Risk groups - advice and information
Most people who are infected will probably have mild respiratory symptoms which will pass, while some may experience a more severe disease, with for example pneumonia and breathing difficulties. The risk of transmission in the population is rising and local transmission has been observed in Norway that is not related to travel abroad.
Who is at risk of severe illness?
Based on information from China, Italy, UK and USA, it appears that the following groups have a higher risk of serious illness from COVID-19:
- Older people (over 65 years)
- Adults with underlying chronic diseases such as cardiovascular disease, diabetes, chronic lung diseases, cancer and high blood pressure (hypertension).
- People who smoke also have a possible higher risk of serious illness from COVID-19-infection.
Elderly people with risk factors may have a serious disease course and the risk of severe disease rises with increased age and more risk factors. It is uncertain whether patients in Norway with chronic diseases that are well managed have an increased risk of a serious disease course.
The European Society of Cardiology has stated that there is no reason to change treatment with antihypertensive medicines based on the coronavirus outbreak.
- Several user organisations are able to answer questions from people with chronic diseases by telephone (helsenorge.no).
To date, we know little about the other risk groups. It is possible that people with chronic renal disease, liver disease and people with impaired immunity (also that caused by medical treatment) also have an increased risk of severe illness from COVID-19. Information on this page may change as we learn more about COVID-19.
There is no reason to advise against starting or stopping ongoing immunosuppressant treatment. If people who use immunosuppressants become sick, they should contact their doctor for advice about medication, testing and examination.
Children appear to have mild symptoms and so far, it is not shown that children with chronic diseases have a more serious disease course. Among 44 000 confirmed cases of COVID-19 in China, only 2.4 per cent were children. Among these, few were seriously ill. Similarly, the United States Center for Disease Control has reported that as of March 12, 2020, there were 4226 COVID-19 cases in the United States. Among children and adolescents under the age of 20, only 1.6-2.5 per cent were admitted to hospital. None of them needed intensive care, and none of them died.
What should you do if you are sick?
Contact the healthcare service early if you feel ill and suspect that you may have been infected with the coronavirus. If you develop symptoms such as fever, shortness of breath and reduced condition, contact your own doctor or emergency out-of-hours clinic (tel. 116117) as soon as possible. If you have severe symptoms ring 113. If you develop other acute symptoms that you would normally seek medical attention for, contact the healthcare service regardless of whether or not you may be infected with coronavirus.
Keep in touch with your closest contacts so they can help you if you become ill. If you become ill and do not have any close contacts, arrangements for follow up with the local healthcare service can be made.
Specific advice to people in risk groups:
- Stay at home as much as possible
- Ensure you have all necessary medication available. Continue with regular medication and only make changes in consultation with your doctor.
- Keep a distance to others and avoid crowds. You can go for walks as long as you keep a distance from others.
- Limit use of public transport if possible, particularly during rush hour.
- Make arrangements about who can help you with necessary purchases
- Avoid looking after small children because they often have mild or no symptoms and can infect people in risk groups.
- Limit visits and ask visitors to ring before they come. If they have symptoms of respiratory tract infection, cancel the visit.
- If someone you live with is feeling unwell (particularly if you suspect COVID-19), limit time spent together. If possible, stay and sleep in a different room and use a separate bathroom/toilet. If this is not possible, it is important to keep a distance and use a separate towel and toiletries. See advice when you or other household members have acute respiratory infections
- Employees in risk groups should talk to their employer about the possibility for remote working and videoconference facilities.
- You should attend planned check-ups and appointments unless you hear otherwise from the healthcare institution. If you are unsure, contact the healthcare institution.
General advice to reduce the risk of infection
- Wash hands frequently and thoroughly with soap and lukewarm water, especially when you have been among people. Hand disinfection is a good alternative if hand washing facilities are unavailable.
- Ensure that people you live with wash their hands often. This also applies to visitors.
- Avoid shaking hands and hugging.
- Avoid touching yuor face with your hands.
- Clean the home often, particularly surfaces that are frequently touched.
- Avoid unnecessary contact with people with symptoms of respiratory tract infections.
- Keep up-to-date about the situation and follow the local media, NIPH's website and/or helsenorge.no.
- Follow the advice given to reduce the risk of getting infected
- Do not visit people in risk groups if you have symptoms of respiratory tract infection or do not feel completely healthy.
- Keep in touch with people at risk and offer to help with necessary errands
- If you live with someone who is at risk and you have symptoms of arespiratory tract infection or do not feel well, limit time spent together. If possible, stay and sleep in separate rooms and have your own bathroom / toilet. If this is not possible, try to keep your distance and have a separate towel in the bathroom / toilet and your own toiletries. See advice when you or other household members have acute respiratory infections.
The aim of infection control efforts in Norway is to maintain a sufficient healthcare service level so that people in risk groups are followed up as necessary. Therefore, people who have confirmed COVID-19 disease, their close contacts or people who have been to areas with widespread transmission should be in home quarantine or isolation. Comprehensive measures have been introduced in Norway to limit transmission.
The Norwegian Institute of Public Health recommends that patients with chronic diseases should attend appointments and check-ups unless they hear otherwise from the institution. If in doubt, contact the institution.
Currently, there is no vaccine against COVID-19 but several research groups are working hard to develop a vaccine.
The Norwegian Institute of Public Health recommends that people in risk groups should take the influenza vaccine every year and the pneumococcal vaccine (against a bacterium that can cause pneumonia) every 10th year. These recommendations apply regardless of the coronavirus situation, but people in risk groups are asked to ensure that they are updated with these vaccinations.
Due to limited availability of vaccine, those at highest risk will be prioritised. These vaccines do not prevent coronavirus infection.
Healthcare personnel in risk groups
Healthcare personnel with patient contact are at risk of exposure to coronavirus from infected people who are seeking medical attention.
The recommended infection control equipment should be used by all healthcare professionals during contact with a patient with suspected or confirmed COVID-19 disease. For healthcare professionals with risk factors, adjustment is recommended so that other healthcare professionals without risk factors can take samples and treat people with suspected COVID-19 disease where possible.
Workplace adjustment should be done in consultation with the employer.
When patient contact and exposure to COVID-19 patients cannot be avoided, transfer to other tasks or remote working should be considered based on individual risk. Sick leave is not recommended unless workplace adjustment or remote working is not possible. The Norwegian Directorate of Health has issued guidelines about this (in Norwegian only).