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COVID-19: First results of the voluntary screening in Iceland

Kari Stefansson

A large scale testing of general population in Iceland has begun, intended to gather insight into the actual prevalence of the virus in the community.

Iceland, which has a population of around 364,000, has the unique position of having very high testing capabilities with help from the Icelandic medical research company deCODE Genetics, who are offering to perform large scale testing.

“This effort is intended to gather insight into the actual prevalence of the virus in the community, as most countries are most exclusively testing symptomatic individuals at this time,” said Thorolfur Guðnason, Iceland’s chief epidemiologist.

Iceland health authorities and deCode Genetics have undertaken comprehensive screening for the virus that causes COVID-19 among the Icelandic population. The testing by deCode Genetics started Friday 13 March and the results of the first 5 571 diagnosed tests have yielded 48 positive samples (0.86%) indicating that the prevalence of the virus is modest among the general population. As of March 23rd, a total of 473 cases have been identified in Iceland since the first case on February 28th. One person with COVID-19 has died. Twelve individuals with COVID-19 were hospitalized.

Update March 29th: As of March 25th, 11 727 individuals have been tested by deCODE or the University Hospital of Iceland and around 737 people have been diagnosed with COVID-19. The hospital is testing patients with distinct symptoms or individuals that are returning home from risk areas, and at deCODE everybody who wants can take a test for free.

“It is amazing to see how the community is coming together as one to deal with this threat. Here at deCode people are working 24/7 to screen for and to sequence the virus. The screening tells us where the virus is and the sequencing how it differs between the places where it is and how it continues to mutate”, said Kári Stefánsson, CEO of deCode.

Provide insights that can contribute to the world’s response to this pandemi

“There are strong indications that our efforts to contain the spread of the virus have been effective. About half of the diagnosed cases are from individuals who had been quarantined. Our focus is to protect those must vulnerable from contracting the virus, while trying to ensure that the overall spread of the virus remains slow. We are optimistic that the combined efforts to test a large part of the population will provide insights that can contribute to the world’s response to this pandemic,” says Thorolfur Gudnason, Chief Epidemiologist.

“Our number one priority is to limit the damage of the pandemic to the health of our citizens and to our social and economic infrastructure. We have followed the policy of adhering to the best available advice of the medical community in Iceland. The large scale testing by deCode Genetics among the general population will hopefully inform improved decision making throughout the current crisis, and more importantly, serve a useful purpose for how the world prepares for similar events in the future,” says Svandís Svavarsdóttir, Minister of Health.

Valuable insights

Iceland has as of March 23rd, tested 9 768 individuals for COVID-19, which translates to 26 762 per million, compared with 6 343 in South Korea and 13 999 in Bahrein. The country has tested a higher proportion of inhabitants than any other country after medical research company deCode genetics started offering free screening among the general, non-symptomatic, non-quarantined population, states the Government of Iceland.

In terms of tests per one million inhabitants, Iceland has as of March 23rd tested 26 762, which is the highest proportion we are aware of in the world, the government states.

“This leads to a higher confidence in our efforts to contain the spread of the COVID-19 disease in the country. The combined efforts also provide a very valuable insight into the spread of the virus. In the coming days more results from testing in the general population will continue to elicit a much clearer picture of the actual spread of the SARS-CoV-2 virus in Iceland,” states the Government in Iceland.

The results of the additional tests performed by deCode have given an indication that efforts to limit the spread of the virus have been effective so far, states the government. In Iceland, these measures have focused on testing, contact tracing of infections, social distancing, public efforts to increase basic awareness of hand sanitation, voluntary self-quarantine measures (currently about 5 448 individuals), and strict measures at healthcare institutions, nursing homes and the likes. Of the 473 cases identified 13 are individuals over age 70, considered to be the most at-risk group.

Clinical work, not a scientific study

The CEO of deCODE, Kari Stefansson’s desire to screen the general population was not without controversy, as both the Data Protection Authority and the Scientific Ethics Committee initially believed he required a special permit in order to conduct the screening. However, both bodies have reversed their position on the matter, as the screening is considered clinical work; not a scientific study, reports Reykjavik Grapevine.

A statement from deCODE emphasizes that people’s personal data will not be permanently recorded nor put in the company’s general knowledge bank. Rather, the purpose of the screening is meant to inform those who have symptoms whether or not they have COVID-19, in conjunction with the Directorate of Health, in order to assist already ongoing efforts.

Photo of Dr. Kari Stefansson, CEO of deCODE genetics

This article was updated March 27th and 29th 2020