This article is from the WeChat public account: World said (ID: globeusnews) , author: Study Iceland, drawing from the title: vision China

In a game that has been delisted, Iceland and the nearby Greenland are both “light of humanity”: they are lonely overseas, the land is wide, the people are scarce, the traffic is inconvenient, the temperature is low, and the social distance between people The long distance and low population movement are extremely unfavorable to the spread of the virus. The fall of Iceland is almost synonymous with world destruction in the game.

Different from the game story, in the new crown epidemic that will sweep the world in 2020, the isolated Iceland has not been able to stay out of the scene-the first patient was diagnosed on February 28, as of April 2, the country The number of confirmed cases has reached a thousand, reaching 1,220 and two deaths. Considering that there are only 364,000 people in Iceland, the proportion of confirmed cases in the total population has exceeded all currently severely infected countries such as Spain and Italy, ranking sixth in the world. (The first place is the Vatican with a population that is too small to be relevant) .

Has Iceland fallen? Perhaps, in addition to “zero infection”, “Human Light” can also be achieved in another way.

Tracking and universal testing

Different from most countries, Iceland added that when the number of new Japanese cases remained in single digits, for the sake of controlling the spread of the epidemic, it could not be satisfied with simple epidemiological investigations.

On March 9, deCODE Genetics, Iceland’s best private bio company, announced that it will be open to all people to make appointments for New Coronavirus screening, regardless of whether the subject is symptomatic, or whether they have a history of travel in the affected area and a history of contact with confirmed cases. . After a few days of discussion, deCODE opened free screening for everyone on the 15th, and nearly 1,000 people reported that dayParticipating and being screened, including the Icelandic presidential couple.

Eliza Reid, Iceland’s First Lady tested on March 15th / Network

Iceland then entered a general test performed by the National University Hospital of Iceland (NUHI) for symptomatic patients and suspected populations with contact history , And the large-scale detection of “two-pronged” status for all citizens operated by deCODE Genetics. Although the supply of swabs was stopped halfway, deCODE Genetics’ testing was interrupted for a while, but the supply problem was resolved shortly after, and large-scale testing began again.

As of April 1, the total number of people tested in Iceland has exceeded 19,500. The two test methods each account for about 50%. The total number of people tested is close to 5% of the total population, which is far higher than any country in the world. According to the relevant data released by the Icelandic government, of all the tests that have been completed so far, 54% of confirmed cases have been isolated when they were diagnosed, which means that up to 46% of people are still before the screening results are obtained. Free time.

Schematic diagram of Iceland’s detection, blue is operated by the National University Hospital of Iceland, orange is deCODE Genetics operation / covid.is/data webpage screenshot

At the same time, about 50% of people do not show any symptoms when they receive the test and get a positive result, which is commonly called “asymptomatic infection”, although doctors do not rule out that some of them may Related symptoms appear later. This proportion is similar to that obtained when Italy implemented the comprehensive screening policy, but it is much higher than the current estimates of the proportion of asymptomatic infections in countries such as the United States.

Of course, the positive detection rate of the large-scale test operated by deCODE Genetics is much lower than the test subjects found by Iceland National University Hospital through infection traceability and symptom screening. Until now, only 84 of the 1,220 confirmed patients were deCODE Genetics detected, the detection rate is about 0.86%, but from the daily data, from the voluntary registration population, the proportion of positive detection did not show a significant increase or decrease.

The detection amount of each of the two test paths / covid.is/dataWebpage screenshot

This means that almost 1% of people who remain untested may still be infected.

With regard to an epidemic that is forming a pandemic on a global scale, Iceland has made an advantage for the prevention and control of epidemics in all countries around the world due to its advantages such as isolation abroad, low population mobility, and basically controllable imported cases. Control model. On the other hand, deCODE Genetics has other huge advantages-the founder of the biological company, Dr. Stefanson, revealed in a recent interview that his company has traced the geographical origin of all detected viruses in Iceland, At the same time, the company already has medical and genotypic data for nearly half of Iceland’s population, which makes it possible to study the causes of viruses with different mutations that show different symptoms in infections.

Another good news is that the proportion of people with “untraceable origin” in Iceland has decreased significantly. In the retrospective analysis of more than 400 cases on March 23, the proportion of cases with unknown infection was as high as 33.2%. 4On January 1, among all 1,220 confirmed patients, 301 were imported cases abroad, and 803 were caused by infections in the domestic community. There were 116 people with unknown sources of infection, the proportion has dropped to 9.5%.

Not closed, but supervised and isolated

Up to now, Iceland has not implemented the measures of “blocking the country” and “blocking the city” in most European countries. Except for announcing the suspension of middle schools and universities for three weeks, prohibiting assembly of more than 20 people, and all companies that need close contact temporarily No further bans have been issued beyond the closure.

Government officials have explained that there are no plans for stricter measures at this time because of the need for large-scale testing and widespread tracking, there is no need to implement a blockade policy. Stefanson, founder of deCODE Genetics, is equally optimistic. He believes that the spread of the virus in Iceland has been “relatively controlled.” Until now, Iceland’s primary schools and kindergartens are still attending normal classes, but according to the situation, the implementation of epidemic prevention measures such as student grouping system and school attendance system at different times, this is to ensure that front-line staff will not worry about their children at home alone.

deCODE Genetics Locations / Networks in Reykjavik

The Icelandic government has also urged various enterprises and units to implement stricter epidemic response measures, strengthen protection and disinfection, and adopt shifting measures to reduce contact with people to avoid large-scale infections. However, in addition to stricter immigration control, Icelandic tourists were not required to be quarantined because they were considered to have “limited access to locals.”

The origin of this “loose” attitude, in addition to economic considerations similar to those in other countries, is also a series of stricter control measures than in other European countries, such as large-scale testing, patient identification and tracking. In Iceland, there are People with related contact history have been required to be strictly isolated from the beginning. On March 25th, Icelandic officials also announced that a chaseA mobile app that traces national footprints, which will allow the government to track down diagnosed patients and locate close contacts. Similar apps have been used to control the epidemic in South Korea and Singapore, but for the first time in Western countries.

This kind of control and tracking measures is not without controversy. The footprint tracking app still needs to be licensed by the Icelandic data protection department. At the same time, deCODE Genetics’ screening for the general population is also facing pressure from the data protection department and the scientific ethics committee. , But the problem was finally resolved by a workaround: screening was considered a clinical measure, not a scientific research activity.

Model of epidemic development trend made by the University of Iceland in collaboration with the Icelandic Health Agency and the National Hospital / University of Iceland

More importantly, Iceland has not relaxed its vigilance: In a statement, the Icelandic Health Agency reminded that the current large-scale screening is still subject to voluntary registration, which means that it is not a universal test in the strict sense, but is more likely Attract nationals who are more concerned about the development of the epidemic, but currently a real random screening program has begun, and in the future, serum tests for antibodies are planned. deCODE Genetics plans to test at least 50,000 people.

Until now, all walks of life in Iceland have acknowledged the existence of unknown variables: A report released by the University of Iceland on March 31 stated that at the current scale of testing, the age distribution of the confirmed population has changed slightly from previous forecasts-the elderly People become more. If the proportion of older people in the patient population rises, the medical system will undoubtedly face greater pressure than previously predicted. On the other hand, due to the small population of Iceland and the limited sample size, there is still uncertainty about the stability of the system itself.

Reference Group

In terms of the current situation of the global epidemic, of course, Iceland cannot be regarded as a hot spot: Until the press time, only 41 people were admitted to Iceland for new crown infections.Two people, and another 982 people are in mild home isolation. On the other hand, Iceland is just a small country with a population of more than 300,000. It also has many natural advantages to limit the spread of the virus. Whether it is its large-scale detection measures or outbreak response programs, it is difficult to replicate in most countries around the world.

But Iceland ’s test results provide at least some important information to other countries around the world, such as a significantly higher proportion of asymptomatic infections than other countries ’estimates, such as the sex ratio of infections that are diametrically opposite to those in countries like Italy “text-remarks” label = “Remarks”> (slightly more women than men) , and the proportion of people who are actually infected in the entire population when the current cognition cannot be traced back to the source of the infection.

Swedish National Health Agency experts have acknowledged that the country’s infection rate must be higher than Iceland. In other hotspots where outbreaks have already occurred, the actual infection rate among the population will only be higher, and it will be more difficult to control the spread of the epidemic. In the face of a global epidemic, Iceland may not be the antidote today, but it still counts as a reliable “reference group” in assessing “invisible infections” and assessing the effectiveness of epidemic prevention measures.

This article is from the WeChat public account: World said (ID: globeusnews) , author: Study Iceland