Covid (?) in Norway: ERs are Overflowing with Twice as Many Patients as 'Normal' while Hospitals are Calling upon Retirees to fill the Staffing Gaps

Here's the 64,000 $ question: how much longer will the authorities manage to continue not talking about the elephant in the room?

Yes, the situation in Covidistan and elsewhere is interesting, at least to me, but we’ve got other things to follow-up on as well. So, today, we’ll talk a bit about Norway and it’s been a while since my last dedicated post, dated 10 June.

One of the chief reasons it’s hard to follow this ‘story’ is that the Norwegian authorities decided to stop disclosing patients’ injection status a while ago. I’ve summarised it four weeks ago, so, if you’re willing to join me going down this particular rabbit hole, feel free to click on the below link for further particulars:

Covid in Norway: IPH Monkeys w/Data, 'unvaxxed' virtually unaffected by Omicron in May, Authorities Call for End of Covid Passports

Yes, the Institute for Public Health (IPH) still publishes biweekly updates (the last one, covering weeks 23 and 24, is here). It’s all quiet on the Covid front, so to speak, with perhaps the exception of a light increase of hospitalisations due to Covid. This is due to ‘reduced’ or ‘weakened immunity’ and the ascent of the BA.5 variant. Thankfully, as the IPH insists, there’s yet ‘no sign that BA.5 causes a more severe course of disease’, as measured by the absence of critical ICU admissions or deaths. Still, ‘high vaccination coverage continues to support protection against severe disease’, a statement that has been repeated, almost mantra-like, for months now, without any supporting evidence provided (the evidence, as summarised and linked-to in the above post from 30 May, has been pointing towards the opposite effects of the injectable products).

Let’s move on, then, shall we?

Healthcare is in Trouble

A couple of weeks ago, I posted a long-ish exposé about the coming crash of the healthcare system in Norway. As evidence, I cited a drastic 23% decrease in the number of applicants for bespoke training, which is about twice as large compared to the average decrease of student applications in 2022 (relative to 2021).

The reasons are easily identifiable: ‘poor pay and working conditions’, as an article that appeared in the trade union Forskerforbundet’s magazine explained in late April. Yet, averages are one thing, the way they play out locally are quite another one. As I wrote back then,

many locations are witnessing a decline of 30% or more in terms of the number of applications, with dedicated institutions such as the one in Sandvika and Hammerfest [in the far north] seeing declines of 50-60%.

There’s of course a large number of reasons for this problem, including little immigration (often from Eastern Europe, which merely shifts the problem eastwards), the opportunities offered by the oil industry (much higher wages), and the like.

Still, the implications for the foreseeable future are enormous: as of spring 2022, there are but two applicants for every nursing training position, which means that it’s virtually guaranteed that nursing schools will have to enroll everyone who bothers to actually show up at the start of the term.

Another big issue is that many trained nurses leave the profession, apparently quite literally right after their residency (turnus) is over. In other words: taxes are used to train specialists who, in turn, never really work for the (socialized) healthcare system that paid for their training in the first place.

For further particulars, please see this post:

The Sun is Setting on Big Healthcare and Big Education--in Norway, of all places: buckle up!

Sure, the government could raise salaries and improve working conditions, but then again, where I live, kindergarten employees, nurses, and primary school teachers went on strike last spring because the government’s offer (+1.4%) was very low and didn’t cover rapidly rising costs of living (I moved to Norway in summer 2020, and core inflation rose by some 4.1%, but that was last year).

In other words: a pay-cut, arrived-at through the backdoor. By the way, it’s the same this year: some teachers and nurses are again striking, for inflation is even higher than last year, with the government ‘offering’ (at least my employment group) some +2.46% this year as a one-off, followed by annual wage increases of 1.1% for the next ten years. Yes, there’s some wiggle room in local negotiations, but keep in mind that I’m among the privileged few.

Most people (including me) will continue to bleed financially: gas prices are around 27-28 Norwegian crowns per litre of gasoline or diesel fuel (divide by 10 to get to US$ or € prices)—which is approx. US$ 13 per gallon; food prices and rents are shooting up, and the central bank just followed the US Federal Reserve in raising interest rates, i.e., increasing the price of loans, in particular mortgages.

Yet, the question is: would people notice?

The Future is Here—Now!

If you paid attention—and some of my Scandinavian readers certainly have been doing so—you would be able to read, every now and then, media pieces telling us that something is rotten in the state of Norway.

Take, e.g., media outlet Document.no, which ran the below piece in mid-May (!) already (my emphases):

Caption: ‘the capacities of St Olav’s Hospital in Trondheim are exhausted. Patients are storming the ERs, and so far, we’re seeing an increase by 17% of ER visits, compared to last year’

Recently, St Olav’s Hospital in Trondheim has had to raise its emergency preparedness due to a record influx of patients, with management quite concerned about these pressures:

‘Usually, there are some 30-35 patients in the ER at the same time every afternoon. Recently, we have experienced several days with over 60 patients’, says Lars Erik Laugsand, assistant head of acute and emergency medicine at St Olav’s hospital, to Adresseavisen.

It is the emergency room that is primarily affected by the difficult situation and which for several days in the last week has had to increase staffing. At the same time, the hospital has a record number of patients ready for discharge.

‘With the increased stress we are experiencing now, there is also a greater danger of unfortunate incidents and additional burdens’, Laugsand points out.

Trondheim municipality recently started using the new [electronic] medical record system Helseplattformen. The board of St Olav chose to postpone the introduction until after the summer for fear of reduced capacity at the hospital in the run-in phase, writes Adresseavisen. After the start-up with the new system, there have been problems with electronic messages between the hospital and the municipality.

See: some hospitals were having troubles reported in the media already in mid-May.

Now, in mid-June, the problem of over-crowded hospitals has exploded onto the national scene, as state broadcaster NRK reported just last week (my emphases):

Caption: ‘overcrowded ERs—heightened readiness levels in many hospitals: ER visits are through the roof, and hospitals don’t have any good explanation’

Hospitals in Trondheim, Stavanger, and at [Akershus, i.e., the capital’s university] hospital in Oslo are reporting full ERs and capacity problems. A new Covid wave, patients ready for discharge who cannot be turned over to municipal outpatient services, refugees from Ukraine who need medical help, and an ongoing wave of elderly people are cited as possible explanations. But no one has good answers.

‘We do not know why there are so many acute admissions to Norwegian hospitals. It’s not just at St Olav’s. We see that this is happening in all the hospitals, and no one has an explanation for that.’ That’s what Grethe Aasved, hospital director of St Olav’s hospital, says.

Oh, well, where shall we start? A new Covid wave? Really?

So, apart from gratuitous anti-refugee sentiments (yeah, you know, Ukraine’s ‘governments’ ran the country into the ground—well before Mr. Zelensky’s current predicament)—but to blame refugees is a quite distinct low, even allowing for legacy media’s conventional biases. (Also, way to go, Norway, it’s probably suboptimal for your self-identification as the world’s leading do-good country, too…)

Also, what are all the senior citizens doing in the hospitals? Could it be that after two years of Covid insanity, with many screenings and regular appointments postponed or cancelled, that this overall problem now disproportionately affects the elderly?

If anything, I doubt that there’s any single one explanation, so, perhaps the article explains to us what’s going on?

St Olav’s hospital switched to yellow emergency on Wednesday [22 June] night. There are a number of simultaneous situations that result in the hospital now as having capacity problems.

The number of ER visits has increased, and Aasved says it is a question of internal medical disorders, and not related to accidents. In addition, the hospital is noticing the influx of Ukrainian patients and an increase in Covid-19 patients. The patients therefore accumulate in the ERs.

‘It can be dangerous when we do not get them further into the hospital where they will be treated. It challenges patient safety’, says Aasved. The hospital director describes the situation as ‘very demanding’ ahead of the summer holidays.

Oh, look: Covid? It’s a nothingburger here in Norway. No-one talks about it anymore, and there’s no data to support the notion that ‘cases’ and the like are much higher here than in, say, South Africa. You know, Norway isn’t Portugal, Covid-wise.

See the highlighted sections: ‘internal medical disorders’, i.e., it could be anything and everything. (As an aside, when I told my wife about the media item, she immediately shot back: ‘it’s the vaccination, stupid! All these internal problems, I bet it’s cardiovascular issues…’)

St Olav’s also has a high proportion of patients ready for discharge, which has contributed to the need for an increased level of preparedness. Due to the situation, the hospital has decided that hospitalisations and scheduled operations will be postponed.

The hospital director cannot provide further particulars about the extent of the postponements, but she points out that each and every case will be based on a rigorous medical assessment in each individual case.

‘We’re worried that the situation may get worse. There is so many things going on simultaneously, and we don’t have control over that. At the same time, no one in our region should be afraid of getting sick. We prioritise the necessary preparedness to provide emergency help’, says Aasved.

She describes the situation for the employees as very demanding and praises them for their efforts during a demanding period: ‘I want to pay a huge tribute to the employees who have been in this for so long and how they go the extra mile’, she says.

Oh, look: postponed treatments in the absence of any crisis. And empty words, again, but no mention of, say, increased wages or better working conditions. Let’s all have a round of applause for the nurses, again, for that shall be enough, eh?

But, wait, there’s more (and see how many sentences fit between the first 180° contradiction between statements):

Lacking staff: the director of health and welfare in Trondheim municipality also says that the situation has been unexpected. ‘Personnel capacity has been stretched for some time, it’s just acknowledging it’, says Wenche Dehli. She believes the pressure is due to a lack of qualified healthcare workers during the summer. Dehli tells NRK that the situation is more difficult now than during the two past Covid summers.

‘We focus on maintaining sound healthcare service for all residents, that is our main task. We may have to resort to reducing the level of service a bit’, says the director. Nevertheless, she explains that several services have already been marginally staffed for two years, and that it has gone well.

‘But I am concerned about a tough work environment, and that those who receive services will have a slightly poorer quality than what we would rather have been able to offer them’, says Dehli.

See, there were significant personnel shortages, exacerbated during the past two years, but all the chap and empty talk (‘great respect’) can no longer gloss over a ‘tough work environment’ that results in reduced standards of care. Of course, Norwegians get to continue the same share or taxes for poorer standards of care, but then again, if citizens just pretend that being a consumer is all that’s required in these allegedly post-political times.

If you haven’t done so, I recommend you venture over to Margaret Anna Alice’s recent essay about this particular, if existential, aspect:

Anatomy of a Philanthropath: Dreams of Democide & Dictatorship

How Bad Are Things?

Well, on the one hand, I’m ‘relieved’, of sorts, that the hospitals are overflowing with non-Covid patients, which renders it quite hard, if not outright impossible, to blame this surge—actually a doubling of ER visits compared to last year—on ‘the unvaccinated’, as the above-cited NRK piece explains:

‘There are currently many admissions for different types of acute, or emergency, help, in addition to a demanding surgical situation and in several recoalescence areas’, Ahus writes in an e-mail.

The hospital writes that there has been an increase in Covid-19 patients that contributes to a demanding situation, but that this group is not the main driver of the increased ER visits.

See, in a 90% ‘vaccinated’ country, such as Norway, increasing healthcare demand does not emanate from ‘the unvaccinated’ few.

‘It is true that there are more people with Covid hospitalised now, mostly elderly people with worsening other conditions and only slightly ill from Covid itself.

However, this situation contributes to the total load being large’, says Anne Maagaard, head of department at the Department of Infectious Disease Medicine [at Akershus University Hospital, Oslo].

She is excited about how the summer will be, since we now live as normal again.

‘Healthcare workers are also looking forward to the holidays, so I hope we get through the season in a not too intrusive way’, says Maagaard.

Here I must explain that under Norwegian law, every employee has the legal right to three consecutive weeks of paid vacation, which is what makes a lot of businesses, public offices, and services hard to maintain during July. Many industries close for the season, with many services, such as public transportation, going into ‘summer mode’ (i.e., reduced schedules), for no other reason than the three-week vacation entitlement.

Here’s the ‘cumulative’ result, by the way:

The University Hospital in Stavanger went into green emergency earlier this week. Emergency preparedness is increasing because the hospital receives far more patients than expected. The hospital has seen over time that the group of patients who end of in the ER has increased. They now have 150 emergency admissions a day. This is twice as many as normal. On Wednesday, seven of the patients in the cardiovascular ward had to lie in the hallway.

‘There is pressure on the whole house. We must try to help out with whatever happens, if we have a free room or free corridor space’, says nurse Kjellaug Hagen Bakkedal.

Eldar Søreide is the district director at Helse [Healthcare] Stavanger and believes that the aging wave [eldrebølge] is the explanation for the increased pressure on the hospital.

‘Many people probably think that it is an expression that the general population is getting older. Then you have more need for health services and immediate help’, says Søreide.

Bottom Lines

So, instead of blaming the elderly now, here’s what I think: much like the significant reductions in the birth rate of other countries (e.g., -23% yoy in Taiwan or -8% in Germany, on which see Igor Chudov’s pieces here and here), there is not one single explanation.

I do think that it’s a combination of repeat injections with these darned mRNA products, which I deduce from the many ‘internal’ and ‘cardiovascular’ issues cited. In addition, 2+ years of significantly reduced screening and regular examination scheduling is fuelling this crisis.

On the other hand, as I’ve explored earlier (see the above-linked item), the personnel, or staffing, issues was a big thing everywhere for the past two or more decades. This isn’t news, to the contrary, and the Norwegian government’s Covid Committee, on which see the four-part series (all linked in the below piece).

Covid in the North: Vulnerabilities, Lessons Learned, and Recommendations by Norway's Koronakommission

I find the government’s non-reaction disingenuous and mind-boggling, but I can understand it, politically: there’s no upside, really, to admitting mistakes here, esp. since we’re talking serious health-related implications.

At some point, these problems will come to the fore anyways, though, because they are quite widespread and hence increasingly difficult to suppress over time. We’re not quite ‘there’ yet, but we’ll get there in the end.

Also, in terms of ‘how bad is the situation already’? Well, some hospitals are bringing back retired nurses to help out, including 84yo Johanne Elisabeth Rudborg who was portrayed recently by NRK.

Let’s see how much longer the powers that be will get away with this.