Danish Epidemic Commission warns health system in peril
The coronapas is back. What we know so far
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Denmark’s Epidemic Commission believes coronavirus is a major threat in the months ahead, especially to the country’s hospitals. On Wednesday, the Danish Health Ministry released all the documentation behind the commission’s decision to restore the ‘socially critical disease’ designation to the coronavirus and reimpose the coronapas. The documents show that Danish authorities believe we are in for a grim winter ahead. Whether the situation becomes dire enough that even more severe restrictions are needed depends on whether the coronapas can make big enough of a difference.
The Threat
The Epidemic Commission has raised the COVID risk level for Metro Copenhagen (Region Hovedstaden) and the rest of Sjælland outside the city (Region Sjælland) to level 4, the second highest level.
The Commission is expecting that COVID infection numbers and hospitalizations across Denmark will continue to increase “in the coming months.”
“This expected development entails an imminent risk that the hospital system in Denmark from December onwards will be critically challenged, so that both handling of acute and non-acute life-threatening conditions, e.g. treatment of patients with cancer and heart disease, will be affected, with consequences for public health. The Commission is of the opinion that this poses risk of a serious disruption of an important function of society.”
The Commission emphasized that the hospital system is currently not in a dire situation, but the threat that it soon could be is very real. It estimates there are about 1,380,000 people in Denmark who are unvaccinated; of those 640,000 are children under the age of 12 who cannot yet be vaccinated. Currently, unvaccinated people make up the highest proportion of hospitalizations and infections are sweeping through young children.
Looking at the data, it says that in the last two weeks alone, hospital admissions have more than doubled. It also stresses that there is a 10-day lag between rising infections and the corresponding number of new admissions. In the last few days the COVID incidence rate across Denmark has risen from 150 per 100,000 residents to 250. All but a handful of Denmark’s 98 municipalities have a COVID incidence rate of 100 or more.
The Commission also found that hospitals are facing other challenges that are making the situation worse. One of them is staffing shortages, which “are currently quite significantly challenged” especially where it concerns the need for more nurses. It says staffing shortages “will persist over the winter.”
The other nursing-related problem is the backlog of delayed procedures that built up during the recent labour dispute with the nursing union. The Commission says that the backlog has not only not yet been addressed but in fact continues to grow due to COVID hospitalizations.
The other problem exacerbating the situation is the spread of other respiratory infections like the RS virus and influenza. Combined with coronavirus patients, the crunch has several hospitals already reducing other operations and procedures by about 20%.
“The expected increase in the number of inpatients with COVID in the coming weeks to varying degrees across the country will trigger the need to further postpone planned operations and outpatient visits resulting in negative consequences for the individual and for society.”
This not only doesn’t help the current situation; it will elongate the crisis so that it will take hospitals longer and longer to catch up, extending well after the pandemic eventually ends.
The Coronapas
The Epidemic Commission believes that reintroducing a broad coronapas requirement with some tweaks is the most effective and least intrusive option to bend down the infection curve. The commission has assessed whether more stringent restrictions are needed “but does not believe that this is the case in the current situation.” It does add the caveat that strict restrictions could return “depending on the development of the infection wave.” The Commission also left the door open for “additional local measures” in specific areas where COVID cases are spreading rapidly.
“At the same time, the Commission expects that if less drastic measures such as the coronapas are not implemented at present, measures with major consequences for citizens well-being, freedom, and the economy in several areas, such as local or wider closures, are expected to be necessary to avoid a critical challenge to healthcare.”
The Commission also raises the idea that the ‘action plan’ for dealing with COVID outbreaks in schools may need to have thresholds lowered so that infection prevention measures can be triggered earlier.
The commission does have a few concerns about reintroducing the coronapas. One of them is that it must be implemented with clear communication, especially for cultural event organizers and businesses. It is also worried that events, venues, and businesses “that have the greatest need for infection containment” will simply choose to ignore the coronapas requirement.
It also cites the Expert Group on a long-term strategy to fully reopen Denmark.
“That early intervention can play a crucial role in keeping the spread of infection under control and thereby avoiding the introduction of stricter restrictions. An early, targeted, and well-adjusted effort can thus have less cost to the economy than the consequences that can arise if the infection continues to increase because you react too late.”
The question yet to be answered is if reintroducing the coronapas is an early intervention or if it has come too late.
Coronapas: How it works
The coronapas gives the user access to events, venues, etc, on the basis of the holder’s vaccination status, immunity via a recent infection, or a negative test result.
A negative test result can be no more than 96 hours old for a PCR test and no more than 72 hours old for a rapid test.
A positive PCR test result proving a recent infection no less than 14 days prior and no more than six months old.
Being fully vaccinated with two doses for most vaccines or one dose in the case of the Johnson & Johnson shot.
As before, one vaccine dose also gives the user all the freedoms of being fully vaccinated, but only for 42 days. If a second dose isn’t administered the coronapas is invalid.
Coronapas Changes
The coronapas has had some changes you need to be aware of.
The Epidemic Commission has lowered the age where a coronapas is required to 15 years old.
The time period where a person is considered to have immunity due to having survived a COVID infection is shortened from 12 months down to 6.
The Ministry of Health is also preparing to adjust the coronapas so that a third dose would be required within a certain period of time for the user to still be considered fully vaccinated.
There are also concerns about personal information in the Danish view of the coronapas. An executive order has been extended to allow its use for four more weeks. If the coronapas is extended beyond that, a decision must be made and it’s possible the Danish display may be switched off to rely entirely on the EU COVID certificate view.
The Ministry of Justice has also “assessed that businesses, private, and cultural institutions, associations, etc. may make stricter requirements for its guests and customers than what follows from the legislation, including, for example, requirements for presentation of documentation for tests and vaccines.”
Where a coronapas applies
The details of where the coronapas will be mandated for use are somewhat fluid at the moment and will be clarified in full on Friday. That said, the Epidemic Commission documents do shed some more light.
Nightclubs and discos
Party buses etc. (when serving alcohol)
Indoor restaurants (with the exception of take-away, and attached cafeterias used in nursing homes or hostels, for example)
Indoor locations and events with more than 200 spectators or participants. This could include movie theatres, restaurants, sports halls, etc depending on venue size and seating.
Outdoor events with 2,000 or more spectators, regardless of whether they are seated or standing.
Concerts and performing arts performances, etc.
Movie screenings and big screen events.
Paying spectators at sporting events.
Large community events.
Museums, art galleries etc
Church services, baptisms, weddings, and funerals, etc.
Evening schools, day colleges, and Folkeuniversitetet
Zoos and aquariums
Swimming pools as well as bathing and play areas.
Amusement parks, arcades, and casinos
Conferences, lectures, fairs, and animal shows.
Visitors to care centers and hospitals (except for close relatives, guardians, personal representatives, lawyers, etc.)
Visitors to prisons and detention centers.
It is important to note that the Epidemic Commission differentiates between spectators and event attendees who are required to show a coronapas on entry and employees, volunteers, athletes, and performers who do not.
“However, the Epidemic Commission recommends that employees, volunteers, etc. in places covered by coronapa requirements are encouraged to live up to the requirement themselves.”
The commission has also recommended that venues hosting political events and debates in relation to municipal elections be exempted from the coronapas requirement.
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Denmark’s Ministry of Employment has also convened a meeting between unions representing employees and employer representatives to tackle issues around requiring a coronapas for going to work. The meeting involving trade unions, ministry officials, and others is set for Friday.
Acting Employment Minister Mattias Tesfaye
“If there are some companies that believe that this is necessary, then we think it is quite reasonable to look at whether we should be able to demand that you present a corona passport in order to get to work.”
Some companies have already announced a coronapas requirement mandating that employees present a valid vaccine passport to go into their workplace. The ministry seems to be wanting to hammer something out that is more of a blanket approach as opposed to a patchwork of businesses either requiring the coronapas or not.
Smitte|Stop
The Epidemic Commission is also questioning the relevance of the Smitte|Stop app. It says there have been about 2.3 million downloads. Data also shows that on average in August 110 users a day reported a positive test result in order to notify close contacts. This is a lower average than the month before. It says since the vaccination effort began rolling out, fewer and fewer people have used the app to report a positive test result.