Facts about infection control measures during the COVID-19 outbreak
How is transmission being handled in Norway?
Work on the epidemic is following two paths: an infection control strategy to reduce transmission and a treatment strategy to prevent deaths among people who become severely ill. The infection control strategy aims to delay the onset of the epidemic and give the healthcare service more time to prepare, and then slow down transmission so that the epidemic is spread over a longer period and fewer become infected overall.
Updated summaries of the number of infected people are posted daily on fhi.no.
There is no vaccine and no specific treatment for COVID-19. Only general infection control measures can help to reduce transmission. The benefits of these measures will vary over the course of the outbreak. Before measures are recommended and implemented, their benefits must be weighed up against any disadvantages for individuals and society.
Different phases of the outbreak - different infection control measures
The outbreak of COVID-19 in Norway will evolve through various phases:
- The disease is diagnosed among individuals who have been travelling in outbreak areas.
- The number of people infected abroad increases, there are clusters of people infected in Norway, and for an increasing number of people, the chain of infection cannot always be traced to a confirmed case with known risk.
- The outbreak is ongoing, with widespread infection among people in Norway.
- The outbreak reaches a peak, where infection is widespread in Norway and a large number of people are infected.
- The outbreak is declining, there are fewer new people infected, and a large part of the population has had the disease
Infection control measures
Good hygiene in the population
These measures aim to reduce transmission through coughing and via hands and contaminated objects. This applies to the entire population, regardless of their own and others' infection status. These measures are important throughout the whole outbreak of COVID-19, but especially when infection is widespread throughout society (phases 3, 4 and 5)
- Frequently wash or disinfect hands
- Increase cleaning of objects touched by many people
- Avoid touching your face with your hands
- Avoid coughing on others
- Avoid shaking hands, kissing and hugging
The aim is to reduce transmission from people who are unaware that they are contagious. Reducing the frequency of contact between people reduces the possibility of transmission. The measures may include the entire population, or they may include special risk groups or people who are in contact with risk groups.
- Increased social distance in general, and especially in educational institutions, in workplaces, meeting venues and public transport
- Less use of educational institutions, meeting venues and public transport
- Closing of educational institutions, businesses, meeting venues and public transport
- Cancellation of events and gatherings
These measures are most relevant when infected people in society are unaware that they are contagious. Until then, the measures only reduce contact between uninfected people. The disadvantages of the measures increase with their duration. We should aim for a set of measures with sufficient effect and remove any measures that are too intrusive compared to the benefit they give. Some of these measures are appropriate from phase 2, while others may only be appropriate from phase 3.
Detect infection early and isolate the infected
The aim is to find anyone who is infected early and prevent them from passing the infection on. Infected people can be found through the use of specific diagnostic tests. At the start of the outbreak (phases 1 and 2), it is important to test people who have been travelling in outbreak areas, to isolate infected people and to trace contacts who may be infected. In later stages, the infection is widespread in the population, and the focus is on preventing infection to at-risk groups and within the healthcare service. Testing of patients and staff with suspected COVID-19 in the healthcare service becomes particularly important. With widespread transmission, there may be a lack of equipment and personnel to carry out testing and it is important to prioritise testing where a precise diagnosis has the greatest effect on treatment course.
Find and follow up people who are exposed to infection (contact tracing)
The aim is to find and follow up people who are exposed to infection (contact tracing) so that infection among this group can be detected early before they infect others. Quarantine for people who have been exposed to infection (close contacts) is part of this measure.
Contact tracing is done by district medical officers and healthcare institutions, in collaboration with the Norwegian Institute of Public Health. A distinction is made between close contacts and other / low risk contacts. People who may have been exposed during air travel should also be traced. Contact tracing is an important step in the initial phase of the outbreak when the goal is to delay the onset of the outbreak to give the healthcare service more time to prepare and it becomes less appropriate when the infection is widespread in the population.
Fewer travellers from areas with epidemic transmission
The aim is to limit transmission from people who have stayed in areas with widespread transmission. Both travel advice and quarantine for people who have been travelling are part of this measure.
The measure is important during the initial stages of the outbreak (phases 1 and 2) when there is a large difference in the incidence of infection within Norway and abroad. In later stages of the outbreak, infection in Norway will be as widespread as the infection in other countries, so imported infections from abroad will have little impact on the development of the outbreak.