How Iceland clamped down to conquer coronavirus
- Published
Yes, Iceland is a remote island in the North Atlantic, with just one international airport. And yes, it is home to fewer than half a million people. So it would be fair to assume that it has luck to thank for becoming the first country in Europe to virtually rid itself of Covid.
But say that to Icelanders, and you won't make many friends. Because when you peel back the geography and look at the detail, there is more to it, and these islanders are pretty proud of their success.
It is a Thursday night and young people are packing out karaoke night in central Reykjavik, the capital, screeching renditions of every classic down the microphone. They're hugging and kissing, as droplets of spit fly through the air.
Nights out are back, as are restaurants, concerts and everything else the rest of Europe is yearning for. There are just 20 active cases at the time of writing. One person is being treated in hospital, and Iceland has had a total of just 29 deaths, which equates to 8.5 per 100,000 people.
"I've been preparing for this pandemic for 15 years," Iceland's chief epidemiologist told the BBC, when asked exactly how he had managed it. Prof Thorolfur Gudnason was put firmly in charge of Iceland's pandemic response from the start.
"We decided immediately what we would do: testing, contact-tracing, and putting everyone diagnosed into isolation. We did this aggressively, from day one."
His contact-tracing team, manned with real-life detectives, was up and running before Iceland had recorded its first case.
As I pulled up outside an ugly hotel in the centre of Reykjavik, a large, cheerful man drew back the metal barricades, blocking the door: "Welcome to the isolation hotel," he chuckled.
Gylfi Thor Thorsteinsson left a job in marketing last March to open the hotel, where people diagnosed with the virus are sent. "On my first day, most of the hotel staff just walked out, they refused to take part."
Gradually, he coaxed them back, and, over the past year, they have cared for more patients than all the hospitals in Iceland combined. Every day, he dresses repeatedly in full PPE to go into their rooms and keep them company. "It's been a journey, never knowing what the day will bring," he says.
Now the hotel has just a handful of patients.
But Iceland has been here before. It got its first wave under control quickly, and by May 2020 people had started to declare the country Covid-free. Things stayed that way for a while, but by late summer Iceland was hit unexpectedly by another, more ferocious wave, after two tourists who had tested positive broke the rules of their isolation.
Gylfi had already closed up and gone home. He had even thrown a huge party for all his staff in celebration.
"We honestly thought we had won," he said. "But then I got the call: it was back. Within half an hour, I had opened up again, and people kept coming and coming and coming, and they still are."
The difference now is that they come straight from the airport.
After eradicating the virus from society, Iceland erected borders of steel. Since June last year, every arriving passenger has been put through quarantine and there are mandatory tests at the airport.
"Next," a nurse shouts before poking a swab stick up my nose and down my throat, all before passport control. Something that took some countries nearly a year to crack, Iceland figured out within months. If society had any chance of re-opening, the virus had to be contained upon entry.
When I asked Gylfi what had given Iceland this edge, he was adamant: "It has been the scientists making up the rules, not the politicians. That matters. They know what they are talking about, the politicians do not."
At every step, Iceland has followed the science, led by Prof Gudnason and his team, with politicians nowhere to be seen in the daily briefings.
Meeting Iceland's prime minister later, I was curious to know why she had taken such a backseat.
Katrin Jakobsdottir, 44, has led the country's left-green government since 2017. For her, pandemic and politics are two words that do not belong together.
I think it's important for a politician to realise what is politics and what needs to be solved by scientific means. It's my firm belief that we need to listen more to the experts
She told me how excited she was to get behind the rigorous testing, tracing and isolating, hoping to spare the country from drastic lockdowns, which by and large she did.
But taking a backseat did not mean taking it easy: "This pandemic has kept me awake for a whole year now. I just wish it would all be over and I could go back to talking about politics again."
Some unexpected help came early on. Reykjavik is home to one of the world's leading human genetics companies, run by Kari Stefansson, a lively man in his 70s who has achieved celebrity status in Iceland.
Within days of the virus arriving on the island, Mr Stefansson had agreed to hand over his state-of-the-art laboratories to track its spread.
"In the beginning, this looked like the extinction of mankind, so we dived in with full force," he told me as we toured the labs. "We're just a small community. Everyone knew we could do this, so it was clear that we had to do it."
His teams have since sequenced every single positive case, to understand how it is spreading and mutating. As the virus mutates with every fourth transmission, 25% of the time, they can work out who has given it to whom, he says. "Did John give it to Peter or did Peter give it to John?" as he puts it.
He has no doubt this has helped Iceland stay on top. "For me, this has been a fun time. I feel a bit guilty admitting to it, but it's been thrilling."
For months, Iceland has managed to stop the British variant from entering the country by containing cases at the border. But while I was there, Kari Stefansson's team noticed that the first case had slipped through and spread to another person.
That person had gone to work, in a hospital, and then on to a concert with 800 others where they had mingled at the bar during the interval. It looked like a disaster. But here, I witnessed the full force of Iceland's mighty contact-tracing system in action.
Within hours, everyone had been contacted, and within days more than 1,000 had been tested. Two more cases were identified and all those infected were taken to the isolation hotel. Remarkably, the variant was contained, unable to wreak the havoc seen elsewhere at the moment in Europe.
"We are usually a rather unruly nation, but we flourish in a crisis," Mr Stefansson noted with pride.
Putting the science aside, it is impossible to ignore the role Iceland's unique geography has played in its success. This volcanic island, with all its eruptions and avalanches, is used to dealing with disasters.
For weeks, Iceland has experienced a swarm of thousands of earthquakes a day followed by a volcanic eruption, and it has become clear the pandemic is just another catastrophe to manage. The prime minister even admitted she had the same teams working on both.
Gylfi Thor Thorsteinsson is in good spirits at the isolation hotel despite his new patients.
"We are in control," he grins, defiantly. "This is the spirit we keep up. We are winning." But he is not yet ready to celebrate: "No more 'farewell Covid' parties. Not yet."
Additional reporting in Iceland by Kate Vandy.
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- Published17 March 2021