Economic Inequality Impacting Health Care in Iceland

Director of Health Alma Möller

According to Director of Health, Alma Möller, Icelandic authorities must tackle economic inequality, as it affects health care outcomes.

In an interview with Heimildin this weekend, Alma said that even if most people imagine there to be equality when it comes to health care in Iceland, the reality is different. “People with an economic disadvantage are more likely to have long-term illnesses that can greatly impact their quality of life and shorten it,” she said.

She added that improving the health of the poor is a task that the health care system can not accomplish alone. “Authorities need to make equality a priority and society as a whole needs to work together,” she said. “Because inequality affects us all.”

Inherited poverty

The Directorate of Health is a government agency that promotes high-quality and safe health care for the people of Iceland, health promotion, and effective disease prevention measures. Alma, the first woman to serve as Director, is therefore a key voice on health care policy in Iceland.

“We need to face this issue and start with the children,” she said. “Nothing is more valuable for communities than to keep children out of poverty. If people start their lives in a tough spot, it’s hard for them to recover. We need to create conditions in society so that people have the opportunity to live a healthy life. Poverty, in fact, is something that people inherit, much like trauma.”

Excess outsourcing

Alma is an anaesthetist and intensive care physician who turned her attention to public health. She became Director in 2018 and was a leading figure during the Covid-19 pandemic.

In the interview, she went on to warn against excess outsourcing of health care services to private companies that could weaken the core competencies of the Landspítali, The National University Hospital of Iceland. “Decisions on outsourcing must always be made on the basis of patient welfare and the common good,” she said.

COVID-19 in Iceland: Restrictions Imposed to Combat Delta Variant Uncertainty

Kamilla Sigríður Jósefsdóttir infectious disease specialist

While there is data showing vaccinations prevent serious illness due to COVID-19, there is uncertainty regarding how the rapidly spreading Delta variant will affect Iceland’s majority-vaccinated population, Director of Health Alma Möller stated in a briefing in Reykjavík this morning. Authorities reimposed domestic restrictions in the country last weekend in response to rising infection rates. According to Alma, the goal of the restrictions is to protect the healthcare system as well as vulnerable groups.

Iceland reported 96 new domestic cases yesterday and the number may rise yet, as samples from the day are still being processed. Total active cases thus number at least 709, up from 60 just under two weeks ago.

Pregnant women in the Reykjavík capital area will be invited for vaccination at Suðurlandsbraut 34 this Thursday. Authorities encourages residents of Iceland returning from abroad to register for testing on heilsuvera.is, whether or not it was officially required in their case.

The following is a lightly-edited transcription of Iceland Review’s live-tweeting of the briefing.

 

On the panel: Kamilla S. Jósefsdóttir Deputy Chief Epidemiologist, Director of Health Alma Möller and Director of Civil Protection Víðir Reynisson.

Yesterday’s numbers are up on covid.is. Iceland reported 82 new domestic cases (23 in quarantine) and 4 border cases. Total active cases: 695. Two are in hospital. 68.58% of the population is fully vaccinated. Pregnant women have been encouraged to get vaccinated due to rising case numbers. They will receive an invitation for the Pfizer vaccine in Reykjavík at Suðurlandsbraut 34 this Thursday, Vísir reports.

The briefing has begun. Víðir begins by reviewing the border regulations that are currently in force. He encourages all residents of Iceland and those who have a social network within Iceland to get tested upon arrival to the country though it is not an official requirement.

Kamilla takes over to review the numbers. There were 96 new domestic cases yesterday, a higher number than previously reported as some cases were added later. Kamilla reviews that quarantine regulations have been updated. The same regulations will apply to vaccinated and unvaccinated people in terms of the length of their quarantine. There are few cases with serious symptoms, which shows that vaccines are working in preventing serious illness among those infected with COVID-19, Kamilla says. Kamilla adds that pregnant women in the Reykjavík capital area will be invited for vaccination this Thursday.

Alma takes over. She discusses the Delta variant of SARS-CoV-2, spreading now in Iceland. It binds better to cells and multiplies faster. It is also believed to cause more serious illness and even more fatalities than other variants of the virus. She says that vaccinations are however very effective in preventing serious illness, including from the Delta variant [among those unvaccinated]. There is also published research on the effectiveness of Moderna vaccines against the variant.

We imposed domestic restrictions due to the uncertainty, Alma says. We do not know how many serious illnesses the Delta variant will cause in a majority-vaccinated country like Iceland. We are monitoring other countries that are at a similar place regarding vaccinations, especially the UK and Israel.

The reserve force in the healthcare system has been activated now for the third time and Alma encourages people with healthcare credentials who are not currently working in the healthcare system to register. There is also a reserve force for welfare services and a need for other types of workers in the healthcare system, such as in kitchens and to assist with testing. Alma concludes by saying there’s nothing else for us to do but continue onward, continue to gather information, particularly on the Delta variant, and do our best to protect those at risk and the healthcare system.

The panel opens for questions. “Is it necessary to tighten restrictions once more considering the numbers of cases being diagnosed?” It’s too early to say at this point, Kamilla responds. If more patients are hospitalised, then we will of course have to reconsider measures, says Alma.

“Europe will soon release a new COVID-19 map, what colour will Iceland be?” Víðir says according to the data it will be labelled orange.

Alma says that of course it is disappointing to be in the situation once more where we must impose restrictions but there is data from abroad showing that vaccinations are minimising the rate of hospitalisation, which is positive.

“Is it the Janssen vaccine that is not proving as effective as others?” It’s not fair to judge according to this current wave, says Alma, as in this wave it is mostly young people that are contracting COVID-19 and they are more active in society. More young people happened to receive Janssen so it is not accurate to assume that it is less effective than other vaccines administered in Iceland.

Alma says the short-term goal of restrictions is to curb infections and buy time but there is uncertainty regarding the effects of the Delta variant regarding how much serious illness it will cause, especially among vaccinated people.

“Is it not disappointing that our restrictions-free summer has been cut short?” Víðir says all crises are characterised by uncertainty and unpredictability. Hopefully we will have more good times as many people did over the past few weeks.

“What’s the status of research on vaccinations for children? Is vaccination safer than infection with COVID-19 for children?” Kamilla says that depends on the situation in each country. We have been lucky in that there have been low infection rates so we haven’t been vaccinating all children even though the Pfizer vaccine has been approved for older children. There are certain side effects of course so we must proceed carefully, but considering that we are in a wave right now, it will likely happen that we will recommend vaccinations for children 12-15 at some point in the future.

As for younger children, the chances of serious illness from COVID-19 is low and there is not data on the effects of vaccination for that group as of yet. Much of preschool staff received the Janssen vaccine, and plans are in place to offer them a booster shot. We hope the timeline will be such that they will have additional protection when the fall season begins.

“There are four people in Iceland being monitored because they appear to have been infected a second time with COVID-19. Are they exceptions and have they been vaccinated?” Kamilla says that none of the four had been vaccinated. It has been a relatively long time since they were infected the first time. We know from cases abroad that there have been reinfections of COVID-19. Such reinfections are more common among people who have immune disorders, Kamilla says. Alma adds that reinfection is however generally rare.

“In the US and UK, they have 7-10 day isolation for people who are infected with COVID and we have 14 days. Are you considering shortening this period or offering testing to people to minimise the time they have to spend in isolation?” Kamilla: Testing doesn’t help in that context because people can test positive for a long time after infection. Regarding shortening the isolation period, we have done that before but we reversed that decision when the Alpha variant took over as symptoms lasted longer.

Víðir takes over to close the briefing. We still have the same goals: protecting vulnerable groups and the healthcare system. We will do everything we can to limit infections crossing the border and curb infections within the community so we can minimise restrictions. Keep washing your hands, use hand sanitiser, compartmentalise workspaces, social distance. Residents returning to the country from abroad can register for testing on heilsuvera.is. Víðir encourages them to do so even if testing is not officially required in their case. The briefing has ended.

COVID-19 in Iceland: Case Numbers Drop as Authorities Urge Continued Caution

COVID-19 Iceland

At a briefing in Reykjavík today, Icelandic authorities reminded the public to stay on their guard despite the country’s success in containing the COVID-19 pandemic. Iceland currently has 64 active cases of the disease, a number that has been regularly dropping and has not been as low since September of last year. Rögnvaldur Ólafsson, Assistant to the Director of Civil Protection, expressed his concern that the public was relaxing more than warranted, reminding that a fresh local outbreak could still occur.

Vaccination against COVID-19 began on December 29 in Iceland, and over 4,500 have received both doses of either the Pfizer or Moderna vaccines since that date: mostly front-line workers and nursing home residents. Per the current distribution schedule, Icelandic health authorities hope to vaccinate most individuals belonging to priority groups by the end of March.

The following is a lightly-edited transcription of Iceland Review’s live-tweeting of the briefing.

 

On the panel: Director of Health Alma Möller, Assistant to Director of Civil Protection Rögnvaldur Ólafsson, and Chief Epidemiologist Þórólfur Guðnason.

Yesterday’s numbers are in on covid.is. Iceland reported 1 new domestic case (in quarantine at the time) and 4 at the border. Total active cases: 64. 17 are in hospital. 4,546 have completed vaccination for COVID-19.

The briefing has begun. Rögnvaldur says numbers have been good over the weekend but encourages the public to continue to get tested if they have any symptoms. We’re seeing indications that people are relaxing more than is warranted, says Rögnvaldur. More people are gathering and in larger groups, and we urge people not to gather unless necessary.

Þórólfur takes over. He states that the weekend had good numbers: few cases and most in quarantine, although fewer tests were administered. We don’t have recent information on the viral strains being diagnosed but deCODE has told us that 43 people have caught the British strain, 7 domestically. The domestic cases had all been in close contact with people arriving from abroad and this strain hasn’t spread locally. “I think it’s important to keep asking people experiencing symptoms to get tested and stay at home until they’ve received a negative result, it’s the key to our work in stopping the spread of the virus.” -Þórólfur

Þórólfur: A considerable number of people are testing positive at the border. This reflects the increased spread of the virus abroad, so I repeat my recommendation to the public to not travel abroad unless absolutely necessary. Þórólfur does not believe there’s reason to relax restrictions further at this moment.

We’re sitll waiting for news of Pfizer and Moderna’s distribution schedule after February and news of AstraZeneca’s pending market authorisation in Europe. This week we will receive 1,200 doses of the Moderna vaccine and 2,000 from Pfizer, says Þórólfur. Þórólfur and [deCODE CEO] Kári Stefánsson’s negotiations with Pfizer on vaccine research that would provide vaccines for the whole nation are still ongoing and there’s nothing new to report.

Alma takes over. Our current status in fighting the virus is good, especially compared to our neighbouring countries, she says. A new report from the ECDC last week covers the new strains wreaking havoc on the countries around us, such as the British strain. It managed to spread despite harsh social restrictions. The British restrain is more infectious, but it has not yet been proved conclusively that it’s more deadly, though mortality rates in the UK are higher than ever. Authorities believe the vaccines currently available are effective against the strain, but the situation will continue to be monitored closely.

The South African strain is another one authorities are watching closely: it has been detected in the Nordic countries and it might be resistant to vaccines. The Brazilian strain has caused increased workload on local healthcare systems but local authorities don’t have much information on the development of that strain. The World Health Organisation is asking nations to increase their efforts in sequencing COVID-19 viral strains. deCODE sequences 100% of infections in Iceland and has done so since the pandemic began, and we’re very grateful for their efforts, says Alma.

Early detection is still the cornerstone of our fight against the virus, says Alma. Alma goes over the symptoms of the virus, and reminds everyone to get tested if they experience any of these symptoms and stay at home until they receive their result. “We must stick this out and not rest on our laurels.”

The panel opens for questions. Reporter: Why aren’t we satisfied with our success? Answer: In our experience, when we are diagnosing fewer infections, we’re likely to get another spike. If people relax too much, it takes a lot less for a new wave of infections to spread and can be much harder to contain it. When asked about relaxing restrictions, Þórólfur reminds the public that it’s less than two weeks since authorities last relaxed restrictions and says there’s no reason to hurry. Þórólfur: We can wait and see what happens in the coming days and weeks – authorities are constantly re-evaluating restrictions.

Þórólfur is asked about delays in vaccine distribution which will have the effect that vaccination of all priority groups will not be completed before the end of March. Þórólfur stated that this isn’t news: individuals in priority groups number around 40,000 and according to current plans we’ll have received enough doses for 30,000 people by the end of March. Þórólfur still hopes that AstraZeneca will receive their market authorisation in Europe soon and that they’ll receive additional doses of that vaccine before the end of March.

A reporter asks about vaccination efforts in other European nations, claiming Denmark has gotten further in its efforts despite receiving vaccines through the same European contracts as Iceland. Þórólfur states that he can’t speak for Danish authorities.

Þórólfur is not ready to give projections for when each individual will be vaccinated as he doesn’t want to make promises he can’t keep. There’s still much uncertainty about vaccine distribution but if we receive more vaccines, we might be able to make more detailed plans, says Þórólfur. Þórólfur is not ready to make any predictions for next summer regarding large gatherings: there are still too many variables such as vaccine distribution and the looming possibility of vaccine-resistant viral strains. Asked about how many have ordered certificates to confirm their vaccination, Þórólfur says he does not have information on the certificates.

When asked about reported parties in the capital area over the weekend, Rögnvaldur replies that authorities are concerned that the public might be relaxing too much. Asked about anti-restriction protests, Þórólfur states there have been some but fortunately groups haven’t been large. Restrictions here are relatively mild. There is a chance protests will increase if they need to tighten restrictions again but he hopes that won’t be the case.

Where can people in priority groups receive information on when they will have access to vaccines? Þórólfur: That differs depending on their municipality. If people believe they are being forgotten, the simplest thing to do is to contact their healthcare centre. While not everyone will receive the vaccine at the same time, I can confirm that no one will be left behind, says Þórólfur. In the end, everyone will be able to get the vaccine.

When asked if they’re relaxing restrictions too quickly, Þórólfur states that he has repeatedly stated that he thinks it’s important not to relax restrictions too quickly and that the current regulations are in place until February 17. Rögnvaldur closes the briefing with his usual reminders to the public: “This is not over, we must keep our guard up.”

 

Iceland Review will live-tweet authorities’ next COVID-19 briefing on Thursday, January 28 at 11.03am.

COVID-19 in Iceland: Vaccination Will Take 3-6 Months, Say Authorities

Iceland has signed contracts for the purchase of COVID-19 vaccines from Pfizer and AstraZeneca and a third contract with Janssen is expected to be signed tomorrow. A fourth contract with Moderna is expected to be signed on December 31. Iceland’s government has already secured enough doses of COVID-19 vaccines for most of the population, but the timeline of when those doses arrive is not yet clear.

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

Enough doses of the Pfizer COVID-19 vaccine for 5,000 people are expected to arrive on December 28. Health Ministry Secretary Ásta Valdimarsdóttir stated in a briefing today that the government expects to vaccinate most of the nation in the next 3-6 months.

Below is a lightly edited transcript of Iceland Review’s live-tweeting of the briefing.

 

On the panel: Director of Health Alma Möller and Director of Civil Protection Víðir Reynisson. Special guests: Secretary of the Ministry of Health Ásta Valdimarsdóttir and Director of the Icelandic Medicines Agency Rúna Hauksdóttir Hvannberg, who are expected to discuss imminent COVID-19 vaccination in Iceland.

Yesterday’s numbers have been updated on covid.is. Iceland reported 7 new domestic COVID-19 cases yesterday (5 from quarantine) and 4 from border testing. Total active cases have risen to 141, the number in hospital has dropped to 29, with 3 in intensive care.

The briefing has begun. Víðir begins by discussing Seyðisfjörður, East Iceland, which has been devastated by mudslides in recent days. The mudslides are calamitous and while it’s miraculous that no one has been hurt, the damage is extensive and the pain is great. There are over 200 residents of the town that may not yet return home due to ongoing risk. Those who are not residents are asked to stay away from the town and area. The people of Seyðisfjörður’s sense of security is damaged and the work ahead is great. There will be an online town hall meeting via Facebook for Seyðisfjörður residents at 4.00pm today. If people want to be of assistance, we ask them to contact the East Iceland Police. The police is working according to procedure to try to help communities respond to trauma. We stand with the residents of Seyðisfjörður, we will face this together. And Seyðisfjörður will be safe once more.

Alma takes over. She starts by sending her regards to those in Seyðisfjörður, before going over the numbers. The cases of COVID-19 diagnosed in recent days are connected to friend groups and families and tracing has been mostly successful. There are 27 in hospital due to COVID-19 but just 5 of them have active infections. Three are in intensive care and two of those are on ventilators.

There are questions about whether the pandemic is rising again, at least we know that the situation is such that it won’t take much to get it going again. The ratio of positive tests from those getting tested due to symptoms is rising slightly. It was 0.4 per cent a couple of days ago but now it’s 0.9%. Authorities are aware of the news of a new strain of the virus in the UK that seems to be more contagious. While that particular strain’s spike protein has more mutations, it doesn’t cause more severe illness and there’s no indication it won’t respond to vaccinations. One person has been diagnosed with that strain of the virus at the Icelandic border. They went straight into isolation and have not infected anyone else. This indicates clearly that our actions at the border are effective and underlines their importance, says Alma. Healthcare authorities implore people to avoid gatherings in the next few days. “Let’s think of each other and make sure we can all have a merry Christmas,” says Alma.

We are all thinking about vaccination these days, and Secretary of the Ministry of Health Ásta Valdimarsdóttir and Director of the Icelandic Medicines Agency Rúna Hauksdóttir Hvannberg are here to discuss vaccination in Iceland. Ásta takes over and begins by sending her regards to Seyðisfjörður as well. She states she’s at the briefing in order to give information on the government’s vaccine contracts. She states that the Icelandic government began thinking about ensuring vaccine access last spring even though they didn’t think a COVID-19 vaccine would be ready this soon. The COVAX deal and the EU negotiations, of which Iceland is a part, began shortly thereafter. She discusses the COVAX program and its purpose, which is in part to ensure equal distribution of vaccines and ensure vaccine access for developing countries. While COVAX is mostly intended for developing countries, it also gives Iceland the option to purchase additional vaccines.

She also discusses the EU deal which secures Iceland access to vaccines at the same level as EU member countries. Iceland has been cooperating with Icelandic pharmaceutical companies and distributors as well as with Norway, which Ásta says has been helpful. A working group that contains lawyers and specialists with drug acquisition experience is working on vaccine acquisition and another group consisting of medical specialists is concerned with domestic distribution. While Iceland has contracts in place securing vaccine access and a certain number of doses, the contracts don’t outline distribution schedules (i.e. when the doses will arrive). Let’s keep in mind that no vaccine has a market licence within the EU yet, even though we expect Pfizer to receive one before Christmas. There are four contracts currently in the works and we will post updated information on the new website boluefni.is.

We know now that we will receive 10,000 doses of the Pfizer vaccine on December 28. From that point until March we will receive 50,000 doses from Pfizer, enough to vaccinate 25,000 people. We expect to be able to vaccinate the majority of the nation in the next few months, beginning with frontline healthcare workers and nursing home residents. With the introduction of vaccination, we will likely be able to ease some restrictions in the next year. We will look into that further once vaccination commences.

The Icelandic Medicines Agency (Lyfjastofnun) is in charge of issuing drug licences for the Icelandic market. The European Medicines Agency’s specialists are overseeing vaccine licencing in Europe and two different vaccines seem to be close to being approved. The European Medicines Agency’s licensing of the vaccines is the prerequisite for licensing of the vaccines in Iceland.

The vaccine has been tested on tens of thousands of people, more people than new vaccines are usually tested on. The most common side effects are mild and disappear in a few days but if someone experiences more severe side effects, they are encouraged to report them to the Icelandic Medicines Agency. Many people have wondered why the (Pfizer) vaccine has been approved so fast but it’s important to note that the COVID vaccines have to fulfill the same strict requirements as all other vaccines. While the process has been faster than usual, no steps have been skipped in the approval of COVID vaccines. Vaccination will change life in Iceland and it’s a complicated task. It won’t be easy and it’s important that we’re resilient. She ends by sending her regards to the people of Seyðisfjörður.

On to questions from reporters. The panel is asked about conflicting reports of vaccination timelines – originally the government announced that it would be possible to vaccinate most of the nation by April but now says it will take longer. It’s normal that people wonder about this. We’ve secured vaccines for the whole nation through various contracts but the timeline is not confirmed. Concerning the Bloomberg report and the false information, we have six deals in place which is enough for the whole nation. I also wonder why it’s so desirable that nations secure vaccines for more than double their population while poorer nations don’t have that same access. The World Health Organisation has criticised this behaviour.

The panel is asked about criticism of the EU policy in the vaccination deals. Was it the right decision to work with the EU instead of negotiating for our small nation by ourselves? Ásta replies that states negotiate for themselves and states’ size varies. The European Union is much larger than Iceland and we believed that we would have a stronger negotiating position if we cooperated with the EU instead of negotiating on our own. She mentions that the government first started planning for vaccines in the spring when much less was known about how vaccine production would develop. At that point everyone thought the Sanofi vaccine would be first on the market and Pfizer was much lower on the list. It’s been difficult for negotiators to know which baskets to put their eggs in but Icelandic officials believe Iceland is better off working with the 460 million people of the EU instead of on its own.

It’s not the time to discuss relaxing restrictions now, but Icelandic authorities have done their best throughout the pandemic to ensure that restrictions would not be more severe than they had to be at any given time.

Would it have been possible for Iceland to order more doses from Pfizer and reduce the orders of other vaccines that are not expected to be available soon? Concerning additional doses of the Pfizer vaccine, discussions are ongoing but it’s too early to disclose details. Any additions to the EU deal will be proportionally distributed. She mentions on the other hand, however, that the first doses, which have been called Pfizer’s Christmas present, are not proportional. Iceland will receive 10,000 doses, the same as Germany for example. Those doses cover a much larger proportion of our small population.

When further pressed on the vaccination timeline, Ásta mentions that the end of 2021 is the most pessimistic outlook, they believe they will be able to vaccinate the whole nation in the next three, four, or five months.

Ásta is asked about conflicting reports from Bloomberg and the Icelandic government on how many vaccine doses are available to Iceland. She mentions Iceland’s first three vaccine deals, which will altogether cover vaccinations for 235,000 people. She suggests that it’s possible the secured vaccine dose numbers other countries have reported may include the COVAX contract, which Iceland did not include in its reported numbers, as those doses are mostly intended for developing nations. Iceland has signed two vaccine contracts and is expected to sign the third one tomorrow. They’re working on an additional three but we only have exact dose numbers available for these first three contracts. The vaccine registrations will likely arrive in droves in the next few days and they have different properties that make them more or less suitable for different groups. This is a watershed moment in vaccination, we will learn a lot in the coming weeks and especially from other nations that begin to vaccinate. It’s very important for Iceland that other nations are successful in their vaccination efforts as well.

Ásta mentions the COVAX deal and its benefits for the developing nations and Víðir adds that the fight against COVID-19 won’t be over until it’s over everywhere.

Are Icelandic authorities considering banning travel from the UK, as other nations have done in light of the new strain of the virus that has emerged there? Víðir mentions that there’s heightened surveillance at the airport and they talk to most people arriving in the country. Some people have decided to meet their children at the airport, arriving home from studies abroad, and quarantine with them. If the arriving travellers then test positive, that’s a long quarantine and health risk. Plenty of hotels accept people who need to quarantine due to arriving from abroad, Víðir points out. Plenty of people are being diagnosed and we need to be careful about our reactions to that, so that no one is afraid to get tested or to disclose their symptoms or status. Víðir sends special regards to the people who will be in quarantine or isolation over Christmas and asks others to try to enjoy these strange times with their those closest to them. Víðir notes that this is the last briefing before Christmas. The next briefing will be held on Monday, December 28.

Iceland Review live-tweets authorities’ briefings every Monday and Thursday at 11.03am UTC.

 

COVID-19 in Iceland: No Herd Immunity Until Second Half of Next Year

Iceland will not achieve herd immunity until the second half of next year, according to Chief Epidemiologist Þórólfur Guðnason. Until that time, the nation will have to live with some social restrictions, he stated in a briefing this morning in Reykjavík. Icelandic authorities had hoped to vaccinate enough people to achieve herd immunity by April, but delays in vaccine production mean fewer doses will arrive in the country early next year than originally expected.

Although Iceland will receive its first doses of COVID-19 vaccines around Christmas, it will only receive enough to vaccinate around 5,000 people at first. Another 8,000 doses are expected in January and February. Þórólfur stated that although he would have liked to see more doses arrive sooner, it is good news that at-risk individuals can start being vaccinated soon. However, the small amount of vaccine expected to arrive in the coming months means that Iceland will not be able to achieve herd immunity until at least the middle of next year. The delays are due to vaccine manufacturing, not due to Iceland’s contracts negotiated through the EU, authorities have stated.

Health authorities have defined priority groups for vaccination, and healthcare staff and nursing home residents are first on the list. The first five priority groups contain some 20,000 individuals, so it is clear that authorities will need to further break down who receives the first 13,000 doses of the COVID-19 vaccine expected to arrive in the next two months.

Below is a lightly edited transcript of Iceland Review’s live-tweeting of the briefing.

 

On the panel: Chief Epidemiologist Þórólfur Guðnason (below), Director of Health Alma Möller, and Assistant to the Director of Civil Protection Rögnvaldur Ólafsson. Special guest: Ingileif Jónsdóttir, Professor of Medicine at the University of Iceland and department head at deCODE genetics.

Yesterday’s numbers have been updated on covid.is. Iceland reported 8 new domestic cases yesterday (7 in quarantine at the time) and 8 at the border. Total active cases have dropped to 124. 33 are in hospital and 3 in intensive care.

The briefing has begun. Rögnvaldur says a state of uncertainty has been declared in Seyðisfjörður, East Iceland due to mudslides that have led to evacuations. The weather forecast is calling for more rain.

An important reminder to people arriving in the country from Rögnvaldur. Arriving children (who don’t have to be tested) have sometimes been sent to stay with other family members such as grandparents. This leads to them being at risk of infection and is highly discouraged.

Þórólfur goes over the numbers. He is happy with the recent numbers but encourages people to continue to get tested if they experience symptoms. He is also happy with the ratio of positive tests from people who are experiencing symptoms. It’s currently low, around 0.3%.

Eight people tested positive at the border, which makes sense, considering increased traffic (mostly Icelanders returning home for the holidays).

On to vaccines: the timeline is becoming clearer after deals have been reached with pharmaceutical companies. Due to a lack of resources, we won’t get all the vaccines we require at once. Around Christmas, we’ll receive vaccines for 5,000 people and another shipment of vaccines for around 8,000 people in January or February. This means authorities will rethink prioritisation, starting with frontline healthcare workers and moving on to nursing home staff and residents.

Iceland’s Chief Epidemiologist: This means we won’t achieve herd immunity until sometime in the second half of next year. We must therefore live with restrictions next year and maintain personal preventative measures. We will be able to relax restrictions somewhat once at-risk groups have been vaccinated, but that will likely not happen until the middle of next year. It won’t be possible to loosen restrictions until we see how the pandemic develops in the next days and weeks. The current regulations are in effect until January 12, Þórólfur reminds the public.

Alma takes over to review restrictions for nursing homes over Christmas. Nursing homes will be open and residents can receive up to 2 visitors at a time. Authorities advise against residents making outings to attend Christmas parties. If residents attend Christmas parties outside their nursing home, they will have to quarantine at a relative’s home for 5 days and be tested for COVID-19 before returning to the nursing home.

The goal of vaccination is to protect people from COVID-19 and reach herd immunity. For herd immunity, we need to vaccinate at least 65% of the nation. Authorities are preparing further information on vaccination. In addition to the individual being vaccinated receiving protection, all of society stands to gain from people being vaccinated.

Ingileif takes over to discuss vaccinations. She begins by explaining the science behind vaccinations and how they work. Vaccination consists of injecting weakened or dead viral matter or viral proteins. This harmless viral matter activates the immune system and the protection can last for years. Ingileif goes over the phases of vaccine development. Early phases mainly emphasise the safety of the vaccine. “One thing I want to say is that for a vaccine to be licenced, its efficacy must be proven first.”

When a vaccine’s development is accelerated, the safety/efficacy requirements are not relaxed. The only change is that authorities receive the data from the research as soon as it’s available. This allows authorities to process the vaccine licences faster. Rare side effects are always a possibility, that possibility can’t be entirely eliminated. Ingileif goes over the details of the Moderna vaccine’s testing, which shows that after two doses of the vaccine, the rate of infection goes down by 95%.

We can say that the protection from the mRNA vaccines is good and that it is consistent across different age groups and genders. In all these testing phases, there were few serious side effects and they were the same among people receiving the vaccine as the ones in the control group (receiving the placebo). If we look at the advantages of mRNA vaccines vs traditional ones, is that they both encourage our own cells to create the immunity response themselves. The disadvantages are mostly that they require storage temperatures of below -20°C. The benefit of vaccination is “much, much much greater” than the risk, says Ingileif. The risk from the vaccine is much lower than the health risk involved in contracting COVID-19.

The panel opens for questions. Pregnant women have not been included in the tests, says Þórólfur. We will be careful but usually, vaccines cause no risk to people breastfeeding. Older people have isolated themselves, Þóróflur states that as soon as they’re vaccinated, restrictions will be relaxed.

Þórólfur states that the first shipment of vaccines is expected to arrive on December 24 and authorities hope to start vaccinating as soon as possible after Christmas. Asked about the “extra doses” that healthcare staff has found in the Pfizer vaccine vials, Þórólfur states that it remains to be seen.

The vaccination production is not as far along as we had hoped but it’s good news that we’re starting to vaccinate risk groups. So it’s still good news but we would have hoped to receive more of the vaccine sooner, says Þórólfur. It is the production of the vaccines themselves, not Iceland’s deals with the EU that are causing delays. Due to the limited amount of vaccines we will receive at first, we won’t be able to vaccinate every high-risk group immediately.

This new information (about vaccines) won’t change much in our work, says Þórólfur. I am aware of the need for long-term predictability, but as soon as we try to make long-term plans, they get derailed by an unpredictable virus. The only predictability we could create would be to lock everything down for many months, says Þórólfur, but I don’t think anyone would like that. So we will have to expect unpredictability in the coming months, unfortunately.

When asked about groups and gatherings around Christmas, Rögnvaldur tells people they must find creative ways to meet as few people as possible and keep groups from overlapping. When the situation arises that a social distance of 2 metres can’t be kept, people should wear masks.

Director of Civil Protection Víðir Reynisson who was diagnosed with COVID recently is out of isolation but he is still recovering and won’t return to work until after Christmas. Rögnvaldur closes the meeting by going over what the public needs to keep in mind when arriving in the country. Quarantine upon arrival to Iceland is necessary because there’s always a certain number of people that are infected upon arrival. He reminds people to keep up personal preventative measures such as handwashing. “Let’s do this together.” The briefing has ended.

Iceland Review live-tweets authorities’ briefings every Monday and Thursday at 11.03am UTC.

COVID-19 in Iceland: Government Introduces Colour-coded Information System

Table of colour-coded COVID-19 system

The government has agreed to institute a colour-coded warning system much like the weather warning system used by the Icelandic Meteorological office. The suggestion came from The Department of Civil Protection and Emergency Management and the Directorate of Health.  

The warning system is meant to increase long-term predictability concerning pandemic infection prevention regulations, in order to minimise damage to the community. It’s not directly related to the Department of Civil Protection’s emergency alert system but rather, it’s intended to better inform the public of what can be expected.

The government has issued a graphic explaining the system, which reveals that the colour codes will include grey (the “New Normal”), yellow (Alert), orange (Increased Risk), and red (Serious). The system will be presented and explained in the next COVID-19 information briefing on Monday.

Iceland Review will be live-tweeting the meeting on Monday at 11 am.

COVID-19 in Iceland: Continued Border Testing Key to Christmas Celebrations

keflavik airport COVID-19 testing

Icelanders can tentatively look forward to Christmas with fewer restrictions if border testing measures are maintained, stated Iceland’s Chief Epidemiologist Þórólfur Guðnason in a COVID-19 briefing this morning. Authorities stated that it was too early to celebrate over dropping daily case numbers, and the coming days will determine whether harsher restrictions that took effect last week have been effective in containing Iceland’s third wave of COVID-19 infection.

Iceland reported 50 new domestic COVID-19 cases yesterday, 66% of which were in quarantine at the time of diagnosis. Active COVID-19 infections in the country number 1,022, close to the record of 1,096 reached on April 5. There are currently 23 COVID-19 patients in hospital and 2 on ventilators. At the briefing, Director of Health Alma Möller stated that the National University Hospital was managing the load well for the time being, but could expect increased strain in the coming weeks as COVID-19 symptoms worsen among those newly diagnosed.

Antibody Parties are Not a Good Idea

When questioned about a young man who proposed throwing a party for all Icelanders who had antibodies to the virus, the Chief Epidemiologist stated that he did not recommend such events. “I think it would maybe provoke people to try to get the virus so they could then go party and that could turn out badly.” Alma added: “Also people [with antibodies] can still have the virus on their hands and transmit it between people, though they themselves are immune. So we encourage everyone who has had COVID-19 to exercise caution regarding preventative measures.”

Chief Superintendent Víðir Reynisson also added that the regulations in place apply equally to everyone, regardless of whether they’ve had the virus or not. “We are in a country where the same laws apply to everyone and the same rules to everyone, so there will be no change regarding how many people can congregate based on whether they have antibodies or not.”

Christmas Celebrations Tied to Border Testing

Reporters asked the panel whether Icelandic residents could expect regulations to be relaxed by Christmastime. Þórólfur stated that he hoped the current measures would be successful in containing the virus, but relaxing restrictions would also depend on maintaining current border testing measures. Since Iceland implemented double testing and five-day quarantine at the border in August, Þórólfur says, no new strains of the virus have been detected in the country. Those measures will be in place until at least December 1.

Iceland Review live-tweets Icelandic authorities’ COVID-19 briefings. The next briefing is scheduled for Thursday, October 15.

COVID-19 in Iceland: Authorities Address Pandemic Fatigue

COVID-19 Iceland

Pandemic fatigue is setting in among Icelanders, Director of Health Alma Möller stated during authorities’ COVID-19 briefing in Reykjavík this morning. Tightened social restrictions took effect in Iceland today, limiting gatherings to 20 people (down from 200) and closing bars, clubs, and gyms. At the briefing, authorities addressed criticism of the restrictions and emphasised the importance of working together to tackle the current wave of SARS-CoV-2 infection, which continues to rise.

Iceland’s Department of Civil Protection declared a national state of emergency yesterday due to the current spread of SARS-CoV-2. The country has reported 689 new domestic cases of COVID-19 between September 15 and October 5. The number of active cases continues to rise, though Chief Epidemiologist Þórólfur Guðnason stated growth is mostly linear (not exponential).

Authorities Respond to Criticism of Restrictions

At the briefing, Þórólfur addressed criticism of the newly-imposed restrictions. Some have dismissed them as too harsh while others have stated they don’t go far enough. The Chief Epidemiologist stated that discussion and disagreement were normal, but stressed that at some point decisions had to be made using the information at hand.

One particular criticism of the restrictions is that they have been imposed across the entire country, while most active COVID-19 cases are in the capital area. (Just over 79% of current active cases are in or near Reykjavík.) Þórólfur argued that if restrictions were not imposed unilaterally, we could end up chasing outbreaks from region to region and it could take longer to contain the virus.

Pandemic Fatigue Sets In

Director of Health Alma Möller stated that “pandemic fatigue” was setting in among the Icelandic population. She stressed that it was normal to be tired of restrictions and for some people to disagree with authorities’ decisions. However, it is important for the nation to stick together and remember how solidarity helped tackle Iceland’s first wave.

Alma underlined the importance of washing hands with soap for at least 20 seconds and using hand sanitizer before entering stores to protect others, as well as after to protect ourselves. She urged the public to avoid crowds, stick to their nearest and dearest for companionship, and stay home if experiencing symptoms. She thanked all those who were following regulations.

Police Did Not Store Bar Patrons’ Data

Reporters questioned authorities on group outbreaks that had occurred in several Reykjavík bars and restaurants. Following the outbreaks, card companies provided the Office of the Chief Epidemiologist with information on patrons from several venues where outbreaks had occurred. The companies came to the conclusion that providing this information was in compliance with their data protection policy. The information was used to contact those who had been exposed to SARS-CoV-2 at the venues and request they come in for testing. The police did not receive the data and are not storing it.

Víðir closed the briefing by reminding the public of the small actions they can take to prevent the spread of infection, such as sanitising commonly-used surfaces. He encouraged the public to contact those who live alone as well as those in nursing homes and organise fun events to help them cope. “Endurance and perseverance will get us through this,” he stated. “Small victories lead to success. Let’s take this one day at a time.”

COVID-19 briefings will take place at 11.00am UTC on Mondays and Thursdays from now on. Iceland Review live-tweets all briefings in English on our Twitter page.

Iceland’s COVID-19 “Trifecta” Invested with Order of the Falcon

COVID-19 Iceland

Iceland’s Chief Epidemiologist Þórólfur Guðnason, Director of Health Alma Möller, and Director of Civil Protection Víðir Reynisson were invested with the Order of the Falcon by Iceland’s President yesterday. The order is a recognition of the trio’s work preventing the spread of the COVID-19 epidemic in Iceland. The three have become known as þríeykið (the trifecta) among the Icelandic public, and have been highly praised for their leadership of Iceland’s successful response to the novel coronavirus. Iceland currently has 5 active cases of COVID-19.

COVID-19 Border Screening Going Well

The trifecta held a briefing in Reykjavík today to review Iceland’s newly-started initiative of screening travellers entering the country for COVID-19. Both Icelandic residents and foreigners can opt for a COVID-19 test upon arrival to Iceland or to undergo a 14-day quarantine. A total of 2,332 travellers were tested at the border between Monday and Wednesday, five of whom tested positive (not all five infections were active).

In the briefing, Þórólfur stated that these numbers were more or less what authorities had expected. He added that although screening had gone well overall, there had been a few hiccups, mostly in communicating test results to travellers. Authorities are working on shortening the wait time for results so that all those arriving through Keflavík Airport have their results within 12 hours and those arriving at other entry points within 24 hours.

Alma expressed her concern regarding an approaching nurses’ strike, as nurses are employed both in border testing and contact tracing. She stated that if the strike does occur, it is clear that authorities would need to apply for an exception in order to continue screening.

Thanked the Teams Behind Them

When asked how they felt about being invested with the Order of the Falcon, Víðir, Þórólfur, and Alma all stated they had accepted the award on behalf of the teams that have been working hard to contain the spread of the coronavirus, who are not visible to the public but have been crucial in the fight against COVID-19 in Iceland.

Iceland’s Last Daily COVID Briefing Ended in Song

COVID-19 briefing

Iceland’s Chief Epidemiologist, Director of Health, and Chief Superintendent of Civil Protection became a different sort of trio yesterday when they joined their voices in song to celebrate the end of Iceland’s regular COVID-19 briefings, RÚV reports. The three sang Ferðumst innanhúss (Let’s travel at home), a song released in early April to encourage Icelanders to stay home during the Easter weekend. Press and others present at the briefing joined in and cheered for the three, who have been praised for their leadership in the response to the COVID-19 pandemic in Iceland.

Chief Epidemiologist Þórólfur Guðnason, Director of Health Alma Möller, and Víðir Reynisson, Director of Iceland’s Department of Civil Protection and Emergency Management, have been a fixture on Icelanders’ screens over the past months as they have led the country’s daily half-hour briefings on Iceland’s local response to the pandemic. They have been widely lauded for their strategy, which has proved effective in containing the spread of COVID-19 in Iceland.

Þórólfur, who plays in a Beatles cover band, took confidently to the microphone while his two colleagues sung along a little farther from centre stage.

A video of the performance is available on RÚV’s website.