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Risk groups and their relatives - advice and information
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Most people who become infected with coronavirus (SARS-CoV-2) will experience mild respiratory symptoms that pass. Some groups are at particular risk of developing more severe illness (resulting in hospital admission, intensive care or even death), but even the majority of people in risk groups will experience mild symptoms.
The risk of a severe COVID-19 disease course rises with age and underlying medical conditions, with men being at greater risk than women. In rare cases, younger people without known risk factors may also experience severe illness.
Everyone should follow the general infection control measures, including good hand hygiene and cough etiquette, limiting the number of close contacts and keeping a safe distance to others. This is particularly important for people in risk groups.
If the infection rate increases in society, people in risk groups should live in a more secluded way. This advice applies for adults over 18 years.
Advice for risk groups
Make sure you have the medicines you need to hand. Continue taking your regular medication, and only make changes in consultation with your GP.
- You should attend planned check-ups and appointments unless you hear otherwise from the healthcare institution. If you are in doubt, contact the healthcare institution concerned.
- Remember good hand hygiene and cough etiquette. This also applies to persons you live with and to visitors. Clean your home frequently, paying particular attention to surfaces that are touched frequently. See Hand hygiene, cough etiquette, cleaning and laundry
- It is better to meet others outside where the risk of transmission is lower, but avoid places with crowds.
- Limit your use of public transport if possible, especially during the rush hour. See When you are sick or suspect that you have COVID-19 disease
- Keep up to date with the situation by following your local media, the Norwegian Institute of Public Health's website and/or helsenorge.no
The table below provides advice and guidance for risk groups who have not been vaccinated against COVID-19:
Slightly/ moderately increased risk
Moderate/ high risk
Live like others
You can generally live like the rest of the population, but be particularly careful to follow the general advice:
Live in a more secluded way
You can be with people you live with as normal and socialise with others provided you follow the advice in the green box, and:
Workplace planning and adjustment may be appropriate.
Slightly/moderately increased risk
Moderate/ high risk
Live in a more secluded way
You can be with the people you live with as normal and socialise with others provided you follow the advice in the green box, and:
Workplace planning and adjustment may be appropriate.
Live in a secluded way
To avoid infection, you should live in a more secluded way during this period. You can go for walks and have normal contact with those you live with provided you follow the advice in the yellow box, and also:
Patients with a risk of severe COVID-19 may be put on sick leave under certain circumstances. More information about assessing sick leave for patients in risk groups can be found at nav.no
*Rate of transmission in society: Assessed by the Municipal Medical Officer in collaboration with NIPH. There may be local outbreaks e.g. workplaces, regions or municipalities.
You define who is in your closest (physical) circle. They will normally be the people you live with.
Assessment of risk for unvaccinated persons
Risk assessment applies at a group level, not to the individual. There will be considerable individual variations within each risk group. If necessary, speak to your doctor about your risk of a severe COVID-19 disease course
Younger people are at a low risk of a severe COVID-19 disease course, but those with poorly managed diseases/conditions, or combinations of several underlying conditions, may be at greater risk.
Advice for people in the risk group who have been fully vaccinated against COVID-19 can be found at the bottom of this page.
Groups with slightly/ moderately increased risk:
- Age 65–69 years
- Age 50–64 years with one of the following chronic diseases:
- chronic liver disease
- immunosuppressive therapy with autoimmune diseases
- chronic lung disease, including severe asthma that has required the use of high dosage inhalation steroids or steroid tablets during the last year
- obesity with body mass index (BMI) of 35 kg/m2 or higher
- cardiovascular disease (except high blood pressure)
People under 50 years of age are at lower risk of developing severe COVID-19 illness. However, some people with poorly-regulated chronic conditions or a combination of several chronic diseases might be at increased risk.
Groups with moderate/ high risk
- Residents of nursing homes
- Over 70 years of ageα
- Severe health conditions, regardless of age *:
- solid organ transplant
- hematologic cancer in the last five years
- other active cancer, ongoing or recently completed treatment for cancer (especially immunosuppressive therapy, radiotherapy targeted at the lungs or chemotherapy).
- neurological or muscular disease with impaired coughing strength or lung function (e.g. ALS, cerebral palsy, Down's Syndrome)
- chronic kidney disease and renal failure
α There is an exponential (sliding) increase in risk from 70 years and over. Age is the most important independent risk factor.
* Other serious and/or chronic diseases that are not mentioned may also increase the risk of serious illness and death from COVID-19. This is assessed individually by a doctor.
* These diseases/conditions can result in a high risk of severe illness and even death, including amongst younger people.
Further information about risk groups
NIPH’s assessments may change as more knowledge becomes available. Here is an overview of the main risk factors. This assessment applies to people aged over 18 years.
The risk of developing severe COVID-19 illness rises significantly with age, and age appears to be the dominant risk factor regarding the development of severe illness and death. With advanced age, the incidence of chronic diseases also increases. It may be difficult to distinguish the risk caused by age from the risk caused by disease, but analyses that adjust for several risk factors show that age is an independent risk factor.
A person's risk should not be based solely on age, but also on an individual assessment of their general health.
Several studies show that people who have undergone organ transplantation have a significantly increased risk of a severe COVID-19 disease course. People on the waiting list for organ transplantation should preferably be vaccinated before transplantation. Organ transplantation shall not be postponed due to vaccination.
This includes severe congenital or acquired immune deficiency conditions that can lead to significant immune deficiency, and are more severe and rare conditions than the autoimmune diseases. People in this group may be at high risk for severe COVID-19 disease course. The conditions include severe combined immunodeficiency, immunodeficiency associated with major defects (e.g., Wiskott-Aldrich syndrome), common variable immunodeficiency, immunodeficiency with predominant antibody deficiency (e.g., hypogammaglobulinemia) and some other types of severe immunodeficiency conditions. The group also includes HIV patients with low CD4 counts who should be considered for vaccination by their doctor.
People with sickle cell anemia also have an increased risk of a severe disease course.
People with active cancer, ongoing or recently discontinued treatment for cancer (especially immunosuppressive therapy, radiation therapy for the lungs or chemotherapy) have an increased risk of a severe COVID-19 disease course. Active cancer is defined as a cancer that has not been radically treated and assumed to be cured. Recently completed cancer treatment is defined as completed within the last 6 months.
When planning the start of cancer treatment, it should be considered whether patients can be vaccinated before starting. Vaccination should not delay the start of treatment. A large study from England indicates that people with blood cancer have a particularly high risk in the first five years after the diagnosis is made.
Neurological diseases or muscle diseases that cause impaired coughing or lung function (e.g., ALS, Down's syndrome)
The risk of a severe disease course in people with cerebral palsy (CP) depends on how severe their CP is, that is, their physical immobility, reduced lung function and coughing power, the risk of food or drink entering the respiratory tract, or whether they have a genetic condition that gives increased morbidity. Milder degrees of CP will not pose any risk in themselves.
Several studies suggest that Down's syndrome increases the risk of a severe COVID-19 disease course. As adults with Down's syndrome are a heterogeneous group, the risk probably varies considerably within the group. Everyone with Down's syndrome aged 16 years and over is prioritised for vaccination.
Chronic kidney disease
Chronic kidney disease increases the risk of a severe COVID-19 disease course when you adjust for age and other risk factors. This is especially true for people with significantly impaired renal function. People with moderate / severe kidney failure are considered to have a significantly increased risk.
Chronic liver disease
Chronic liver disease also carries an increased risk, especially with significantly impaired liver function.
Immunosuppressive therapy in autoimmune diseases
Patients using immunosuppressive drugs may have an increased risk of severe disease course. It is probably the drugs themselves, and not the underlying disease, that increase the risk. Immunosuppressive drugs include TNF-alpha inhibitors, interleukin inhibitors, methotrexate, and more (see Felleskatalog). These drugs are used, among other things, for multiple sclerosis (MS), inflammatory joint diseases and inflammatory bowel diseases.
Diabetes has been reported as one of the most common underlying diseases in patients with a severe disease course. In studies that have been adjusted for age and other risk factors, patients with diabetes have a higher risk of severe COVID-19. Some studies find that people with well-regulated diabetes have a lower risk of severe disease compared to people with non-well-regulated diabetes. The duration of the diabetes disease and the incidence of late diabetic complications also seem to increase the risk.
Chronic lung disease
It appears that the risk of a severe COVID-19 disease course is increased in people with chronic lung disease, including severe asthma, defined as asthma that has resulted in the use of high-dose inhaled steroids or steroid tablets during the past year.
People with obesity have an increased risk of a severe disease course, and the risk increases with increasing body mass index (BMI).
Cardiovascular diseases include a range of diseases that may increase the risk of a severe COVID-19 disease course. There is evidence to suggest that the risk increases with the severity of the underlying disease. In studies that adjust for age and other risk conditions, including other cardiovascular diseases, high blood pressure does not appear to be an independent risk factor for hospitalisation or death from COVID-19.
Other chronic diseases
A number of studies suggest that dementia and stroke are independent risk factors for a severe COVID-19 disease course
Nursing home residents
Residents of nursing homes are considered to be at greater risk of a severe COVID-19 disease course, based on a combination of advanced age, frailty, multiple chronic diseases, impaired functions and low activity level.
Children and adolescents in risk groups
Children and adolescents appear to develop mild illness, even those with chronic conditions. Some groups may be more vulnerable and teaching adjustment should be considered as a precaution in schools and childcare centres. For more information about these groups and about COVID-19 in children and adolescents, see:
Employees in risk groups
In some situations, workplace adjustment should be considered for employees who are at greater risk of a severe COVID-19 disease course. With widespread transmission in the community, this will also apply to people with a moderately increased risk. With widespread transmission, sick leave should be considered for people at moderate or high risk if workplace adjustment or remote working is not possible.
The Norwegian Directorate of Health has prepared its own recommendations for employers in the health sector.
Should people in risk groups change ongoing treatment?
No. There is no reason to advise against starting or stopping ongoing immunosuppressant treatment. If people who use immunosuppressants become ill, they should contact their doctor for advice about medication, testing and examination.
What should you do if you become ill?
Anyone who has symptoms of COVID-19 or have been exposed to infection should be tested. If you develop symptoms such as fever, cough, shortness of breath and reduced general condition, contact your GP or emergency out-of-hours clinic (tel. 116117) as soon as possible. If you develop severe symptoms call 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.
General advice for relatives
Advice for relatives of people at particular risk:
- Keep in touch with people at risk.
- Follow the current advice about hygiene and other measures 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 well.
- Young people and adults who have been with friends and in other situations where they have not kept a distance of one metre should keep a distance of two metres to people in risk groups.
- If you live with someone who is at risk and you have symptoms of a respiratory tract infection or do not feel well, limit the time you spend together and arrange to be tested for SARS-CoV-2. If possible, you should live and sleep in separate rooms, and use a separate bathroom/toilet. If this is not possible, it is important to keep your distance from them and to use separate towels in the bathroom/toilet and separate toiletries. See When you are sick or suspect that you have COVID-19 disease.
Vaccination is one of the most effective forms of preventing infectious diseases. The purpose of vaccination is to prevent disease or to make the course of the disease milder. The main aim of the coronavirus vaccine is to protect the lives and health of those most at risk of a severe COVID-19 disease course.
Advice for vaccinated persons at risk
When people in risk groups have been vaccinated, they will be at lower risk of SARS-CoV-2 disease and a severe disease course and will be able to live some other people and follow the advice in the green box. The full effect of the vaccine is achieved 1-2 weeks after full vaccination. We do not yet know how long the protection lasts. If the protection decreases over time, refresher doses may be appropriate. We do not yet know how well the vaccines prevent the spread of infection. Currently, people who have been vaccinated must therefore follow the general infection control rules.
Vaccination advice will be published on an ongoing basis, see:
- Who can receive the coronavirus vaccine?
- Coronavirus vaccine– information for the general population
The Norwegian Institute of Public Health has recommended that people in risk groups should be given an influenza vaccine every year and a pneumococcal vaccine (against a bacterium which can cause pneumonia, among other things) every ten years. It is important to stress that these vaccines will not prevent infection with SARS-CoV-2.
The Norwegian Institute of Public Health receives an immense amount of enquiries about the coronavirus pandemic. Unfortunately, we do not have the capacity to reply individually to members of the public.
Our advisory service is primarily intended for Norwegian government agencies, the healthcare service and municipalities.
You will find general advice about coronavirus on this website and on helsenorge.no.
If you do not find the answer your to your question, you can ring the information helpline 815 55 015 that is open on weekdays from 08:00-15:30.
The Norwegian Directorate of Immigration has answers to many frequently asked questions about travelling to Norway, and a helpline 23351600 that is open on weekdays from 10:00-14:00.
The Ministry of Foreign Affairs also has answers to many frequently asked questions.
If you need acute medical attention, contact your doctor. If you cannot reach your doctor, contact the emergency out-of-hours clinic on 116117. If life is in danger, call 113.
For questions about the Smittestopp app, ring Helsenorge on 23 32 70 00.
For healthcare personnel
You will find information on these pages and at helsedirektoratet.no
If you are a healthcare professional who is responsible for infection control at their institution can ring Smittevernvakta.
For questions about whether or not you should attend work if you are a healthcare worker, contact the person who is responsible for infection control at your institution.
Contact your doctor or emergency out-of-hours clinic for questions about your personal health.