Speech/statement | Date: 26/04/2021
By Prime Minister Erna Solberg (The Storting)
Brief by Prime Minister Solberg on the way the Government intends to follow up the Coronavirus Commission’s report.
Thank you for this opportunity to brief the Storting on the way the Government intends to follow up the Coronavirus Commission’s report.
The Coronavirus Commission’s overall assessment is that the authorities have managed the pandemic in a sound manner.
The Commission points out that in a demanding situation for the country, the authorities adapted quickly and took decisions of crucial importance to the evolution of the crisis. After over a year of pandemic, Norway has one of Europe’s lowest mortality rates and its economy is among the least affected.
I would also like to add that we have had less stringent domestic measures than many other countries. And we have a health service that has managed to maintain most of its normal activities.
The coronavirus pandemic has been the most difficult challenge that Norwegian society and the authorities have faced since the Second World War.
Particularly at the beginning, we were forced to take decisions in a situation fraught with uncertainty and without reliable information about the effects of the infection control measures. That is also why we made it clear that we would make some mistakes. It has been important to act decisively and then adjust our approach as needed, rather than to wait until it was too late to take decisions.
We have learned along the way, and we have corrected our course when this has been necessary.
The Commission points out that we were not adequately prepared to deal with a crisis of this kind.
We will consult the report closely and learn from it. That is why the Government took the initiative to appoint the Coronavirus Commission. The Commission’s report contains 17 central conclusions and 63 lessons and recommendations. Today, I will focus on the most important of these.
We have asked the Coronavirus Commission to continue its work. So far, the Commission has evaluated Norway’s preparedness prior to the crisis and the response in the first phase of the pandemic.
When the pandemic is over, we will conduct a thorough review of the organisation of the response, our emergency preparedness plans and relevant legislation. The Government will then present a white paper based on this and the Commission’s final report.
We are still in a pandemic, and we do not intend to change the crisis management framework in the midst of a crisis. Nevertheless, we see that some of the points raised by the Commission have already been addressed, or can be addressed quickly. I will come back to this.
As I have already mentioned, the Commission’s overall assessment is that the authorities have managed the pandemic in a sound manner.
At the same time, the Commission has concluded that there is room for improvement in a range of areas. I will now go through some of the issues that have been highlighted.
The Commission points out that Norway was not adequately prepared when the COVID-19 pandemic arrived. The authorities had not designed scenarios or carried out exercises to prepare for a situation where large parts of society would have to be shut down.
I agree that we have not adequately challenged assumptions about how pandemics should be dealt with in Norway in our emergency preparedness efforts.
The responsibilities of the various health sector entities and coordination during crises generally is described in Norway’s national health preparedness plan. This was last updated by the Ministry of Health and Care Services in 2018.
The national emergency preparedness plan for outbreaks of severe infectious diseases was adopted in 2019. This is a general plan that covers various types of infection, not just one type of virus. The decision to draw up the plan was taken on the basis of experience gained from the handling of the Ebola outbreak in West Africa in 2014 and the work on the national strategy for chemical, biological, radiological, nuclear and explosive (CBRNE) threat preparedness and response.
The biological events preparedness committee was also established in 2019. Its purpose is to bring together decision-makers at agency level and from various sectors and to strengthen coordination of preparedness efforts and response to biological events.
An influenza pandemic was considered to be the most likely crisis scenario. Norway was therefore prepared for a potential influenza pandemic, and the authorities had drawn up a national influenza pandemic preparedness plan putting in place systems and procedures for national action to deal with this.
This preparedness plan addresses a situation in which a large proportion of the population could fall ill, which in turn could lead to a high rate of sickness absence and many hospital admissions. The plan encompasses all sectors, but does not provide adequate analyses of the ramifications of high sickness absence and a high illness rate for society as a whole. Nor does the plan cover viruses that have other characteristics than the influenza virus.
In principle, the plan does not recommend introducing measures to restrict the activities of the population or parts of the population, as the costs could be huge and the benefits limited. It also advises against closing borders and introducing quarantine for suspected cases or mass testing of people arriving in the country.
Instead, infection control measures were to be used to slow down transmission and ‘flatten the curve’ to keep too many people from falling ill simultaneously.
The Government realised early on that a deceleration strategy would be very difficult to implement. The spread of infection could get out of control too easily, and the pressure on the health and care services would be too great.
Norway thus had plans in place and was prepared for an influenza pandemic, but we were not prepared for a pandemic that would require the widespread shutdown of activities.
A similar weakness in preparedness plans and crisis scenarios can also be found in other Western countries. The World Health Organization’s (WHO) plans, for example, have focused exclusively on the influenza virus because an influenza pandemic was considered to be the most likely scenario.
Under WHO’s leadership, the international community has long worked to create a framework that would make it possible to avoid closing borders and to maintain economic activity, trade and cross-border mobility in the event of outbreaks of infectious diseases. The adoption of the International Health Regulations is an example of this.
The way we have been tackling the pandemic for over a year now represents a paradigm shift. We have employed infection control measures to an extent and for a length of time few had imagined possible or had planned for. Our response has challenged assumptions about the tools that can be used to combat a pandemic.
The Commission has also been clear on this point. It has stated that no Western country had foreseen tackling a pandemic in this way.
One of the Commission’s conclusions is that the Government has paid little attention in its emergency preparedness efforts to how risk in one sector is affected by risks in other sectors.
The Commission’s criticism is partly based on the fact that the Norwegian Directorate for Civil Protection (DSB) had determined that, of the various crisis scenarios it had developed, a pandemic was the most likely. DSB’s scenario describes a pandemic that the authorities were better prepared for, an influenza pandemic.
In DSB’s scenario, an influenza virus spreads quickly, the pandemic peaks after six weeks and lasts for four months.
In the Commission’s view, there were shortcomings in DSB’s crisis scenarios, because they did not include a sufficiently broad assessment of the impacts on society. The Commission believes that a more in-depth analysis should have been carried out of the interaction between impacts in various sectors and the effects on society as a whole.
A pandemic exercise could have uncovered some of the weaknesses in the plans that the Commission has pointed out. At the same time, there is reason to question whether our training exercise would have focused on a pandemic that required a lengthy shutdown of society, given that over the past year there has been a paradigm shift, as the Commission describes it.
Crisis scenarios can be developed in several ways, and it is important to identify a reasonable level of detail. If scenarios are too detailed, there is a risk of using a great deal of resources to develop very elaborate plans for a crisis that will often differ widely from the crisis that actually strikes.
Just how detailed crisis scenarios should be, and the role they can and should play in preparedness efforts, is an important discussion. The Ministry of Justice and Public Security is now considering whether there is a need to further develop DSB’s crisis scenarios. The Coronavirus Commission’s assessment will provide important input to this work.
One key lesson is that we cannot just develop scenarios for what we consider to be the most likely crisis situations. We must also plan for less likely developments.
That said, I would like to emphasise that it will never be possible to plan for all crisis situations in advance. It is telling that the most important decisions taken by the Government, and those that have been most instrumental in ensuring that Norway has fared better than the majority of countries, were not in line with or based on existing plans.
Good crisis management entails tackling the unknown, taking decisive action and daring to make mistakes. At the same time, it is about having a fundamental framework for preparedness in place.
Preparedness is built up through systematic learning from exercises and events, the establishment of a system for crisis management and the development of concrete tools to be used in crisis management. The fact that we had previously identified the public functions that are critical to safeguard public security in Norway is one example.
We are prepared for the fact that major events can strike at any time, and we have a well-developed crisis management system that the public administration is familiar with, in part through participation in crisis management exercises. This has been vital to the Government’s pandemic response.
The pandemic has highlighted the degree to which a crisis can extend across sectors, and how impacts in one sector can have ramifications in another. It is important to assess potential cross-sectoral impacts both in preparedness efforts and during the response.
All the ministries are required to coordinate their prevention, preparedness and crisis management efforts with other relevant ministries. In addition, the Ministry of Justice and Public Security has a coordinating role and is responsible for ensuring that cross-sectoral issues are addressed.
The ministries are therefore familiar with a cross-sectoral approach. For example, since the new Security Act entered into force, identifying cross-sectoral interdependencies has been an important element of the ongoing security work.
During the pandemic, the Government has worked to maintain an overview of the overall impacts of the response. All the ministries have reported on the effects of implemented and potential measures. Assessing the cross-sectoral impacts has been a key element of this work, for example considering how closing schools and child day-care centres could affect access to qualified personnel and the economy, how the quarantine rules would affect capacity in the health and care services and how infection control rules affect vulnerable children and young people.
In addition, we have had a good overview of our ability to maintain continuity in critical public functions, as previously defined.
My assessment is that when the crisis struck, the coordination of the response was effective. Decisions were taken at government level. An effort was made to ensure an integrated approach.
The Government will use the experience it has gained from the pandemic and the Commission’s conclusions to determine whether the need for and responsibility for cross-sectoral impact assessments should be clarified in Norway’s preparedness plans.
The Government will also assess whether there is a need to establish a cross-sectoral cooperation mechanism at agency level to strengthen the coordination of prevention, preparedness and response to all types of events and crises. As already mentioned, a mechanism of this kind was established for the health sector in 2019.
Personal protective equipment, medicines and activity in the health authorities
The Commission points out that the risk of shortages of personal protective equipment (PPE) was made clear in connection with evaluations of the SARS epidemic in 2003 and the Ebola outbreak in 2014. Norway could have had and should have had larger stockpiles of PPE than we had at the start of the pandemic. I agree with this. This is a weakness in our preparedness that the Government has learned from.
At the same time, I am pleased that the Commission recognises the job that was done to ensure that Norway received sufficient supplies of PPE.
In March 2020, a national procurement scheme was established to ensure the rapid delivery of PPE to municipalities and hospitals. Those who were involved worked 24 hours a day to acquire enough equipment, in what was a highly effective and creative effort.
The scheme that was put in place by the Directorate of Health, South-Eastern Norway Regional Health Authority and the hospital purchasing authority, Sykehusinnkjøp HF, functioned well and the costs of the procurements were covered by the state. Later on in 2020, the situation concerning PPE delivery was normalised.
In the view of the Commission, too much priority was given to the specialist health services and too little to the municipalities when it was decided how the equipment should be distributed. We have noted this.
At the same time, it is important to bear in mind that systems were established for identifying needs in the municipalities. Municipalities that experienced shortages of equipment were encouraged to report their needs under the national scheme.
The county governors coordinated their efforts and distributed equipment between the municipalities based on the availability of equipment and infection situation in the individual municipalities. The various types of PPE were also unevenly distributed, reflecting the different ways the equipment was used in the municipalities and in the specialist health services. The distribution of the equipment was therefore not always in line with the overall distribution formula.
During the pandemic, we have accumulated a substantial national contingency stockpile, which is in addition to the local stockpiles held by the municipalities and the health authorities. For example, we now have a stockpile of respiratory protective equipment that is sufficient to cover what the Directorate of Health has estimated as 400 years of normal use. And we have enough eye protective equipment for more than 2000 years of normal use.
The Directorate of Health is now preparing a report on how this national stockpile should be permanently organised, together with other measures to improve security of supply of PPE. One of the key issues in this work will be to clarify how to coordinate this national stockpile with the stockpiles held by the municipalities and hospitals.
Cooperation with other sectors, for example on procurement, national production and production agreements, will also be covered in the report.
The Government aims to put forward a proposal for a permanent scheme for PPE stockpiling and preparedness in connection with the budget for 2022.
Throughout the crisis, we have managed to secure access to the medicines we need. The Commission believes that the review of Norway’s pharmaceutical preparedness carried out in 2019 has played a role in enabling us to rapidly implement the measures needed to secure supplies.
As a result of our preparedness in this area and the fact that we have managed to keep the pandemic under control in Norway, we have also been able to assist Sweden by providing critical medicines for intensive care treatment.
Since May 2020, the Government has also developed substantial contingency stockpiles of other critical pharmaceutical products. The Government will present a proposal for a permanent solution in this area at a later stage.
Norway will never be self-sufficient in pharmaceuticals or medical technical equipment. The preparedness of Europe as a whole is therefore an important element in the discussion about Norway’s future preparedness.
The Commission highlights the importance of strengthening cooperation within Europe and the Nordic region. This is in line with the Government’s ambitions. Throughout the crisis, Norway has actively promoted Nordic and European cooperation on access to pharmaceutical products.
The European Commission has proposed establishing a new European Health Emergency Preparedness and Response Authority (HERA), which to a large extent will address issues relating to the development and production of pharmaceuticals in emergencies, and in situations where availability is limited. It will be vital in terms of our national preparedness for Norway to participate in this work.
The Commission points out that there was a significant reduction in hospital activity at the start of lockdown in March last year. In a situation of great uncertainty and with numbers of COVID-19 cases rising, it was necessary to reduce planned activities so that the hospitals could put in place new infection control routines and prepare to deal with a larger number of patients. This required more far-reaching adjustments for some hospitals than for others.
We have noted that the Commission points out that the reduction in planned activities and the resumption of a more normal level of activity were not coordinated well enough, and that it could be beneficial to develop national plans to avoid an unnecessary reduction in treatment capacity.
We will bear this in mind as we move forward.
At the same time, I would like to emphasise that the Government attached great importance to maintaining emergency care services, and healthcare services for cancer patients, children and people with substance abuse or mental health problems. The specialist health services have been successful in this regard.
In the areas of mental health care for children and young people and substance abuse treatment, waiting times were slightly shorter in 2020 than in 2019.
The Commission has received feedback from the hospitals that a shortage of personnel with the right knowledge and skills is the most significant obstacle to increasing intensive care capacity. I agree with that.
In order to meet the needs in this area in the short term, a national training programme for nurses has been established on intensive care treatment for COVID-19 patients.
In order to meet longer-term needs, we will carry out an assessment of the future, overall intensive care capacity required in our hospitals. But there is no doubt that capacity in this area must be increased. We have already asked the regional health authorities to train more intensive care nurses. At least 100 new trainee intensive care nursing positions will be established, and efforts to recruit, train and retain intensive care nurses in hospitals will be intensified.
I was pleased to note the Commission’s view that cooperation between the specialist health services and the municipalities has been effective. Cooperation within the recently established healthcare communities has been significantly strengthened.
There has also been a considerable increase in the use of video and telephone consultations. This is a positive trend that we have encouraged. To ensure that this trend continues, the Government has set a target of 15 % per year for the proportion of outpatient consultations that are to be carried out by video or telephone.
Measures introduced on 12 March
The Commission has carried out a very thorough review of the process leading up to the introduction of comprehensive infection control measures on 12 March. In the view of the Commission, the decision to impose the measures was right, and the Commission agrees with the Government’s analysis that the negative economic impacts would have been greater if the restrictions had been imposed later. I am pleased about that.
At the same time, the Commission points out that the package of measures should have been better evaluated and documented, and that the time pressure built up more than was necessary.
It is true that the time pressure was great. In the days leading up to 12 March, the infection was spreading far more quickly than anticipated.
It is important to make clear that the measures that it was necessary to introduce represented a paradigm shift in public health preparedness and response. We have been used to countries in Asia dealing with outbreaks of infectious diseases differently from Western countries. This time, we had to recognise that our Western approach was not adequate, but the countries that had implemented measures before us were not many days ahead. Time was of the essence.
The Commission also points out that the decision to impose the measures should have been taken by the Government, referring to Article 28 of the Norwegian Constitution, which states that matters of importance are to be taken up in the Council of State.
Our priority on 12 March was to take decisions quickly, gain control of the situation and prevent the further spread of the virus.
It was the Directorate of Health that took the decision to implement the package of measures. Under Norway’s Act relating to control of communicable diseases, the Directorate of Health has been granted broad powers by the Storting to take decisions to protect the population in the event of outbreaks of communicable diseases. The emergency powers under the Act were activated as far back as January 2020 when the coronavirus was defined as a communicable disease that is hazardous to public health.
Until 12 March, the pandemic was primarily dealt with as a health crisis, and in accordance with the distribution of roles set out in the plans. In light of the situation in the period leading up to 12 March, it was natural for the Directorate of Health to take the decision.
Nevertheless, I would like to emphasise that although the formal decision to introduce the comprehensive set of measures was taken by the Directorate of Health, the decision was taken in consultation with the Government. However, I agree that the decision should have been adopted by the Government in the Council of State, as the Commission points out.
As a result of the measures that were imposed, the crisis went from being a health crisis to a crisis with ramifications for all sectors of society. After 12 March, the Government assumed both formal and practical responsibility for managing the crisis.
As early as 13 March, the Regulations relating to quarantine etc. upon arrival in Norway were adopted in the Council of State. On 13 March, the Ministry of Justice and Public Security took over as lead ministry for the response. In an extraordinary meeting of the Council of State on 15 March 2020, the Government adopted new regulations on quarantine, isolation and a legal basis to prohibit stays at holiday properties.
The Commission points out that at the beginning of the pandemic, the authorities did not ensure that their infection control measures were in line with human rights and the Constitution.
This is a problem that the Government recognised early on and took steps to address.
Measures are now assessed against the Constitution, Norway’s human rights obligations and the European Convention on Human Rights. These assessments are documented and made public, together with the basis for decisions regarding infection control measures.
As already mentioned, under the Act relating to control of communicable diseases, the municipal authorities and the Directorate of Health have been granted broad powers to implement necessary infection control measures in the event of a serious outbreak of a communicable disease that is hazardous to public health. The Act stipulates that the measures must be proportionate, i.e. reasonable, given the situation.
I agree with the Commission that these powers are critical to ensuring a rapid response to outbreaks of communicable diseases. The purpose of the Act is to protect the population and prevent the spread of infection. The Act does not contain explicit provisions on democratic control of decisions, and I agree that this needs to be assessed more thoroughly.
All the powers under the Act have been activated in connection with the pandemic, and we have gained completely new experience of how the Act works in practice. I agree that the Act should undergo a comprehensive revision, and that the Storting should be invited to consider the issue of democratic control, the processes and the division of roles again. The Government will initiate a review of this kind and will present more details to the Storting in due course.
The Commission believes that too few consultative reviews have been held prior to decisions to implement infection control measures.
I agree with the Commission that consultations on new legislation are an important democratic instrument, including during crises. Many important proposals have been circulated for review, but often with a short deadline for responding due to the need to get the legislation in place quickly. In many cases, consultations have not been held because of the immediate need to introduce rules to prevent the spread of infection.
Regulations relating to the introduction or amendment of infection control measures have generally not been circulated for review, whereas regulations under the Corona Act have by and large been subject to a short consultative review.
Most proposals for amendments to legislation have been circulated for review. However, this was not possible in the case of the Corona Act, given our assessment of the situation in mid-March 2020, but there was instead direct dialogue with the Storting and other affected stakeholders before the Government’s proposal was presented. The Official Norwegian Report that the Corona Act is based on was, however, circulated for consultation.
Despite the fact that consultations have not been held consistently and the deadlines for responding have been short, it has been possible to provide input to the Government’s work. The recommendations of the various sectoral authorities have been published. Enquiries from private individuals, business and organisations about how the rules work and should work are taken into consideration when assessing the need for amendments. This public debate has helped to ensure that we have had the best possible rules for managing the spread of infection.
As I see it, there is a need to think along new lines about how to develop and document measures and rules in protracted crises. This could include holding subsequent consultations on selected issues, commissioning committee reports or formalising the process for providing input to the development of legislation.
The Government shares the Commission’s view that a clear framework should be established for accelerating legislative processes during a crisis, without undermining fundamental democratic principles and the rule of law.
Throughout the pandemic, the Government has attached importance to ensuring that the Storting has been fully informed of the Government’s crisis management efforts. Initially, there were frequent meetings between the Government and the Storting’s special committee on the coronavirus.
And this is the ninth address to the Storting on the Government’s response to the pandemic, given by either myself or the Minister of Health and Care Services.
Choice of strategy and reopening of society in spring 2020
In its report, the Commission gives its support to the Government’s choice of strategy. In March last year, we chose to take action to stop the spread of infection. This meant that we were able to gain control of the situation.
But there are limits to how long such a strategy can be maintained. As the Commission points out, the strategy must be assessed on the basis of the prospects for vaccines and immunity, the development of the virus, available treatments and the impacts on society.
The reason we were able to stick to our strategy is that it became clear early on that a vaccine would be developed fairly rapidly.
The Commission’s assessment is that we were right to open up society gradually during the course of the spring last year. This step-by-step approach enabled us to keep the situation under control.
In line with our strategy, one of the first priorities was to ease restrictions for child day-care centres, schools and universities. I note that the Commission agrees with this order of priorities.
The Commission points out that in the process of reopening, the Government to some degree gave into pressure from certain interest organisations such as the Federation of Norwegian Industries and the Football Association of Norway.
Throughout the crisis, the Government has maintained close contact with a wide range of stakeholders, such as industry organisations, employee and employer organisations and companies.
This contact has been vital for ensuring an effective response and for enabling us to gain an overall picture, adjust our course as necessary and introduce exemption schemes to avoid excessive impacts of the infection control measures. In some cases, we have agreed with the input we have received, and have made changes. In most cases, however, we have not complied with requests for exemptions or relaxation of restrictions.
During the pandemic, the level of measures has gone up and down, both at the local and the national level. But by managing to keep the spread of infection under control, Norway has overall had less stringent measures than many other countries.
At the same time, our rules for entry into the country have been among the most restrictive in Europe. As early as 15 March last year, we introduced strict restrictions on the right of foreign nationals to enter Norway. In early summer we gradually eased the entry rules. At the time, we were one of the last countries in Europe to open up its borders.
Starting on 15 June, an exemption to the quarantine rules was introduced for people travelling to Norway from regions in other Nordic countries where the rate of transmission was low. From 15 July, this was extended to include people arriving in Norway from other EEA countries with a low rate of transmission. The infection situation was assessed on a weekly basis.
The criteria for assessing the infection situation were determined on the basis of recommendations from the Norwegian Institute of Public Health and the Directorate of Health.
In the Commission’s view, the Government lacked a plan for handling imported infections when a new wave of the transmission emerged in Europe in autumn 2020.
The infection situation was moving in a favourable direction both in Norway and in most countries in Europe when we eased restrictions at our borders. The situation gradually deteriorated from late summer onwards. The requirement to undergo quarantine applied to people travelling from regions in the Nordic countries and countries in Europe where the rate of transmission was not low the whole time.
By this stage, we had a system in place whereby the rules on quarantine applied to people arriving in Norway from countries where the level of infection had exceeded specified thresholds.
In hindsight, we must acknowledge that the quarantine system was based on trust for too long. The Commission points in particular to the scheme allowing foreign workers to start working once they had received a negative test result. My assessment is that the entry system was based too much on trust, given the rising levels of infection in Europe in the autumn.
At the same time, I would like to point out that the Act relating to control of communicable diseases stipulates that when implementing infection control measures, importance is to be attached to voluntary compliance by those affected. It was therefore natural to try out trust-based measures before tightening the rules.
Around the turn of the year, there was a need to increase restrictions at the borders due to the emergence of new variants of the virus that spread more easily and caused more serious illness.
Foreign workers travelling to Norway are now required to provide documentation of a negative test, to take a test at the border, and to undergo quarantine at a designated hotel, and strict rules regarding which types of foreign workers are permitted to enter Norway have been introduced.
As a result of the decisive action we have taken, the proportion of confirmed cases originating from infections abroad has fallen dramatically and is currently very low.
Role of the municipalities
The Commission points out that substantial municipal-level responsibility for infection control in Norway is a strength. Norway’s municipalities have been responsible for implementing the testing, isolation, contact tracing and quarantine strategy and have thus played a key role in keeping the pandemic under control.
Many municipalities think that information about amendments to the infection control measures and new expectations of the municipalities should have reached them at an earlier stage, before this information was made public. I can understand that.
Dealing with a pandemic is no easy task. Decisions have to be taken quickly in many contexts. As a result, changes are often abrupt. If we had informed the municipalities of our decisions first, it would have taken longer for us to inform the rest of the population and other stakeholders. In balancing the various considerations involved, we decided to inform everyone of our decisions at the same time, and as quickly as possible.
But we are constantly striving to improve information and the flow of information to the municipalities. Recently, for example, we have chosen to allow for a somewhat longer period between communicating amendments to the measures and their entry into force. Our aim is to give the municipalities more time to adapt.
In the first phase of the pandemic, less attention was directed to municipal measures because, on the whole, the measures we implemented were national measures. Once we succeeded in suppressing the virus, we were able to take a more differentiated approach and suppress local outbreaks at the local level. In this phase, the municipalities have been followed up closely for example by the Institute of Public Health and the Directorate of Health. My assessment is that coordination has gradually improved.
The framework has also become clearer. Early last autumn, a circular was sent out providing guidance to the municipalities on local measures that could be appropriate, the potential design of the measures and the legal considerations required.
We have also put in place a scheme that ensures that municipalities and other relevant stakeholders are informed of amendments to the regulations when these are sent for publication on the Lovdata website.
The county governors also play a vital role in providing information and advice to the municipalities. In addition, they convey important information about the situation in the municipalities to the central authorities. The county governors are now required to review risk assessments from the Directorate of Health and the Institute of Public Health with the municipalities on a weekly basis.
Authorities’ management and coordination
The Commission gives a favourable account of the Government’s ability to deal with matters quickly and effectively. At the same time, it questions whether too many issues have been dealt with at too high a level.
In principle, I agree that matters should be dealt with at the lowest possible level. But during the pandemic it has been necessary to address a great many issues at government level. There is a need to see the overall picture, and to balance different considerations. This is a political responsibility. During the pandemic, there has also often been a need to cut through the various arguments and take decisions.
As a result of this need to address so much at the political level, the division of tasks between the Ministry of Health and Care Services and the Directorate of Health has deviated from the procedures normally followed in crisis situations managed by the health and care services.
The Directorate of Health has had responsibility for providing the Government with information on which to base decisions and proposals for measures based on input, primarily from the Institute of Public Health, but also from the health authorities, the municipalities and the county governors.
The Ministry has then carried out an overall assessment, which in turn has provided the basis for the Government’s decisions. The Commission’s general impression is that cooperation between the various governmental actors in the health and care sector has largely been constructive and flexible.
But I have noted the Commission’s point that too much micromanagement can undermine the scope for comprehensive, strategic assessments. In my view, we have managed to balance these considerations by establishing a clear strategy early on in the crisis, which we have stuck to but have reviewed on an ongoing basis.
The Commission also points out that there has been extensive and close collaboration between the Directorate of Health and the Institute of Public Health.
Both these organisations have been working under enormous pressure since the outbreak of the pandemic. This is the first time they have been able to test their cooperation and division of roles so extensively and over such a long period of time. It is only natural that it took a while to determine the optimum interface between them.
When the pandemic is over, the Ministry of Health and Care Services will review and evaluate how the various actors in the health sector have cooperated and whether there is a need to make revisions to legislation, emergency preparedness plans and the organisation of crisis response.
The pandemic has affected everyone, but the effects have varied
The Commission has concluded that overall, the pandemic has been managed in a sound manner. I am pleased about that.
The Commission points out that we adapted quickly and took decisions of crucial importance to the evolution of the crisis. After a year of pandemic, Norway has one of Europe’s lowest mortality rates and its economy is among the least affected.
We have many people to thank for this. We would have not been able to succeed without the population’s support of the infection control measures. In Norway, we have a high level of trust in each other. This puts us in a strong position to tackle crises.
We have sought to communicate openly about the assessments we have made, and have made public the expert recommendations we have received. I am pleased that in the view of the Commission, this openness has helped to promote trust.
We have not succeeded in reaching all segments of society equally. The Commission points out that we have had less success reaching the immigrant population than the rest of the population.
We had measures targeting the immigrant population in place early on, and we have gradually refined these efforts as we have gained experience and acquired more knowledge. We have learned a great deal about communication and various ways of reaching different groups in society.
An interministerial project has been established to ensure that we learn from this so that when the next crisis strikes, we are better prepared to provide information quickly to the whole population, including all segments of the immigrant population.
Even though we have managed to keep society open to a greater degree than many other countries, the pandemic has taken its toll. As the Commission writes, the pandemic has affected everyone, but the effects have varied.
The Government has attached importance to ensuring proportionality between the infection situation and the measures implemented. We have introduced compensatory measures where possible.
And we must not forget that the alternative to imposing restrictions would not have been to carry on as normal. We have seen in other countries that once the spread of infection gets out of control, drastic measures are needed to manage the situation.
As the Commission points out, it is too early to draw conclusions about the long-term effects of the pandemic. The long-term impacts will also be affected by the political choices we have made and will make in the time ahead.
The Government’s aim is to ensure that no one is left to deal with problems caused by the pandemic on their own. We have tackled this crisis together. And if we are to achieve our aim, we must come out of the crisis together as well.
Some people will have to cope with the ramifications for longer than others. Some will have fallen behind at school. Some children will be dealing with the after-effects of violence in the home. Some people will have mental health problems. Some will have health problems following COVID-19 or other illness. Others will have problems finding a job.
In my address to the Storting on 7 April, I described the Government’s plans to ensure that no one is left to deal with problems caused by the pandemic alone, and to minimise the long-term effects of the COVID-19 crisis.
In the revised budget, which will be presented soon, the Government will further strengthen these efforts, for example by proposing allocations for new measures to improve the situation of vulnerable children and young people. We will also continue to work to ensure that those who have missed out on education and training receive the support they need. We will also implement measures to prevent students from dropping out or delaying their studies.
In the revised budget, we will also follow up the report of the expert group appointed to assess the impacts of the pandemic on mental health and substance abuse.
We also need better knowledge about the long-term effects of the pandemic. We can acquire this through more research. The Government will therefore propose funding for this in the revised budget.
I would like to thank the Coronavirus Commission for its constructive and thorough report. The report contains 17 central conclusions and 63 lessons and recommendations.
The Government will use the report in its ongoing efforts to manage the pandemic, and not least in its work to prepare Norway for future crises. The report provides a good basis for this. The Government will also circulate the Commission’s report for comment.
But we are still in the midst of a crisis. There are still some 200 people admitted to Norwegian hospitals with COVID-19. Last week, nearly 3 000 new cases were registered. This spring, a new more infectious variant of the virus has emerged, and we have seen from other countries that the number of cases can suddenly skyrocket. At the same time, more and more people have been vaccinated. Nearly 1.2 million Norwegians have received at least one dose.
Against this backdrop, the Government has asked the Commission to continue its work and draw up a final report.
Managing the crisis is still our top priority. The Commission’s work so far will be very useful to us.
Some of the Commission’s recommendations involve major, far-reaching changes. We will have to take steps to address these when the pandemic is over. As I have already mentioned, the Government intends to present a white paper after the Commission delivers its final report. In the white paper, the Government will present its own assessments and proposals for follow-up action to ensure that Norway is better equipped to respond to pandemics in the future.