First Measles Case in Iceland in Five Years

Landspítali national hospital

An adult traveller visiting Iceland was diagnosed with measles on February 2, Iceland’s first case of the highly infection illness in five years. The man is in isolation at the National Hospital and all those at risk of exposure to the illness have been contacted by authorities.

A serious illness

Measles are a highly infectious, serious illness, characterised by red flecks that spread across the skin. The death rate of measles infection is 1-3 per 1,000 cases. Once infected, it usually takes 10-12 days for symptoms to appear.

While those who have been vaccinated against measles are very unlikely to get infected, participation in measles vaccination in Iceland has been falling in recent years. According to the newest review by the Directorate of Health, participation has dropped from around 93-95% down to around 90%, which is too low to maintain herd immunity.

“We would really like to see higher [participation] in order to better prevent the spread of infection through society, but participation needs to be quite good to ensure that,” Chief Epidemiologist Guðrún Aspelund told RÚV. She added that measles infections are on the rise in Europe, which increases the likelihood of an outbreak in Iceland.

Eradicated in the 90s in Iceland

Measles were eradicated in Iceland in the 1990s, and were not diagnosed again until 2014. Since that date, all measles cases diagnosed in Iceland have originated abroad. “It’s not circulating here in Iceland and we want to prevent it from spreading and leading to group outbreaks or more cases here,” Guðrún stated.

Children in Iceland typically receive two measles vaccinations, which Guðrún says provide protection for life.

COVID-19 the Likeliest Explanation for Excess Mortality in 2022

From the night shift at the COVID-19 ward.

Chief Epidemiologist Guðrún Aspelund believes that COVID-19 is the only possible explanation for excess mortality in Iceland last year, RÚV reports. Guðrún emphasised that vaccinations had in all likelihood reduced mortality and that the number of deaths was to be explained by a large number of infections.

COVID-19 deaths on the rise again

After a significant decline last autumn, the number of deaths due to COVID-19 has begun to rise once again; thirteen individuals died from COVID-19 in Iceland in January 2023, compared to an average monthly mortality rate of three between the months of August and October last year.

Yesterday’s RÚV reported that there had been an inordinate number of excess deaths last year, which suggests that twice as many people – or about 400 – had died from COVID-19 last year than previously thought.

Chief Epidemiologist Guðrún Aspelund told RÚV that COVID-19 was really the only explanation: “There were excess deaths in 2022 at around the same time as the big omicron wave hit between February and March. And then there was another smaller wave in July, which was when the excess mortality rate rose again,” Guðrún remarked. “And there is no other explanation for these deaths other than COVID-19.”

As noted by RÚV, excess mortality also increased in other countries after waves of COVID-19 passed. Guðrún noted that the pandemic could also have had an indirect effect on mortality: “It could mean reduced access to the healthcare system in some countries, or some other societal trends,” Guðrún observed.

More deaths in January 2023 than in all of 2021

In 2020, there were 31 confirmed COVID-19 deaths, while in 2021, the number decreased to 8. Last year year, however, there were 211 confirmed COVID-19 deaths, but as previously mentioned, the deaths last year were probably closer to 400. The latest available data from the health authorities are from January, 2023, which indicate that thirteen individuals died from COVID-19 during the first month of the year. This number exceeds the total number of deaths for all of 2021.

As noted by RÚV, there were also excess deaths in January: 70 deaths per 100,000 inhabitants, while deaths in January are, on average, usually around 60 per 100,000 inhabitants. Guðrún noted that around the turn of the year, there was a great number of covid infections. “But then there were also other infections, like influenza and RS.”

More infections = more deaths

82% of the population, aged five and over, are fully vaccinated against COVID-19, and more than 55% of the nation has been diagnosed with the disease. Given this, a reporter from RÚV asked why the number of COVID-19 deaths had increased last year.

Guðrún replied that a rise in the number of deaths could not be attributed to vaccinations. “On the contrary, I think the situation would have been much worse if there had been no vaccinations … the omicron wave was, of course, much bigger than others that had preceded it, and, as a result, more people got sick,” Guðrún remarked.

Record Number of Coronavirus Deaths Since Start of 2022

vaccination Laugardalshöll

Deaths from COVID-19 have hit a record high, Vísir reports, with 188 people having died from the coronavirus since the beginning of 2022. According to Chief Epidemiologist Guðrún Aspelund, the effect of COVID-19 far outweighs the effects of other infectious diseases such as influenza.

Mainly individuals 70 years and older

Deaths from COVID-19 have surged since the start of 2022, Vísir reports. Thirty-one people died from the coronavirus in 2020 compared to eight in 2021. During the first ten months of 2022, however, that number has risen to 188.

According to Chief Epidemiologist Guðrún Aspelund, this upswing in cases owes primarily to the highly infectious Omicron variant and the fact that no social restrictions are in place. Deaths have mainly occurred among individuals seventy years and older.

“Which is why we’re encouraging older people, everyone sixty years and older, and those who are at risk, to get their booster shots. That’s the best form of protection,” Guðrún remarked, adding that protection from vaccines diminishes over a period of a few months.

“We’ve also got new vaccines now that offer protection against the original variant of coronavirus and Omicron, which offers better protection. We need to repeat these vaccinations to enter into winter with good protection.”

Read More: Long-form Interview with former chief epidemiologist Þórólfur Guðnason

Guðrún observed that Iceland’s neighbouring countries have also been seeing a rise in cases in 2022. “Confirmed deaths from COVID-19 are believed to be around six and a half million. But there are many who believe that those figures are at least twice as high – thousands of people are still dying from coronavirus every week.”

According to Guðrún, deaths from coronavirus are significantly higher than deaths from influenza. Coronavirus deaths in Iceland are, however, lower when compared to other countries, with Iceland having the lowest death toll among the Nordic countries.

When asked to speculate why, Guðrún pointed to Iceland’s speedy vaccination campaign, its social restrictions, and the fact that the healthcare system had responded well. “I think we can chalk up this achievement to these factors along with the participation of the citizenry.”

Nine Infected with Monkeypox, Vaccine En Route from Denmark

Nine people had been diagnosed with monkeypox in Iceland as of last week. RÚV reports that Iceland has still not received its own shipment of the monkeypox vaccine and so will be borrowing vaccines from Denmark in the meantime.

In an interview on Wednesday, Chief Epidemiologist Þórólfur Guðnason said there was no indication that the monkeypox epidemic is on the decline. Around 14,000 people have been diagnosed with the disease worldwide, 8,000 of whom are in the European Union and 2,000 of whom are in the UK.

“The figures are going up. There’s nothing that indicates that this on the decline. So every country is just preparing to offer vaccination and even antivirals when they get them,” said Þórólfur.

Þórólfur added that Iceland is receiving a loan of 40 vaccine doses from Denmark, as the country  is still awaiting its vaccine allotment from the European Union.

“It’s not clear when they will arrive,” said Þórólfur, “but it shouldn’t be long now.”

Imposing COVID Restrictions Now Would Have Limited Effect, Chief Epidemiologist Says

Chief Epidemiologist Iceland Þórólfur Guðnason

Iceland’s Chief Epidemiologist Þórólfur Guðnason told Kjarninn that imposing COVID-19 restrictions in Iceland now would have limited effect on the spread of the SARS-CoV-2 virus. The currently dominant variant, BA.5, is more contagious than the omicron variant, and a newer variant that is emerging elsewhere in the world, BA.2.75, appears to be still more contagious. Very strict measures would be needed to prevent the spread of these varieties, and their success would be far from guaranteed.

Most re-infections among those who caught the virus early

COVID reinfections in Iceland are by far most common among those who were infected early in the pandemic: before the Omicron variant became widespread. The reinfection rate among people who were infected with the Omicron variant is under 1%. Þórólfur says this could change, however, with the arrival of new variants that could be evading previous immunity. The Chief Epidemiologist noted that in almost all cases, reinfections have been milder than the initial infection.

The Chief Epidemiologist observed that likely neither the Icelandic public nor the government is likely to welcome restrictions at this time, but luckily the COVID-19 situation in Iceland has been relatively stable. Around 30 people in Iceland are in hospital due to a COVID-19 infection, most infected for the first time, and one or two of them in the ICU.

Þórólfur expressed his hope that immunity against COVID-19 would continue to build up and infection rates and rates of serious illness would begin to decrease soon. Iceland’s herd immunity is already very high, he added, and fourth doses are not recommended except for at-risk groups.

Increase in COVID Admissions, But Infections Much Milder

Iceland National Hospital COVID-19

As many as 150 new cases of COVID-19 are being diagnosed every day in Iceland and the number of patients admitted to the hospital for COVID infection is also rising incrementally, RÚV reports. While there are a considerable number infections all throughout Iceland, however, Chief Epidemiologist Þórólfur Guðnason says that fortunately, these cases are much, much milder amongst those who are vaccinated.

Fortunate as well, says Þórólfur, is that the stress on Iceland’s health system is not nearly what it was at the height of the pandemic, when there were 88 patients in the COVID ward at once. There were only two people in Landspítali’s COVID ward at the start of May, which increased to nine patients on Thursday, and 16 on Friday. Admissions are mostly elderly patients and those with underlying conditions, but as the infections are not as acute, none of those currently in the hospital are on ventilators.

“There’s no doubt about it, of course we would have liked for the vaccine to prevent infection,” Þórólfur remarked. “It doesn’t do that, but what it does do, first and foremost, is prevent serious illness. If we didn’t have this widespread vaccination, particularly amongst older age groups, I think we’d have much worse infections and more people in the hospital.”

Iceland’s Chief Epidemiologist Resigns

Chief Epidemiologist Þórólfur Guðnason

Chief Epidemiologist of Iceland Þórólfur Guðnason has sent in his resignation. The Directorate of Health announced the decision on its website this morning. Þórólfur is leaving the job both for personal and professional reasons.

According to the Directorate of Health, the main reason for Þórólfur’s resignation is that the current wave of COVID-19 infection has mostly subsided and a new chapter is beginning in the Chief Epidemiologist’s role. “This new chapter includes, among other things, a review of the response to the COVID pandemic with the aim of improving response to future pandemics,” the notice from the Directorate states. The Chief Epidemiologist will also be shifting focus back to the routine projects that were largely put on hold due to the pandemic.

Pandemic far from over

Led by Þórólfur, Iceland’s response to COVID-19 received global attention early in the pandemic. With a focus on testing, tracing, and isolating cases, the country managed to contain the first wave with relatively few infections and deaths – and without ever instituting a total lockdown or closing schools.

“While Iceland is currently in a good place in the COVID pandemic, it is far from over globally and while such is the case, it will be necessary to closely monitor the emergence of new variants of the virus and how well and for how long the immunity that individuals have achieved will last,” the notice on Þórólfur’s resignation states.

Another reason for Þórólfur’s resignation is that he turns 70 next year: the age at which the Chief Epidemiologist is required by law to leave the position. His resignation will take effect September 1.

Þórólfur recently reflected on his work throughout the pandemic in an interview with Iceland Review.

 

 

What’s the status of COVID-19 vaccination in Iceland?

bólusetning mass vaccination Laugardalshöll

Iceland received the first doses of COVID-19 vaccine on December 28, 2020 and vaccination began the following day. As of April 2022, 79% of Iceland’s total population has been fully vaccinated, or 82% of the eligible population. Iceland began administering booster shots in late 2021 and offering vaccination for 5- to 11-year-olds in January 2022.

 

COVID-19 vaccination is optional and free of charge in Iceland. Vaccines were initially administered according to priority groups defined by health authorities, but the priority groups were abolished in June 2021 once all residents aged 16 and over had been offered vaccination.

All foreign residents in Iceland have access to vaccination regardless of residency status or whether or not they have a local ID number (kennitala). 

Icelandic data shows that vaccinated individuals are less likely to contract the SARS-CoV-2 virus and that vaccines are very effective at staving off serious illness and hospitalisation due to COVID-19. Iceland’s Chief Epidemiologist Þórólfur Guðnason has stated that booster shots could help Iceland reach herd immunity. Local data shows that a third dose may increase protection against COVID-19 infection, transmission, and serious illness by 90%, as compared to just two doses.

Vaccines Through European Union 

Iceland and other EFTA countries are guaranteed the same access to vaccines as member states of the European Union. The European Commission has signed contracts with six vaccine manufacturers, including AstraZeneca, Pfizer, and Moderna. The Commission negotiates the number of doses it receives from each manufacturer and they are divided among countries proportionally. Each individual country also makes contracts with vaccine manufacturers and EFTA member states such as Iceland do so through Sweden.

Below is the latest information on the status of all COVID-19 vaccines expected in Iceland.

This article will be regularly updated.

 

Our Latest news articles on COVID-19

COVID May Be a Factor in Elevated Number of Deaths in Early 2022

Chief Epidemiologist Iceland Þórólfur Guðnason

Statistics Iceland reported an unusually high number of deaths in the first quarter: 760 in total, or 150 more than during the same period last year. Iceland’s Chief Epidemiologist Þórólfur Guðnason says COVID-19 could be a factor. He says, however, that the numbers much be considered in context.

When looking at the numbers of monthly deaths between 2012 and 2019 on one hand, and 2020 and 2022 on the other, it comes to light that there was an increase in deaths among those 70 and older in March, but not in February. The wave of omicron infection peaked in March, as Þórólfur told RÚV. “As we have pointed out before, it seems that COVID has been an influencing factor in the deaths of many senior citizens and people with underlying illness.”

COVID restrictions likely prevented senior deaths

Þórólfur adds that it is difficult to make conclusions about COVID deaths from these numbers alone, but it is interesting to note that in the middle of 2020 and at the start and end of 2021, the number of deaths among those 70 and older was unusually low. “I think it is very likely that the measures that were in effect in 2020 and 2021 protected this age group well,” Þórólfur stated.

COVID-19 in Iceland: 80+ Offered Fourth Dose

bólusetning mass vaccination Laugardalshöll

Iceland’s Chief Epidemiologist Þórólfur Guðnason has decided to offer a fourth dose of COVID-19 vaccine to those 80 years of age and older, as well as all residents of nursing homes, Vísir reports. The decision is based on data from abroad that show COVID infection among older demographics can lead to serious illness even after three doses of COVID-19 vaccine. Þórólfur expects infection rates to remain low throughout the summer but points out that there is still uncertainty about how long immunity from vaccines and previous COVID-19 illness lasts.

“There is data emerging both from across the pond and from Europe that infections among these individuals that have received three doses can be very serious, much more serious and worse than among younger people that have received three doses,” Þórólfur stated. “There are recommendations from the European Centre for Disease Prevention and Control and the European Medicines Agency to offer these people a fourth dose and it’s on that basis that we are doing so.”

Chronically ill encouraged to receive fourth dose

Previously, the Chief Epidemiologist has only recommended fourth doses of COVID-19 vaccine to those who are chronically ill. Þórólfur says, however, that participation among the group has been lower than hoped when it comes to the fourth shot. The general population is still not being offered a fourth dose in Iceland. Currently, 81% of eligible residents in Iceland are fully vaccinated, and around 56% of the total population have received a third dose.

Unknown how long immunity lasts

Iceland is currently reporting 100-200 new COVID-19 cases per day, but authorities believe the true number to be higher. Seventeen are currently in hospital with COVID-19 infection. Þórólfur says he expects infection rates to remain low throughout the summer, but the coming autumn and winter are less certain, both because COVID-19 has shown itself to be seasonal and because we still do not know how long immunity provided by vaccines or by COVID-19 infection lasts.

“There are viruses that ramp up in the fall and winter time and I think it’s fairly likely we will have a good period this summer. Then it’s a question of what will happen in the fall. We just have to wait and see. I’m not predicting anything bad, necessarily, but we have to just monitor the situation closely.”