COVID-19 pandemic in Iceland

The Department of Civil Protection declared an uncertainty phase on 27 January in response to the unfolding outbreak of COVID-19 (known at the time by the provisional name 2019-nCov) in China.[11] Targeted testing for COVID-19 started on 31 January in Iceland for persons determined at high risk for infection.[12]

On 28 February, Iceland confirmed the first case of COVID-19, an Icelandic male in his forties, who had been on a ski trip to Andalo in Northern Italy and returned home on 22 February; when he developed symptoms after his arrival, he was quarantined at Landspítali hospital in Reykjavík.[13][14] Subsequently, The National Commission of the Icelandic Police declared an Alert Phase.[15]

On 1 March, a second and a third case were confirmed, an Icelandic male in his fifties who had returned home on 29 February from Verona, and a female in her fifties who had returned home from Italy via Munich.[16]

On 2 March, additional six cases were confirmed, bringing the total to nine: five men and four women. All cases to date have been in the Reykjavík area. Five of those cases have been traced to Italy.[17] In response, the Directorate of Health has defined Italy as a risk area for the disease, and all those arriving to Iceland from Italy are being asked to go into a 14-day home quarantine.[18] The ninth case is that of an Icelander who had spent time in Austria and flew home on 1 March.[19] After additional cases were traced to Ischgl in Austria, the Health Directorate defined Ischgl as a high-risk area.[20] Authorities in the Tyrol state of Austria however contend that the Icelanders returning from Ischgl probably became infected on their flight from Munich but this is considered "very unlikely" by Icelandic health authorities as this group presented symptoms very soon after the flight.[21][22]

On 3 March, in an official press report, sanctions were announced for those who would break the quarantine, which includes up to three months in prison, as it is considered an intentional contagion of the virus.[23]

As of 5 March, around 400 people are in home-based quarantine in Iceland and around 330 individuals have been tested for the virus, but no cases of transmission within the community had been identified. Among individuals who had been tested for the virus, 35 had been confirmed as infected with COVID-19, but officials warned that this figure would rise when additional test results become available in the next days.[24]

On 6 March, the total number of infected rose to 45, including the first 4 cases of local transmission of the virus.[22][25] Iceland's Department of Civil Protection and Emergency Management declared a civil protection distress phase within minutes of local transmission of COVID-19 being officially confirmed.[26]

On 7 March, five additional cases were confirmed: three cases of local transmission and two from previously defined high risk areas. All seven confirmed cases of local transmission are in the Reykjavík area. A total of 484 tests have been administered to date.[27]

On 8 March, the total amount of infected rose to 58, a total of 10 of which are cases of local transmission.[28] Three cases identified on 8 March were of Icelandic residents who had returned to Iceland on a special flight from Verona on 7 March; all passengers were Icelandic residents who had spent time in high-risk areas, and special precautions had already been taken to ensure that they would remain isolated from other passengers on arrival to Keflavík International Airport.[29] That same day, no COVID-19 patients were ill enough to require hospitalisation.[30]

On 9 March, two additional passengers from the special flight from Verona on 7 March tested positive for COVID-19.[31] Three cases of local transmission were identified and two cases of Icelandic residents returning from ski areas in the Alps, bringing the total to 65.[32]

On 11 March, it was reported that a COVID-19 patient had developed more severe symptoms and admitted to hospital, thus becoming the first patient in Iceland to develop more than mild symptoms of the disease. Also on 11 March 90 people in total had been diagnosed with COVID-19 and 700 were under quarantine.[33]

On 13 March, it was announced that as of Monday 16 March, universities and secondary schools would be closing and a ban on public gatherings of over 100 would be put in place.[34]

On 15 March, it was reported that three COVID-19 patients in Iceland were now in hospital, one in intensive care, and a health clinic in the capital city area (in Mosfellsbær) has been closed after an employee tested positive for COVID-19. A total of 171 cases have been confirmed, a majority of which can be traced to ski areas in the Alps. Chief Epidemiologist Þórólfur Guðnason stated that half of all persons in Iceland who have tested positive for COVID-19 were already self-quarantining (after either returning home from international travel or having been in contact with an infected person), suggesting that measures to control the outbreak through quarantine and isolation in Iceland have been effective so far.[35] An estimated 2500 persons are self-isolating, with the number rising daily.[36]

On 17 March, the first person with coronavirus was confirmed dead, a 36 y.o. Australian citizen who was visiting Iceland with his wife.[37] He sought medical attention because of serious illness and died shortly after arriving at the Húsavík health clinic.[38] Dr. Brynjólfur Þór Guðmundsson stated that COVID-19 was the probable cause of death.[39] However, this had been later challenged by Dr Þorólfur Guðnason, the chief of the health directorate's national vaccination program in his interview to public broadcaster RUV: "While he [the visitor] was found to be infected with the coronavirus, it is unlikely to have been the cause of his death. His symptoms came on very quickly and were not those usually associated with Covid-19 deaths." The man's Australian family had also been told that health officials didn't believe the cause of death was due to COVID-19.[40][41]

On 23 March, an Icelandic woman in her early 70s died from COVID-19 after a week-long battle with the illness.[42]

Two patients at Landspítali hospital died on 1 April, a man and a woman in their 70s. The man, aged 75, was the husband of the woman that died on 23 March.[43]

A mobile app to trace infections was developed and released on the first of April;[44] after passing review by Google and Apple,[45][46] the app was downloaded almost 75,000 times by 3 April 2020.[47]

Two more deaths occurred due to the virus on 5 April, taking the total tally of deaths to six. One of the deceased was 67-year-old Sigurður Sverrisson, a renowned Icelandic bridge player; the other was Gunnsteinn Svavar Sigurðsson, a male resident of a nursing home in Bolungarvík in the Westfjords aged 82.[48][49] On 5 April Iceland also recorded the highest number of active cases during the outbreak, at 1,096; since then, recoveries per day have outnumbered new cases.

Another two individuals died due to the virus by 11 April, taking the total deaths in the country to 8.[50] A ninth patient, in their sixties, died at Landspítali hospital on 16 April;[51][52] a tenth, a woman in her eighties, died at Berg nursing home in Bolungarvík in the Westfjords on 19 April.[53]

A sharp rise in the number of infections in mid to late September was traced to two restaurants in Reykjavík, Irishman and Brewdog, and ultimately to two French tourists who tested positive in mid-August but did not follow all rules of quarantine.[54]

On 16 October, Iceland recorded its eleventh death, its first death since April and first death in the second wave.[1][55] Iceland announced its twelfth and thirteenth deaths on October 28 and 29; in the previous week, a spike in the number of cases of those aged over 80 had been recorded.[1][56][57]

On 31 October, Iceland recorded its lowest number of cases outside quarantine since September. However, hospitalizations rose to 67 and two more deaths were recorded.[58]

Iceland recorded its sixteenth death on 1 November,[59] its seventeenth on 2 November,[60] its eighteenth on 4 November,[61] and its nineteenth and twentieth on 7 November.[62] A further three deaths occurred on 8 November,[63] and another – the 24th overall – on 9 November.[64] The 25th death occurred on 11 November in Sólvellir care home in Eyrarbakki;[65] the 26th death occurred on 17 November.[66] On 22 November, there were no new cases outside quarantine.[1] The 27th death occurred on 30 November,[67] the 28th on 7 December,[68] and the 29th on 28 December.[69]

Icelandic health officials have used voluntary home-based quarantines for all residents returning from defined high-risk areas and virus testing as the primary means of preventing transmission within the community. Icelandic health officials have tested a proportionately high number of arriving passengers from high-risk areas for COVID-19, with the hope that early detection of infections will prevent their spread.[83]

An early concern among Icelandic residents placed in home-based quarantine has been employees' rights to paid leave while being quarantined; it was announced on 5 March that the COVID-19 outbreak will likely result in changes to legislation within the next weeks.[84]

Those with symptoms of COVID-19 were asked to avoid health care centres and hospitals without calling ahead, to avoid exposing vulnerable individuals to the virus. Even mild symptoms of illness should be reported to 1700 (+354 544–4113 for foreign numbers) for further guidance.[85]

Official quarantine facilities for healthy individuals unable to enter a home-based quarantine (for example, foreign nationals) have been established at a local hotel in Reykjavík. The Icelandic Red Cross will assist those who require help with acquiring necessities during quarantine and isolation. Any person in quarantine or isolation in Iceland can contact the Red Cross Helpline at 1717 (+354 580 1710 from foreign numbers), which is open 24/7.[86]

Initially, COVID-19 testing for Icelandic residents in quarantine took place mainly in their own homes. Due to the high volume of tests required, the decision was made to use mobile units parked outside health clinics; individuals not experiencing severe symptoms who require testing must contact authorities to book a time and location.[30]

A shortage of tests has reduced the volume of COVID-19 testing in Iceland, hampering control and tracing efforts. It was announced on 22 March that an order of 5,000 swabs set to arrive the following week had been reduced at short notice by 3,000.[87] The unexpected discovery of an additional 6,000 swabs in a warehouse was announced on 26 March 2020.[88]