How did Norway manage to test so many people?

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When Norway confirmed its first case of coronavirus on February 26, the Norwegian Institute of Public Health immediately began to take steps to significantly increase the number of coronavirus tests it can perform.

“Since the start of the epidemic, there has been a massive expansion of testing capacity,” Didrik Vestrheim, senior consultant at the institute, told the Telegraph. “When we reported the first case in Norway, coronavirus testing was already available in the laboratories of major hospitals. Our institute then formulated advice and recommendations for diagnostic PCR testing, and it has been deployed in diagnostic laboratories across the country. “

The country has since tested 101,986 people for the virus, or 18,996 per million people – compared to just over 2,250 tests per million people in the UK.

The country’s enormous testing capacity may be one of the reasons it has managed to keep the virus under control, with only 66 deaths recorded on Sunday.

“We are one of the countries that tested the highest percentage of our population and the assumption would be that the more you test, the more mild cases you have among the confirmed cases, and the more benign cases in the denominator will have an impact on estimating mortality, “said Vestrheim.

He said widespread testing may also have helped slow the spread of the disease. “The more you test, the more people you find with mild symptoms, and you can also search for contacts and quarantine people with these mild cases,” he said.

Some 5,208 people tested positive for coronavirus in Norway, which means that less than 5% of those who reported symptoms and were tested positive for the virus.

Dag Berild, a doctor and associate professor at Olso University Hospital, argued that the low level of antibiotic resistant bacteria in Norwegian hospitals may also have played a role in the low death rate.

“Many cases of influenza pneumonia are complicated by bacterial pneumonia, so if this is also the case with the coronavirus, then patients in a country with a low resistance rate among bacteria would have a better prognosis than those in Italy , where they have a terrible lot of resistant bacteria, especially in Lombardy, “he said.

Vestrheim said that increasing Norway’s testing capacity has not been easy. “There has been a shortage of analyzes, for the equipment to extract before the PCR test, for the swabs you use to collect the samples,” he said. “There is also a huge shortage of protective equipment for health workers. “

But this had been helped by the fact that Norway has more than 20 public testing laboratories in the country’s hospitals, as well as those run by private providers.

“The health service in Norway is quite decentralized due to the geography, so we have diagnostic laboratories all over the country and a good network of collaboration between laboratories,” he said.

In addition to testing, Norway has had the highest number of confirmed pertussis cases in Europe for decades. According to him, this allowed his institute to rapidly deploy the tests across the country.

“Initially we had this quality control mechanism where all the positive samples were confirmed here in our institute, but gradually more and more laboratories have established good quality assurance, and it is therefore more and more widely available nationwide. “

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