MEASURES TAKEN IN 2020
Even though access to highly skilled health personnel (physicians and nurses) in Norway is amongst the best in Europe, there are regional differences in access and shortages have been reported in the long-term care (LTC) sector. To ensure continued access to health workforce, from 12 February until 7 May all health professionals working with patients were restricted from travelling abroad. The restriction applied to all purposes of travels, for business and leisure, and is in force until further notice.
According to regulations, all municipalities and health trusts have pandemic preparedness plans and have the authority to order health personnel to work extended shifts, require health personnel not employed in the health sector to report to duty, as well as hire retired personnel to ensure sufficient staffing. As elderly people a particularly vulnerable to COVID-19, at the end of February the Directorate of Health (DoH) advised the municipalities to engage students and younger personnel. An official call was made on 24 March for all health personnel (currently not employed in the health sector) to register at the DoH and 4000 health workers registered within two weeks of the call. Data from this register is available to the municipalities and hospitals upon request. Previous calls, from mid-February, including local calls through various web-pages/Facebook requested healthcare personnel to get in contact with local institutions. Medical and nursing students are also encouraged to join healthcare personnel, under caution that their first and foremost responsibility is as students. Access to university facilities has been closed for students and staff and there has been a switch to digital teaching (including provision of exams) (see Section 1.2).
Hospitals and their staff will, together with their unions, plan reallocation of personnel and necessary training for task-shifting (these plans are specific to each hospital). Nurses working in wards other than intensive care units (ICU) have been trained to assist/work in ICU as the number of ICU beds increased dramatically. This ICU-training is to be maintained in preparation for the next wave in the pandemic.
When day-care centres and lower primary schools were closed down (see Section 1.2), they remained open for children with parents who perform critical public functions, such as healthcare workers, to enable them to stay at work. Another measure to support healthcare workers is the buddy-system set up by the Norwegian Medical Association, which providers the members of the Association with a list of peers who may be contacted for an informal talk.
The DoH has published guidelines on psychosocial support for employees during the COVID-19 pandemic in line with the WHO Mental Health and Psychosocial Considerations Guide during COVID-19 (https://www.helsedirektoratet.no/veiledere/koronavirus/psykososial-stotte-til-medarbeidere-under-covid-19). The guidelines provide advice for managers, employees as well as union and work safety representatives on how to look after oneself, one’s colleagues or employees during the pandemic. A list of useful apps for mental health training and stress relief are included in the guidelines.
As from 7 May the prohibition against foreign travel for health personnel is repealed. Given the limited spread of the infection, demand for health personnel is no longer deemed to be critical. The ban may be reinstated if the circumstances change.
By 18 May, a total of 6492 healthcare personnel have registered in the new national preparedness registry. Amongst them were 1453 registered nurses, 754 physicians and 518 health workers. The register is temporary and voluntary but it might become a new feature of the preparedness system. The current plan is to have the registry in operation for 2021 to 2022. The registry is solely aimed at health personnel currently not employed by a health trust or municipality.
Health personnel arriving from Sweden will be tested twice with at least 48 hours interval between the test. Before the first negative test is confirmed, the personnel are quarantined and may not work. If the first test is negative, the person may work, but must quarantine out of hours. After the second negative test, they are no longer subject to the quarantine rules.
From 8 November, employees and contractors who cross the border frequently who arrive in Norway from areas in Sweden or Finland with quarantine duty are exempt from quarantine during working hours if they are tested for SARS-CoV-2 in Norway at least every 7 days. This also applies for healthcare workers who commute from Sweden and Finland, as long as they are not also working in the Swedish or Finnish health service.
From 7 December the Ministry of Justice have made exemptions in the immigration regulations for health personnel or students who are residing in Norway with limited access to work within healthcare. The exemptions are being made for health personnel and student health personnel to work within the healthcare sector to ease the burden of COVID-19 on the system.