Updates on coronavirus in Norway

coronavirus

Guidelines from the Norwegian Institute of Public Health and Directorate of Health. For information in both Norwegian and English, visit www.helsenorge.no/coronavirus

We know many of readers of The Norwegian American are concerned about the status of the novel coronavirus in Norway, whether out of care for relatives, friends, or loved ones, or due to planned travel to Norwegian destinations. While we cannot offer official advice or recommendations, we can provide online updates on the status of the virus in Norway and how the country is handling the ongoing outbreak, as well as helpful links to general information about the virus. We will do our best to update this page daily, Monday to Friday, until further notice.

Daily update from the Norwegian Institute of Public Health:

March 29, 2020
Note: NPHI totals are now reflecting information from the MSIS (the national reporting system for infections diseases) instead of the outbreak register. The situation is constantly changing, so the data is provisional.

There is a total of 4,102 cases of infection reported to the MSIS in Norway as of 11:59 p.m., March 28.

Highlights from the daily report
-A total of 22 deaths have been reported as of Mar. 29, 9 a.m. (Oslo time). The average age of the dead is 84 (ranging from age 62 to 95).
-317 patients are hospitalized as of March 29, 12:15 p.m. (Oslo time), according to data from the Directory of Health.
-There is a total of 139 people who have been admitted to intensive care with confirmed COVID-19; of these, 94 are still in intensive care.
-The average age of these 139 intensive cases is 60; 76% are men. The age breakdown of confirmed cases in intensive care is as follows: 0-39 years: 11; 40-59 years: 53; 60-79 years: 68; 80 years or older: 7 (data from the Norwegian intensive register as of March 29, 9 a.m. Oslo time).
-A total of 85,136 cases are reported to have been tested for coronavirus (SARS-CoV-2) as of Mar. 28, 3 p.m. (Oslo time). About 4% of those tested are infected.

Message from the Institute of Public Health, March 27: “Not on a collision course”
In the VG commentary “Government on a collision course with experts,” Astrid Meland at VG depicts the way politicians have acted against the advice of experts. Both the Institute of Public Health and the Directory of Health disagree with this assessment.

We stand behind the government’s decisions about measures and the objective of shutting down the spread of the virus as much as possible. It was necessary to put in place the comprehensive measures of March 12 and it is necessary to continue measures at the same level until April 14.

Meland is entirely correct in that there are diverse perceptions among both laypeople and experts about how this crisis should be handled. This is true both in Norway and internationally. In part, this is due to the fact that this is a crisis that we have far too little knowledge about. But that does not mean that we disagree about what is currently being done.

The challenge we face is extraordinary. None of us has experienced anything resembling this before. Whatever decisions are made, they will be open to criticism, presumably with some legitimacy. There are no simple solutions. All solutions will come at great cost and all will include great risk. The only thing we are totally certain of is that we must act now—and continually develop new knowledge and methods for dealing with the epidemic.

The package of measures the government has now put in place has support in our organizations and in the wider healthcare system. The goal of shutting down the spread of the virus is the right one at this time. If that will still be the case in a number of weeks, no one can say. If we manage to shut down the epidemic, it will be necessary to change the strategy. Over time, as we gain more knowledge, it can also be necessary to shift our way forward. But right now it is most important to shut down the spread of the infection in order to gain time. More time puts us in the best position to allow the healthcare system to build greater capacity and give better treatment and care to all patients.

As expert organizations, both the Institute of Public Health and the Directory of Health will continue to give politicians the best guidance about preventing infection and caring for patients as possible. Our research and guidance reveals disciplinary dilemmas in the basis for making decisions in the government. That occurs in the open. Openness and transparency make cooperation and learning possible and provides the basis for trust.

In the next days and weeks, we will gain more knowledge of the effects of the measures we’ve taken. We will also gain more knowledge of the ripple-effects of these measures in other areas of society. So it is the task of politicians to weigh all considerations, including those that don’t directly concern protection against infection or the healthcare system, and decide how we can best protect life and health, the people, and the society. This is how it must be in a democracy. These are our roles.

Bjørn Guldvog, Director General of the Directorate of Health
Camilla Stoltenberg, Director of the Norwegian Institute of Public Health

 

The Norwegian Institute of Public Health’s fourth risk assessment for COVID-1 (from March 24)
“The Institute of Public Health recommends that the selection of a strategy for the further development should be delayed one to three weeks. In this period, one can, among other things, get a getter basis for evaluation, especially knowledge of the effect of the actions taken from Mar. 12,” said the Institute’s director, Camilla Stoltenberg.

In the immediate weeks, it is vital to gain time and fight the epidemic with actions that can significantly reduce the spread of the virus.

“Clear goal-setting is important for the strategy. A central premise is that there must be high enough herd immunity that can give lasting protection against new, large outbreaks. This is achieved when enough people are infected or with the help of a vaccine,” said Stoltenberg. “The selection of a strategies and actions is done in a context of great uncertainty, and there is a need to get more and better knowledge as quickly and effectively.”

Grounds for the risk assessment
The Norwegian Institute of Public Health is working to understand the situation and give prognoses for the epidemic’s development in Norway. In order to do so, the Institute uses a mathematical model together with data from the real world, primarily hospitalizations.

The Institute presents today the first estimates for the total infected in Norway with projections of the total infected, the need for hospitalization and intensive care for the coming three weeks. Thereby, we can also make the first estimates of the unknown cases in Norway.

There are still great uncertainties, and the prognoses can be changed next week. Over time, as the epidemic advances, the NIPH will have better data that can be incorporated into the model, and the Institute will adjust the model. The assumptions that form the basis of this assessment are:
-A collective mortality rate among the infected of under 1%.
-Strong age-dependent lethality; 90% of the deaths are patients over 70 years old.
-Altogether, 1% of all the infected will need hospitalization and one fourth of these will need mechanical breathing assistance.
-The actions need to be adapted so that we get an RE—that is, a count of how many an infected person infects—down to or perhaps below 1%.
-Depending on the strategy selected and the effect of our actions, we can account for between 5% and 50% of the population becoming infected in the course of the epidemic.

NIPH’s recommended strategy
It is clear that the actions required to decrease the total infections is necessary. The selection of a strategy and actions is difficult and must be done under great uncertainty. There are no simple solutions, and all strategies are experiments. Decisions with potentially large ripple-effects must be made with uncertainty, regardless of who makes them.

NIPH recommends that the selection of a strategy for the further development should be delayed one to three weeks. In this period, we can acquire better grounds for the decision, especially knowledge of the effect of our measures from Mar. 12 onward.

The Institute will further develop new tools for optimizing testing, isolation, infection-tracing, and quarantine. This work is fully underway, and will continue with great haste. In this period, the burden of the measures taken can also be analyzed—that is, the negative ripple-effects of the actions in society, businesses, groups of the sick and individuals, including consequences on life and health. This period will also allow us to build better capacity in the healthcare system.

Helpful links:

Norwegian Institute of Public Health
Coronavirus disease – advice and information
Travel advice

VisitNorway.com
Coronavirus and traveling to Norway

FjordNorway.com
Coronavirus and traveling to Norway

World Health Organization
Information and guidance regarding COVID-19

U.S. Centers for Disease Control and Prevention
Information page on COVID-19

Johns Hopkins University
Coronavirus resource center

Updated by the The Norwegian American staff.