Chief Epidemiologist: Rise in COVID Cases a Reason for Concern

Iceland National Hospital COVID-19

Iceland’s National Hospital has once again converted the infectious diseases ward into a COVID-19 ward to address a rise in COVID-19 cases, RÚV reports. Iceland’s 14-day COVID-19 incidence rate has more than doubled over the past month, from 108.3 four weeks ago to 241.3 as of yesterday. Iceland’s Chief Epidemiologist Þórólfur Guðnason says the development gives reason for concern.

“In recent weeks, there has been a fairly rapid increase in the number of diagnosed COVID-19 infections in Iceland,” Þórólfur wrote in a statement published on Iceland’s official COVID-19 website. “The infections have been diagnosed in almost all regions of the country, around 50% were in quarantine at the time of diagnosis and about 50% were fully vaccinated.” Þórólfur continued on to say that hospitalisation rates due to COVID-19 had also risen: “In recent weeks and months, about 2% of those diagnosed have been admitted to hospital, 0.4% have been admitted to the intensive care unit, and about 0.2% have required the assistance of a ventilator.”

Personal infection prevention not enough to control pandemic

Þórólfur underlined that there is “every reason to be concerned about the current development of COVID-19 in Iceland,” adding that the spread of infection has increased hand-in-hand with the loosening of restrictions, and “it is clear that personal infection prevention is not enough to control the pandemic. Although widespread vaccination prevents infection, and especially serious illness, it does not seem to be enough to stop the current wave nor to prevent hospitalisation of those who are seriously ill.”

Read More: COVID-19 Vaccination and Herd Immunity in Iceland

The Chief Epidemiologist encouraged locals to practice personal infection prevention measures such as handwashing in order to reduce the need for social restrictions. He also reminded the public that higher hospitalisation rates impact not only the care of those with COVID-19 but also other hospital services.

Iceland is set to lift all domestic restrictions on November 18. Þórólfur stated today, however, that if the situation worsens significantly he would consider recommending harsher restrictions. He added that he did not know how the government would react to such recommendations.

Hospital affected by COVID-19 outbreak

The National University Hospital has not only been impacted by rising case numbers in the wider community recently, but also within its walls. Five patients and one staff member in the hospital’s Cardiac and Pulmonary Ward tested positive for COVID-19 this week. At least 30 other staff members are in quarantine and some of them are expected to test positive, stated Már Kristjánsson, head physician of the Infectious Diseases Ward.

Seasonal viruses were also hitting children harder than usual this year and the Hringur Children’s Hospital was over capacity, Már stated. He encouraged the public to continue personal infection prevention such as handwashing and using masks in public spaces. “The healthcare system’s infrastructure is in a weak position when facing these major shocks.”

Why has vaccination not led to herd immunity in Iceland? What is Iceland’s strategy for tackling COVID now?

Icelandic healthcare system

The short answers to these questions are: the Delta variant of SARS-CoV-2 has proved more infectious than experts hoped; and Icelandic authorities have adopted a policy of curbing the spread of infection with mild social restrictions rather than aiming to eliminate the virus entirely with harsh restrictions. This policy allows Icelandic society to operate as “normally” as possible at any given time.

Now for a longer answer: Icelandic health authorities began administering vaccines against COVID-19 at the end of 2020. The country lifted all domestic restrictions due to COVID-19 on June 26, 2021, when around 88% of the population 16 and over had received one or both doses of the COVID-19 vaccine. Before that point, the newer Delta variant of the SARS-CoV-2 virus had not spread widely in Iceland. Just four weeks after restrictions were lifted, they were reimposed due to rising case numbers.

The Delta variant of SARS-CoV-2 was responsible for the wave of infection that followed, Iceland’s largest until that point. Iceland’s Chief Epidemiologist Þórólfur Guðnason, like many other health experts, had hoped that vaccines against COVID-19 would not only reduce rates of serious illness but would also reduce transmission rates until the virus was no longer a threat to public health. Unfortunately, vaccines proved less effective against the Delta variant than the variants they had been developed for, and Iceland learned that vaccinated individuals could still contract and transmit SARS-CoV-2 at high enough rates to kickstart a larger wave of infection.

It bears noting that vaccination has had a significant impact in reducing rates of serious illness, hospitalisation, and even infection due to COVID-19 in Iceland and has therefore significantly reduced strain on Iceland’s healthcare system. Local data revealed unvaccinated individuals were four times as likely to be hospitalised due to COVID-19 infection and six or seven times more likely to end up in the ICU than those who are vaccinated in the most recent wave of infection. This is clear in the continually updated data on Iceland’s official COVID-19 website.

Though vaccination has been moderately effective, COVID-19 remains a public health threat in Iceland. Authorities’ approach is to minimise the spread of infection using the mildest restrictions possible at any given time. This allows society to operate as openly as possible and avoids lockdowns. Iceland also maintains border restrictions including testing and quarantine depending on the vaccination status of arriving travellers to prevent COVID-19 cases from entering the country.

COVID-19 in Iceland: Domestic Restrictions Extended

mask use social distancing

Iceland’s current domestic restrictions to curb the spread of COVID-19 will be extended for an additional two weeks. The restrictions, which include a general gathering limit of 500 people and one-metre social distancing, were set to expire tomorrow, October 6, but will now remain in effect until October 20, 2021. The Health Minister Svandís Svavarsdóttir decided to extend the regulations on the recommendation of Iceland’s Chief Epidemiologist Þórólfur Guðnason.

Current domestic restrictions in Iceland mandate a gathering limit of 500 and general social distancing of one metre. Distancing is waived at seated events, provided all guests are registered in their seats and wearing masks. The regulations do not apply to school events. Bars, restaurants, and clubs must close by midnight and all customers must have left the premises by 1:00 AM. Swimming pools and gyms are permitted to operate at full capacity. Masks are required in all situations where one-metre distancing cannot be insured, such as on public transportation and in service requiring contact (such as haircuts and massages).

Risky to relax further

Iceland lifted all domestic restrictions on June 26 after a majority of the population had been vaccinated. Two to three weeks later, the rate of COVID-19 infection began to increase as did the rate of serious illness and hospitalisation. Icelandic authorities reintroduced domestic restrictions in July, and has been slowly relaxing them as the wave of infection dies down.

While infection rates have lowered in recent weeks, the Chief Epidemiologist stated in his memorandum that he did not consider it advisable to further relax domestic restrictions in Iceland. “In light of the development of the pandemic abroad and Iceland’s experience of the full lifting of restrictions, I consider it risky to relax the domestic infection prevention measures further than those currently in force,” the Chief Epidemiologist wrote in his memorandum to the Health Minister.

Iceland is currently reporting between 30-60 cases of COVID-19 per day. The country has 361 total active cases and 8 hospitalisations. Over 75% of the population is fully vaccinated against the SARS-CoV-2 virus.

Two Domestic Infections Outside Quarantine Yesterday

COVID-19 test tubes

Two COVID-19 infections were diagnosed within Iceland yesterday, both outside of quarantine at the time of diagnosis, according to a press release from Iceland’s Civil Protection and Emergency Management Department. Both of the infected individuals were vaccinated. One attended Reykjavík’s Bankastræti Club last weekend, and club management encourages any attendees experiencing symptoms to get tested.

According to Hjördís Guðmundsdóttir, director of communications for the Civil Protection Department, a number of people have been placed in quarantine in connection with the two infections. Contact tracing is still ongoing and is expected to take a few days.

Hjördís encouraged the public to download the Icelandic government’s official contact tracing app, Rakning C-19. “The app can help the contact tracing team to track infections and it can be said that it plays a key role now as there are no social restrictions in place in Iceland,” Hjördís wrote. “Let’s continue to be careful and get tested if we notice symptoms, both vaccinated individuals and unvaccinated.”

Vaccination is widespread in Iceland: 92% of women and 88% of men aged 16 and over in Iceland have received one or both shots of COVID-19 vaccine. Of the total population, 64.8% is fully vaccinated while 71.6% have received one or both shots.

Iceland’s Chief Epidemiologist Þórólfur Guðnason told RÚV the two infections are not connected to each other or to any cases recently diagnosed at the border.

COVID-19 in Iceland: Widespread Testing to Determine Scope of Virus Spread

Director of Civil Protection Víðir Reynisson, Chief Epidemiologist Þórólfur Guðnason, Director of Health Alma Möller

Iceland’s health authorities will conduct both targeted and randomized SARS-CoV-2 testing in the coming days to help establish how far the virus has spread in the community. The results of the testing will determine whether harsher restrictions are necessary to contain the spread of COVID-19. Iceland reported a spike in cases over the weekend linked to two group infections, which can be traced to individuals breaking traveller quarantine.

Iceland reported 27 new domestic cases of COVID-19 yesterday, most connected to a group outbreak at a Reykjavík preschool. Authorities stressed the importance of getting tested immediately when experiencing even the mildest symptoms that could point to COVID-19 and staying home until a negative result is received. Symptoms of COVID-19 can be very mild and can include fever, fatigue, cough, muscle aches, breathing difficulties, vomiting, diarrhoea, and sudden changes to sense of taste or smell.

The following is a lightly-edited transcription of Iceland Review’s live-tweeting of today’s COVID-19 briefing.

 

Stay tuned for a live-tweeting of Icelandic authorities’ COVID-19 information briefing, beginning shortly at 11.03am. On the panel: Chief Epidemiologist Þórólfur Guðnason, Director of Health Alma Möller, and Director of Civil Protection Víðir Reynisson.

Numbers have been updated on covid.is. Iceland reported 27 new domestic cases yesterday (just 2 out of quarantine) and 2 at the border. Total active cases: 97; 3 in hospital. 29,686 have been fully vaccinated, 8% of the population. Most of yesterday’s cases are connected to a group outbreak at Jörfi preschool in Reykjavík, according to a representative of the Civil Protection Department.

The briefing has begun. Víðir says authorities are tracing the group outbreaks that are ongoing. He encourages the public to not judge everyone based on the actions of a few, although those actions have had consequences.

Þórólfur goes over the numbers. Several people tested positive over the weekend in two group infections, one linked to a preschool in Reykjavík. Both group infections can be traced back to people breaking quarantine and going to work while experiencing flu-like symptoms. Many people were tested yesterday and even more will be tested today but the situation shows that just one infection can set off a wave of new infections if people aren’t vigilant.

Þórólfur: These group outbreaks show the importance of going to get tested when experiencing even the slightest symptoms. Go and get tested if experiencing even the mildest symptoms and stay at home until you receive your results. Both group infections involve the British variant of the virus. At the moment, it’s not clear if we need to tighten restrictions but Þórolfur reminds the public that the infections we’re discovering now occurred before changes were made to border restrictions.

Authorities are conducting broad testing to determine the spread of the virus including randomised testing to see if the virus has spread further into the community. The results of these tests will help determine if tighter restrictions are needed.

Vaccinations continue this week: 10,000-15,000 are scheduled to receive a dose this week. The AstraZeneca vaccine will continue to be used for people over the age of 60.

Þórólfur urges the public to keep up their personal infection prevention practices and get tested as soon as they experience even the slightest symptoms. Alma takes over, calling the development of cases over the weekend “a disappointment. We can’t let this get us down, instead let’s focus on what we need to do and what we need to do better.”

She repeats Þórólfur’s statement about people needing to get tested when experiencing even the slightest symptoms and goes over the list of possible symptoms of COVID-19. Symptoms can include fever, cough, muscle aches, breathing difficulties, vomiting, diarrhoea, and sudden changes to sense of taste or smell. Some people can experience very mild symptoms. Alma reminds people to stay at home after the test until they receive their result. The easiest way to book tests is online at heilsuvera.is but you can also contact your local healthcare clinic or call 1700.

We’re still learning about this British variant, says Alma, and healthcare authorities have a feeling, albeit unconfirmed, that the British variant isn’t detectable as early as the other variants we’ve seen here. This hypothesis is based on the data that shows more people are now testing positive in the second border test than the first one.

Companies should be ready to support people who need to stay out of the workplace due to symptoms. While the majority of people testing positive yesterday were in quarantine, most of them hadn’t been quarantined for long so there’s a possibility that they infected others before going into quarantine.

The panel takes questions. Þórólfur is asked about the need for requiring travellers to quarantine in government-run hotels. Þórólfur states that the quarantine regulation infractions occurred before the increased surveillance of home quarantines began. Þórólfur still believes, however, that requiring people to quarantine in quarantine hotels would have minimised the risk of people breaking quarantine. Capital Area Police are looking into the case of the person who broke quarantine, Víðir does not have information on if they will be charged.

Police are not yet making home visits to people in quarantine but they’re making more calls and there’s a “low threshold” for police reaction if there’s the slightest indication that people are breaking quarantine. There are ongoing legal procedures to verify the legality of home visits to enforce quarantines and the police want to be extra sure there is a legal basis for making home visits.

Teachers will be vaccinated around the start of next month and preschool teachers will likely take precedence as preschools are strategically important for keeping society running. Authorities reacted as soon as they learned of the quarantine breaker but the disease doesn’t reveal itself until a week or two has passed since the infection, making it hard to suppress. At this point, we don’t know how the future with the virus looks. We might have to vaccinate annually but we don’t know at this point.

Asked if the quarantine period between border tests is too short, Þórólfur states that the cases of people testing positive after two negative border tests are so rare that it’s not necessary to start thinking about changing border procedure (for ex. requiring longer quarantine). 70% of those who test positive upon arrival from abroad have presented a negative PCR test certificate before departure.

Víðir ends the meeting by stressing the importance of getting tested if you’re feeling even slightly different from normal. When experiencing the slightest symptoms, such as an upset stomach, dry throat, unusual fatigue, or headache: get tested. Víðir: “Let’s not relax now.” The briefing has ended.

 

Iceland Review will live-tweet authorities’ next COVID-19 briefing here.

Customers of “The Icelandic Bar” from April 9 Invited for COVID-19 Testing

Íslenski barinn the Icelandic Bar

All customers of the Icelandic Bar on Ingólfsstræti in Reykjavík on April 9 have been invited to undergo a COVID-19 test. A COVID-positive individual went to the bar on that day. Bar guests do not have to go into quarantine but are asked to keep to themselves until they receive their test results.

Over 20 people tested positive yesterday, a spike compared to case numbers in recent days. Most of the cases are linked to a group outbreak at a Reykjavík preschool. It has yet to be confirmed how many of the cases were in quarantine at the time of diagnosis.

Icelandic health authorities will hold a COVID-19 briefing at 11.03am UTC today, which Iceland Review will live-tweet here.

COVID-19 in Iceland: Domestic Regulations Relaxed on April 15

mask use social distancing

Iceland will raise its national gathering limit from 10 to 20 people on Thursday and reopen gyms, bars, and swimming pools. The relaxed domestic restrictions, recommended by the country’s Chief Epidemiologist and approved by Iceland’s cabinet this morning, will remain in effect for three weeks.

The main changes that will take effect on April 15 are as follows:

  • Gyms and pools will reopen at 50% capacity.
  • Sports competitions and athletic activities with or without contact will be permitted among adults and children. The maximum number of adults in such activities is 50. Children are subject to the same gathering limits as in school activities.
  • Performing arts activities, including choirs, are permitted with up to 50 performers and maximum 100 guests in each separate section.
  • All shops can accept up to 5 guests for every 10 squared metres of space up to a maximum of 100 people, in addition to 20 employees in the same space.
  • Nightclubs, pubs, and slot machine venues may operate under the same conditions as restaurants. They must close by 9.00pm.
  • Driving and flight lessons are permitted to restart.
  • The general distancing rule for schools will be reduced from two metres to one metre. Preschool and primary school children will be permitted to engage in sports and recreational activities.

Iceland currently has 93 active cases of COVID-19 and one of the lowest infection rates in Europe. Only one patient is currently in hospital due to COVID-19. A total of 28,056 have been fully vaccinated (7.6% of the population) and an additional 33,078 have received their first dose (8.97%).

The updated regulations are in line with the Chief Epidemiologist’s recommendations, Health Minister Svandís Svavarsdóttir stated in an interview today. No changes will be made to border regulations at this time.

Iceland Keen on Russian Vaccine

The Icelandic government is in the early stages of negotiations to purchase the Russian-produced vaccine against COVID-19, Sputnik V. The government intends to continue the negotiations, possibly in collaboration with neighbouring countries. The Ministry of Health confirmed this in a statement to RÚV.

Iceland’s purchase of the Sputnik V vaccine would be subject to the drug receiving a conditional marketing licence from the European Medicines Agency. The Agency began a phased evaluation of the vaccine on March 4. The negotiations do not affect Iceland’s participation in the European co-operation on the purchase of COVID-19 vaccines, through which it is expected to acquire six different vaccines.

Research has shown the Sputnik V vaccine to be both safe and effective. A peer-reviewed study published in The Lancet found the vaccine to have 91.6% protection against COVID-19 disease in the study as a whole and 100% protection against severe and moderate COVID-19 disease. Effectiveness was consistent across age groups and side effects were generally mild.

Iceland has so far fully vaccinated 6.6% of its population or 24,344 people. Another 25,915 have received their first dose. Vaccination rollout will speed up this month, with 10,000 scheduled to receive a dose this week alone. Iceland’s Chief Epidemiologist stated in a briefing yesterday that the country was on track for vaccinating a majority of the population by the end of July.

Icelandic Authorities Appeal Court Ruling on Quarantine Hotels for Travellers

Fosshotel quarantine Reykjavík COVID-19

Icelandic authorities did not have legal grounds to require travellers to complete their quarantine at a government-run quarantine hotel when they had adequate facilities at home, according to a ruling made yesterday by the Reykjavík District Court. Icelandic authorities will appeal the decision. In a briefing today, the country’s Chief Epidemiologist Þórólfur Guðnason called the ruling “unfortunate,” saying hotel quarantine was the best way to ensure travellers from abroad do not breach quarantine regulations and risk a domestic outbreak of COVID-19.

Iceland tightened border regulations on April 1, requiring all travellers arriving from designated high-risk areas for COVID-19 to complete their mandatory five-day quarantine in designated government facilities. The rule was implemented after health authorities found travellers were breaching quarantine regulations, leading to community transmission of the SARS-CoV-2 virus.

Several guests required to stay in the facilities challenged the regulation in the Reykjavík District Court, which ruled in their favour yesterday. Icelandic authorities subsequently informed all guests at the facilities that they could complete their quarantine elsewhere if they had access to housing that fulfilled the requirements. A notice from authorities nevertheless encouraged the remaining guests to complete their quarantine at the hotel, “as it is the best way to reduce the spread of the COVID-19 disease.” At least three travellers staying at the quarantine hotel tested positive for COVID-19 since the facilities began operation last week.

Chief Epidemiologist Calls for Clearer Legislation

The Chief Epidemiologist expressed his disappointment with the ruling in a radio interview this morning, saying it was “thwarting one of the most effective measures that has been taken to try to prevent this virus from entering the country and spreading. We have been basing these measures on facts, what we see is lacking, and in that way try to prevent it from happening, that the virus gets in. Unfortunately, it has been the case that people have not been following quarantine. It is on that basis that I suggested [mandatory hotel quarantine measures].”

In light of the District Court ruling, Minster of Health Svandís Svavarsdóttir and Chief Epidemiologist Þórólfur Guðnason are now determining what additional steps will be taken to minimise the risk of active COVID-19 infections entering the country. Þórólfur stated his hope that the government would clarify the legal framework surrounding quarantine hotels so that the measure could be used as intended.

RÚV reported that travellers arriving in Iceland from high-risk areas today are not being sent to the government-run quarantine facilities if they have access to private facilities that fulfil quarantine requirements. If there is reason to believe travellers are likely to break quarantine rules (for example if their stay in Iceland is shorter than five days) they are sent to the government-run quarantine facilities.

COVID-19 in Iceland: Calls to Clarify Legislation on Quarantine Hotels

Fosshotel quarantine Reykjavík COVID-19

Iceland’s Chief Epidemiologist Þórólfur Guðnason is calling on the country’s government to clarify the legal framework for requiring travellers to quarantine in designated government-run facilities. Þórólfur expressed his disappointment in a ruling made in the Reykjavík District Court yesterday that found the state had no legal grounds for requiring several travellers to quarantine in a hotel when they had adequate facilities to do so at home. The ruling is being appealed by authorities.

Iceland tightened border regulations on April 1, requiring all travellers arriving from designated high-risk areas for COVID-19 to complete their mandatory five-day quarantine in designated government facilities. The regulation was set after health authorities found travellers were breaching quarantine regulations, leading to community transmission of the SARS-CoV-2 virus. Several guests at the hotel challenged the regulation in the Reykjavík District Court, which ruled in their favour. The Chief Epidemiologist has spoken in support of the quarantine facilities in Reykjavík, where at least three travellers tested positive for COVID-19 since the facilities began operation last week.

At a briefing today, Þórólfur expressed confidence that authorities would meet their goal of vaccinating a majority of the population against COVID-19 by the end of July 2021. Some 15,000 people are scheduled to receive a jab in the country this week, while 22,344 (6.6% of the population) are already fully vaccinated and an additional 25,915 have received their first dose. Confirmed distribution schedules ensure Iceland will receive enough doses to fully vaccinate 136,000 people by the end of June. That number does not include vaccines from several manufacturers who have yet to confirmed their shipping schedule.

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

 

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

The panel will likely address yesterday’s Reykjavík District Court ruling that determined health authorities did not have legal grounds to require a number of travellers to quarantine in government-run facilities in Reykjavík when they had access to adequate facilities at home.

Iceland’s Chief Epidemiologist Þórólfur Guðnason has expressed his support of mandatory hotel quarantine for those arriving from high-risk areas, calling on the government to pass legislation in support of the regulation, which took effect April 1.

Yesterday’s numbers have been updated on covid.is Iceland reported 4 new domestic cases, all in quarantine at the time of diagnosis. Total active cases: 123. 24,344 have been fully vaccinated, 6.6% of the population.

The briefing has begun. Rögnvaldur starts by going over the news from the eruption. New fissures have opened and the eruption site is closed to the public today. Scientists are working on mapping the new situation at the eruption site and emergency responders are working on new ways to ensure travellers safety.

Back to COVID: Rögnvaldur says we’ve done pretty well so far, managing to keep our healthcare system running and for the most part keeping the pandemic at bay. Infection prevention restrictions are, by nature, restrictive and many have suffered due to them, but our success is not a coincidence. We’ve listened to the experts and worked hard to ensure our success.

Þórólfur takes over. We’re still seeing several new domestic cases each day but the majority have been in quarantine. We’re still seeing cases outside quarantine that have proved hard to trace. We’re not seeing an increase in infection rates, and Þórólfur thanks the public for their efforts in following personal infection prevention. All new domestic infections are of the British variant. The situation at the hospital is good, no one is hospitalised with COVID-19 but we might still expect new hospitalisations. The current domestic regulations are in effect until April 15.

Yesterday, the district court ruled that there aren’t clear legal grounds for making stays in quarantine hotels mandatory for arriving travellers. Þórólfur says he considers the decision “unfortunate” and adds that it will be appealed. Five travellers tested positive at the border yesterday and 18 in total have tested positive with an active infection since March 25, all with the British variant and most of them residents of Iceland. Þórólfur believes that it’s necessary to clarify the legal framework for infection prevention regulations in order to ensure continued success in containing the pandemic in Iceland.

Þórólfur addresses vaccine rollout. Distribution schedules have been confirmed for vaccines for 136,000 people by the end of June. That’s not counting vaccines from several producers who haven’t confirmed their shipping schedule yet. There’s every reason to believe the government will be successful in meeting its goal to vaccinate a majority of the population by the end of July. 15,000 people are scheduled to be vaccinated against COVID-19 this week in Iceland.

Director of Health Alma takes over. She states that even with vaccination efforts revving up, we still haven’t achieved herd immunity and at the moment, the pandemic is soaring in the countries around us. There’s still the threat of new variants entering the country. Infection prevention restrictions at the border have proved a learning experience and things are still up in the air so we still have to be careful domestically.

Get tested as soon as possible if you are experiencing any symptoms, even if they’re mild, Alma says. She cautions that symptoms can vary and goes over the most important symptoms, including cough, fatigue, and muscle aches. It’s important to stay at home until you receive confirmation that you are negative for SARS-CoV-2. Alma is grateful that COVID infection numbers haven’t risen drastically over the past week and thanks healthcare staff for their efforts as well as the public. Let’s continue to stick together and keep a level head. This isn’t over yet but it’s not long now.

The panel opens for questions. A reporter brings up a recent announcement from the European Medicines Agency regarding a link between the AstraZeneca COVID-19 vaccine and blood clots. Will it change the approach to vaccinating with AstraZeneca in Iceland? Þórólfur will look into new information on the AstraZeneca vaccine as authorities have done before. Research has shown that younger people are at risk for blood clots. If there’s new information on an increased threat for older people we’ll take that into consideration.

“If you could decide, would you close the borders entirely?” A reporter asks the Chief Epidemiologist. Þórólfur: What we’ve been trying to do is find the people who are carrying an infection and basing our efforts on what’s worked before. I don’t think closing the country is possible, what does that even mean? Þórólfur: There are Icelandic residents abroad who have to be able to come home and people here who have to be able to go abroad for work and I don’t think closing the country is possible. We have to find other ways to minimise risk.

People who choose to leave the quarantine hotels are informed that they need to have suitable accommodation for continuing quarantine. They don’t have the possibility of verifying that. Information on accommodation and rules for quarantine are available at covid.is.

The court case regarding quarantine hotels seems to centre on the definition of quarantine centres and what their role is. Þórólfur hopes that the matter will end with the government being able to require people to spend quarantine in designated government-run facilities. If not, we won’t be able to curb the pandemic as effectively and won’t be able to relax restrictions to the same extent. One of the aspects of the hotel quarantine that was most criticised was guests’ inability to go outside. Alma states that that’s clearly something that needs to be worked out. Asked whether the dissemination of information could be improved for staff and guests in hotel quarantine, Þórólfur said that was likely the case.

Alma emphasises that as vaccination efforts continue, new variants remain a threat, especially as new variants are more likely to infect younger people and lead to serious illness in younger demographics as well as older groups.

“When we finish vaccinating locals 70+ will we continue to use the AstraZeneca vaccine?” Probably, until everyone 65+ has been vaccinated. Iceland’s health authorities are looking into the option of administering the second dose for people who have received one dose of AstraZeneca with a different vaccine. No decisions have been made on the matter at this point.

Contact tracing officials are discovering quarantine breaches through viral sequencing. When they discover the spread of new variants, they go back and find the people who brought the cases over the border, who might, when pressed, admit that they didn’t follow quarantine regulations to the letter. People know if they haven’t been following the rules to the letter and are reluctant to tell authorities. Alma emphasises that these breaches are not always intentional and urges those in quarantine to go over the quarantine rules carefully. That’s why the quarantine hotel method was implemented, to eliminate the temptation of breaking the rules. Þórólfur believes that higher fines or more threats of quarantine infraction repercussions aren’t a solution. A more effective approach would be to monitor people in quarantine more closely.

Rögnvaldur closes the briefing by saying that although vaccination deliveries are speeding up, it’s clear this isn’t over yet and we need to keep our guard up. The briefing has ended.