The COVID 19 pandemic - risk factors, severity, and the consequences of nationwide control measures on public health

In this project, we want to study the clinical effect of the COVID19-pandemic as well as the consequences of national control measures on multiple levels in close collaboration with Trøndelag county council and Trondheim and Frosta municipalities. The largest, population based, prospective study in Norway, the HUNT study, has been conducted in Trøndelag through 4 waves, between 1984-2019. Based on the HUNT 4 study (2017-2019), with a 60 % attendance rate in Frosta, and 54% overall, we have an excellent bases of recent prospective health data and biological markers to study both biological, economic and social consequences of the pandemic and various levels of lock-down. We will build on an already established collaboration with public health services on county and municipality level. We will address a variety of health issues, such as i) general health and well being ii) the short and long-term effect of COVID19, iii) overall and cause-specific mortality and development of other common diseases, iv) outcomes for mental health and effects of socioeconomic positions, v) a special focus on adolescents and the elderly, vi) a clinical follow-up of infected in the population and a surveillance protocol to monitor vaccination response and potential side-effects based on the same cohort. The study started Sept 1, 2021, and so far we have already included 5000 participants, a 63% attendance rate.

In spite of a relatively low infection rate both nationwide and regionally by the corona virus, SARS-CoV2, we have reasons to believe that the national control measures and the fear of being infected and taken seriously ill, have affected public health significantly. There were, however, also serious outbursts of COVID-19 in at least one municipality in Trøndelag, Frosta kommune, that lead to the first total lockdown in Norway, setting the entire municipality in quarantine. In this project, we want to study the effect of the pandemic on multiple levels in close collaboration with Trøndelag county council and Frosta municipality. The largest, population based, prospective study in Norway, the HUNT study, has been conducted in Trøndelag through 4 waves, between 1984-2019. Based on the HUNT 4 study (2017-2019), with a 60 % attendance rate in Frosta, and 54% overall, we have an excellent bases of recent prospective health data and biological markers to study both biological, economic and social consequences of the pandemic. We will build on an already established collaboration with public health services on county and municipality level and focus specifically on this work packages WP1 - General health and well being WP2 - Overall and cause-specific mortality and disease trajectories WP3 - Mental Health WP4 - Socioeconomic positions (SEP), WP5 - Adolescents (Young HUNT), WP6 - The elderly (HUNT 70+) WP7 - Clinical follow-up of all infected as well as nearest family/social contacts WP8 - Vaccination oohort Collecting new information from HUNT 4 participants extensively screened, 1 -2 years prior to the introduction of the SARS-Cov2 virus, constitute an excellent design to study all these aspects of the pandemic.