Norway moves to normal everyday life with increased emergency preparedness

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The Norwegian Directorate of Health and Norwegian Institute of Public Health have recommended moving to normal everyday life with increased emergency preparedness at the end of September/beginning of October. After closely monitoring the situation this week, the Norwegian Government has decided to move to normal everyday life with increased emergency preparedness on Saturday 25 September at 4 pm.

‘Even though most people's everyday lives will now return to normal, the pandemic is not over. People will continue to get sick, which is why it is important that everyone gets vaccinated. In addition, society will have increased preparedness and quickly be able to take action if the situation calls for it. The municipalities will continue to play an important role in responding if outbreaks put the capacity of the health service under pressure’, stresses Ms Solberg.

The following rules and advice apply in A normal everyday life with increased emergency preparedness
When we move to normal everyday life, all domestic restrictions will be removed, apart from the requirement of going into isolation if you have COVID-19. This will apply from Saturday 25 September at 4 pm.

‘We no longer need to keep a distance. We can spend time with people the way we did before. 

We are removing the restrictions on the number of people who can attend events together. 

Drinks no longer need to be served at tables, and admission after midnight is no longer banned’, says Ms Solberg

If you have any respiratory symptoms, you should still get tested. This also applies to people who are vaccinated.

If you are infected with COVID-19, you need to go into isolation in order not to transmit the virus to others. This is not a recommendation, but a rule that comes with a fine if you fail to comply.

Unvaccinated people who live with someone who is infected are advised to take a test or quarantine, regardless of whether they have symptoms or not. Other unvaccinated close contacts do not need to quarantine, but should take a test.

‘We will also keep the advice we all know so well: wash hands often, cough into a tissue or our elbow, and stay home if we are sick’, states Ms Solberg.

Even though most industry standards and infection control guidance will now be revoked, she encourages businesses to keep good infection control measures, such as customers having access to hand sanitiser.

‘We are keeping the traffic light model for schools and kindergartens. If a municipality believes that the situation calls for local measures, the traffic light model will offer good guidance. This is important in order to give students the most normal everyday lives possible. Even though increasing numbers of people are vaccinated, situations may still arise that call for local measures’, the Prime Minister points out.

‘In short: we can live like normal now’, stresses Ms Solberg.

Adjustments to the strategy
The primary objective of the Norwegian Government's strategy so far has been to keep the pandemic under control. Because so many people now are vaccinated, the assessments of what is required to keep the pandemic under control have changed. The transition to normal everyday life with increased emergency preparedness means that Norway is moving from a control strategy to a preparedness strategy.

‘The new objective of the Norwegian Government's strategy is to prevent the pandemic from resulting in a considerable disease burden that puts a strain on the capacity of the municipalities and hospitals. At the same time, people should live as normally as possible. Public services must operate at an appropriate level, and the economy must be protected’, says Minister of Health and Care Services Bent Høie.

The following four indicators will be applied when the authorities assess how large a disease burden we must be able to handle:

• The number of patients in hospital
  
  
• The number of patients in intensive care units
  
  
• The age distribution of patients
  
  
• Capacity in the municipalities

The COVID-19 infection rate will therefore play a smaller role in the future, while the overall burden, which includes the flu and RSV, will become more important.

Preparedness going ahead
‘We are lifting most national infection control measures, and the municipalities will have primary responsibility for implementing measures and adopting local regulations if the situation calls for it. In the face of large outbreaks that are difficult to map and that threaten capacity in the municipalities, it may be necessary, for example, to introduce measures for groups at particular risk, like the elderly and the sick.

We have had a good dialogue with the municipalities, and have informed them both orally and in writing that they need to be ready to introduce local regulations when necessary’, stresses Mr Høie.

The municipalities must have test preparedness going ahead. They must be able to hand out rapid antigen tests to 10% of the population per week, have the capacity to test 1% of the population per week and, at one week's notice, be able to increase test capacity to 5%. They must be able to maintain vaccination capacity of 200 000 doses per week and have preparedness that makes it possible to considerably increase capacity over a 4-week period.

The regional health authorities must have plans that allow for many patients to be admitted to hospital with COVID-19 and other infectious diseases at the same time, and have preparedness for good capacity to perform analyses in their laboratories and for increased sick leave among employees.

‘We must have good national monitoring systems that quickly detect outbreaks and new virus variants, but the municipalities must naturally also monitor the local situation. All of this is required in order to be prepared to handle any changes in the situation. The Norwegian Government has determined that we must maintain this preparedness until the end of the year, at the very least.

We recommend that the strategy be reviewed at the end of the year. But everyone must be prepared for increased preparedness to be maintained throughout the winter of 2022. The Norwegian Government has assured the municipal sector that the state will continue to provide compensation for these expenses’, says Mr Høie.

National rules and advice for normal everyday life with increased emergency preparedness

With the authorities’ rules and advice generally being lifted, individuals may decide what risk they wish to take and what measures they will practice. The lifting of measures like national rules and advice does not prevent individuals from choosing a higher level of protection for themselves. For example, people who want greater protection from respiratory infections may choose to keep a distance from others and wear a face covering.

Actions	Rules and advice
Hand hygiene	Wash hands often. Use soap and water or an alcohol-based hand sanitiser.
Cough hygiene	Use a paper tissue or your elbow when you sneeze or cough. Throw away the tissue and wash your hands afterwards.
Advice for respiratory symptoms	Advice for new respiratory symptoms (fever, cough, sore throat, loss of sense of smell or taste, decreased general condition): Stay home. Get tested for COVID-19. This primarily applies to young people and adults. Testing of children can be considered in consultation with their parents, for example if the child develops new symptoms after close contact with a confirmed case. When to return to work, school, etc.: Young people and adults should have a negative test result for COVID-19 before they return. If the symptoms vanish completely after one day, they can return to work and school. If symptoms persist, the person should stay home until their general condition is good, symptoms subside, and they have not had a fever for 24 hours without the use of fever relief medication. In most cases they should stay home for a couple of days. If symptoms are more serious or persist, they should contact a doctor for an assessment. If you have a negative COVID-19 test result, your symptoms are mild, and your general condition has not been affected, you do not need to stay home. Young people and adults can return to school/work when their health has improved or the same day that the test was taken if the reason for the test was mild or vague symptoms. You can return to work/school if you have residual symptoms like a runny nose or light cough. There may be separate advice for health personnel and certain other professions.  Special rules for children in kindergarten and primary school: Children who only have a runny or blocked nose or chronic respiratory symptoms do not need to stay home. Children with new symptoms, like a fever, cough, sore throat or decreased general condition, should stay home, but can go to kindergarten/school when their health improves. This applies even if the child still has some symptoms, such as a runny nose or light cough.
Testing	Testing is recommended for the following groups: All people with new respiratory symptoms or other symptoms of COVID-19, regardless of their vaccination status. Unvaccinated household members or corresponding close relations of an infected person. Other unvaccinated close contacts. Expanded regular testing will be phased out. Use of time-limited regular testing may be considered during outbreaks. In the event of a large outbreak, regular testing in accordance with the expert guidance of the Norwegian Institute of Public Health may be appropriate. Self-tests are the recommended test method for this purpose. If you receive a positive result from a self-test, it is recommended that you take a PCR test to confirm the result.
Isolation in connection with infection	People who have a confirmed case of COVID-19 are required to isolate. This also applies to people who are vaccinated. Isolation means staying at home or at other suitable accommodation, isolated from others, also as far as possible from other people in the same household. People who are in isolation at home can come out of isolation 5 days after the onset of symptoms and if they have not had a fever for over 24 hours without the use of fever relief medication. If the person with a positive test result is not fully vaccinated, nor shows respiratory symptoms, they must count 5 days from the test date. Testing is not recommended for fully-vaccinated people without respiratory symptoms. If they receive a positive test result despite this, they should remain in isolation for 2 days, in case they develop symptoms.
Contact tracing	The municipalities’ routine contact tracing should only include household members and corresponding close relations, such as romantic partners.  If you are infected or the parent of an infected person, you should notify other close contacts and recommend that they get tested. In health and care institutions and home-based services, contact tracing should be conducted in line with dedicated plans.
Advice for close contacts	Unvaccinated household members and corresponding close contacts of an infected person are advised to refrain from contact with others for 7 days or to take a test. If you have no further exposure, you may get tested regularly instead of refraining from contact with others. The following methods may be used:  1. Daily self-testing for 7 days 2. PCR test every other day for 7 days Vaccinated household members or corresponding close relations are advised not to refrain from contact with others, but to get tested if they develop symptoms.  People who are close contacts, but who are not household members or corresponding close relations, are recommended to: Get tested as soon as they have been informed that they are a close contact. Limit social contact until they have received a negative test result. Closely assess their health with a view to identifying symptoms for 10 days after the close contact. Not hesitate to take a new test if they develop symptoms. The chief municipal medical officer may make assessments regarding the use of and recommendations regarding quarantine.
Face covering	When necessary, a local recommendation/order may be issued to use face coverings. Face coverings are an important infection control measure in the health service.

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