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Health director Bjørn Guldvog had long understood that it might be necessary. At the same time, health leaders had to find the right moment. The shoots increased in scope. The incidence of covert infection increased. It was the right moment.
– It was a race. We tried to clarify various issues with the National Institute of Public Health as much as possible, at the same time that we saw that we had different approaches to some of the questions. Depending on the situation, we thought it was better to present it and rather take the processes that come later.
On Friday, October 23 at 3:30 p.m., the National Institute of Public Health received a commission from the Ministry of Health and Care Services to recommend the national measures that were necessary to reduce the risk of contagion. Already on Sunday October 25 at 10 a.m., the Norwegian Health Directorate had to present its evaluations to the ministry. The deadline was so tight that it broke within an hour.
– It is terribly exhausting, but it is necessary. In a way, that is what we are trained for, and that is why society wants us to have these jobs, that we must take whatever blow may come.
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Shelf in the castle
Guldvog meets Dagbladet in a living room on the premises of the Norwegian Health Directorate in Oslo. He is tall. 190 centimeters. And soft. He continues to smile despite a serious daily life.
Earlier that day he had been to the castle. There, Crown Prince Haakon and Queen Sonja praised him, the other health leaders and the entire Norwegian health service for their power of action and difficult decisions during the pandemic.
– In fact, I took this here, because I thought that it is not so often that he has lunch in the castle, says Guldvog and takes a note from his pocket in his suit jacket.
– It was potatoes with salmon rilette, cucumber and fennel salad. And it was carrot cake with mascarpone and ginger. So it was an unusual lunch for me.
Around the table were, among others, Health Minister Bent Høie, Director Camilla Stoltenberg of the National Institute of Public Health, Director John-Arne Røttingen of the Research Council and Ministerial Advisor Bjørn-Inge Larsen.
The latter also hangs on the wall behind Guldvog along with his other predecessors. None of them had to deal with a crisis like this as health director.
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Helga
Guldvog does not have an overview of how much work time he left behind that weekend when the new national measures were designed. He only knows that he was not in the premises of the Norwegian Health Directorate for more than five hours on Saturday. At home, the work continued. He sent documents and read emails throughout the night.
On Sunday morning, the first meeting started at 07:30. Then the crisis committee met at 08:30. Then, the Norwegian Health Directorate had a clarification meeting with the National Institute of Public Health at 0930 hours. Between these meetings, clarification meetings were also held with the Ministry of Health and Care Services. An hour after the deadline, the Norwegian Health Directorate submitted its assessments.
– It felt good to receive the evaluations. We were confident that both FHI and the Norwegian Health Directorate provided good information, with generally good evaluations. Knowing that we could have sent a more unanimous message if we had had more time. We didn’t get that far.
The Norwegian Health Directorate proposed strengthened measures in the red zones in Norway. That is, in living and working regions where municipalities over time have been at a level of contagion with more than 20 infected per 100,000 inhabitants in the last 14 days. The Norwegian Institute of Public Health thought this was inappropriate and the government decided to ignore it.
The Norwegian Health Directorate also proposed introducing a measure of a maximum of five guests in addition to household members in municipalities with high levels of infection. NIPH proposed a maximum of ten people in private meetings. The Government and Prime Minister Erna Solberg ended up presenting the proposal of the Norwegian Health Directorate at the national level.
Collaboration
Disagreements related to work with the new measures were posted on the front page of Dagbladet’s newspaper. The image was split in two with Guldvog on one side and Stoltenberg on the other.
– I think it’s a bit boring. Clearly, it can be difficult to get two large organizations, which have slightly different roles, to keep up in all situations. Nor is it a goal. The reality is that Camilla Stoltenberg and I have a very good and trustworthy collaboration. We agree that we must be open about the situation where it is also difficult to reach full agreement.
– What does it take to frustrate you?
– I can get frustrated. And I can get stressed. And I can get mad. But it is rare that it lasts long. It’s like being on any team: if you want to win, all the players have to be good. My goal is to make everyone good at this collaboration.
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The desagree
On the corresponding Sunday night, Guldvog and Stoltenberg presented the solutions they had come up with to the government. Among other things, Guldvog acknowledges that they and the National Institute of Public Health had the most different views, namely the three advice proposals from the Norwegian Health Directorate related to quarantine. The government sent them home to discuss this further, which resulted in the new government council.
Originally, the Norwegian Health Directorate proposed, among other things, that household members of a quarantined person should refrain from social activities and participate in leisure events for ten days.
They also suggested that household members of a person with corona symptoms should refrain from doing so, pending their test results.
– These are areas on which we have received feedback from the health service that are difficult to practice. We wanted to assess if there was any better advice related to this, says Guldvog and continues:
– We had to discuss this based on the professional understanding of FHI infection control and, at the same time, promote the situation to general practitioners, pediatricians and infectious disease physicians, who should take a position on it.
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Responsibility
This time it was different from March 12. Now the government is responsible for making the decisions. In March, an acute crisis situation was considered where the Norwegian Health Directorate made the decisions on behalf of the government and society.
– What do you think of your own responsibility?
Guldvog chews the answer.
– I feel that responsibility. And it is incredibly important to me that when I have that responsibility, I must also always be sure that I deserve it.
Guldvog looks down. Chewing the answer a little more. The words are deeper.
– I think the most important thing to deserve it is to be very honest with the assessments we make, and try to have the shortest possible agenda, which goes beyond treating this situation well for the population and the country. .
