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Europe Versus Coronavirus - Estonia, Digital Technology in Action

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19/05/2020

Europe Versus Coronavirus - Estonia, Digital Technology in Action

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Europe Versus Coronavirus - Estonia, Digital Technology in Action

Author

Morgan Guérin

Fellow - Europe, Defence

Timeline

February 27 : First Coronavirus case detected in the country.
March 12: The government declares a state of emergency until May 1.
March 13: Launch of an online hackathon called “Hack the crisis”.
March 17: Borders are closed to foreign nationals. Estonians and residence permit holders who return to Estonian territory must now quarantine for two weeks.
March 19: The government announces a €2 billion economic stimulus plan.
March 23: The government introduces a chatbot named Suve which is embedded on the websites of several government institutions and designed to answer citizens’ questions about the epidemic.
March 25: First death of a coronavirus patient.
March 27: Reinforcement of social distancing measures and introduction of the "2 + 2" rule (two people maximum and at least two metres away from other people).
April 2: The country reaches its peak of new daily infections after identifying 93 new infected patients.
April 4: The country now has more than 1,000 cases of infection.
April 22: The government approves the crisis exit strategy and submits it to Parliament

Analysis

“In Estonia, all public services are available online; the only act you have to do in person is get married”, as Kersti Kaljulaid, president of the Republic of Estonia, explains in an interview to the Harvard Business Review on April 20.

Estonia remains relatively unaffected by the Covid-19 epidemic that has severely affected the major Western European States. As of May 4, only 1,700 people had been infected and 55 deaths were reported, for a rate of 1,255.9 per million inhabitants, compared with 3,367.26 for Italy, 4,564.99 for Spain and 1,967.75 for France. However, these numbers should be viewed with caution, as they are highly dependent on the number of tests carried out.

With a gross domestic product of 30 billion euros in 2018 (World Bank), the country experienced a growth of 4.8% (OECD) in the same year and a public debt of 12.7% of GDP, the lowest in the eurozone. In 2018, the Estonian government was spending 4.9% of its GDP on public health care, compared to 9.2% in Japan, 9.5% in Germany, 9.3% in France and 6.5% in Italy.

Again according to the OECD, the country had 4.7 hospital beds per 1,000 inhabitants in 2017, with the same ratio of 13.1 in Japan, 8 in Germany, 6 in France and 3.2 in Italy. There has generally been a steady improvement in the level of health of the Estonian population since 1991: in 2015, life expectancy in Estonia was 78 years, which is close to the average of 80.6 years for other EU countries.

Over the last twenty years, the young Estonian state has shown an impressive level of maturity in its administration in terms of its use of digital tools. Tallinn has become an important center of technological innovation in just a few decades. Thanks to Bolt and Skype, the country has become a hub for many start-ups with global importance, valued at well over one billion dollars.

The outbreak of the epidemic

On February 27, the first case of coronavirus was identified on Estonian territory, an Iranian national traveling by bus from Riga, the Latvian capital.

At the beginning of March, the island of Saaremaa, located west of the Baltic coast, became the epicenter of the epidemic in the country. On March 4 and 5, the Milan volleyball team stayed on the island for a sporting event. More than two hundred cases were recorded in the following days, notably among the spectators and their relatives. On March 12, the government declared a state of emergency for the whole country and banned non-residents from going to the island, which has only 147 hospital beds for its population of 36,000. In response to the health situation in Saaremaa, the authorities decided to set up a military hospital, to organize the transfer of some patients to the mainland, and to increase testing. This included drive-through testing, a method which allows people to be tested while remaining in their cars.

The Government’s Response

Throughout Estonia, emergency measures were comparable to those taken elsewhere in Europe. Citizens were asked to stay at home and were only allowed to go out to work, or to buy food or medicine. Public events were banned and museums and cinemas remained closed. In shops permitted to remain open - food shops, pharmacies, telecommunication companies, and banks - as well as in the street, citizens were asked to respect the "2 + 2" rule, limiting travel to groups of no more than two people and imposing a distance of two meters separating them from others. This rule did not apply to families. Schools and higher education establishments - with the exception of nursery schools - closed starting March 16, with continued educational activity via remote learning arrangements.

Starting March 17, health checks were organised at the borders to identify the infected. Every person entering the country was required to fill in a questionnaire to specify the reasons for their stay and declare where they would be staying. Daily ferry trips between Tallinn and Helsinki, economically important cities, were prohibited.

If the question of masks and screening methods have, like elsewhere, been the subject of much debate, it is the role of digital tools that is at the heart of Estonia's singular response to this unprecedented crisis.

In mid-March the Estonian press reported on the difficulties companies had in obtaining mask supplies on the market, and a price increase of more than 1,000%. On March 22, the Health Board, the national health agency under the Ministry of Social Affairs, announced the imminent arrival of deliveries and explained the difficulties facing the country. For Merike Jürilo, the agency's director general, these difficulties stemmed in particular from German restrictions on the export of masks and Chinese production being halted. At the same time, the country's police authorities indicated that there was a possibility of a shortage of masks for its officers.

By the end of March and throughout April, millions of masks were being delivered from Asia and Russia, while the country's manufacturers were simultaneously increasing their own production capacity. On April 15, Prime Minister Jüri Ratas announced the shipment of 60,000 masks to Spain and Italy in response to the two countries’ request for assistance from their European partners. Less than a week later, it was Taiwan's turn to offer 80,000 masks to Estonia...

Estonia has been one of the most active countries in Europe in terms of testing. With 41.62 tests carried out per 1,000 inhabitants, they were far ahead of France (11.1), Spain (28.9), Germany (30.4) and Italy (34.88). While it seems that Estonia’s small population partly explains their success, it is also important to take the government's proactive approach into account. As early as April 6, the country's health authorities indicated that they wanted to screen symptomatic as well as asymptomatic people. This was in order to have a better understanding of the evolution of the epidemic between the different countries and of the rates of prevalence of the virus within the total population. Tests have been therefore conducted randomly and reported on a weekly basis.

If the question of masks and screening methods have, like elsewhere, been the subject of much debate, it is the role of digital tools that is at the heart of Estonia's singular response to this unprecedented crisis.

Digital Technology in action

Since the late 1990s, Estonia has been developing initiatives and increasing investment in order to transform its public services and make them digitally accessible to every citizen. In 2016, Wired, the American magazine specialized in new technologies, described Estonia as "the world's most digitally advanced society".

Within hours of the country's declaration of an emergency, the Estonian government announced a major hackathon called "Hack the crisis", to be held entirely online. The event took place March 13-15 and was organized by Accelerate Estonia, an innovation platform launched by the Ministry of Economic Affairs, and Garage48, an Estonian start-up specializing in hackathons.

Its purpose was simple: each participant was invited to share an idea with the community that dealt with one of the issues brought up by the epidemic. The best ideas were to be selected by a jury of experts from the public and private sectors. Five winners would receive €5,000 to help them set up their project. The event was supported by several investment funds that could eventually commit additional funds to a project. In less than 48 hours, there were almost 1,000 participants. Around 30 projects were submitted.

In 2016, Wired, the American magazine specialized in new technologies, described Estonia as "the world's most digitally advanced society".

Since then, around 50 other countries have organised their own hackathons, some of them working directly with the Estonian organizers using the same name, "Hack the crisis". Four initiatives developed during the event have already been implemented in the country.

1. An interactive dashboard to monitor the statistical evolution of the epidemic

A website called KoroonaKaart with an interactive map and a dashboard was launched. It allows any user to follow the evolution of the epidemic. Easy to consult and continuously updated, it offers real-time monitoring of numerous indicators, including the number of confirmed cases (at the national level and by county), the number of tests carried out, as well as the number of deaths. The dashboard, which also exists as an application, has been developed on the Estonian government’s open data platform.

2. The Suve chatbot for responding to citizens' questions

The chatbot, developed at the request of the government, answers the most frequently asked questions about the epidemic, in Estonian and in English. This artificial intelligence service ensures that the information shared by the automatic responses is updated instantaneously and eliminates the need for users to perform searches. From a budgetary standpoint, the chatbot costs less than the multiple call centers that would need to be set up across different departments.

Upon its development, the same chatbot was embedded on many websites: on the government’s site, the emergency page, and the Estonian information site for foreign investors, for example. It allows users to ask questions at any stage of their search and get a comprehensive answer without having to go to another site. Another advantage is that the number of questions that the chatbot can answer is constantly increasing. Unanswered questions - with a priority placed on the most frequently asked - are forwarded to the eeBot team, which works directly with the government's communication department. Each developer has been invited to participate in the improvement of the tool thanks to a website that displays its main technical features.

3. An online questionnaire for the medical self-assessment of users

The Ministry of Social Affairs has created an online questionnaire allowing anyone to make a preliminary assessment of their own medical situation and receive specific advice on the steps to take.

By answering this questionnaire, individuals can also choose to share their information with the government, allowing for improvement of their data and thus for better monitoring of the evolution of the epidemic.

4. The COVID-help platform to organize volunteer care-giving

The Estonian start-up Zelos, a volunteer team management platform created in 2019, has developed a platform called COVID-help, which connects elderly people in need of special assistance with a volunteer.

From a technological point of view, Zelos operates according to the classic Software-as-a-Service (Saas) business model entirely hosted in a cloud. In less than forty-eight hours, the Zelos teams connected the IT system (backend) of their service to a dashboard designed by Trello, a famous online management tool. They then designed an API (Application Programming Interface) which lets each government website or application (frontend) incorporate this service into theirs.

The system developed by Zelos manages the inventory of the requests filed either online or via a specifically-created call center, and organizes the work of the volunteers. An elderly person in need of someone to run errands can thus find a neighbor able to do so. More than 2,000 volunteers throughout Estonia have registered on this platform.

The examples presented here are just a sample of the many digital initiatives launched in recent weeks. In just a few days, the Estonian government also made it possible for every employee to obtain a digital medical certificate so as not to overwhelm doctors’ offices or emergency services. Similarly, a platform has been set up to enable companies hardest hit by the economic crisis to put their employees to work at other companies in need of workers.

The Three Lessons to Learn from Estonia

The Estonian government’s success in implementing efficient digital public services has been well established. Analyzing the Estonian case highlights three lessons.

The first well-known lesson is the need to beginalong-term digital transformation. For any technological solution to work perfectly - no matter how powerful and intelligent it may be - it must fit into a mature digital ecosystem. It also has to have a population who knows and trusts in digital tools, whether they are developers, designers, administrators, or end-users.

The development of information technology in Estonian public administration and society over the last 25 years has been the subject of numerous academic studies and reports. Tallinn, aware of the soft power of its success, has also been increasing its communication in this field, never missing any opportunity to showcase its achievements on the numerous websites of its institutions - some of the information in this article itself is based on it.

In Estonia, tax declarations have been possible online since 2000. The following year the public data management system X-Road, still in production today, was launched. Its architecture has made possible the many initiatives that launch in Estonia every year. In 2002, the digital ID-card system was launched; it gradually became a global authentication system. ID-card has enabled citizens to carry out almost all their administrative acts online. All Estonian public services have gradually been digitized, from medical services to education, e-policing to cadastral databases - with one exception: marriage. More than just the rapid innovations that the country has been able to create since the beginning of the epidemic, it is this efficient and intelligently-designed public information system that explains much of Estonia's health and administrative resilience.
The virtues of the second lesson that the Estonian example inspires are immediately recognized by anyone: the importance of user experience (UX). This notion, employed by all companies wishing to interact with their customers through digital channels, refers to how easily websites, applications, and software can be used, as well as how quickly the information or service they are looking for can be found. Unlike many sites of national governments or international organizations, the vast majority of Estonian government web pages are quite user-friendly. In a digital world where hundreds of millions of sites can be accessed in a matter of seconds, UX is probably the most important factor in how successful a website is, i.e. its adoption by users.

Immediately launching the website, KoroonaKaart, the primary source of data on the evolution of the epidemic, has certainly proven to have many advantages for the Estonian government. Transparency has strengthened the trust between administrations and citizens. The site plays the role of a justice of the peace in the public debate and thus limits the amount of possible controversies. Ultimately, each citizen can follow the precise evolution of infection in their region on a daily basis, adapting travel decisions accordingly. It is not just the publication of this data that makes all this possible, but rather the simplicity of UX, and the ability of each user to utilise the information provided. The same data online on an Excel spreadsheet, on the margins of a complicated website, would have been consulted considerably less, and would therefore be considerably less useful.
The third and final lesson seems so obvious that we are used to hearing about its merits without actually being able to see it: the platform model and the fruitful cooperation between the public and private sectors. Hackathons are probably the best examples of the effectiveness of collaborative models and platforms wherein students, developers, government officials, and business leaders all exchange ideas with one other. By organising an online collective brainstorming event during the very first days of the emergency, the Estonian government avoided long weeks of bureaucratic red tape that could have yielded uncertain results. In just a few hours, several ideas for the common good were identified and a first analysis of their technical and functional feasibility was carried out by the many experts participating in the event. A company like Zelos was thus able to take advantage of the initiative’s media exposure to demonstrate the effectiveness of its solutions and make them useful to everyone.

The demographic factor for a country with only 1.3 million inhabitants partly explains the success of this mode of collaboration. Nonetheless, this type of successful partnership between public authorities and private companies is also the result of long-standing investments in a solid and transparent public data management system. It enjoys a high level of public confidence, as well as a legal and regulatory framework suited to it, and is constantly evolving to respond to each new technology.

Conclusion

These various innovations have not had miraculous effects in and of themselves on the evolution of the epidemic. Faced with the accelerating rate of infection, Estonia, like most other European countries, was forced to impose lockdown measures that were costly to its economy. Nevertheless, these various digital solutions, developed successfully in just a few days, have enabled the public authorities to provide citizens with accurate and continually-updated information, and to resolve new problems, most of them due to lockdown measures. When the epidemic is over, it seems that these digital tools - among other factors - will have let Estonia avoid the lack of organization seen in other countries.

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