Pandemic Preparedness in Norway: A Mixed Methods Study on the Availability and Quality of Personal Protective Equipment for Paramedics in Oslo in the Light of COVID-19

Abstract

Background: Norwegian authorities predicted a pandemic outbreak as the most likely crisis and anticipated problems with the procurement of Personal Protective Equipment (PPE). Albeit national shortage of PPE during the onset of the COVID-19 pandemic resulted in rationing, likely leading to preventable infections among healthcare workers, as reported by a prior investigation. Former research indicates that paramedics were mostly infected among healthcare workers. Ensuring the UN’s goal of good health for all depends on access to healthcare, relying on healthcare workers’ access to safe health products. Pandemic preparedness in Norway focusing on PPE is assessed to ensure effective future responses. Objectives: Explore possible key factors of vulnerability for pandemic preparedness in Norway by documenting the availability and quality of PPE for paramedics in Oslo city centre during the first month of lockdown in 2020 caused by the COVID-19 outbreak, to identify future needs for improved pandemic preparedness. Methods: A mixed methods study with a cross-sectional design combining quantitative and qualitative approaches with defined points of integration. Record reviews on PPE availability were retrieved and later integrated into the qualitative data enquiry for further exploration. Paramedics’ perspectives on PPE quality, pandemic preparedness and future needs were investigated through focus group discussions and a key informant interview. Quantitative data were analysed descriptively, while qualitative data were analysed thematically. Results: Percentage availability for PPE were 1,50% for goggles, 129% for face masks, 28% for gowns and 28% for hoods. Paramedics experienced rationing and deficient PPE quality. Challenges with distribution strategies, unclear guidelines for PPE use, lack of training for infection prevention and weakness in protection against airborne transmission were reported. Conclusion: Results indicate key factors of vulnerability for pandemic preparedness in Norway. Paramedics showed strong resilience to maintain life-saving services while fighting for self-protection amidst handling a global medical crisis. Proper procurement and distribution of good quality PPE, clearer guidelines for PPE use, more infection prevention training, and focus on protection against future airborne transmission are recommended.