Under § 27 (3) and § 28 (2) 5) and § 28 (6) of the Communicable Diseases Prevention and Control Act and considering the provisions of § 27 (1) 1) and 2) and § 28 (8) of the same, requirements for quarantine for the purpose of avoiding and preventing the coronavirus SARS-CoV-2 causing COVID-19 from spreading outside the focus of the disease are imposed as follows:
1. Persons
who have been diagnosed with COVID-19 or whose SARS-CoV-2 RT-PCR or SARS-CoV-2
antigen RTD test by a health care provider has come back positive
(hereinafter infected person) are prohibited from leaving
their place of residence or permanent place of stay from the
time they were diagnosed or received their test results until
their recovery. A place of residence or a permanent place of
stay also means places where shelter services and safe house services are
provided. Whether a person has made a recovery is decided by a physician.
2. The
restriction set out in clause 1 does not apply when an infected person is
given an order by a health care professional, a police officer or an official
of the rescue service to leave their place of residence or permanent place of
stay, or when a health care professional refers them to receive health
services, or in the event of an emergency that puts their life or health at
risk.
3. A
person who is living with or permanently staying in the same place of stay as
an infected person or who has otherwise had close contact with an infected
person (hereinafter close contact) is prohibited from leaving their
place of residence or permanent place of stay during a
period of 10 calendar days. For a person who is living with
or permanently staying in the same place of stay as an infected person the
10-calendar-day period starts from the onset of the infected person’s symptoms
or, if the infected person exhibits no symptoms, from the
day the infected person took the positive test for SARS-CoV-2 referred to in
clause 1. For a person who has otherwise had contact
with an infected person the 10-calendar-day period starts from last close
contact with the infected person.
4. The
restriction set out in clause 3 does not apply if the close contact is
showing no symptoms of COVID-19 and the following circumstances occur:
1) the close contact is given an order by a health care professional, a
police officer or an official of the rescue service to leave their place of
residence or permanent place of stay;
2) the close contact leaves their place of residence or permanent place
of stay when a health care professional refers them to receive health services
or in the event of an emergency that puts their life or health at risk;
3) the close contact is a health care professional who is performing urgent
duties by a decision of their employer;
4) the close contact is a person who is performing urgent duties by a decision
of their employer and with advice from the Health Board and without whom the
performance of a task of a state or local authority would be impossible or highly
complicated;
5) if the person referred to in sub-clause 4) is a person ensuring
the continuity of a vital service, they may perform urgent duties only by a
decision of their employer and on the latter’s proposal justified in writing
and with the approval of an authority or local authority referred to in § 36
of the Emergency Act and with advice from the Health Board;
6) the close contact is getting the everyday essentials near their place
of residence or place of stay because it is otherwise impossible;
7) any and all contact between the close contact and an infected person
who is living in the same place of residence or staying in the same place of
stay is excluded;
8) the close contact is outdoors and completely avoids any contact with
other persons.
5. The
provisions of clauses 3 and 4 do not apply to a close contact who:
1) has suffered from COVID-19 and has been declared healthy by a physician
and no more than six months have passed since the person was declared healthy
(hereinafter recovered person);
2) has completed their vaccination series for COVID-19, has developed full
protection after the last dose of vaccine and no more than one year has passed
since (hereinafter vaccinated person);
3) is considered equal to a vaccinated person (hereinafter person
considered equal to a vaccinated person). A person considered equal to a
vaccinated person is deemed to be a person who has been given one dose of vaccine
after recovering from COVID-19, has developed full protection after the dose
of vaccine and no more than one year has passed since, or who has contracted
COVID-19 after the first dose of vaccine and no more than one year has passed
since the person was declared healthy by a physician. If a person contracts
COVID-19 within 14 calendar days after the first dose of vaccine, the person
will be subject to the provisions of sub-clause 1) applicable to recovered
persons.
6. The
time when the full protection referred to in clause 5 is developed is,
according to the manufacturers, 7 calendar days after the second dose of
vaccine for Pfizer/BioNTech Vaccine Comirnaty, 15 calendar days after the
second dose of vaccine for AstraZeneca Vaccine Vaxzevria, 14 calendar days
after the second dose of vaccine for Moderna COVID-19 Vaccine, and
14 calendar days after one dose of vaccine for Janssen COVID-19 Vaccine.
For other COVID-19 vaccines not mentioned in this clause, the specific
manufacturer’s instructions for full protection shall be followed. Full
protection for recovered persons vaccinated with one dose is deemed to have
been developed at the times stated in this clause.
7. The
provisions of clauses 4 and 5 are applied if during the 10-calendar-day
period referred to in clause 3 close contacts:
1) wear a protective mask or cover their mouth and nose (hereinafter mask)
in indoor settings where they come into contact with persons with whom they
are not permanently staying in the same place of residence or place of stay.
A mask need not be worn by children under 12 years of age and in cases
when wearing a mask is not possible for health reasons, due to the nature of
work or other activities or for other significant reasons;
2) they carefully monitor
their health, they show no symptoms of the disease and they comply with
measures imposed by the Government of the Republic or the Health Board for
preventing the possible spread of the communicable disease and take all
possible measures for preventing the spread of the communicable disease.
8. The
rights and obligations provided for in this Order also apply to persons who are
close contacts at the time this Order takes effect or who have recovered from
COVID-19 or have been vaccinated before the entry into force of this Order.
9. The
time of development of full protection for persons vaccinated before the entry
into force of this Order or persons considered equal to vaccinated persons is
calculated according to clauses 5 and 6.
10. In
the events described in sub-clause 3) of clause 5 before the entry
into force of this Order a person is deemed to be a person considered equal to
a vaccinated person for the purposes of this Order.
11. Supervision
over the requirements imposed by this Order is exercised by the Health Board,
involving the Police and Border Guard Board by way of professional assistance
or in another manner provided by law, where necessary.
12. The
restrictions and measures established by this Order shall apply until the date
specified in this Order or until this Order is changed or repealed under
§ 53 (1) 4) and (2) 3) and § 66 (2) 1) of
the Administrative Procedure Act.
13. This
Order takes effect on 1 June 2021 and remains in effect through
31 December 2021.
14. This
Order shall be published in the official gazette Riigi Teataja and on the
website kriis.ee.
For the
protection of the life and health of people and overriding public interest,
this Order imposes quarantine requirements for preventing the spread of the
coronavirus SARS-CoV-2 causing COVID-19.
Quarantine
has been applied since the emergency situation from 26 March 2020. After
the end of the emergency situation the Government of the Republic imposed a
quarantine on persons diagnosed with COVID-19 and on persons close to them from
18 May 2020 until 1 July 2020. Government of the Republic Order
No. 257 “Imposition of quarantine on persons diagnosed with the COVID-19
disease caused by the coronavirus SARS-CoV-2 and on persons living with or
permanently staying in the same place of residence as them and on persons who
have otherwise had close contact with a person diagnosed with the disease” of
16 July 2020 was in effect from 16 July 2020 through 30 September
2020. Government of the Republic Order No. 336 “Imposition of quarantine
on persons diagnosed with the COVID-19 disease caused by the coronavirus
SARS-CoV-2 and on persons living with or permanently staying in the same place
of residence as them and on persons who have otherwise had close contact with a
person diagnosed with the disease” of 29 September 2020 was in effect from
1 October 2020 through 31 December 2020. Government
of the Republic Order No. 455 “Imposition of quarantine on persons
diagnosed with the COVID-19 disease caused by the coronavirus SARS-CoV-2 and on
persons living with or permanently staying in the same place of residence as
them and on persons who have otherwise had close contact with a person
diagnosed with the disease” of 17 December 2020 was in effect from
1 January 2021 through 1 February 2021. Government of the Republic
Order No. 47 “Imposition of quarantine on persons diagnosed with the
COVID-19 disease caused by the coronavirus SARS-CoV-2 and on persons living
with or permanently staying in the same place of residence as them and on
persons who have otherwise had close contact with a person diagnosed with the
disease” of 30 January 2021 is in effect from 1 February 2021 through
31 May 2021.
This
Order extends the requirements for quarantine and imposes restrictions and
measures for a another period of time starting from 1 June 2021.
Under
§ 27 (5) of the Communicable Diseases Prevention and Control Act,
quarantine shall be terminated after the spread of the communicable disease has
been prevented, the requirements for the control of the communicable disease
have been fulfilled and the focus of the disease has been rendered harmless. As
the virus is highly contagious the Science Council advising the Government of
the Republic has recommended permanently imposing the quarantine requirement on
persons suffering from the disease and on persons who have had close contact
with them for the purpose of preventing the spread of the infection. Therefore
the Government of the Republic has sought to keep the quarantine requirements
in effect. Considering the number of persons infected, the rate at which the
disease spreads, the possible serious nature of the disease and the fact that
as of 17 May 2021 vaccination against COVID-19 has been available to the
entire population of Estonia but providing vaccines for all still depends on
the quantities of vaccines arriving in Estonia and there is still no
disease-specific effective treatment, it is necessary to extend the
restrictions. On 25 May 2021, 160 new tests came back positive in
24 hours. According to the population register the most new positive tests
were recorded in Harju County and Ida-Viru County where 81 and 30 persons,
respectively, were diagnosed with the coronavirus (the morbidity rate per
100,000 inhabitants is 207.3 and 550.4, respectively). The Estonian
morbidity rate per 100,000 inhabitants for the past 14 days is 236.1.
189 people have been hospitalised, 25 of them are in intensive care
and 13 of the latter are on mechanical ventilation. 3138 infected
persons were recorded within the past 14 days. Although the infection
rates and the workload of hospitals has somewhat decreased, the spread of the
infection has not been stopped and not applying restrictions may result in increased
spread of the infection and higher workload of hospitals.
Under
§ 34 of the Constitution of the Republic of Estonia (hereinafter the Constitution),
everyone whose presence in Estonian territory is lawful has the right to move
freely in that territory and to choose freely where to reside. The right to
freedom of movement may be circumscribed in the cases and pursuant to a
procedure which is provided by law to protect the rights and freedoms of
others, in the interests of national defence, in the case of a natural disaster
or a catastrophe, to prevent the spread of an infectious disease, to protect
the natural environment, to ensure that a minor or a person of unsound mind
does not remain unsupervised, or to ensure the proper conduct of a criminal
case. Under § 27 (3) of the Communicable Diseases Prevention and
Control Act, if the establishment of quarantine is accompanied with a
significant effect on the society or economy, the quarantine shall be
established by an order of the Government of the Republic. The purpose of the
quarantine imposed by this Order is to prevent and stop the further spread of
COVID-19 caused by the coronavirus SARS-CoV-2.
Under
§ 2 (2) of the Communicable Diseases Prevention and Control Act,
COVID-19 corresponds to the signs of a dangerous novel communicable disease
because COVID-19 is a disease with a high level of infectiousness which spreads
rapidly and extensively and which may be serious or life threatening and
currently there is also no effective treatment for COVID-19 and explosive intensification
of the spread of the disease may result in a situation where the number of
patients who need to be hospitalised exceeds the hospital treatment capacity.
The quarantine is necessary for the protection of the life and health of people
and overriding public interest in order to prevent and stop the spread of the
virus causing COVID-19. The quarantine imposed by this Order is necessary
for containing disease clusters and for slowing the spread of the disease down.
Quarantine
is imposed on persons diagnosed with COVID-19 and on persons living with or
permanently staying in the same place of residence or place of stay as
diagnosed persons and on persons who have otherwise had close contact with a
person suffering from the disease. As a new requirement, a
person tested with a SARS-CoV-2 RT-PCR or SARS-CoV-2 antigen RTD test by a
health care provider, if the test results are positive, is also required to be
quarantined. This quarantine requirement is justified because the virus
spreads fast and may cause great damage to health and without effective
application of the restrictions the slightest focus of the disease may lead to
extensive spread of the disease and weigh heavily on the healthcare system.
Exceptions are made for asymptomatic persons in quarantine and in justified
cases they may leave home. Exceptions may be made for close contacts provided
they carefully monitor their health, comply with measures imposed by the
Government of the Republic or the Health Board for preventing the possible
spread of the communicable disease and take all possible measures for
preventing the spread of the communicable disease. So the freedom of movement of
asymptomatic persons is not excessively restricted.
Although
studies on post-vaccination immunity are still on-going and any data is
preliminary, the Expert Committee on Immunoprofylactics at the Ministry of
Social Affairs has, by relying on available information, found that there is no
reason to believe that post-vaccination immunity would be reduced during at
least 6 to 8 months after the completion of the vaccination series1, and it will presumably last
even longer. The precise duration of post-vaccination immunity and the precise
time when re-vaccination becomes necessary due to reduced immunity is not known
because the studies are still on-going and more and more data becomes available.
It must also be considered that currently there is also not enough information
about how effective the protection provided by COVID-19 vaccines that hold a
marketing authorisation in the European Union currently is against new strains
of the virus, but there are studies being conducted. When new strains emerge it
may turn out that vaccines that have been granted a marketing authorisation in
the European Union do not provide sufficient protection against them and even
those who have already completed their vaccination series must be
re-vaccinated. As new data becomes available, release from quarantine and the
appropriateness thereof shall be reviewed.
Clause 5
of the Order sets out that close contacts who have recovered from the disease
or who have been vaccinated or who are considered equal to vaccinated persons
are subject to release from quarantine during the period of time provided by
the Order.
According
to available data, post-recovery immunity lasts for at least 6 months2,3,4,5. However, according to the
Expert Committee on Immunoprofylactics and available information, this may
depend on the severity of COVID-19. For ensuring subsequent adequate
protection, the Expert Committee on Immunoprofylactics recommends vaccinating
recovered persons with one dose at six months after recovery. According to the
European Centre for Disease Prevention and Control (ECDC)6, preliminary information shows
that naturally developed immunity reduces over time and may not last long.
However, available data shows that contracting the disease again within six
months after recovery happens in rare cases. But having recovered from the
disease may not protect against new strains.
This
Order set out release from quarantine for one year for persons who have
completed their vaccination series for COVID-19, have developed full protection
after their last dose of vaccine and no more than one year has passed since
that time. A person is deemed to have completed their vaccination series:
1) after the administration of the second dose of vaccine for two-dose
vaccines; 2) after the administration of one dose of vaccine for one-dose
vaccines. Release from quarantine does not arise immediately after completion
of the vaccination series but after the passing of the time required for the
development of full protection. Full protection is developed after different
periods of time for different vaccines.
One year
is estimated to be an optimum period of time during which data about the
duration of immunity and need for re-vaccination, including against new
strains, should become available. Since it is impossible to predict the precise
time when such data will become available and when possible new strains will
emerge, there is a chance that the one-year release from quarantine must be
either prolonged or shortened at some point. Consequently, the Order contains a
clause 12 that allows the conditions of the Order to be changed if
justified by the epidemiological situation.
Vaccination
against COVID-19 in Estonia started on 27 December 2020 using the
Pfizer/BioNTech Vaccine Comirnaty (as per week 21 of 2021, Estonia has
received 470,340 doses). As per week 21 of 2021, Estonia has received
82,800 doses of the Moderna COVID-19 Vaccine, 252,000 doses of the
AstraZeneca Vaccine Vaxzevria and 19,600 doses of the Janssen COVID-19
Vaccine. On 25 May 2021, there were 442,089 persons in Estonia who
had had at least one dose of vaccine and 226,105 persons had completed
their vaccination series.
A person
considered equal to a vaccinated person is deemed to be a person who has been
given one dose of vaccine after recovering from COVID-19, has developed full
protection after the last dose of vaccine and no more than one year has passed
since the development of full protection after the dose of vaccine, or who has
contracted COVID-19 after the first dose of vaccine and no more than one year
has passed since the person was declared healthy by a physician. Should a
person be infected within 14 calendar days after the first dose of
vaccine, they will be regarded as recovered and they will be subject to the
provisions concerning recovered persons.
Information
about the vaccine used, the date of administration of the last dose of vaccine
and so on is entered on immunisation certificate but the latter does not
reflect the time when full protection is reached, which is calculated from the
day of completion of the vaccination series and the duration of which depends
on the time specified in the summary of product characteristic of the specific
vaccine.
Despite
the specifications set out in the Order it is necessary for close
contacts to carefully monitor their health, comply with measures imposed by the
Government of the Republic and the Health Board for preventing the possible
spread of the communicable disease and take all other possible measures for
preventing the spread of the communicable disease. It is as important for close
contacts to wear a protective mask or otherwise cover their nose and mouth
indoors (for example, in public indoor spaces, at work, in administrative
agencies or educational institutions, and sports and leisure facilities and so
on) where they come into contact with people with whom they do not share a
place of residence, for the purpose of preventing the potential spread of the
virus (except in the special cases referred to in the Order).
Therefore, for 10 calendar days, close
contacts who are released from the restriction are still required to
wear a mask or other protective equipment in places specified in the Order.
Said requirement does not apply to children under 12 years of age and in
cases when wearing a mask is not possible for health reasons, due to the nature
of work or other activities or for other significant reasons.
The
implementing provision of the Order is necessary to specify how are the
provisions of the Order applied to persons who are close contacts at the time
this Order takes effect or who have recovered from COVID-19 or have been
vaccinated before the entry into force of this Order.
Imposing
quarantine on infected persons and persons suspected of having been infected
ensures the protection of the health of persons in risk groups, including
persons suffering from chronic diseases, persons with a weak immune system and
the elderly. According to §§ 16 and 28 of the Constitution, the state
shall ensure the protection of the life and health of people but people
themselves also play an important role – they must look out for the health of
their family and colleagues as well as the weaker groups of society and the
public as a whole.
Since
§ 27 (3) of the Communicable Diseases Prevention and Control Act
requires that in the event of a quarantine the term of quarantine shall be set
out and a quarantine cannot be established without a term, it was planned upon
the issue of this Order that the Order will remain in
effect through 31 December 2021. The date was chosen due to the fact that
by 31 December 2021 more or less a year will have passed since the
beginning of vaccination in Estonia and by that time enough reliable studies
will presumably have been published to clarify the need for re-vaccination and
the duration of immunity after vaccination and recovery as well as the efficacy
against new strains.
Failure
to duly comply with measures for preventing the spread of the communicable
disease will prompt the application of the administrative coercive measures set
out in § 28 (2) or (3) of the Law Enforcement Act. According to
§ 23 (4) of the Law Enforcement Act, the amount of penalty payment is
9600 euros. This penalty payment, which serves the purpose of enforcing
the requirements, measures and restrictions imposed by this Order and
preventing the spread of a communicable disease, may be imposed repeatedly.
This
Order can be appealed against by filing a challenge with the Government of the
Republic pursuant to the procedure provided by the Administrative Procedure Act
within 30 days as of the day the relevant person became or should have
become aware of the Order. This Order can also be appealed against by filing an
action with the administrative court pursuant to the procedure provided for in
the Code of Administrative Court Procedure within 30 days as of the day of
announcement of this Order.
The
explanatory memorandum to the Order is available on the website kriis.ee.
1 https://www.nejm.org/doi/full/10.1056/NEJMc2103916
2 https://science.sciencemag.org/content/371/6529/eabf4063
3 https://www.gavi.org/vaccineswork/natural-immunity-covid-19-may-be-long-lasting?gclid=EAIaIQobChMI0MaQ7uGR8AIVBHYYCh1mDAihEAAYAiAAEgJFYPD_BwE
4 https://science.sciencemag.org/content/371/6529/eabf4063
5 https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3
6 European Centre for Disease Prevention and Control
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