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Corona management in Norway – Points to weaknesses

On Monday, the National Institute of Public Health published one report where it is concluded that Norway has recovered very well from the pandemic so far, but that some groups have been particularly hard hit. Director Camilla Stoltenberg acknowledges that much could have been done differently.

– It is clear that we are doing well compared to other countries and historical examples. But that does not mean we should be satisfied. We will think about how we can become even better, and then it is first and foremost about stopping outbreaks of infectious diseases before they become epidemics and pandemics – that is the most important thing, says Stoltenberg to Dagbladet.

– Is there a new pandemic?

– It is quite certain that it does. But whether it will come next year or in ten years, we do not know.

INFECTION: Stoltenberg would like to have more information about where and how the spread of infection takes place. Photo: Frank Karlsen / Dagbladet
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Improvements

There are not many surprises in the report, Stoltenberg believes. A lot of the content has been collected along the way, so it would have been strange if there had been significant surprises, she points out.

– Would you have liked something to be done differently?

– There is a lot that we would like to improve, and which should have been done differently.

– What?

– We would have liked more information about where the infection occurs and how it spreads, and we would have liked to have received this information continuously during the outbreak in Norway. We do not have such information at a more detailed level in Norway today, and the attempts we have made to obtain that type of information have failed.

– How could one have received more information about it?

– The first infection stop app could have given us that. It could have given us information about the spread of infection that took place before people developed symptoms, and about how the infection spread. All this we could have got through one system. But that solution was developed at record speed and had shortcomings.

The infection stop app was launched in mid-April 2020, and was downloaded by one million Norwegians during the first 24 hours. Two months later, the Norwegian Data Protection Authority announced a decision on a temporary ban on the collection of privacy information through the Infectious Disease app. After this, FHI deleted all data and deactivated it. A total of NOK 40 million was spent on the app before it was declared scrapped.

Spread of infection

– Isn’t it the least one can expect from health authorities that they can find out where the infection takes place during a pandemic?

– There are very few countries that have received clarity in this, and current regulations make it difficult to achieve this. The reality is that because we were not allowed to use the first version of the Infection Stop app, we have had many different solutions with infection tracking data around the country.

– So I agree with you, but no one has put in place a perfect solution to obtain detailed information about where and how the spread of infection takes place. Such a solution must provide good data while safeguarding privacy and security.

– But does not the infection spread at home, then?

– Yes, and we know this because we ask those we catch, but it also happens elsewhere. The spread of infection occurs among those closest to you, but not everyone lives with their loved ones, and a home can be many different things.

THE PROBLEM: We do not know if we have had measures that have not been necessary.  That is the problem, Stoltenberg believes.  Photo: Frank Karlsen / Dagbladet

THE PROBLEM: We do not know if we have had measures that have not been necessary. That is the problem, Stoltenberg believes. Photo: Frank Karlsen / Dagbladet
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The measures

However, obtaining information about the spread of infection is just one of the things that could have been done better, Stoltenberg believes. One could also develop reliable rapid and self-tests in the past, as well as have better digital systems for sharing information about testing, isolation, infection tracking and quarantine.

In addition, one should have planned better to conduct research in real time – especially to get more information about the effect of infection control measures.

– We have been good at putting together large packages of measures, but we do not know exactly which measures were necessary, or which measures were sufficient, or how long it was necessary to keep the measures, or whether we introduced them too early or too late.

– Have we had measures that have not been necessary?

– We do not know, and that is the problem. We have felt that one should have tried out school measures more systematically, and been more reluctant with such strict measures in schools sometimes.

– School closure is very intrusive for children, and is used primarily to protect the elderly and people in the risk groups. It illustrates the dilemma. One should have known when it was necessary to introduce strict measures in schools, when it was not necessary, and when the measures could have been more targeted than those we introduced.

NATURAL: For Stoltenberg, it is natural to acknowledge that things could have been done differently during the pandemic.  Photo: Frank Karlsen / Dagbladet

NATURAL: For Stoltenberg, it is natural to acknowledge that things could have been done differently during the pandemic. Photo: Frank Karlsen / Dagbladet
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Hit hard

The immigrant population is one of the groups that was hit particularly hard during the epidemic in Norway. The new report shows that foreign-born accounted for 40 per cent of all hospital admissions from March 2020 to February 2021. This is despite the fact that they make up only 15 per cent of the population.

– That number is important. This does not apply to all immigrant groups. Some groups are overrepresented in terms of serious illness, and have obviously been hit much harder than other sections of the population. This has happened both in Norway and in other countries, and is among the most important things we have learned.

– Have you had a bad conscience for not doing enough to protect that part of the population?

– Bad conscience is not the term I want to use, because there have been many attempts to reach it, especially in Oslo and some municipalities in Viken and in the eastern part of Norway. A lot of people have done a great job that they have partly succeeded in, but we have not succeeded well enough in reaching everyone.

– How does it feel to sit here and acknowledge that things could have been done differently?

– Its natural. It would have been very strange if we had thought differently. I am glad that it has gone as well as in Norway, and there are many we can thank for that. But we all need to think about how we can improve in the future, and I am absolutely sure that we will do something about it despite the fact that we are relatively happy with the handling so far.

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