Monday Morning News & Notes
Denmark is hunting for the real number of Omicron infections
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How widespread is the Omicron variant in Denmark? And how many people have been infected without knowing it? The Staten Serum Institut is teaming up with the Danish Blood Bank to find those answers.
About 6,000 people donate blood every week in Denmark. They range in age from 17 to 70 years old. Blood from those donors will be tested for antibodies specific to having had an infection. Then the Staten Serum Institut will cross-check the results to see if any of them have a registered positive test. The number of those that haven’t will be added to a constantly updated ‘shadow number’ report. That report will be posted every two weeks.
Aarhus University Hospital Immunology Chief Physician Christian Erikstrup:
“We will test the blood for antibodies, which are only formed when you have been infected with coronavirus. In previous studies, we have not been able to see if antibodies are formed by infection or a vaccine. Therefore, the study will be able to provide answers to whether donors have been infected with corona, without actually knowing it.”
The hope is the data will help determine how severe the Omicron variant is, how many hospitalizations it causes, and how many people it has killed. They even hope the information might be able to help determine where in the Omicron infection wave Denmark is and how much more of the wave is left.
Staten Serum Institut Director Henrik Ullum:
“It is less likely that someone with a former Omicron infection will be infected again, unless a new variant emerges. We therefore need to know how many people have been infected, so that we can better come up with an estimate of what we can expect from the infection wave.”
The blood donations will be tested every two weeks and the project is expected to run for three months.
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The Omicron variant wave in Denmark continues to drive increasing numbers of infections that are punching through to infect those with two and even three vaccine doses. However, in its latest update, the Staten Serum Institut notes cases of severe infection requiring hospitalization among the vaccinated continue to remain stable.
The SSI says since vaccinations began on December 27, 2020 and up until January 18, 2022, there have been 434,803 infections among those with two vaccine doses (9.19%) and 105,271 COVID cases among those with a booster dose (3.02%). Since the last breakthrough infections report two weeks ago, that is an increase of 139,818 and 70,811, respectively.
The SSI notes that by the end of 2021 COVID was punching through vaccine protection more often among younger age groups. But, in the last week of the year, increasing numbers of breakthrough infections were noted across several age groups including seniors 65 and older.
Graph below courtesy of the Staten Serum Institut: Breakthrough infections by age group.
The institut says hospitalization rates among vaccinated people who become infected have been stable for three weeks now. It credits that to the protection vaccines offer against severe coronavirus infections. But, the SSI does warn that if breakthrough infections do increase among older age groups hospital admissions will likely rise.
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Despite record-breaking daily infection numbers, the Danish government is scaling down rapid testing capacity. The daily capacity for rapid tests will drop from 500,000 to 200,000 for each day of the next two weeks. It says the capacity of 200,000 rapid tests matches the average quick testing numbers over the last few weeks. It also cites the proliferation of self-testing kits for students, school staff, and hospital workers as reducing demand for rapid testing.
Minister of Justice Nick Hækkerup:
“The test effort is a constant balancing act, where on the one hand we must ensure sufficient test capacity, so that people have access to tests when they need it, and we avoid long queues to the test sites. On the other hand, the test effort costs a lot of money, which could be better spent elsewhere if there is no need to test to the same extent. Therefore, we continuously adjust the test effort to match the situation we are in. Now is the time for us to turn down the test capacity again, and from the government's side, we are ready to adjust further downward if the experts assess that it is sound to do so.”
The government adds it wants to change the COVID testing system to be more flexible to better adapt to the ups and downs of the epidemic’s development. Health authorities have engaged with external experts in virology, pandemics, and economics to determine what that will look like.
Director of the Danish Agency for Security of Supply Lisbet Zilmer-Johns:
“A lot of people test themselves for corona, and that means that we are now reducing the capacity for quick tests in the test centers. We have a robust and flexible test system, and therefore we can react quickly and adapt the capacity to the situation.”
Publicly paid express testing sites at Danish airports in Copenhagen and Billund will also close as of February 1. The government says this is due to changes in the testing requirements for entering Denmark, reducing the overall demand for those sites.
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Denmark added 124,969 COVID infections and another 58 coronavirus deaths over the weekend. On Friday, it reported a record-high 46,831 infections, followed by 36,120 on Saturday, and then another 42,018 on Sunday.
There were 397,534 total corona tests done on Saturday, of which 228,118 were PCR tests equaling a positivity percentage of 18.42%.
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As Omicrom runs amok across Denmark, there have been a stunning number of coronavirus infections among children over the last week. Among kids 19 years old and younger, there were over 100,000 COVID cases in the last seven days including 6,033 among infants and 35,571 among kids 6 to 11 years old.
Thankfully, hospitalization numbers among infected young people are not reflecting the huge surge in COVID cases. There were 284 total hospitalizations combined among the age groups from infants to those 19 years old. The highest number of hospitalizations in the last week among young people by age group were infants with 139, followed by children aged 6 to 11 years old with 40.
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COVID hospitalizations (813) jumped on Sunday (+32) while the number of infected people in an ICU (42) dipped (-3) and of those the number on a ventilator (27) also edged downward (-1). The number of corona admissions to psychiatric wards (198) continued to rise (+4).
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On the vaccination front, there were just 13,476 total inoculations as we hit the usual weekly Sunday slump. Most of those doses were booster shots, 10,260.
To date, 82.4% of the entire population have one vaccine dose, 80.5% have two, and 59.3% have a booster dose.
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The Danish National Board of Health has elected to hold off on a fourth round of vaccinations, at least for now, for seniors 85 years old and older as well as those in nursing homes. The agency says the group is well protected with the current three doses noting that despite a sharp increase in infections numbers haven’t risen among Denmark’s oldest population.
Deputy Director Helene Bilsted Probst:
“The very high adherence to a booster dose among nursing home residents and people over the age of 85 provides really good protection against serious illness. This is the main explanation why we have seen fewer serious COVID infections among nursing home residents and those 85 year olds and older, In addition, we also see a general tendency for mild infection bouts in people who have a booster dose and been infected with Omicron, and this also applies to the oldest and most vulnerable.”
The health board does anticipate the protection offered by a booster dose will wane over time. But it adds that at the moment it isn’t clear when booster dose protection will wane or what the impacts of that might be. It does expect the drop in immunity to be seen among the oldest and most vulnerable first.
“Although we right now feel confident about immunity after a booster dose among the very oldest, we will keep a close eye on how the epidemic develops and whether there is a decrease in immunity. We are prepared to roll out the 4th dose to the group, and if a need arises, a second booster shot can be rolled out very quickly.”
Currently, Denmark has begun administering a 4th dose to vulnerable populations including people who are immunocompromised, those being treated for cancer, and others with healthcare conditions making them a high COVID risk.
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Beginning this week there will be one uniform rule across Denmark that fathers, even if they have tested positive, will be allowed to be with their wife during the birth of their child. DR found that the rules were different across Denmark, with Region Hovedstaden (Metro Copenhagen), Region Syddanmark, and Region Nordjylland all forbidding partners who have tested positive to accompany their wives into the hospital for childbirth. While in Region Sjælland and Region Midtjylland a woman’s partner, even when infected, was allowed to be there for the birth of their child.
Danish Health and Medicines Authority Manager Bolette Søborg told DR in response that new guidelines have been published that specify infected partners can participate in the birth of their child. The new rule came into force this week.
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Sweden won’t provide its first COVID update of the week until Tuesday.
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COVID hospitalizations continue to mount in Sweden’s capital region. As of Sunday afternoon, Region Stockholm is reporting 582 coronavirus patients hospitalized including 32 of them in an ICU.
The region has 201 empty care beds, a drop from the 260 that were available the day before.
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Students who are asymptomatic and who are not living with someone who has a coronavirus infection can go to school, according to health authorities in Southern Sweden. Region Skåne says students who have symptoms must remain home and get a COVID test.
“Of course, asymptomatic students who are a household contact with an infected person must follow the rules and stay home from school for the recommended isolation period.”
Prior to this, students who had been close contacts with a COVID infection but were asymptomatic were required to stay home for five days and get tested. With Omicron tearing through the population health officials in Skåne say this approach no longer works to mitigate virus spread.
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The Swedish Public Health Agency has shortened the interval between vaccine doses for those with severely compromised immune systems. The agency says immunocompromised people who are 18 years old and older can now get another booster dose three to four months after having a 3rd shot.
The agency says people who have extremely low antibody response to vaccination like organ transplant recipients, chronic kidney diseases, non-Hodgkin's lymphoma, myeloma, and other diseases and transplants can get another booster dose three months after having the first one.
For others with severe immunodeficiency, it will be a four month wait to get boosted again.
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Vaccination efforts in Southern Sweden are entering a new phase. Health teams from Region Skåne have ended mobile vaccination efforts at upper secondary schools. Students 12 to 15 years old will have to book a vaccination appointment like everyone else now.
The Region says new vaccination clinics have opened up and there are plenty of times open and ready to book for a 1st, 2nd, or booster dose.
Vaccination Coordinator Per Hagstam:
“It is not possible to choose which vaccine you should receive, but what determines which vaccine you receive is the availability of the vaccine and your age. This means that you can get a different vaccine than the one you previously received when you take the third dose.”
Hagstam is urging people to get a booster dose even if they have had a recent coronavirus infection.
“The Omicron variant has been shown to be easier to get past, both natural immunity after the infection and immunity after vaccination. A third dose has been shown to protect better both against being infected with Omicron and infecting others. Provided you have fully recovered from COVID, you can take your third dose. Even if some immunity arises during an infection, it is unclear how long this will remain, so get your third dose when you have the opportunity.”
In Sweden, the Pfizer/BioNTech vaccine is used for everyone younger than 30, while those who are older get Moderna.
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COVID patients may need less oxygen than the standard set out by the World Health Organization, according to a new Swedish study. Researchers at Uppsala University focused on 126 coronavirus patients in Region Sörmland who had a serious infection requiring oxygen but who were not put on a ventilator. They “continuously optimized the oxygen flow” in each case and carefully documented every adjustment. The results found that the patients “needed significantly less oxygen” than is recommended by the WHO.
Västmanland Center for Clinical Research Dr. Anna Hvarfner:
“The results are surprising but should be interpreted with caution because the study was small. For the larger studies that are now needed, the simple method that has now been developed in Sweden can be used.”
People struggling with severe cases of COVID infections often cannot extract enough oxygen when they are breathing as the virus attacks their lungs. This has made oxygen one of the most important treatment tools in caring for a severe infection case.
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Finland does not update COVID stats on weekends. It will table three days worth of infection data later today.
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The Omicron wave seems to have overwhelmed the COVID testing and contact tracing system in Finland as a number of hospital districts have abandoned official quarantine mandates for those testing positive. According to a report from Finnish news agency YLE, the hospital districts making the move include Pirkanmaa and Central Finland, as well as the City of Helsinki. People in those districts who become infected will have to self-isolate and inform anyone who has been a close contact.
According to a press release from the Pirkanmaa Hospital District:
“Since the Omicron variant is significantly contagious before the onset of symptoms and there are delays in testing, most of the following infections have already occurred by the time the test result comes to the attention of the communicable disease authority. There is no epidemiological basis for placing a person in isolation.”
The City of Helsinki is also warning that due to a rapid increase in COVID infections testing, contract tracing, and healthcare services are swamped. Due to infection crush, it says, even getting a COVID test could take several days.
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Finland’s epidemic is far from over, according to test results from the country’s wastewater surveillance program. COVID rates continue to increase in wastewater testing across the country, according to the Finnish Institute for Health. For a second week in a row in Espoo, Helsinki, Hämeenlinna, Joensuu, Kuopio, and Vaasa, wastewater COVID testing has returned the highest measurements in the history of the surveillance program.
The institute says they have also made some advancements allowing wastewater testing to actually identify specific variants. However, getting results is slow as the sequencing takes a full month to return results.
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Norway has added 36,128 infections and had no new deaths since its update on Friday.
COVID hospitalizations (227) have dropped slightly (-3) while the number of severely infected people in an ICU (67) crept upward (+1) and of those the number on a ventilator (45) also inched upward (+1).
To date, 79.9% of Norwegians aged 12 years old and older have one vaccine dose; 73.7% have two, and 45.9% have a booster dose.
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The Norwegian Institute of Public Health says a data issue has impacted COVID reporting since January 15. The issues have been sorted out, but the agency is warning that it could mean a correction adding 5,000 to 8,000 infections over the last week that were not initially included in the daily reporting.
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Norway is seeing a pandemic baby boom. For the first time in 13 years, birth rates have increased in the Nordic country. After years of seeing declining birth rates, almost 3,000 more babies were born in 2021 than the year prior. According to the Norwegian Institute of Public Health, there was a 10% increase in births in January of last year and then there was another big surge in March. In both cases, the increase coincided with COVID lockdowns.
All told, the NIPH says 56,551 babies were born in 2021, up from 2020’s 53,626.
NIPH Medical Birth Register Chief Physician Kristine Stangenes:
“This is very gratifying, but we do not know if it will continue. We know little about the reasons for the increase in the number of births, other than that they are complex.”
Within Norway, the country’s northern region saw the biggest increase in births.
“The largest increase was in northern Norway, but it is important to remember that this region also had the largest decline in 2020.”
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The Omicron infection wave continues to tear across Europe, sending numbers to never-before-seen heights.
On Sunday France reported 301,614 new infections, Italy had 138,860, the Netherlands logged 65,325 cases, and Portugal rang in with 45,659.
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The COVID situation across Europe is of high or very high concern in all but two EU/EEA countries according to the latest pandemic assessment from the European Centre for Disease Prevention and Control. The COVID incidence rate per 100,000 across Europe continues to shoot upward, going from 2,157 to 2,621 from one week to the next. The ECDC says of the 28 countries reporting hospital and intensive care admissions data, a full half reported increasing numbers. COVID deaths across Europe have remained somewhat stable for eight weeks now.
The EU healthcare agency says 10 countries are assessed as being of very high COVID concern. They are Belgium, Bulgaria, Croatia, Estonia, France, Germany, Ireland, Italy, Latvia, and Portugal. 19 nations are rated a high concern including Denmark, Finland, Iceland, Norway, Sweden, Spain, and the Netherlands. Only one country comes in as a moderate concern, Austria.
The ECDC says the cumulative vaccination uptake in the EU and greater European Economic Area for two vaccine doses among the entire population is 69.4% while for booster shots it is 37.6%.
On the variant front, in the EU Omicron is king making up 69.4% of all sequenced positive tests, while the Delta variant still accounted for 23.3%. Of the 22 European nations the ECDC assesses as having “adequate sequencing volume” it says Omicron is now the dominant variant in 15 of them.
Omicron is spreading like wildfire as the ECDC notes increases in the number of cases of 20% or higher in just one week in Bulgaria, Cyprus, Czech Republic, Estonia, Germany, Hungary, Italy, Luxembourg, Malta, Spain, and Sweden.
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The European Centre for Disease Prevention and Control is challenging any assessment of the Omicron variant as being “mild.” Yes, it says, studies have proven a reduced risk of hospitalization but it adds immunity from previous infection, vaccination including booster doses, and improved treatment options make it “challenging to estimate the inherent risk of severe infection for Omicron.”
“Given the exponential growth advantage of Omicron and the high numbers of cases, any potential benefits of a lower observed severity can be outpaced by the sheer number of severe outcomes over time.”
This all adds up in the eyes of the ECDC that the “true risk of severe infection” may be underestimated due to the sheer numbers of those who have immunity either induced by vaccination or from having had a coronavirus infection. “This could lead to an underestimation of severity.”
The agency adds it is also crucial to account for infections sweeping through much younger and generally healthier populations. It says there is very little data on Omicron’s severity among older age groups and those with underlying health conditions.
The ECDC is recommending EU countries take “urgent and strong” action to keep infection spread down, prevent hospitals from being overrun, and protect vulnerable populations. It advises countries to assess healthcare capacity and their coronavirus surveillance, and testing regimes, along with quarantine, and isolation policies. The ECDC advises COVID restrictions remain in place and be strengthened to “keep the disease burden manageable.” Measures should include social distancing, restricting large public and private gatherings; have mask mandates, and, whenever possible, keep people working from home.
“Vaccination remains a key component of the multi-layered approach needed to address the ongoing circulation and reduce the impact of the Delta and Omicron variants. Efforts should continue to increase full vaccination uptake in individuals who are currently unvaccinated or partially vaccinated and accelerate the roll-out of booster doses.”
By the numbers:
The median age for Omicron infections in Europe is 30 years old.
7% of cases have been among people 60 years old and older.
Examining 111,946 Omicron cases, the ECDC found 76% resulted in symptoms while 24% of the infections were asymptomatic but still highly infectious.
Among 124,849 Omicron cases with thorough contact tracing, travel-related infections accounted for 7% while the remaining 93% were the result of community spread.
Among cases in the EU “with known outcomes” 1.14% were hospitalized, 0.16% were in an ICU or had to be put on a ventilator, 0.06% resulted in death.
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While COVID vaccinations enter a third and fourth round of booster doses, the pharmaceutical company Pfizer says it is working to change that. The vaccine maker says it is working on a COVID vaccine that would be administered one a year like the flu shot without the need for booster doses taken every few months.
The company’s CEO, Albert Bourla, dropped that tidbit of information while being interviewed by N12 News in Israel. He was asked if we would have to just get used to having a booster dose every four or five months.
“It will not be a good scenario. What I hope is that we will have a vaccine that you will receive once a year.”
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With slightly less than two weeks to go until the start of the Winter Olympics in Beijing, China, and the coronavirus is already making its presence felt. As the first wave of athletes and staff begin to arrive, Chinese authorities say, initial COVID screening has already identified 72 infection cases. It says none of them have been among the 171 athletes that have arrived in the country so far.
During the games everyone will be isolated as much as possible and undergo frequent COVID testing. More than 330,000 tests will be performed over the three week period of the games, according to estimates.
The Winter Games begin February 4.
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Canada doesn’t report COVID statistics over the weekends and we will have to wait until the next national update to get a better sense of the situation.
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What we do know is that the latest hospitalization data shows numbers continue to surge upward. In the week of January 10 to 17, another 2,500 COVID patients were admitted to hospitals pushing the total number of people across the country who are currently hospitalized to 10,588.
Of those, hospitalizations (9,408) rose (+2,293) while the number of severely infected in an ICU (1,180) also increased (+207) and of those the number on a ventilator (576) also jumped (+148).
The Canadian vaccination effort has so far administered 31,771,194 1st vaccine doses (83.09% of the total population) while 29,817,403 people (77.98%) have two doses, and of those 14,068,011 are fully vaccinated with three doses.
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Canada’s Chief Public Health Officer, Dr. Theresa Tam, is warning that the pandemic is not over yet.
“We still have some difficult weeks ahead and the potential for more bumps along the way, our many months of efforts have given us better protection with vaccines and brought us several effective treatments.”
Tam says booster dose rates among adults need to improve. She also singled out vaccination uptake among children 5 to 11 years old, where there is also plenty of room for improvement, with 51% having one vaccine dose so far.
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Due to testing efforts being overwhelmed or having collapsed entirely across the country, we are now focusing on hospital numbers, and the positivity percentage as a more accurate assessment of the pandemic situation in the provinces.
Of the provinces that report on weekends:
Ontario hospitalizations (3,797) fell (-229) while ICU numbers (604) inched up (+4) and of those the number on a ventilator (375) dropped a little (-3). Not all hospitals report on the weekends in Ontario, so take the numbers with a grain of salt. It also recorded another 56 deaths. The province has a positivity percentage of 18.2%.
Quebec saw its hospitalizations (3,283) drop slightly (-12) while ICU numbers (273) also edged downward (-2). The province suffered another 33 deaths.
Newfoundland and Labrador saw hospitalizations (19) increase (+4). The Sunday update did not include ICU numbers. The province has a positivity percentage of 14%.
In Nova Scotia, hospital admissions (85) have edged upward (+3) with ICU numbers (11) unchanged day to day.
New Brunswick hospitalizations (126) crept upward (+1) while ICU numbers (10) declined slightly (-2) and of those ventilator numbers (6) are unchanged.
In Saskatchewan hospitalizations (252) continued to climb (+8) while ICU numbers (26) were unchanged.