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The deadline was broken when the Norwegian National Institute of Public Health and the Norwegian Health Directorate this weekend were to give the Ministry of Health and Care Services their recommendations on new national measures to prevent the spread of infection in Norway.
Internal reports reveal disagreements that developed in the rush to prepare the measures. The Norwegian Institute of Public Health reacted strongly to the Norwegian Health Directorate’s proposal to make areas of Norway red and, apparently, extend quarantine provisions significantly.
But most seriously, the Norwegian Health Directorate and the National Institute of Public Health apparently have a very different understanding of the infection situation in Norway today.
“Therefore, the Norwegian Health Directorate has an assessment of the situation of the pandemic in Norway at the end of October 2020, which deviates somewhat from the assessment of the situation of the Norwegian Institute of Public Health,” it is acknowledged in the Norwegian Health Directorate report to the Ministry of Health and Care Services.
The National Institute of Public Health believes that there is a low probability of further spread of the infection in Norway at the national level and moderately at the regional level. The Norwegian Health Directorate, on the other hand, believes that Norway “with a continued increase in infection in Norway is not necessarily many weeks away from a situation that is more similar to early March.”
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Rush
On Friday at 3:30 p.m., the National Institute of Public Health was commissioned to recommend new specific national measures based on the development of the infection. The deadline was set for Saturday at 12.00. Subsequently, the Norwegian Health Directorate was to prepare its report for the Ministry of Health and Care Services before Sunday at 10 am.
The Norwegian Health Directorate broke the deadline by one hour, according to its response to the Ministry of Health and Care Services.
An hour and 40 minutes later, the National Institute of Public Health sent its response to the Norwegian Health Directorate report. They cautioned that the proposed measures required more thought and processing, and that other measures could have a better effect.
“We believe it would be wise to spend a few days arriving at adequate solutions that the population understands and adheres to,” was the clear message from FHI.
Red zones
The Norwegian Institute of Public Health reacted strongly to the Norwegian Health Directorate’s proposal to the Ministry of Health and Care Services to make areas of Norway red.
This is through the proposal that the government should recommend reinforced measures in the living and working regions where the municipalities over time have been at an infection level of more than 20 infected per 100,000 inhabitants in the last 14 days , and where increased infection pressure is not solely due to known and ongoing outbreaks.
We believe that it would be inappropriate to use an internal figure of 20 infected per 100,000 inhabitants in the last 14 days as a threshold for a “red level” for the living and working regions. This is an interior threshold intended primarily for the land and not for smaller geographic areas. Norway’s living and working regions are too small to use this threshold. In addition, we want much more detailed information in Norway to allow us to better target measures, “wrote the National Institute of Public Health.
Rule five
On Monday, Prime Minister Erna Solberg announced the national initiative for up to five guests in private homes in addition to household members. This is consistent with the proposal of FHI and the Norwegian Health Directorate.
The National Institute of Public Health proposed a recommendation of a maximum of ten people in private meetings, while the Norwegian Health Directorate recommended a measure of a maximum of five guests in addition to household members in municipalities with high levels of infection. The government, on the other hand, decided that the measure should have a national effect.
Quarantine
The Norwegian Institute of Public Health also considered the Norwegian Health Directorate’s proposal for measures to strengthen compliance with current advice and regulations. The National Institute of Public Health warned that this would be a significant extension of the quarantine scheme.
The Norwegian Health Directorate proposed the following three points:
- That after a recent respiratory illness you must be asymptomatic before returning to work and school, regardless of the results of the SARS-CoV-2 test, when it is not just an occasional residual cough that often occurs in the weeks after respiratory illness.
- That members of the household of a quarantined person should refrain from social activities and participate in leisure events for 10 days, even if they are not quarantined themselves.
- That members of the household of a person with new symptoms of covid-19 should refrain from social activities and participate in leisure activities, pending the results of their tests for SARS-CoV-2.
The main concern of the National Institute of Public Health was that the points would cause a large absence. NIPH is under the impression that rising absenteeism is a concern for municipalities and county governors.
“A proposal to expand this should be studied in more detail in dialogue with the agencies responsible for socially critical functions, health trusts and municipalities, in addition to being adequate and proportionate,” wrote the National Institute of Public Health.
Points
In particular, the NIPH disagreed with the Norwegian Health Directorate on how people should relate to their own symptoms after a negative test result. FHI believes that a negative test has great “predictive value.”
“It will lead to even greater challenges with absence if all people with respiratory infections must stay home until all symptoms are gone. Many people have residual symptoms over time, this applies to both adults with residual cough and children who snore “.
Cash refunded
Then FHI addressed the second point of the Norwegian Health Directorate. The proposal was rejected in cash. They cautioned that this could be seen as the beginning of the introduction of second-class quarantine.
“This is not in line with current advice, and it is difficult to see the infection control professional to the extent, as the vast majority of those in quarantine today are not infected with COVID-19. The important thing should be that those who are actually exposed reach quarantine and comply with the quarantine. “
The third point is that FHI can lead to fewer tests.
“A person with a new cold may not want to be tested if it means the whole family should be home until the test result is available. 99 percent of those who get tested are not positive in the test, so his family / home will have been unnecessary while waiting for quarantine, “says the National Institute of Public Health.
