COVID-19 pandemic in Iceland
The COVID-19 pandemic in Iceland is part of the worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. The virus was confirmed to have reached Iceland in February 2020., the total number of cases registered was 1,893, of which 1,825 had recovered and 10 deaths had occurred. With a total population of 366,130, the infection rate is 1 case per 203 inhabitants, which was one of the highest in the world throughout March and April, though this is attributed to more tests having been carried out per capita in Iceland than any other country; these include a screening of the general population run by Icelandic biotech company deCODE genetics to determine the true spread of the virus in the community.
On 8 April, as the cases surged over 1,600 and more recoveries than new infections were recorded for the second day in a row, Iceland's head epidemiologist, announced that it was highly likely that the country had reached the peak of its outbreak.
Background
On 12 January 2020, the World Health Organization confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, which was reported to the WHO on 31 December 2019.The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll.
Timeline
January 2020
The Department of Civil Protection declared an uncertainty phase on 27 January in response to the unfolding outbreak of COVID-19 in China. Targeted testing for COVID-19 started on 31 January in Iceland for persons determined at high risk for infection.February 2020
On 28 February, Iceland confirmed the first case of COVID-19, an Icelandic male in his forties, who had been on a ski trip to Andalo in Northern Italy and returned home on 22 February; when he developed symptoms after his arrival, he was quarantined at Landspítali hospital in Reykjavík. Subsequently, The National Commission of the Icelandic Police declared an Alert Phase.March 2020
On 1 March, a second and a third case were confirmed, an Icelandic male in his fifties who had returned home on 29 February from Verona, and a female in her fifties who had returned home from Italy via Munich.On 2 March, additional six cases were confirmed, bringing the total to nine: five men and four women. All cases to date have been in the Reykjavík area. Five of those cases have been traced to Italy. In response, the Directorate of Health has defined Italy as a risk area for the disease, and all those arriving to Iceland from Italy are being asked to go into a 14-day home quarantine. The ninth case is that of an Icelander who had spent time in Austria and flew home on 1 March. After additional cases were traced to Ischgl in Austria, the Health Directorate defined Ischgl as a high-risk area. Authorities in the Tyrol state of Austria however contend that the Icelanders returning from Ischgl probably became infected on their flight from Munich but this is considered "very unlikely" by Icelandic health authorities as this group presented symptoms very soon after the flight.
On 3 March, in an official press report, sanctions were announced for those who would break the quarantine, which includes up to three months in prison, as it is considered an intentional contagion of the virus.
As of 5 March, around 400 people are in home-based quarantine in Iceland and around 330 individuals have been tested for the virus, but no cases of transmission within the community had been identified. Among individuals who had been tested for the virus, 35 had been confirmed as infected with COVID-19, but officials warned that this figure would rise when additional test results become available in the next days.
On 6 March, the total number of infected rose to 45, including the first 4 cases of local transmission of the virus. Iceland's Department of Civil Protection and Emergency Management declared a civil protection distress phase within minutes of local transmission of COVID-19 being officially confirmed.
On 7 March, five additional cases were confirmed: three cases of local transmission and two from previously defined high risk areas. All seven confirmed cases of local transmission are in the Reykjavík area. A total of 484 tests have been administered to date.
On 8 March, the total amount of infected rose to 58, a total of 10 of which are cases of local transmission. Three cases identified on 8 March were of Icelandic residents who had returned to Iceland on a special flight from Verona on 7 March; all passengers were Icelandic residents who had spent time in high-risk areas, and special precautions had already been taken to ensure that they would remain isolated from other passengers on arrival to Keflavík International Airport. That same day, no COVID-19 patients were ill enough to require hospitalisation.
On 9 March, two additional passengers from the special flight from Verona on 7 March tested positive for COVID-19. Three cases of local transmission were identified and two cases of Icelandic residents returning from ski areas in the Alps, bringing the total to 65.
On 11 March, it was reported that a COVID-19 patient had developed more severe symptoms and admitted to hospital, thus becoming the first patient in Iceland to develop more than mild symptoms of the disease. Also on 11 March 90 people in total had been diagnosed with COVID-19 and 700 were under quarantine.
On 13 March, it was announced that as of Monday 16 March, universities and secondary schools would be closing and a ban on public gatherings of over 100 would be put in place.
On 15 March, it was reported that three COVID-19 patients in Iceland were now in hospital, one in intensive care, and a health clinic in the capital city area has been closed after an employee tested positive for COVID-19. A total of 171 cases have been confirmed, a majority of which can be traced to ski areas in the Alps. Chief Epidemiologist Þórólfur Guðnason stated that half of all persons in Iceland who have tested positive for COVID-19 were already self-quarantining, suggesting that measures to control the outbreak through quarantine and isolation in Iceland have been effective so far. An estimated 2500 persons are self-isolating, with the number rising daily.
On 17 March, the first person with coronavirus was confirmed dead, a 36 y.o. Australian citizen who was visiting Iceland with his wife. He sought medical attention because of serious illness and died shortly after arriving at the Húsavík health clinic. Dr. Brynjólfur Þór Guðmundsson stated that COVID-19 was the probable cause of death. However, this had been later challenged by Dr Þorólfur Guðnason, the chief of the health directorate's national vaccination program in his interview to public broadcaster RUV: "While he was found to be infected with the coronavirus, it is unlikely to have been the cause of his death. His symptoms came on very quickly and were not those usually associated with Covid-19 deaths." The man's Australian family had also been told that health officials didn't believe the cause of death was due to COVID-19.
On 23 March, an Icelandic woman in her early 70s died from COVID-19 after a week-long battle with the illness.
April 2020
Two patients at Landspítali hospital died on 1 April, a man and a woman in their 70s. The man, aged 75, was the husband of the woman that died on 23 March.A mobile app to trace infections was developed and released on the first of April; after passing review by Google and Apple, the app was downloaded almost 75,000 times by 3 April 2020.
Two more deaths occurred due to the virus on 5 April, taking the total tally of deaths to six. One of the deceased was 67-year-old Sigurður Sverrisson, a renowned Icelandic bridge player; the other was Gunnsteinn Svavar Sigurðsson, a male resident of a nursing home in Bolungarvík in the Westfjords aged 82. On 5 April Iceland also recorded the highest number of active cases during the outbreak, at 1,096; since then, recoveries per day have outnumbered new cases.
Another two individuals died due to the virus by 11 April, taking the total deaths in the country to 8. A ninth patient, in their sixties, died at Landspítali hospital on 16 April; a tenth, a woman in her eighties, died at Berg nursing home in Bolungarvík in the Westfjords on 19 April.
Prevention measures
The response to the pandemic by Icelandic health authorities has focused on early detection and contact tracing and social distancing measures such as a ban on assemblies of more than 20 persons. As a member of the Schengen area, Iceland is restricting unnecessary travel by persons who are not citizens of the EU, the United Kingdom or the EFTA countries into the area but has not made other formal restrictions against international or domestic travel.On 24 January, the Directorate of Health announced preventive measures to curb the spread of SARS-CoV-2. Passengers arriving at the Keflavík International Airport with signs of respiratory infection and asymptomatic individuals who had been either in Wuhan for the past 14 days were medically assessed at the airport.
From 2 March, healthcare workers in Iceland were being encouraged to avoid travel and to remain in the country.
As of 16 March, no official social distancing measures or limitations or bans on public gatherings are in effect. However, organisers cancelled or postponed a number of upcoming events, including the annual conference of the School of Humanities of the University of Iceland, Hugvísindaþing, which was set to have taken place on 13 and 14 March.
At a press conference on 13 March, it was announced that public gatherings of more than 100 would be banned and universities and secondaries schools closed for four weeks. Later that day, announcements were made that stated or emphasised that:
- panic-buying was unnecessary;
- no shortage of food or medicine was foreseen;
- elementary schools and preschools would not be closed, although restrictions would be in place to maximize social distancing within schools; and that
- all schools in the Reykjavík area would close on 16 March in order to prepare.
On 16 March, the supermarket chain Samkaup announced that 27 grocery shops throughout Iceland would have special shopping times for vulnerable members of the public, including the elderly and those with chronic and underlying illnesses. Beginning 17 March, select Nettó and Kjörbúðin locations would reserve the hour from 9 to 10 a.m. for those shoppers at greatest risk of severe complications should they contract COVID-19.
As of 18 March, the whole world is defined as a high risk area. All travel abroad is discouraged and residents in Iceland who are currently abroad are encouraged to return home as soon as possible. Residents in Iceland who arrive from abroad will now go into quarantine.
On 21 March, a stricter ban on public assemblies was put in place in Vestmannaeyjar. Assemblies there with more than 10 persons would now be prohibited. A still stricter ban was announced for the Húnaþing vestra district, where all inhabitants have been ordered to stay at home except to buy necessities.
From 00:00 on 24 March, a nation-wide ban on public assemblies over 20 took effect. All swimming pools, museums, libraries and bars closed, as did any businesses requiring a proximity of less than 2 m.
Testing and quarantine
Icelandic health officials have used voluntary home-based quarantines for all residents returning from defined high-risk areas and virus testing as the primary means of preventing transmission within the community. Icelandic health officials have tested a proportionately high number of arriving passengers from high-risk areas for COVID-19, with the hope that early detection of infections will prevent their spread.An early concern among Icelandic residents placed in home-based quarantine has been employees' rights to paid leave while being quarantined; it was announced on 5 March that the COVID-19 outbreak will likely result in changes to legislation within the next weeks.
Those with symptoms of COVID-19 were asked to avoid health care centres and hospitals without calling ahead, to avoid exposing vulnerable individuals to the virus. Even mild symptoms of illness should be reported to 1700 for further guidance.
Official quarantine facilities for healthy individuals unable to enter a home-based quarantine have been established at a local hotel in Reykjavík. The Icelandic Red Cross will assist those who require help with acquiring necessities during quarantine and isolation. Any person in quarantine or isolation in Iceland can contact the Red Cross Helpline at 1717, which is open 24/7.
Initially, COVID-19 testing for Icelandic residents in quarantine took place mainly in their own homes. Due to the high volume of tests required, the decision was made to use mobile units parked outside health clinics; individuals not experiencing severe symptoms who require testing must contact authorities to book a time and location.
A shortage of tests has reduced the volume of COVID-19 testing in Iceland, hampering control and tracing efforts. It was announced on 22 March that an order of 5,000 swabs set to arrive the following week had been reduced at short notice by 3,000. The unexpected discovery of an additional 6,000 swabs in a warehouse was announced on 26 March 2020.