COVID-19 in Iceland: Chief Epidemiologist Recommends Cautious Optimism Toward Vaccine News

At a briefing in Reykjavík today, Iceland’s Chief Epidemiologist encouraged locals to keep their optimism in check regarding news that COVID-19 vaccinations could arrive in Iceland as early as next month. While that is a possibility, the COVID vaccines Iceland is in line to acquire have yet to be approved by European authorities. Furthermore, vaccines will need to be administered in two doses and it takes about a month after the second dose for recipients to develop immunity. The Icelandic government has published a press release with the latest information on upcoming COVID-19 vaccination in Iceland.

 

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

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

Yesterday’s numbers have been updated on covid.is. Iceland diagnosed 14 new domestic cases yesterday (only 1 out of quarantine) and 4 at the border. Total active cases: 205, 38 are in hospital and 2 in ICU.

The briefing has begun. Rögnvaldur starts by noting that everyone’s tired of COVID so he starts by discussing the upcoming cold snap. Þórólfur takes over to discuss the numbers. 14 were diagnosed yesterday domestically, a similar number as the past few days but only one wasn’t in quarantine, lower than in recent days. We don’t know how the pandemic is trending but we hope this is a positive sign, says Þórólfur. It’s positive that the proportion of positive cases of all those tested is decreasing. Hopefully this is an indication that community spread is on the wane.

We’re still seeing small group infections within families, groups of friends, an even one prayer group, says Þórólfur. We’re seeing the same strains we’ve been dealing with recently with but also a newer one from the border. I think we can say that the pandemic has been growing in a linear fashion in recent days but we don’t know what will happen next. Projections show the R factor to be just above one and we are in a delicate spot.

Þórólfur addresses comments from athletes, who have been vocal about how restrictive the regulations are to them. He says restrictions have heavily affected many groups, including tourism workers, all artists and performers, hair salons, restaurateurs, and the public as a whole. He is compassionate toward their plight and hopes they can return to their normal training activities soon. He adds that the restrictions have been successful in helping Iceland keep the pandemic at bay.

We’ve heard much talk on vaccinations in the past few days. Vaccines are awaiting a decision from European authorities. We can expect that by the end of December. But vaccination efforts might not start as soon as January in Iceland, let’s be cautiously optimistic. Also, vaccines become effective about one month after they are administered. We have to be patient. It is important to not let the positive news about vaccination lead to us relaxing our personal preventative efforts, says Þórólfur, as that will only lead to another wave.

The panel opens for questions. Will you suggest harsh restrictions until everyone has been vaccinated? That depends on how the pandemic develops domestically, answers Þórólfur. The UK’s decision to begin vaccinating is interesting but most countries in Europe agree that we need to wait until scientists give the green light, says Þórólfur.

How is Víðir? His symptoms go up and down, answers Rögnvaldur, but hopefully he’ll feel better soon.

When will we know the regulations from December 9? Þórólfur says regulations will be presented by the Health Minister, not him, and mentions that things can change quickly so he doesn’t expect they will be introduced a long time in advance.

Þóróflur and Rögnvaldur are asked about their Christmas “baubles,” and answer that they will be spending Christmas with their immediate family members only.

Will everyone receive the same amount of the vaccine? Usually, vaccines are administrated in equal doses for adults, no matter their size or weight, though children receive a smaller dose. We’ll vaccinate people according to instructions from the pharmaceutical companies.

Can you tell us more about the new strain? Þórólfur says he does not have much information but it would be interesting to know more.

The situation at the hospital is taken into account when Þórólfur issues his recommendations and the situation at the hospital right now is good. Þórólfur points out that strain on the hospital occurs around 2 weeks after cases are diagnosed, as it takes time for serious illness to develop.

The Director of the Icelandic Medicines Agency told Vísir reporters that they could get enough vaccinations for all Icelanders in the first shipment. Þórólfur says that is not the case, but we will most likely get all the vaccines we have access to at first in a single shipment.

Are you considering reopening swimming pools? Þórólfur answers: It’s like I’ve said before, I can’t discuss the details of regulation changes a long time in advance. There are always steps that must be taken and they have to be assessed. We’re aware that people are impatient for swimming pools and gyms to reopen but we’ll have to wait and see. When asked whether he will recommend regionalised restrictions, Þórólfur says there are varying opinions on the matter and he is looking into it.

Will vaccines be free? And will people with more funds have access to them in private clinics?
The vaccine regulations issued by Icelandic authorities are clear: the vaccines will be free and will be distributed through local public healthcare clinics and hospitals.

Þórólfur is asked about vaccination sceptics and their planned response to those who oppose being vaccinated. Þórólfur replies that once they have scientific reports that vaccines are safe and effective, they will recommend their use to the public. Of course, I don’t have a report on the vaccine’s long-term effects, that would be impossible with a new vaccine, but we must consider the long-term effects of the COVID-19 disease: all data points to them being considerable.

Regarding the pending colour-coded COVID risk warning system, the plan was to implement it this week but it’s being fine-tuned and will be presented after the weekend.

Will we get enough of the Pfizer and Moderna vaccines to vaccinate the whole nation? Þórólfur says no, we’ll probably get around 80,000 doses of the Pfizer vaccine and the EU is currently negotiating with Moderna. We don’t know how many doses of the Moderna vaccine we will receive, but it will probably be a little less. That is not enough for the whole nation but we’ll have to wait for more information.

Rögnvaldur says he’s heard that the public is being careful and has postponed gatherings they had planned for the weekend. He expresses his gratitude and says that if things continue as they’ve been, we might be able to have a few more people in our bubble for Christmas. Rögnvaldur ends the briefing by encouraging everyone to keep up the good work and says it will work out if we work together.

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

Ten COVID Vaccines in Final Trial Stages

Ten COVID-19 vaccines are now in their final trial stages, RÚV reports. All of the vaccinations have performed well in trials, but furthest along in its testing is the vaccine that is being developed by Swedish-British pharmaceutical company Astra Zeneca. Iceland is among the countries that have already made arrangements to buy vaccines from Astra Zeneca when it is ready for use and distribution.

See Also: Iceland to Buy 550,000 COVID-19 Vaccinations

Per international agreements that have been put in place regarding COVID-19 vaccination distribution, all nations that are part of COVAX, an international collaboration to accelerate COVID-19 vaccination, will promptly receive enough shots to vaccinate 20% of their populations.

“They’ll need to prioritize who they’ll start with,” explained Ingileif Jónsdóttir, a professor specializing in allergies at the University of Iceland who also works at deCODE Genetics. The rest of the countries’ populations will be vaccinated in a later phase. “One of the conditions of being a member of COVAX is accepting that it won’t be one or two countries that get everything first…[T]here are 74 countries that have been determined to be poor or of average wealth. This is being done in order to ensure that as far as it’s possible, people can’t pay to push to the front of the queue. That won’t serve anyone,” said Ingileif.

See Also: Iceland Contributes ISK 500 Million to International Vaccine Development Initiative

Ensuring that less wealthy countries receive proportional amounts of the vaccine at an affordable price is indeed a priority. “There is also a requirement that each dose costs no more than $3, which is really low,” continued Ingileif. “If we have a lot of countries where there is no protection [against the virus], then the other countries will be just as exposed as before.”

Asked about possible side effects or complications that could arise from being vaccinated against COVID-19, Ingileif pointed to other vaccines against viruses that have been safely used by millions of people for decades. Side effects from vaccination are extremely rare, she said, and not serious.

“It’s maybe one in 500,000 or one in a million people [who have serious side effects from vaccination], while the diseases that these vaccinations prevent were perhaps causing 10% of deaths and having other serious consequences. So if you compare the results of vaccination and are preventing mass deaths…the risk is infinitesimal,” Ingileif concluded.

COVID-19 Antibodies Last for Months, Icelandic Research Shows

COVID-19 test tubes

An Icelandic study published in the New England Journal of Medicine has found that COVID-19 antibodies last at least four months without declining. The research suggests there is little likelihood of developing COVID-19 twice. It also suggests vaccines could be effective in preventing infection over a long period, even with just one or two doses.

The study measured antibodies in samples from 30,576 people, including 1,237 who had recovered from SARS-CoV-2 infection. Among those who had recovered, antibodies proved higher in older people and those who were hospitalised. Men tended to develop more antibodies than women, and there was a positive correlation between the severity of illness and the amount of antibodies. Those who showed only slight symptoms or were asymptomatic general developed fewer antibodies to SARS-CoV-2.

One- or Two-Dose Vaccine

Kári Stefánsson, CEO of DeCODE genetics, which conducted the study, told RÚV that in light of the study results, a vaccine could provide relatively long-term protection from infection. “This indicates that antibodies formed during vaccination should be able to last considerably,” Kári stated. “You do not need to be vaccinated more than once or maybe twice, but in any case, it seems to last considerably.”

Read More: Iceland to Buy 550,000 Doses of COVID-19 Vaccine

Reports of Reinfection Not the Norm

Kári stated that rare reports of cases abroad where individuals are believed to have been infected more than once should not cause alarm for the average person. “When 25 million people have been infected with this virus, it must have reached people who are diverse when it comes to the immune system. But that doesn’t mean that ordinary people who have been infected are at high risk of reinfection.”

Iceland to Buy 550,000 COVID-19 Vaccinations

Iceland will purchase 550,000 doses of the COVID-19 vaccination when it becomes available at the end of this year or beginning of 2021, RÚV reports. According to Health Minister Svandís Svavarsdóttir, this will make it possible for around 75% of the nation to be inoculated against the virus and achieve so-called ‘herd immunity.’ Each person who is vaccinated will receive two doses of the vaccine.

On Thursday, the European Union signed an agreement with the Swedish-British pharmaceutical company AstraZeneca to buy the vaccine. The AstraZeneca vaccine has not yet been licensed for sale, but is in the final stages of testing and it’s hoped to be ready for general use within the coming months. The EU is also negotiating with other vaccine manufacturers. Although it was previously announced that the Swedish government would mediate sales of the vaccine to both Iceland and Norway, it’s now been decided that Iceland and other EEA countries will receive a proportionally equal amount of vaccines as EU countries.

Svandís asserted that international cooperation is vital to ensure that countries around the world have equal access to the vaccine, as well as the importance of all countries that are able contributing to vaccine development efforts. Through its collaboration with WHO, GAVI, and CEPI, Iceland has already donated half a billion krónur [$3.63 million; €3.05 million] to vaccine development and distribution to developing nations.

A Fifth of Icelandic Population to be Vaccinated Before the End of 2021

Iceland intends to vaccinate a fifth of the nation against COVID-19 by the end of next year, RÚV reports.

Iceland has expressed interest in joining the WHO’s COVAX Facility, a World Health Organization (WHO)-backed initiative intended to ensure that countries around the world have fast and fair access to COVID-19 vaccines. In a press conference on Thursday, Chief Epidemiologist Þórólfur Guðnason noted that taking part in COVAX will “guarantee us vaccines when the time comes.” Of the 80 nations that have expressed interest in participating in the project in various ways, he continued, “Nine vaccine manufacturers have been selected to collaborate on this project, which seems likely to yield positive results; six of them already have vaccines in clinical trials.”

See Also: Iceland Contributes ISK 500 Million to International Vaccine Development Initiative

Vaccinating a fifth of the Icelandic population is expected to cost ISK 700 million [€4.44 million; $5.15 million]. “It’s been determined that each person will need two doses in order to be fully inoculated. We anticipate that each dose of the vaccine will cost around ISK 5,000 [€32; $37],” explained Þórólfur.

Asked how authorities would be deciding who would be vaccinated, Þórólfur said it wasn’t yet time to work out such details, but that it was likely that a similar approach would be taken as was during the N1H1 pandemic of 2009, namely that at-risk individuals and healthcare workers would be given priority.

“There are always grumblings and discrepancies about who people think should get priority—it’s just one of the epidemiologist’s headaches,” Þórólfur concluded.

Iceland Contributes ISK 500 Million to International Vaccine Development Initiative

As part of an international coalition of nations, corporations, and institutions, Iceland is contributing ISK 500 million ($3.8 million/€3.36 million) to global efforts to develop a vaccine for the COVID-19 virus. This announcement was made during a virtual conference held by the Gavi Vaccine Alliance, according to a press release on the Icelandic Government’s website.

The coalition, which was founded a month ago, aims to accelerate the development, production, and distribution of the COVID-19 vaccine. It also intends to support the taking of samples and broadly applicable treatment solutions for all people, regardless of residence and economic status. The World Health Organization is part of the coalition, which has been promised millions (in USD) in support from Norway, and hundreds of millions (in USD) in support from the US, the UK, Canada, and Germany.

Iceland will be dividing its contribution: half will go to the Gavi Vaccine Alliance, and half will go to the Coalition for Epidemic Preparedness Innovation (CEPI).

The virtual conference was also tele-attended by UK Prime Minister Boris Johnson and Microsoft founder Bill Gates was one of the speakers. The Bill and Melinda Gates Foundation has pledged $250 million (ISK 32.8 billion/€220.6 million) to fight COVID-19.

When announcing Iceland’s contribution, Prime Minister Katrín Jakobsdóttir emphasised the importance of equal access to health care and safe vaccines, irrespective of gender, economic status, or place of residence. “Equal access to health care is one of the most important public health issues and guarantees the most basic human right – the right to life. Vaccines provide all generations the opportunity for a healthy and fulfilling life.”

The Gavi conference aimed to raise $7.4 billion (ISK 972 billion/€6.53 billion) for its efforts, but it did even better, raising $8.8 billion (ISK 1.1 trillion/€7.77 billion).