Flu Epidemic Likely Following Decline in COVID Cases

Chief Epidemiologist Þórólfur Guðnason believes that the waning COVID-19 pandemic is slowly being replaced by an influenza epidemic. The health authorities encourage individuals with underlying conditions to receive flu shots.

Brynjar Níelsson gets the flu

Last week, Brynjar Níelsson, Assistant to the Minister of Justice, published an essay on the subject of “pushy people” on his Facebook page.

While the former MP’s meditations were mildly interesting, the disclaimer that accompanied his post was even more noteworthy.

“I am extremely sick with the flu and nearly delirious,” Brynjar wrote (ensuring that any controversial statements could be chalked up to the delirious effects of the flu).

… but Brynjar Níelsson isn’t the only one who’s been suffering.

Up to 3,000 visits daily

In an interview with the radio programme Reykjavík síðdegis on Wednesday, Óskar Reykdalsson – Director of Capital Area Health Clinics – observed that the annual flu appeared to be “circulating among the populace in full force.”

Óskar estimated that up to 3,000 people visit capital-area clinics every day, complaining of common-cold symptoms, fever, and a cough.

Among those who have had reason to complain is singer Heiðar Örn Kristjánsson (who competed with Pollapönk in the 2014 Eurovision Song Contest) whose upcoming gig at Gamli Enski in Hafnarfjörður was cancelled for this very reason.

“Heiðar Örn has the flu and has lost his voice,” Gamli Enski announced on its FB page in early March. “In light of this, DJ Drinkalot will be filling in.”

If only Heiðar Örn had taken preventive action …

Flu shots are sensible

The health authorities in Iceland imported 95,000 doses of flu vaccine last year, and an estimated 68,000 individuals have been vaccinated since last fall. There is still plenty of vaccine available.

“It’s not too late to get vaccinated,” Óskar Reykdalsson stated in his interview with Reykjavík síðdegis, “so long as you haven’t been exposed to the flu.”

Chief Epidemiologist Þórólfur Guðnason made the same point in an interview with RÚV this morning, where he encouraged everyone to get their flu shots. “Especially those with underlying conditions.”

“We’ve also been encouraging doctors to treat people with underlying conditions as quickly as possible in the event that they become sick. That undoubtedly helps prevent serious illness.”

Social restrictions to blame

The reason why the influenza epidemic is so forceful this year owes to the social restrictions imposed to curb the COVID-19 pandemic over the last two years.

According to Chief Epidemiologist Þórólfur Guðnason, these restrictions prevented common annual bugs from spreading.

“So we can expect a significant circulation of these bugs now, because the flu hasn’t been spreading for the past two years,” Þórólfur remarked this morning. “This usually means that immune systems are much weaker than they otherwise would be.”

“What’s happening now is what I suggested could happen, that is, that we’re getting an extensive influenza epidemic,” Þórólfur continued. “We don’t know how extensive it will be, or how serious, because it’s just beginning.”

70% of Icelanders May Have Already Had COVID-19

COVID-19 briefing Iceland Chief Epidemiologist Þórólfur Guðnason

Chief Epidemiologist Þórólfur Guðnason wrote in his latest column on covid.is that he estimates the actual number of Icelanders who have been infected with the coronavirus to be as much as double the number of people formally diagnosed. That would mean that around 70% of Icelanders have had COVID-19.

Should that be the case, Iceland could reach the pandemic’s peak in the next few weeks, after which time diagnoses will start to drop, Þórólfur predicts.

COVID-19 is still a serious problem

In his column, Þórólfur reminds the public that COVID-19 continues to spread rapidly through the community, and though the number of tests being conducted is decreasing that doesn’t mean cases are dropping.

3,367 cases of COVID-19 were diagnosed in Iceland on Feb. 28 — 3,215 through rapid testing and 152 through PCR.

He also said the health care system is feeling the pressure.

“At Landspítali, about 10 individuals are admitted daily with or due to COVID-19, and slightly less are discharged,” Þórólfur wrote. “Today, 55 people are in hospital with/due to the disease, three of them in the intensive care unit, all on a ventilator.”

He says it is important that everyone realizes that COVID-19 is still a significant health issue in Iceland, despite official disease control measures being lifted. “Everyone is encouraged to continue to use individual disease control measures aimed at delaying the spread of COVID-19 and preventing uncontrollable strain on our healthcare system.”

No More COVID-19 Prevention Measures at Iceland’s Border

Keflavík Airport

Along with lifting COVID-19 social restrictions domestically, the government has also called off all disease-prevention measures at the border. There is no longer a requirement for a PCR test to board aircraft and no need to quarantine upon arrival, regardless of vaccination status.

Wholesale lifting of restrictions

Before today, all travellers arriving in Iceland were required to present a negative PCR or rapid antigen test administered no more than 72 hours before departure to Iceland (regardless of their vaccination status or whether they have previously contracted COVID-19). These restrictions no longer apply.

As per the authorities’ statements Wednesday, all COVID-19 measures at the Icelandic border were lifted at midnight – regardless of whether individuals are vaccinated or unvaccinated. (Visa requirements, of course, have not changed.)

As noted on Icelandair’s webpage: “All visitors are welcome, with no requirement for a PCR test to board aircraft, or testing or quarantine upon arrival. There is no longer a requirement to present a certificate of vaccination or of a prior COVID-19 infection.”

Travellers are, however, asked to keep in mind that the lifting of these restrictions does not mean that they cannot wear a mask. Travellers should also be aware that different rules apply for different airlines and countries.

Iceland Lifts All COVID-19 Restrictions

ramps downtown Reykjavík

All COVID-19 social restrictions have been lifted as of midnight today. Individuals who test positive for the coronavirus will no longer be required to quarantine, and no disease prevention measures will be in place at the border.

Two years of restrictions

Nearly two years after imposing the first social restrictions due to the COVID-19 pandemic, the Icelandic authorities have lifted all limitations on public gatherings. Rapid tests will replace PCR tests, and individuals who test positive for COVID-19 will no longer be required to quarantine.

According to a statement by Minister of Health Willum Þór Þórsson on Wednesday, the decision to lift social restrictions was unanimous among ministers – and in line with the most recent memorandum of Chief Epidemiologist Þórólfur Guðnason.

The memo noted that severe illness has not increased over the past few weeks – despite over 2,000 infections being recorded daily. Þórólfur believes that the best way to end the pandemic is widespread herd immunity against the virus (ca. 80% of the population is expected to have become infected by mid-March).

Approximately 110,000 individuals have been diagnosed with COVID-19 in Iceland. Antibody testing suggests, however, that an equal number of people have already been infected without testing positive. Sixty one individuals have died from COVID-19 in Iceland since the start of the pandemic.

“We can truly rejoice at this turning-point, but I encourage people to be careful, to practice personal infection prevention measures, and not to interact with others if they notice symptoms,” the Minister of Health stated on Wednesday.

Bar-owners rejoice, despite poor weather

Among those who will be celebrating the lifting of restrictions are bar owners, who may now resume normal operations for the first time since July.

The nightlife in downtown Reykjavík is expected to be especially busy this weekend. The National University Hospital warns of an increased strain on its operations and encourages partygoers to exercise caution.

As noted by meteorologist Haraldur Ólafsson in an interview with Vísir, today’s forecast is less than ideal. An orange weather alert will be in effect for the capital area between 11 AM and 5 PM. Wind speed is expected to reach up to 25 m/s with sleet and rain. The storm will have mostly subsided by the evening.

No More Quarantine And Relaxed Restrictions Take Effect At Midnight

Following a government meeting this morning, Health Minister Willum Þór Þórsson announced that considerably relaxed domestic infection prevention regulations will take effect at midnight tonight. Most notably, people will no longer be required to quarantine, meaning that close to 10,000 people will be released from quarantine. The new regulation will remain in effect until February 25, and barring any unexpected changes, the government hopes to lift all restrictions by the end of the month.

People already in quarantine will not be required to take a PCR test to be released from quarantine. People who have been exposed to COVID-19 will no longer be required to take special precautions, although it is still strongly advised. People with active COVID-19 infections will still need to isolate from others.

While infection regulations at the border will not change, the minister stated that a workgroup will introduce their suggestions for changes to border regulations “very soon”.

While new cases of COVID-19 in Iceland are increasing, hospitalisations have remained within a range of 25-45 since the beginning of the year. 38 are currently in hospital with COVID-19, 15 of which were hospitalised due to COVID-19 illnesses. Ten people have died from COVID-19 in Iceland this year, bringing the total number of COVID-19 deaths in Iceland to 54. Chief Epidemiologist Þórólfur GUðnason’s memorandum to the government stated that following recent restriction relaxations, there are strong indications that infections are increasing.

The Chief Epidemiologist notified the government that it is likely that following recent relaxation of restrictions, new cases of COVID-19 go unnoticed. Despite low hospitalisation rates (0.1% of infected people are hospitalised due to COVID-19 illness), an increase in infections can increase the strain on the hospital.

The changes to domestic regulations taking effect at midnight:

General gathering limits will be raised from 50 to 200 indoors. No gathering limits on crowds outdoors.

Shops no longer have gathering limits.

Events of up to 1,000 people will be allowed for seated events if everyone is wearing a mask. Intermissions will be allowed again, along with the sale of food and drinks during intermission.

Masks will be required if a social distance of 1 metre cannot be upheld.

Gyms, swimming pools, ski resorts, and spas will be allowed to operate at full capacity.

Sporting events and training are permitted with up to 200 spectators per compartment.

All restrictions on school operations lapse, making schools subject only to general gathering limits, with the option of further exceptions.

Elementary and upper secondary schools will be allowed to host events for their students with no infection prevention limitations.

Bars and restaurants are permitted to extend their opening hours by one hour. Establishments will be able to accept new guests until midnight, but all guests must have left the premises by 1:oo AM.

Minister Calls for Easing Restrictions Immediately

Áslaug Arna Sigurbjörnsdóttir minister of justice

Áslaug Arna Sigurbjörnsdóttir, Minister of Science, Industry, and Innovation, has stated that there is no need to await additional data on the newest wave of the pandemic – social restrictions should be eased immediately, RÚV reports. Chief Epidemiologist Þórólfur Guðnason has expressed contentment with the state of affairs at the National University Hospital and with the protection afforded by vaccines.

More infections, fewer hospitalisations

Despite a rising number of infections – almost a week after regulations were tightened – Minister Áslaug Arna Sigurbjörnsdóttir has stated, in an interview with RÚV, that there is no need to await further data for social restrictions to be eased. The Minister’s rationale is predicated on the fewer hospitalisations that have resulted from the Omicron variant as compared to older variants; there has been almost no alteration in the number of people being treated for COVID-19 at the National University Hospital over the past few days.

There are 35 COVID patients in the hospital today. Children are the majority of those getting infected, and severe illness caused by Omicron is rare; although 90% of those diagnosed with COVID-19 over the recent days have been infected with the Omicron variety, the majority of COVID-19 deaths have been traced to the Delta variant

Nearly 1,500 individuals were diagnosed with COVID-19 yesterday, about half of whom were self-isolating. Never before have as many individuals been in quarantine or self-isolation – 24,500 (7% of the nation) – since the pandemic began. An estimated 15% of Icelanders have now been infected with COVID-19. 

Calls for a serious discussion of restrictions

Minister Áslaug Arna believes that it is time to have a serious discussion on relaxing social restrictions: “We sometimes act fast to tighten restrictions, but we can also act fast to ease them. We don’t need to wait for data and then more data to implement relaxed regulations; on the contrary, continued restrictions require substantiating data in each case.

As noted by RÚV, the current government has not been unified in its stance toward social restrictions, and members of the Independence Party have suggested that it’s time to take a new tack with regard to the pandemic, among them Minister of Foreign Affairs Kolbrún Reykjfjörð Gylfadottir.

In terms of social restrictions, Áslaug Arna states that it is necessary to consider the burden that regulations have on society: “If we were a restriction-free society today, and a virus with similar infection numbers and hospitalisations began to spread, would we have the legal authority to take such extreme measures as we are taking today?”

Most ICU patients unvaccinated and infected with the Delta variant

In an interview with RÚV yesterday, Chief Epidemiologist Þórólfur Guðnason expressed his contentment with the state of affairs at the National University Hospital, i.e. that despite increased cases, there were fewer hospitalisations. 

“There are not a lot of hospitalisations, and there are not a lot of COVID-patients requiring intensive care, which is pleasing. It’s not causing a strain on ICU’s .”

Þórólfur added the caveat that a high number of COVID-19 infections could, however, put a strain on the hospital, especially considering the high rate of infections among hospital staff. As noted by RÚV, children in primary schools comprised a third of total infections on Wednesday and nearly half of total infections on Tuesday. 90% of individuals diagnosed with COVID-19 are infected with the Omicron variant, which is not the case for ICU patients: 

“The majority of those who are in intensive care are unvaccinated and infected with the Delta variant. It’s clear that the vaccines are preventing severe illness,” Þórólfur observed.

Government Announces New Social Restrictions

Katrín Jakobsdóttir COVID-19 mask

With COVID cases on the rise, the government has announced new restrictions. A 500-person limit on social gatherings will come into effect next Wednesday, and masks will be mandatory in certain places starting tomorrow. A record number of COVID cases were reported today.

Mask mandate beginning tomorrow

In light of the sharp rise of COVID cases, Chief Epidemiologist Þórólfur Guðnason submitted proposals on new restrictions to Minister of Health Svandís Svavarsdóttir yesterday. Following a cabinet meeting this morning, Svandís – speaking to Vísir – confirmed that the authorities would be tightening social restrictions next week, although masks will become mandatory in those places where individuals cannot maintain a one-metre distance beginning tomorrow.

Children 15 years and younger will, however, be exempt from the mask mandate and so willl those individuals who provide up-close, personal services (e.g. barbers, masseuses). High-school students may also remove their masks after classes begin (even if it is not possible to observe the so-called “one-metre rule).

Bars and restaurants made to close early

Starting next Wednesday (November 10), the following restrictions, among others, will come into effect:

  • The maximum number of people allowed in the same location will be 500 people.
  • The business hours of restaurants and bars will be shortened by two hours so that restaurants that serve alcohol will have to close at 11 pm, and patrons must vacate the premises by midnight.
  • Up to 1,500 people may attend an event if all guests bring a negative result from a rapid antigen test and wear masks.

These restrictions would be in effect for four weeks (until and including December 8).

According to Svandís, there is nothing preventing Christmas concerts from being held and nor do theatres need to cancel shows.

Will not have the intended effect

Despite these new regulations, it is unlikely that these measures will have the intended effect; as noted by RÚV, Þórólfur’s proposal from November 4 contained three possible sets of restrictions. The restrictions that the authorities decided to adopt – which Svandís referred to as “the middle road” – are similar to those that were in effect between September 15 and October 20. In his memo from November 4, Þórólfur stated that if the authorities chose this route, it could “be argued that infections will continue to rise;” between September 15 and October 20, the daily number of cases rose from 20 to just over 60.

A record-number of new cases

A record number of new COVID new infections were diagnosed yesterday, or 167. Not since the pandemic began have so many new cases been reported over a 24-hour period. Sixteen individuals are currently hospitalized with infections, and five are in intensive care.

“If we do nothing, things will take a turn for the worse; we’ll begin to run into real trouble in the hospitals,” Chief Epidemiologist Þórólfur Guðnason stated in a radio interview this morning.

Stricter Social Restrictions Proposed Amid Rising Cases

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

Yesterday, Chief Epidemiologist Þórólfur Guðnason submitted a proposal on new COVID measures to Minister of Health Svandís Svavarsdóttir. Although she declined to comment on the specifics, the Minister confirmed to Mbl.is that Þórólfur has advised that the authorities move to tighten social restrictions.

A record-number of infections?

One hundred forty-four new COVID cases were reported yesterday, the highest number of infections since August 4 of this year. Seventeen people are in hospital, thereof five in intensive care.

These cases are not confined to the Reykjavík area; following a cluster of infections in Akranes and Sangerði, local authorities have decided to close schools and postpone recreational activities in the area.

In light of numerous cases, Chief Epidemiologist Þórólfur Guðnason submitted a proposal on new COVID measures to Minister of Health Svandís Svavarsdóttir yesterday. Speaking to Mbl.is, the Minister stated that authorities would be reviewing Þórólfur’s suggestion at a cabinet meeting this morning.

“Yes, it concerns tightening restrictions. We know what measures can be taken when infections are rising, and that’s what the cabinet will discuss tomorrow,” Svandís stated in an interview with Mbl.is yesterday. The Minister confirmed that Þórólfur’s proposal solely concerned domestic restrictions as opposed to measures to be taken on the border.

Asked if she was concerned about the apparent dwindling of solidarity when it comes to proposed domestic restrictions, Svandís refused to say: “Only time will tell, of course. In conjunction with these measures, we’ll be launching a campaign of booster shots, which will hopefully increase immunity among the populace.”

According to the Minister, the primary aim of the proposed restrictions is to protect the hospital and the healthcare system. “Like all nations struggling against this new wave of the pandemic, it’s about protecting the lives and the health of citizens and preventing the curve from rising too sharply so that the system can continue to provide adequate service.”

Svandís added that easing all domestic social restrictions on November 18 was not realistic: “I think it’s apparent to all of us that the infections are spreading too quickly now.”

A historic proposal

In an interview with Rás 2 this morning, Svandís Svavarsdóttir observed that even more COVID cases had been diagnosed yesterday and would be reported today.

“We know that with the Delta variant, we can expect a hospitalization rate of ca. 2%, with a proportion of that percentage requiring intensive care. We know, given the statistics, what we are dealing with.”

Svandís added that the National University Hospital could handle approximately 40-50 infections a day; in light of the government’s most recent removal of social restrictions, however, the curve is rising too fast for the healthcare system to cope.

Finally, Svandís referred to Þórólfur’s new proposal as “historic;” in the memo, he traces the origin of the pandemic in Iceland and reviews the measures that have been taken. Þórólfur also discusses what has worked and what hasn’t, arguing that the authorities must move switftly to enact tighter restrictions: the aim being to flatten the curve back to approximately 40-50 new infections a day. The measures, according to Svandís, involve placing limits on public gathering, mask mandates, and restrictions on the operation hours of business.

Yet to Submit a Proposal on Updated Social Restrictions

Chief Epidemiologist Þórólfur Guðnason

Over the next two days, Chief Epidemiologist Þórólfur Guðnason aims to submit a proposal on social restrictions to the Ministry of Health. Proposed changes to the regulations will not be presented to the public until after the weekend.

Current restrictions in effect until September 17

Chief Epidemiologist Þórólfur Guðnason aims to submit a proposal on social restrictions regarding COVID-19 to Minister of Health Svandís Svavarsdóttir this weekend, RÚV reports. As there is no cabinet meeting scheduled for today, proposed changes to the regulations will not be presented to the public at this time.

The current restrictions, which, among other things, involve a public-gathering limit of 200 people, were adopted on August 28 and will be in effect until September 17.

Determined to ease restrictions

Earlier this week, Svandís Svavarsdóttir stated that it was clear that the government would ease restrictions on public gatherings. Nonetheless, Svandís remarked that she would await new proposals from the Chief Epidemiologist, which would then be discussed by the cabinet before any decisions were made.

After a cabinet meeting on Tuesday, Þórdís Kolbrún Reykfjörð Gylfadóttir, Minister of Tourism, Industry and Innovation, and Áslaug Arna Sigurbjörnsdóttir, Minister of Justice, stated that they wanted to take a step toward “normal life” as soon as possible.

COVID-19 in Iceland: Vaccination Has Not Led to Herd Immunity, Says Chief Epidemiologist

Chief Epidemiologist Þórólfur Guðnason

While data shows vaccination is reducing the rate of serious illness due to COVID-19 in Iceland, the country’s Chief Epidemiologist Þórólfur Guðnason says it has not led to the herd immunity that experts hoped for. In the past two to three weeks, the Delta variant has outstripped all others in Iceland and it has become clear that vaccinated people can easily contract it as well as spread it to others, Þórólfur stated in a briefing this morning.

The current social restrictions will remain in place until August 13. The Chief Epidemiologist says the government must make the final call on next steps in response to the current wave of infection. Health authorities have sent a formal memorandum to the government expressing concern about the heavy strain on the healthcare system cause by the current record rate of infection.

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

 

On the panel: Director of Civil Protection Víðir Reynisson and Chief Epidemiologist Þórólfur Guðnason.

Yesterday’s numbers have been updated on covid.is. Iceland reported 108 domestic cases (38 in quarantine) and 1 at the border. Total active cases are at a record 1,304. 16 are in hospital.

The briefing has begun. Víðir begins by saying that the long weekend has passed without any large violations of regulations but it will only come to light in a week or two whether the gatherings last weekend have led to infections.

Þórólfur takes over. He reviews the reason restrictions were lifted last June: at the time infection rates were very low, a majority of the nation was vaccinated and there were regulations at the border ensuring a minimum of infections would cross the border. Vaccination rates are high in most groups, though only 10% of those 12-16 have been vaccinated.

What has happened in the past two to three weeks is that the Delta variant has taken over all other variants in Iceland. And it has come to light that vaccinated individuals can contract it relatively easily and spread infection. Sequencing has shown us that the origin of most domestic infections can be traced to group events such as clubbing in downtown Reykjavík or group trips abroad. We’ll have to wait and see whether the current restrictions will suffice in curbing this current wave.

There are however indications that vaccination is preventing serious illness. Around 24 have had to be hospitalised in this wave, just over 1%. In previous waves, that figure was 4-5%. However, 2.4% of unvaccinated people that contract COVID-19 now are hospitalised.

Authorities have decided to offer those who received the Janssen vaccine a booster shot of Pfizer. There are plans to offer 12- to 15-year-olds vaccination in the near future as well. There are still some 30,000 unvaccinated people among older groups and they are more at risk. That could cause strain on the healthcare system. We must also consider that there is additional strain on other patients when there are lots of COVID cases, says Þórólfur.

Þórólfur says we must remember that the COVID-19 pandemic is not close to being over and will not be over until it’s over everywhere. We must be ready to face new challenges that come up in the process. We know what works to curb infection. We can fight COVID-19 if we stand together and reach a consensus on what needs to be done.

The panel opens for questions. “What needs to happen for you to tighten restrictions, Þórólfur? You don’t sound very positive at the moment.” Þórólfur says he has not decided on measures beyond August 13. He is in discussions with the Health Minister, and it is the government that must decide whether it is necessary to impose tighter restrictions. Þórólfur adds that at this time he will likely make recommendations in a different format than the memorandums he has previously sent to the Health Minister.

“Can you give us information about how many people were vaccinated among those who have been hospitalised in this wave?” Þórólfur says around half of those hospitalised have been vaccinated. The two that have been placed in the ICU are unvaccinated. It’s not possible to draw broad conclusions from this data but vaccination appears to reduce serious illness generally.

“What is the reason that you are considering vaccinating children at this time?” Þórólfur says that he has discussed it for some time and children in at-risk groups have already been vaccinated. There is also evidence that the Delta variant causes more serious illness among them.

“Is there a possibility that children that contract the Delta variant will need hospitalisation?” Þórólfur says that children generally have milder symptoms and none in Iceland have been hospitalised in this wave. However, there is data from abroad of children needing to be hospitalised due to COVID-19.

“Do you not want to urge the government to strengthen the healthcare system?” Þórólfur says of course, and the Director of Health has discussed that often at these briefings but it doesn’t happen overnight. What we can do in the short term is to curb infection rates, which will reduce strain on the healthcare system. Þórólfur says: We must keep in mind that people can develop long-term symptoms despite not needing hospitalisation from COVID-19 infection. That’s something that we don’t have long-term data for yet but will come to light.

Þórólfur says health officials have sent a formal memorandum to the government expressing concerns regarding strain on the healthcare system and the National University Hospital. Þórólfur expresses disappointment in the discourse regarding the National University Hospital, he feels the media has been dismissing healthcare workers’ concerns. Healthcare workers are those best positioned to evaluate the hospital’s strain and capacity, he says.

Þórólfur: our main project now is this wave that we have to tackle. Regarding the borders, we must think long-term about how we can minimise infections crossing the border. Then we must consider how we want things to be domestically and what people’s tolerance is for restrictions. But it’s a fact that the more this wave of infection spreads the harder it will be to contain.

Víðir takes over to close the briefing. We know what we have to do: prevent infections, and protect the borders so that we can live as freely as possible within Iceland. We can see that many people are out of patience toward restrictions but unfortunately, this is not over. We don’t have to agree on everything but our message must be clear. It is the virus that is the enemy. We must be good to each other and be patient, try to understand where others are coming from, Víðir says. The briefing has ended.