How Iceland turned into the world's biggest study of Covid-19 - and what it's teaching us
Mass testing has avoided lockdowns - but does this tiny island nation have all the answers?
By
Thor Fanndal
REYKJAVIK
4 April 2020 • 2:09pm
You would be forgiven for thinking the tiny island nation of Iceland is being ravaged by coronavirus.
Raw data shows the highest proportion of confirmed cases anywhere in the world - 1,300 among a population of 365,000.
But step outside into the bright spring sunshine and you won't see ghostly quiet streets and shuttered businesses like in Italy and Spain.
Instead the cafes, pubs and shops are doing a gentle trade, while schools remain open and travel is unhindered - even tourists are welcomed, the ones that manage to book a flight.
The reason behind the high numbers is the most aggressive Covid-19 testing regime anywhere in the world.
In proportion to population, Iceland has now screened five times as many as in South Korea - the poster country for a national Covid response - and 30 times as many as the UK has managed.
At the latest count 22,195 people had been tested - amounting to six per cent of the population. 1,364 have tested positive and four people have died.
With the results authorities are able to pursue aggressive quarantines for those with a higher statistical chance of infection, to slow the spread without a draconian nationwide shutdown.
Across the world, countries tend to have settled into two camps in fighting the virus: containment or mitigation, Thorolfur Gudnason, the government's chief epidemiologist, tells The Telegraph.
"It's like you would choose one or the other," he says. "Iceland is doing both."
Mr Gudnason's team of 60 police investigators and healthcare workers act as detectives on each confirmed case, tracking down those they have come in contact with.
Testing is carried out by The National Health Service on those showing symptoms. But on top of this, a biopharma company, deCODE Genetics, has been screening random samples of the population to build the world's most extensive study yet of how the virus behaves in a population.
Early results show 50 per cent of carriers of the virus are asymptomatic. It has also revealed up to 40 'mutations', or strains, of the disease.
“We can determine the geographic origin of the virus in every single [virus] in Iceland,” Kári Stefánsson, founder of deCODE says.
They claim to have traced strains back to Italy, Austria, the US, and seven cases in particular to one undisclosed football match in the UK.
Crucially, all the testing has meant Iceland has been able to avoid a lockdown or quarantine as cases are tracked, traced and isolated before spreading rapidly - thus alleviating pressure on the hospitals.
The data rolling in has meant authorities can "more accurately design methods" of controlling the virus, Mr Stefánsson says.
So far there is a government ban on gatherings of more than 20 people and light guidelines on social distancing.
The guidance is imposed not by force but by trust, Katrín Jakobsdottir, Iceland's prime minister, tells The Telegraph .
"Iceland has a history of socially liberal culture," she says. "That means acceptance of differences and minorities, but in this case, it means to trust, not to force. We have no tradition of militarism or an army. We ask for cooperation, rather than force it."
She adds that the science approach allows her to leave the virus policy "out of the battlefield of politics".
The limited guidelines means business is slow for most shops, but with few exceptions the country is open for business.
Icelanders can still get their morning coffee, sit down at local bookshops. Even stop at a local ice-cream parlour.
At Reykjavík Roasters, a small but popular independent cafe in Reykjavík's centre, customers trickle in despite the pandemic. The city's centre is unusually calm.
“Honestly, what I miss more than anything are the public pools” pensioner Auður Styrkásdóttir says apologetically, adding “this is a luxury.”
One of the main benefits of Iceland's system is the school programme has been largely unaffected.
Pre-schools, primary, and secondary schools have stayed open while higher education has moved online.
Some people have taken to social media asking why children's safety is perhaps taken less seriously than those of adult students.
Mr Gudnason points out that closing down institutions that serve children has a more significant social impact
"Our study suggests that children are less effective in spreading this virus than adults. We measure every decision with it's effectiveness and closing these institutions is unlikely to produce meaningful results at this time."
Part of Iceland's success story is it's readiness.
"We realised at the end of 2019 that we should prepare for a pandemic," Mr Gudnason says.
"Our emergency system is clear, it is efficient and importantly frequently in use. Be it storms, avalanches, volcanic eruptions or a pandemic the system is the same. Health authorities step into a well-oiled machine, highly trained infrastructure and years of experience in building communication channels and trust."
On Friday the head of Iceland's response, Víðir Reynisson, warned against drawing too much from the Iceland model, pointing out that the country's size, strong channels of communication and social cohesion helped.
"There are many factors that make things easier on us," he said.