DeCODE to Restart COVID-19 Screening of General Population

keflavik airport COVID-19 testing

Private biopharmaceutical company deCODE genetics will restart screening the general population for COVID-19. The company conducted COVID-19 testing of the general, asymptomatic population for around eight weeks this spring to determine how widespread the SARS-CoV-2 virus was in Icelandic society. Following a new cluster of community transmissions in Iceland, CEO of deCODE Kári Stefánsson decided to restart the initiative in order to determine whether the novel coronavirus is spreading in Iceland anew.

There are currently 21 active cases of COVID-19 in Iceland, around half of which are community transmissions. Contact tracing has revealed that a few of the infections have a common, as yet unknown source, leading experts to believe there are more infected, possibly asymptomatic individuals, yet to be found.

New Cases Suggest Virus is Spreading Again

“In the past few days, infections have sprung up with such a pattern that it has caused a bit of anxiety among us [at deCODE] and others,” Kári told RÚV. “For example, there are three people in the community who are infected with a virus with the same mutations that indicate that they come from the same source. And these are people who are not aware of having been connected in any way, and that leads one to the conclusion that there must be individuals between these parties, therefore there are more people out in the community infected with the same strain of this virus.”

Kári says that some of the individuals newly diagnosed had large amounts of the virus in their bodies and were therefore highly contagious. Added to that, there is a possibility that some individuals who attended a football tournament in Reykjavík were infected at the event. “And when you put all that together, it suggests that the virus has picked up again.”

Authorities Delay Loosening Restrictions

Health authorities have decided to delay the planned relaxing of COVID-19 restrictions by two weeks, from August 4 to August 18. Infectious diseases expert Kamilla Sigríður Jósefsdóttir stated that authorities were also considering tightening restrictions, both locally and at Iceland’s borders. An announcement on the matter is expected from authorities later today.

Toddler Diagnosed with COVID-19

COVID-19 Press conference Þórólfur Guðnason Alma Möller V'iðir Reynisson

A child just over the age of one was diagnosed with COVID-19 on Wednesday, RÚV reports. According to Chief Epidemiologist Þórólfur Guðnason, the child is currently asymptomatic.

The child arrived with their mother from Albania on June 20. The woman was confirmed to have COVID-19. Ten people connected to the woman were tested as a result of her diagnosis and 15 are now in quarantine.

See Also: First Community Transmitted COVID-19 Infection in Two Months

There have been eight confirmed cases of community infection in Iceland since travel restrictions were relaxed roughly two weeks ago. Over 400 people are still in quarantine following contact with a soccer player who returned from the US in mid-June. The player tested negative for COVID-19 at the border, but after discovering that she’d been in contact with a person with COVID-19 in the US, she was tested again and the second time, her test came back positive.

Gathering bans in Iceland have now relaxed to allow as many as 500 people to gather in one place. (This excludes children of primary school age, whose may gather in larger groups.) Scheduled events such as summer football tournaments for children, expected to draw as many as 2,300 children over a weekend, are still a source of concern for authorities who stress the risks. Such large gatherings are “undesirable,” remarked Þórólfur in a press conference, but as of yet, authorities have not intervened to postpone or cancel them.

New COVID-19 Study Provides Both “Assurance and Alarm”

COVID-19

A new study published yesterday in the New England Journal of Medicine, examining the spread of the SARS-CoV-2 virus among the Icelandic populace (via targeting testing and by open-invitation and random-population screening), found that children under the age of ten had a lower incidence of SARS-CoV-2 infection than adolescents or adults and that females had a lower incidence than males. The researchers also noted that many individuals who tested positive reported having no symptoms (although symptoms almost certainly developed later among some of them). The study was a collaboration between researchers at deCODE genetics, Iceland’s Directorate of Health, and the National University Hospital.

Targeted Testing

COVID-19 was first diagnosed in Iceland on February 28. Testing, however, had begun a month earlier, on January 31, 2020, with individuals deemed to be at high risk for SARS-CoV-2 infection being targeted. These included mainly persons who were already symptomatic (cough, fever, body aches, and shortness of breath), who were returning to Iceland from regions classified as high risk by the health authorities, or who had been in contact with infected persons.

Roughly 6% of the nation tested

As of April 4, 2020, over 22,000 Icelandic residents had been tested for SARS-CoV-2 or roughly 6% of the entire populace. Of the 9,199 individuals who had been targeted for testing, 1,221 tested positive for SARS-CoV-2 (13.3%). Of the 13,080 individuals tested through population screening, 100 tested positive (0.8%): 87 of the 10,797 (0.8%) individuals who accepted an open invitation for testing and 13 of 2,283 (0.6%) individuals who were invited at random. Most individuals in the targeted-testing group who received positive tests early on in the process had recently travelled internationally, in contrast to those who tested positive later in the study.

Results

The study found that within the targeted-testing group, children under the age of ten were less likely to test positive for SARS-CoV-2 than individuals tens years of age or older (6.7% compared to 13.7%). In the population-screening group, no child under ten tested positive, compared to 0.8% of those ten years of age or older. Furthermore, a smaller percentage of females than males received positive results both in the targeted-testing group (11.0% vs. 16.7%) and in the population-screening group (0.6% vs. 0.9%).

The study suggests that as the proportion of infected individuals identified through population screening did not “change substantially during the screening period,” the containment efforts of the Icelandic authorities proved effective. These efforts include the testing of symptomatic individuals, which began one month before the first confirmed SARS-CoV-2 case in Iceland, along with various social-distancing measures that were imposed roughly two weeks after the first confirmed case. Furthermore, all participants who tested positive for SARS-CoV-2 were required to self-isolate until ten days after their fever had subsided (or until they tested negative), and all persons who were in contact with individuals who tested positive were required to self-quarantine for two weeks.

Assurance and alarm

The researchers note that the prevalence of SARS-CoV-2 infection among persons at high risk for infection and the stability of the infection rate in the general population provide “grist for both assurance and alarm,” as a large portion of those who tested positive reported no symptoms:

“Symptoms were common both in participants who tested positive and in those who tested negative for SARS-CoV-2 in the overall population-screening group. Notably, 43% of the participants who tested positive reported having no symptoms, although symptoms almost certainly developed later in some of them. During the study, the prevalence of symptoms decreased considerably in both testing groups (despite the stability of the SARS-CoV-2 infection rate), probably owing to a general decrease in other respiratory infections, which in turn may have been brought about through measures implemented to decrease the spread of SARS-CoV-2.”

Recently, CEO of DeCODE genetics Kári Stefánsson spoke to Iceland Review and shed light on the spread of the novel coronavirus in Iceland. For further information on the state of the COVID-19 epidemic in Iceland click here.