Health and Welfare and the Swedish Civil Contingencies Agency urged the regions to increase their stockpile, and the National Board of Health and Welfare made minor purchases on its own initiative.

However, it was not until mid-March that the Government gave the National Board of Health and Welfare the mandate and the funds to secure product supply in the health and social care services. In that situation, the shortage was already a fact just as consumption increased sharply, and only limited amounts of protective equipment were available for purchase at high prices.

“The National Board of Health and Welfare partially supplemented the gap between the regions’ and municipalities’ own purchases and their needs. However, the Swedish Work Environment Authority’s fast track, which made available large amounts of approved protective equipment, was delayed and the National Board of Health and Welfare could not take advantage of it for its purchases when the needs were at the highest levels. The Government also allocated significant amounts for the regions’ and municipalities’ own purchases,” says Henrik Segerpalm, project leader of the audit.

A basic problem was that there was no plan and structure for in which situation the State should contribute additional resources to health and social care services in a crisis. Furthermore, the National Board of Health and Welfare did not have any system for obtaining information about the municipalities’ protective equipment supplies, which made it difficult to set effective priorities for distribution.

The Swedish NAO also notes that coordination between public authorities should be improved. The Public Health Agency of Sweden and the Swedish Work Environment Authority found it difficult to agree on a common message on how protective equipment should be used, and the county administrative boards had doubts about whether they had a mandate to assist the National Board of Health and Welfare without a special Government assignment.

“In times of crisis, the agencies responsible are tested on how they manage their responsibility and their roles. Agencies focused on their other core functions rather than on coordinating their measures for effective crisis management. County administrative boards’ hesitation was unfounded and contributed to an unnecessary delay in central government crisis management,” says Helena Lindberg.

Recommendations in brief

The Swedish NAO’s recommendations to the Government include the following:

  • clarify expectations on public authorities’ capacity to act proactively by supplementing the fundamental principles on emergency preparedness with a principle on action.
  • ensure that the National Board of Health and Welfare is given the mandate to collect information on the regions’ and municipalities’ emergency reserves of medical supplies;
  • clarify in which situations the National Board of Health and Welfare must assist regions and municipalities with resources.

The National Board of Health and Welfare is recommended

  • to strengthen support to municipal health and medical care and social services preparedness. This should be done through long-term cooperation with the country administrative boards.

See the report for full recommendations.

Press contact: Olle Castelius, phone: +46 8-5171 40 04.

Presskontakt: , telefon: 08-5171 42 06.

Updated: 29 November 2022

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