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On September 28, the city of Oslo introduced a ban on bandages in public transport when it is not possible to stay one meter away. An internal memo shows that the National Institute of Public Health advises against requesting bandages. The memo also shows that NIPH is very skeptical about the effect of bandage use on the population.
In early September, the Norwegian Health Directorate commissioned the Norwegian Institute of Public Health to provide a framework for the use of sanitary napkins in the population. In FHI’s response of September 14, the following is written about the bandage orders:
“The use of sanitary pads in the population should take the form of advice and not orders.”
Advises court orders
Chief physician Preben Aavitsland of the National Institute of Public Health tells Dagbladet that they believe face masks should be introduced as advice.
– We believe the same as always: we believe that the local introduction of the use of bandages in certain situations should be done as advice to the population, says Aavitsland to Dagbladet.
On September 23, Aavitsland told Dagbladet that, in principle, FHI is not against a court order.
– We believe, in principle, that municipalities should still be able to decide on local measures, possibly as a court order, says Aavitsland and refers to the manual of the National Institute of Public Health for municipal doctors.
FHI is all about bandages
Very skeptical
The internal memorandum states that the National Institute of Public Health is very skeptical about the effect of ordering bandages in the current infection situation. In fact, they believe that “with the current epidemiological situation, the general disadvantages of the measure may outweigh the benefits.”
“There is evidence that medical masks may have a protective effect against the spread of respiratory infections in society, but the results vary. Randomized studies conducted outside health institutions indicate that masks have a small protective effect,” he writes. FHI and continues:
“Given the low prevalence of covid-19 at this time, and although bandages are believed to be effective, the difference in infection rate between wearing face masks or not will be small. Assuming 20 percent of infectious people with SARS-CoV-2 they have no symptoms, and we also assume a risk reduction of 40 percent when using face masks, so 200,000 people must use face masks per week to prevent a new case in the current one. The epidemiological situation “, continues FHI and concludes:
Therefore, there is great uncertainty about the effect of the measure and, with the current epidemiological situation, the general disadvantages of the measure may outweigh the benefits. Although the measure may be helpful, there is no requirement to wear a mask as a helpful after a general assessment. “
Arguments
The National Institute of Public Health also writes that publications show that greater compliance with bandaging advice is obtained if it is a court order. For example, compliance of road users on buses and the subway in Oslo improved significantly when the recommendations were made mandatory, according to the latest risk assessment.
“It cannot be ruled out that there will be further misuse of sanitary napkins as a result of an order, for example by reusing disposable sanitary napkins due to lack of funds to obtain enough sanitary napkins. Precautionary measures may not perceived as appropriate in the population can lead to action fatigue, “writes FHI in the internal memo and continues:
“One aspect of the precautionary measure is that it should be sanctioned. We believe that in terms of resources, it will be possible to have more effect by developing more and better information, etc., than by using resources to develop a system to enforce court orders on the use of face masks “.
Application
On Thursday, Police Chief Beate Gangås told Dagbladet that the Oslo police will not act as Ruter’s inspectors when enforcing the sanitary napkin order. He said that the police, first and foremost, provide advice and guidance. Often that’s enough, he noted.
– So far, we have not taken punitive measures when it comes to masks, but we will provide advice and guidance first. We can impose fines in certain situations where there are clear violations of the Infection Control Act, Gangås told Dagbladet and continued:
– You must keep one meter away and it can be difficult for the police to assess you At the same time, we hear that Ruter is following closely, so I hope that they will contact us if they record flagrant violations of the Communicable Disease Law, and then we will react and respond. First of all with advice and guidance, and in the worst case with fines.
Airborne infection
The National Institute of Public Health has stated that it agrees with the updated conclusion of the Centers for Disease Control and Prevention (CDC) on covid-19 and airborne infections. The CDC concludes that COVID-19 can be transmitted even if it is kept six feet (1.8 meters) away, but that it is much more common for the disease to spread through a droplet infection between people who have close contact.
Such infection events can occur in closed rooms with insufficient ventilation, when the wearer breathes with difficulty, for example, when singing or exercising.
This strengthens the case for wearing face masks, FHI Director Camilla Stoltenberg admitted to Dagbladet.
– If it does. But at the same time, it is not the case that you find yourself in that kind of situation so often. It is common to find yourself in situations where droplet infection predominates. We also believe that droplet infection is the dominant mode of transmission in the events we have had.
