Assistant Director of Health Espen Rostrup Nakstad in the Norwegian Directorate of Health answers about the corona situation. City councilor Raymond Johansen in Oslo on Thursday asked for answers on how the pressure on hospital capacity in Norway is now here, and whether the situation is so challenging that it justifies keeping thousands of people away from their workplaces.
– If we are to understand the pressure, we must look at the entire health service, Nakstad says.
He says municipalities report both challenging or critical access to personnel.
– This means that nursing homes that tend to have several nurses at work at night, now may only have one person at work. This means that emergency services that usually drive around on sick visits can no longer do this, says Nakstad, and adds that the ambulance service is also affected.
– When it comes to hospitals, it is clear that when you have such demanding patients admitted, other activity must be reduced.
This applies, among other things, to planned operations, which several hospitals have had to downgrade by 20 per cent.
– There will then be a backlog of many 100 operations eventually. This simply means that people who do not have covid-19 receive poorer health services than others.
He says that the Norwegian health service is normally operated very efficiently, and that about 100 percent of the capacity is used every single day. A pandemic therefore makes the situation challenging.
– In addition, they have relied on substitutes from Sweden when there is a lot to do, and that access has become significantly lower. Then also comes this with sick leave, that now there are many who are infected, and a lot of health personnel who are at home and are ill. And that makes it extra difficult to staff up. The finely honed machinery we have in the Norwegian health service, it now has a lot of debris in it, he says.
– Overall, this makes the whole system worse, and this is noticeable in all parts of the health care system.
Nakstad says that last year we were also helped by fewer people ending up in hospital for other reasons, partly because we were more at ease, and there was thus less illness with other illnesses, and also fewer traffic accidents.
– When you have used most of the capacity for normal operation, and then you get covid at the top, then it becomes very challenging.
Nakstad says the absolute limit depends on how many other patients you depend on not receiving treatment.
– So far, we have managed to prioritize children and cancer patients. They have received the treatment they should have. But if you are waiting for a new knee, for example, then you have to wait.
He says some patient groups may have to wait months and years for the operation they should have had.
– It results in a loss of health, a long-term absence due to illness, and your health may deteriorate, because you are waiting for the operation you need.
– So there is no specific limit, but a question of how much reduced quality to give to other groups than those who have covid-19, he adds.
– Can we not just get over it and get infected, many ask. Why can we not just do it?
– That’s a good question. Omikron causes less serious illness, and perhaps only a third of what is involved. But it is more contagious, so you get three times more infected at the same time, then you have lost the effect and the load is exactly the same.
For example, let’s say that everyone in Norway is now infected this winter, says Nakstad.
– Then we do not know if it gives a lasting stronger immunity, or about how it will be in the long run. And new variants may appear that cause you to become infected again this summer or autumn. So there is no guarantee that undergoing omikron all together now provides a lasting immunity.
He adds that these are not cases with vaccines either, but says the vaccines protect against serious illness.
Nakstad says a large spread of infection will also affect the unvaccinated.
– They will most easily get sick if we get a large spread of infection. If many of them become infected at the same time, then we get a lot of admissions to intensive care units. Omikron seems to affect more and more unvaccinated people, and the majority of people who are admitted are unvaccinated.
– You do not quite know if you get a herd immunity from infection. Can you tell us a little about the work of knowing – how careful one must be?
– I do not say that getting omikron does not matter. You are probably better protected against being re-infected, if you get omicron at the same time as you are vaccinated. But there is no guarantee of getting infected again.
– Firstly, many will become seriously ill if many are infected in a short time, and we will probably not be done with it.
In Denmark, infection control expert Lone Simonsen has told TV 2 that the country will use omikron to get out of the pandemic, and that it is only the spread rate they now want to control.
– These are statements from Lone, and there are other experts who have said other things, but we are really back on what we just discussed, that yes, if you have a vaccinated population that is well protected against serious illness, then maybe the consequence that fewer people become infected, and if it builds an immunity, then it can be beneficial. But it is not certain that the immunity is lasting, so it is not certain that it serves you as well as you think.
In Denmark, there are now around 25,000 cases of infection daily.
– We also see that the death toll is rising, so there are some consequences. But it is obvious that the health service can tolerate more infections than before.
He also points to the long-term effects.
– There are studies now that show that a fairly large proportion of those who have had a mild illness have a number of difficulty concentrating to begin with and lose their sense of smell. We have known this for a long time, but it is now even clearer in studies that this actually affects quite a few. It’s not that simple.
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