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Summary and assessment week 43
- Monitoring data and modelling show a significant increase in transmission recently after a gradual and slow increase throughout the autumn.
- Last week, 1,686 cases were reported, an increase of 79 % from week 42. There is an increase among most counties and all age groups last week, but there are large geographical variations. Oslo has the highest incidence with 111 reported cases per 100,000 inhabitants and Agder the lowest with 16.6 for weeks 42 and 43 combined. The number of outbreaks is increasing. The most commonly assumed site of infection is own household, private events and schools / universities. An increasing number are infected abroad, mainly people born abroad who are infected in their own home countries, primarily Poland. Import infection information is incomplete and numbers may be higher.
- There is still a low incidence of serious outcomes, but there has been a slightly rising trend in new patients admitted to hospitals with COVID-19 as the main cause since the summer. This may be due to transmission having increased in general in the population in recent weeks. There were 31 new hospital admissions in week 43, the highest number in a week since week 17 (41). Most new admissions in recent weeks have been in the Health South-East region. Five new admissions to an intensive care unit for the second consecutive week is also the highest number since week 17 (11). There were two deaths in week 43.
- Mathematical modelling indicates a slight increase in the spread of infection from September with a reproduction number from 1 October of 1.0 (95 % CI 0.9-1.1). The model shows a much higher infection burden in March-April than now in October and estimates that about 1 in 10 cases were detected at the beginning of the pandemic, while in September and October around 4 in 10 cases were detected.
- There was a significant increase in infection in week 43 compared to the previous weeks. The trend must be followed closely. It is still important that identified cases are followed up quickly locally with contact tracing and testing of close contacts, implementation of quarantine and isolation of the sick. Contact tracing and testing around individual cases and handling of outbreaks still have a high priority to stop outbreaks and prevent further infection after the outbreaks. In areas where there is an increase in infection, it is important that measures are targeted where transmission takes place and where the risk of transmission is greatest, while continuing work to strengthen compliance with the general infection control advice.
- We still have problems with collecting data from contact tracing in municipalities and districts so that data available in Norway can be used to analyse the situation - including where infection occurs and how it spreads - and use such data to model the effect of measures, and projections with scenarios for what may happen next.
Some key points
- In week 43, there were 1,686 cases reported, a 79 % increase from 941 cases in week 42 (49 per 100,000 inhabitants for weeks 42 and 43 combined compared to 36.9 per 100,000 inhabitants for weeks 41 and 42 combined).
- In week 43, there were 98,041 people tested, an increase of 10 % from the week before. The proportion of positive results among those tested increased from 1.05 % in week 42 to 1.72 % in week 43.
- The median age in week 43 was 33 years compared to 38 years since the start of the epidemic. The number of reported cases increased in all age groups and increased most in the age group 13-19 years (from 53 in week 42 to 151 in week 43 (34 per 100,000 in week 43) +184 %)
- During week 43, there was an increase in the number of reported cases from all counties except Agder, which reported fewer cases than the week before. Most cases were reported from Oslo (468 cases in week 43 compared to 302 cases in week 42, 111 cases per 100,000 inhabitants for weeks 42 and 43 combined). A total of 209 municipalities reported no cases in week 43, and of the 147 who reported cases, 93 reported fewer than 5 cases. 54 municipalities reported 5 or more cases in week 43.
- Information about the country of infection is lacking for 50 % (1,301 of 2,627) of the cases reported in weeks 42–43. This is because clinician reports to MSIS are lacking for many of the cases. Where we have information, we see that the proportion of those infected abroad has increased from 17 % in week 41 to 25 % in week 43. All the 310 who were registered as infected abroad in weeks 42–43 came from countries that require quarantine upon entry to Norway. The most common countries of infection in the last two weeks were Poland (190), Romania (16), Russia (7) and Sweden (7).
- The infection situation has so far been clarified for 976 of 1,016 (96 %) who are known to be infected in Norway in weeks 42–43. The most commonly assumed infection sites are private households (387; 40 %), job / university (152; 16 %), private events (116; 12 %) and restaurant / bar / nightclub (61; 6 %). For 148 cases (15 %), the presumed site of infection was unknown.
- The number of consultations for COVID-19 and other respiratory pathogens at the doctor and emergency room has been stable in recent weeks, but with a small increase during the last week.
- An increasing number of outbreaks are reported and followed up by the Norwegian Institute of Public Health. In week 43, the NIPH followed up the infection situation in Oslo, Bergen and Trondheim. In addition, the NIPH has followed up on 24 outbreaks and incidents that are handled by the municipal and specialist health services with assistance from the NIPH when needed. The outbreaks included companies, often linked to the infection of newly-arrived foreign workers; various health services; private and public gatherings; and restaurants.
- In-depth genetic analyses of coronaviruses circulating in Norway show that viruses from some outbreaks have mutations in important positions in the surface “spike” protein. So far, the virus from the coach trip and from the outbreak in Trondheim / Hyllestad have mutations that should be monitored. Some outbreaks appear to be difficult to control either by cases arising from week to week, or by the virus being traced back to several different counties.
- Globally, over 43 million cases and 1.15 million deaths have been reported, of which 3,035,000 of the cases and 40,678 of the deaths have been reported in week 43. Europe accounts for 48 % of the cases reported in week 43 and there has been a rapid increase in many European countries. There has also been an increase in reporting from all continents except Asia.