Inpatient four times as long

Just over two months after Bent Høie folded the ruler, removed the meter rule and opened up society, the new Minister of Health Ingvild Kjerkol had to shut down parts of society again on 7 December.

A new professional assessment from the Norwegian Directorate of Health shows that 30 per cent of intensive care patients in Norwegian hospitals are corona patients.

In addition, they are hospitalized for an average of four times as long, and may require several intensive care nurses at the same time.

– The difference between now and before, is that the admitted covid-19 patients are in addition to the other intensive care patients. Actually, it is full of ordinary patients in the hospitals who do not have covid-19, and then the covid-19 patients come in addition, says assistant health director in the Norwegian Directorate of Health, Espen Nakstad.

30 percent corona patients

For several weeks, chief physicians and nurses at intensive care units at Norwegian hospitals have been giving notice burst capacity.

The Norwegian Institute of Public Health’s figures show that more than 25,000 new cases of infection were registered last week. This is the highest number during the entire pandemic.

Nakstad has explained that we now also have record high death toll as a result of covid-19.

– The number is actually up to seven deaths per day, and we have not had such high numbers since the pandemic started in Norway, Nakstad says.

From midnight on December 9 will be introduced national recommendations and rules which deals with, among other things, distance, social contact, events and serving at restaurants.

NEW MEASURES: The government held a press conference on the new national corona measures. Video: NTB.
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The Norwegian Directorate of Health’s report indicates that corona admissions continue to increase. On Thursday, 316 corona patients were admitted to Norwegian hospitals. 103 of them are in the intensive care unit, and 50 receive respiratory treatment.

In total, corona patients make up around three per cent of all patients in Norwegian hospitals, and 30 per cent of intensive care patients.

Patients admitted with corona are more resource-intensive than other types of patients admitted to hospital and intensive care, as corona patients require increased resources on premises, equipment and personnel.

The professional basis states, among other things, that the sickest corona patients on a respirator must be turned regularly from supine to supine.

It requires four to six health professionals with specialist expertise at the same time.

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The head of the emergency department at Oslo University Hospital (OUS), Øyvind Skraastad, says that patients who develop pneumonia and pneumonia can stay in the intensive care unit for a long time.

This is in line with the Norwegian Directorate of Health’s report, which states that the median length of stay in the intensive care unit is around eight days for corona patients. For other intensive care patients, the same figure is two.

This means that it can accumulate in the intensive care units with corona patients who have to stay for a longer period of time.

In addition, a high proportion of corona patients need long-term and comprehensive rehabilitation after the course of the disease, according to the report.

81 percent of intensive care patients with corona have received respiratory treatment in Norway, according to the Norwegian Directorate of Health.

Compared with other intensive care patients, corona patients also have eight times longer respiratory time.

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Postpones operations

Nakstad explains to Dagbladet that it is hard on the hospital’s operation that the number of corona patients admitted is so high.

This is confirmed by clinic manager Skraastad.

At OUS, they have taken down a lot of planned surgery. This was a measure that was introduced earlier this autumn due to the RS epidemic, but which still has to be practiced due to the number of corona admissions.

– Deductions affect the entire hospital’s operations. We do our utmost to spare cancer surgery and surgery for children. We have managed the whole pandemic, says Skraastad.

– The situation is hopeless

He adds that it is appropriate if most people are careful to help ease the capacity of the health care system.

Skraastad says it is especially important that Motorists drive carefully on slippery roads to avoid accidents.

Stricter drinking regulations can also ease the capacity for Norwegian hospitals because we have daily admissions for injuries under the influence of alcohol. This is reduced when people stay more at home, says the clinic manager.

Located just below the maximum limit

Skraastad believes it is too early to decide whether the measures introduced in society are effective enough, as there is not enough information about omikron yet. On the other hand, he is aware that the intensive care capacity in Norwegian hospitals has been too poor for a long time.

He is worried about the future recruitment of new nurses and doctors in intensive care if there is no improvement.

– We can not be directly below capacity taste. It worries me more than an acute virus situation.

The doctor asks people to remember that intensive care is about social security.

– We must have intensive preparedness – it is life-saving and must be in place. It is sufficient to point to July 22, a landslide in Gjerdrum, life-threatening violence in Kongsberg or a cave party at Lovisenberg, says Skraastad.

– We have employees who have worked very much for a very long time. They have a tolerance limit, he adds.

These are the national measures

All new national injunctions and recommendations take effect at midnight on Thursday 9 December. They last for four weeks – but will be reconsidered after two weeks.

Regulated measures

Events and gatherings

A maximum of 20 people at a private gathering in a public place, in borrowed or rented premises
Memorial services after funerals and burials can have a maximum of 50 people. The funeral itself is considered a public event with fixed seating, see below.
3 x cohorts of 200 people with 2 meters distance between the cohorts all the time at public events with fixed allocated seats.
A maximum of 50 people at public events without fixed allocated seats.
At indoor events, an organizer shall be appointed who shall have an overview of who is present and the implementation shall be professionally sound.
Pouring stop at 24:00 at events with a pouring license.
The organizer shall ensure that everyone who is present at indoor events shall be able to keep at least 1 meter distance to others who are not in the same household or are similarly close. Exceptions are made for several groups, e.g. for athletes at cultural and sports events, participants in certain courses and those who are in the same cohort in kindergarten or primary school.
At events where everyone in the audience sits in fixed allotted seats, there is a sufficient distance if the organizer facilitates that the audience has at least one vacant seat between them on the same row of seats from the time they arrive at the event. People from the same household can sit closer to each other after arrival.

Restaurants

Order that the restaurant shall ensure that everyone can keep a distance of 1 meter to other than household members and similarly close. There must be at least 1 meter distance between the seats on the arrival of guests, however, so that people in the same household or similarly close can sit closer to each other.
Restaurants with a liquor license must have seating for all guests, but it is not a requirement for cultural events at the restaurant.
Alcohol can only be served at the tables.
Pouring stop at 24.00.
The restaurant must register contact information for guests who consent to it.

Infection control responsible operation

Mandate for infection control proper operation for kindergartens, schools and other education and training activities. The municipalities will again use the traffic light model. The level of action is green unless otherwise decided locally. It may be relevant to put all kindergartens and schools in the country at a yellow level again.
The following businesses must be run in a professionally sound manner in order to be open: Libraries, amusement parks, swimming pools, water parks, spa facilities, hotel pools, gyms, bingo halls, gaming halls, shopping centers, shops, trade fairs, temporary markets and the like.
This entails requirements to ensure that it is possible to keep at least 1 meter away from people who are not in the same household or similarly close, and that the company has developed routines for good hygiene, good cleaning and ventilation.
With the exception of libraries, shops and shopping centers, companies must register contact information for those guests who agree to it.
Industry supervisors should be reintroduced for e.g. gyms and swimming pools.

Mouthpiece

Mandatory for the use of face masks when it is not possible to keep at least 1 meter distance in shops, malls, restaurants, public transport, taxis and indoor station areas. The order also applies to employees unless physical barriers have been used.
Mouthpiece orders also apply to hairdressers, dermatologists and other one-on-one businesses.
There is already a national recommendation to wear a face mask where there are a lot of people and it is difficult to keep your distance, for example when you are going to pick up your jacket after an event at the same time as many others or on your way out of a football stadium.

Home office

An order that the employer shall facilitate home offices where possible without compromising services that require a presence that is important and necessary for the business, for example to take care of children and vulnerable groups.

Quarantine

Quarantine obligation for close contacts with a confirmed infected person where there is a suspicion of omicron, is extended to also apply to other close contacts, not just household members and similarly close ones.

Advice and recommendations

Distance and social contact

Everyone should keep a distance of 1 meter to other than household members and similarly close.
The recommendation does not apply to children in kindergartens and primary schools. There are also exceptions for adults who work with services for children and young people and vulnerable groups.
You should not have more than 10 guests at home in addition to your own household. You can have up to 20 guests once during the Christmas and New Year holidays, but there should be a meter distance between the guests. Everyone must think through how many close contacts they have seen in total.
Children in kindergartens and primary schools may have visits from their own cohort / class / department even if it exceeds the recommended number of guests.
Reduce the number of close contacts, but do not isolate yourself.
Meet others outdoors whenever possible.

Organized leisure activities

Leisure activities should be carried out outdoors as far as possible, and changing rooms should be kept closed.
For organized leisure activities indoors, it is recommended that adults over the age of 20 are in groups of up to 20 people. Furthermore, it is recommended that adults indoors keep a distance where it is possible to exercise the activity, and that you keep a distance of 2 meters during high-intensity training.
No specific recommendation is given about distance and number when children and young people under the age of 20 train and participate in sports, cultural and leisure activities.
Top sports can be carried out as normal.

Schools, kindergartens and SFO

Regular testing in schools with high infection pressure.
If necessary, the municipalities will again use the traffic light model in schools and kindergartens. The starting point is the green level, unless otherwise decided locally.
Meetings can be arranged for children in kindergarten or primary school with whole classes / departments / groups with the required number of adults present.
Universities, colleges and vocational colleges should as soon as practically introduce teaching in smaller groups and more digital teaching. Students who are dependent on conducting experiments in laboratories or skills training should be given priority for physical education.
Universities, colleges and vocational colleges should facilitate exams and compulsory courses, either digital or physical, where good infection control is practically possible. The same applies to other educational institutions for adults.

See own online case about measures in school / kindergarten and higher education.

Working life

Recommendation of a distance of 1 meter and increased use of home office.
Recommendation for face masks if it is not possible to keep distance, unless physical barriers such as the use of partitions or the like have been used.
Home offices and face masks do not apply to services where this prevents employees from performing necessary and statutory tasks in meetings with vulnerable groups and children and young people.

Aeration

Good ventilation / ventilation is recommended in situations where you stay in the same room over time with people who are not household members and similarly close.

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