COVID-19 in Norway

          Oslo University Hospital, Norway Norway has been less severely affected by the COVID-19 pandemic than some other European countries, but an ophthalmologist at the Oslo University Hospital was among the first cases registered in the country. The retinal surgeon came to work on 25 February with mild respiratory tract symptoms. Although the surgeon had just returned from holiday in northern Italy, COVID-19 was not suspected at first because the individual had not visited an area that the Norwegian Institute of Public Health identified as being at-risk for the infection. The physician stayed home the next day because of fever and myalgia and tested positive for SARS-CoV-2 on 27 February. Over the next week, four more retinal surgeons and an ophthalmic nurse developed COVID-19 symptoms and tested positive. Subsequently, more than 100 other employees were tested and were all negative. The infected individuals and close contacts were placed in home isolation, all elective appointments were cancelled, and the surgical retinal service was closed. Colleagues described the event in a letter to the editor of Acta Ophthalmologica submitted on 10 March. They stated in the correspondence that no patients or other employees were known to be infected through exposure in the department, and after thorough decontamination, the department would reopen on 13 March. Providing an update to EuroTimes on 14 April, Dr Jørstad reported there are no new COVID-19 cases related to the outbreak within the ophthalmology department, and the department reopened as planned with implementation of important preventive measures. “Nurses and doctors now wear masks and are generally vigilant about hygiene practices. Moreover, guards at the entrance to the building ask everyone about potential symptoms of COVID-19 and travel,” Dr Jørstad explained. “Routine ophthalmic visits have been postponed, but care is being provided to patients for whom workup and treatment should not be delayed, including those needing surgery for retinal detachment, glaucoma, or congenital cataract. ROP screening and anti-VEGF treatment are also continuing.” The ophthalmology department at Oslo University Hospital is located in a separate building, which was fortunate for avoiding more generalised disruption of care. Reflecting on the experience, however, Dr Jørstad and colleagues suggest subdividing certain services to limit any negative impact on ophthalmic care continuity in the face of an infectious outbreak or other events. “In particular, we believe it would be helpful to house a second intravitreal injection clinic at a satellite centre. Our clinic schedules more than 100 injection appointments daily, and postponing these visits can quickly have sight-threatening consequences for patients,” Dr Jørstad said. The authors also called for better dissemination of public health warnings. “In February 2017, the COVID-19 outbreak was rapidly unfolding in Europe, and distributing updated information was crucial. However, advice that travelers returning from areas of contagion in Italy should seek medical attention for respiratory symptoms was only issued as a homepage message and not actively distributed to Norwegian health services,” Dr Jørstad explained.

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