Monday Morning News & Notes
Omicron continues to wreak havoc on infection numbers, staffing, and hospitalizations
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KL, the organization representing the Danish Kommunes, says in the first week of return to school from January 3, an average of 14% of teachers were home, either infected, undergoing testing, or isolating as a close contact across 79 of Denmark’s 98 municipalities.
KL says among daycares “absenteeism was very high” with on average across 73 municipalities, more than one-third of teaching staff being out, either sick or isolating as a close contact.
Among children, 25% were out sick in the first week of back to school.
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Since the summer of 2021, the number of employees in Danish municipalities and regions who have been off work due to having a sick child at home is the highest they have been in six years. This is according to data from the Municipalities and Regions Wage Data Office.
Chair of the Danish Pediatricians Society Klaus Birkelund Johansen spoke to DR to say this is partly COVID but mostly to do with the return of the flu season and other usual viruses. He says due to COVID restrictions, young children have much less acquired immunity after two years where the influenza and other virus seasons essentially vanished due to the pandemic.
“But also coming into play is a tougher call to keep children at home. If you have the slightest symptoms, then you are encouraged to stay home.”
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Some 32,000 students in Danish continuing education schools return to class today for the first time since being sent home due to the COVID epidemic three weeks ago. However, there have been some changes since they were sent home. A coronapas proving vaccination status, recent infection, or a negative COVID test must be shown. A negative test can be no more than 72 hours old if is a PCR or not any older than 48 hours if it is a rapid test. Masks must also be worn in all indoor common areas.
Chair of the Continuation School Association Torben Vind Rasmussen told DR he is convinced that there will be outbreaks in the continuation schools.
“Then, for the individual after-school centers, when the infection comes, it is a matter of minimizing the spread of it.”
It will be up to continuation and adult education schools to send students testing positive home and identify close contacts within each class.
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Denmark’s Staten Serum Institut’s latest report on breakthrough infections has found rising numbers of infections among people with two and even three vaccine doses. Since the vaccination effort began December 27, 2020, until January 4 of this year, the agency has found 294,985 COVID cases among people with two vaccine doses. With 4,630,450 million people in Denmark with two vaccine doses, that equals a breakthrough infection rate of 6.37%.
The SSI’s report also found 34,460 infections among the 3,048,355 people who had a booster shot, or 1.13% of everyone with a 3rd dose.
Department Head Palle Valentiner-Branth says this should not come as a surprise.
"It is a natural consequence of the fact that such a large part of the Danish population has been vaccinated.”
While the Delta variant had some punch-through after two doses, the Omicron strain has proved much more adept at evading vaccine protection against infection. But the institute notes vaccines still offer strong protection against severe illness, hospitalization, and death.
The hospitalization rate per 100,000 people among the unvaccinated in the last week of December was 59.5. This compares to an admissions rate per 100,000 of 15.6% for those with two vaccine doses.
“The number of COVID-related admissions among vaccinated people with full effect of the primary vaccination course is now at the highest level since vaccinations began a little over a year ago. At the same time, the effect of the vaccines on becoming infected with coronavirus dropped markedly. This is due to the introduction of the Omicron variant, which is far more contagious and for which the vaccines are less effective. On the other hand, we are pleased that the vaccines continue to provide good protection against being hospitalized and becoming seriously ill.”
The SSI says for the most widely used vaccine in Denmark, Pfizer/BioNTech, efficacy against serious disease requiring hospitalization is 73.7% after two doses among those 12 to 15 years old. For those 16 to 64 years old it is 82.6%, and for those 65 and over it is 44%. After a 3rd dose protection ramps up to 83.6% among 16 to 64 year olds and 91.2% for seniors 65 and older.
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In the last three days, Denmark has added 49,113 COVID infections while losing 52 more lives to the coronavirus.
On Saturday, 28 pandemic deaths were reported. That is the highest of any day since February 9, 2021.
There were 357,343 total tests on Saturday, of which 210,555 were PCR tests equaling a positivity percentage of 9.14%. Numbers tend to dip over the weekends, so the pandemic picture will clarify itself when we see the numbers reported over the next couple of days.
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As of last Friday, the Omicron variant now accounts for 90% of all sequenced positive tests in the country, according to the Staten Serum Institut. That took just 41 days since the first two Omicron cases were confirmed in Denmark back on November 28.
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The Staten Serum Institut has taken a number of rapid testing kits and tested them all against the Delta and Omicron variants to ensure they can detect an infection. The agency notes the coronavirus is always changing and evolving, so it is important to make sure rapid tests are keeping pace. The kits involved were both for professional use and those distributed for self-testing at home. It concludes that all the testing kits that got a good going over could detect both Delta and Omicron variants “at a comparable level with the wild type (Wuhan).”
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COVID hospitalizations (723) continued to ease (-7) while the number of infected people in an ICU (77) crept downward (-1) and of those the number on a ventilator (50) also inched down (-2).
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There is a concerning increase in the number of COVID hospitalizations among infants in the last week. According to data from the Staten Serum Institut, there have been 2,169 coronavirus infections among children two years old and younger over the last seven days. Of those, there have been 71 hospitalizations.
TV2 is reporting that pediatric wards in Danish hospitals, especially in the capital region, are under increasing pressure, with more and more children being admitted due to a COVID infection. In the last four weeks, the number of hospitalizations among children five years old and younger “has increased significantly.” It says young children are the population group with the fastest rising number of new admissions.
Dr. Klaus Børch, chief physician at Hvidovre Hospital's pediatric ward, spoke to TV2:
“We have seen more than usual. So far, we have been able to handle it, but it is a concern if it rises so much that it challenges our capacity.”
He notes infected children require more resources to treat including the need for them to be isolated, meaning less space for other pediatric patients and a strain on overall resources.
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The Staten Serum Institut has analyzed COVID hospitalizations including the length of stay of admissions lasting less than 12 hours long and those that last longer.
Department Head Camilla Holten Møller:
“We can see that the probability of an admission lasting 12 hours or more increases with age. For those aged 70 years old and older, 80% of admissions have a duration of 12 hours or more. The opposite is true for the youngest children, where the proportion of admissions lasting 12 hours or more is only about 50%.”
The SSI also broke patients down into three categories those who have been admitted with a positive COVID test, patients with other respiratory symptoms where a COVID infection is suspected, and patients being admitted for all other non-pandemic-related issues.
From June 1, 2020 to December 18, 2021, the SSI determined, 82% of admissions were people who had tested positive, 3% met the second criteria of having respiratory symptoms with suspicion of the coronavirus, and 15% were being treated for a non pandemic malady. Looking at just December 2021, the SSI found the breakdown with the same three categories was 73%, 4%, and 23%.
“As the vaccination program has been rolled out, we can see that the proportion of admissions with a COVID diagnosis decreases. We are currently seeing a tail of admissions with the Delta variant. So it is still too early to say how the picture will change when the Omicron variant also dominates among admissions.”
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On the COVID vaccination front, there were 37,948 total inoculations on Saturday as the usual weekend slump arrived.
So far, 82.1% of the total population has one vaccine dose, 79.2% have two, and 53.1 have a booster dose.
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The Danish National Health Board says just over 3 million people so far have a booster dose out of a total of 3.8 million people who have been invited to get one. It says the booster dose vaccination rate is especially high among older people. For those 65 years old and older, the health board says “almost all” have received a 3rd shot. For those over 40 more than two out of every three are boosted.
Deputy Director Helene Probst:
“It is really gratifying that so many have accepted the 3rd dose. It is crucial that we take good care of ourselves and each other in the time to come and limit the burden on healthcare. If you have received your invitation to get a 3rd shot, I would strongly encourage you to go and get vaccinated.”
However, last week the health board raised concerns about vaccination rates among children 5 to 11 years old being too low, with fewer than half having begun the vaccination process.
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Danish health authorities are investigating whether there is a need for a fourth round of COVID vaccine shots, but one particularly at risk group in Denmark has already had a fourth round of shots. A group of about 75 people at Aarhus University Hospital who suffer from particularly serious rheumatic diseases, have had a fourth dose. That is because the medication they receive suppresses their immune system making them very high-risk for a coronavirus infection.
Arthritis Association Director Mette Bryde Lind spoke to DR.
“I think it is really good that they have been offered a fourth dose, because they are being treated with a special drug called Rituximab, which makes the vaccines not work so well.”
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An oasis from the pandemic no more. The Danish island of Christiansø has recorded four cases of COVID, its first confirmed infections of the virus, in the entire pandemic. Island Administrator Søren Thiim Andersen tells the newspaper Bornholms Tidende that due to the coronavirus infections schools, which were supposed to reopen last week, will instead open their doors this week. The island has about 100 residents.
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In Kolding, Carelink has begun a trial where people can both be tested for COVID and vaccinated against it during the same visit. People do not have to wait for a test result before getting their vaccine shot. The trial will continue through this week.
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Greenland has recorded the highest number of new COVID infections it has ever seen over the weekend. On Friday it recorded 591 new infections, but those numbers covered a 48 hour period. Then on Saturday it saw a record 504 infections followed by another 497 on Sunday. Greenland’s National Board of Health says COVID activity has now spread across several cities and out into settlements. There are eight people hospitalized, with one of them in an ICU.
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Sweden does not report COVID numbers on Saturday, Sunday, or Monday and will table its next batch of infection data on Tuesday.
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Region Stockholm has taken the step of releasing brief updates over the weekend on its hospitalization situation. There are 347 admissions in Sweden’s capital region and of those 261 are in general care, 32 are in intensive care, and 54 are in geriatric care. The region says as of 3pm on Sunday emergency hospitals had 137 vacant beds left, that is 50 fewer empty beds than were available on Saturday.
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There is some potentially positive news as the number of COVID patients being admitted to ICU in Sweden, which has been rising for weeks, has declined slightly over the last week. Whether that trend holds or not remains to be seen.
Graph courtesy of Stockholm University Journalism Professor Christian Christiansen (@ChrChristiansen) on Twitter.
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Students return to class in Sweden today as daily infection numbers surge to record highs. The Swedish Public Health Agency is reminding school staff to be on the ball and abide by infection control recommendations to try and reduce the chances of major outbreaks.
Department Head Britta Björkholm:
“Schools have an important mission and it is central to all children and young people's sense of security, social context, and well-being. Today, there is also a consensus in the world about the importance of keeping schools open during the pandemic.”
School-related COVID recommendations include keeping kids outside as much as possible; keeping classes isolated and not mixing with other students, and avoiding large gatherings, especially indoors. Children who are in close contact with an infected person or have someone they live with who is infected should stay home for seven days and take a PCR test. Any student who has possible coronavirus symptoms should also stay home and get tested.
The agency also urges all school staff and teachers to get vaccinated and maintain social distancing on school grounds. It also warns principals to be prepared to handle COVID cases and larger outbreaks should they occur.
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Another member of the Swedish Royal Family has tested positive for COVID. According to Swedish news agency SVT Crown Princess Victoria has been infected. The Crown Princess is vaccinated and reported to be dealing with mild symptoms. This marks the second go around with COVID after she and her husband both had the coronavirus in March of last year. Last Monday, both Sweden’s King Carl Gustaf XVI and Queen Silvia tested positive.
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Finland does not update its COVID numbers on weekends and we will get new data later today covering the last 72 hours.
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Finland tightened COVID restrictions this past Saturday. The measures announced include municipalities closing or restricting access to some public spaces to prevent crowding. Indoor private events have been capped at a maximum of five people plus the residents of the home. All existing border control measures have been extended until at least the end of January.
A recommendation has been made that restaurants and bars close at 6pm, but the measure is not official until the government issues its own decree, which sounds like it could happen this week. Currently, bars and restaurants can remain open until 8pm if they require a coronapas for entry.
The ministerial COVID working group also recommended expanding the use of FFP2/N95 masks with more details to clarify what that might mean coming from the Finnish Institute for Health this week.
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Long-COVID could plague Finland as a chronic disease long after the pandemic officials warned at a news conference on Friday. An expert panel in the country reviewed more than 4,000 studies around the world to determine around half of adults and 2% of children experience coronavirus symptoms long after recovery.
Minister of Family Affairs and Social Services Krista Kiuru as quoted by Reuters.
“There is a threat that Finland will see the emergence of the largest, or one of the largest, new groups of chronic diseases, and that not only too many adults will suffer from a long-term COVID, but worst also children.”
The ministry’s long-COVID assessment said it was more likely to occur after severe infections requiring hospitalization. But it also notes cases that had occurred after mild infection cases.
Expert Panel Chair, and Professor of Neurology, Risto Roine:
“The virus has been shown to enter the brain through the nose and its effects are also seen on magnetic resonance imaging. 20% see long-term cognitive impairment.”
Roine warned that cases of neurological diseases such as Alzheimer’s or Parkinson’s could increase sharply following a COVID infection.
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Norway has added 15,632 corona infections and had no new virus deaths since its Friday update.
COVID hospitalizations (257) have fallen (-23) while the number of infected people in intensive care (96) crept upward (+4).
So far, 79.6% of Norwegians 12 years old and older have one vaccine dose, 73% have two, and 33.8% have a booster dose.
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Norway may soon allow alcohol to be served in bars and restaurants again. A national ban on selling alcohol has been in place as part of COVID restrictions since mid-December. That ban might be lifted this week, according to the Norwegian Minister of Finance, Trygve Slagsvold Vedum, who spoke to Norwegian news outlet Dagbladet.
“If there is no comprehensive advice against it, then we should relax the drinking ban this week. The norm must be to have as open a society as possible.”
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Germany’s plans to make COVID vaccinations mandatory have hit a bureaucratic bump in the road. Procedural delays and allowing for proper debate in the German parliament (Bundestag) will mean the earliest a mandate could be imposed is by May or June, if it gets smooth sailing through the Bundestag. In November, Chancellor Olaf Scholz had warned Germans to prepare for a vaccine mandate by early this year.
Over the weekend, German Health Minister Karl Lauterbach told the newspaper Welt the only way out of the pandemic was with mandatory vaccinations.
Germany has already mandated vaccinations for some healthcare workers. Almost 72% of Germans are fully vaccinated while 42.3 % have received a booster shot.
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On Sunday, Germany registered 42,631 new infections and another 161 pandemic fatalities as its infection curve heads back upward again.
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Austria now mandates face mask use outdoors in situations where two meter social distancing cannot be maintained. So for example in its crowded skiing villages and in lines for the ski lift. Cloth and surgical masks also won’t cut it as Austria mandates FFP2/N95 mask use. It is also worth noting that if it has been more than 140 days since having a second dose, Austria requires a booster dose to enter the country.
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As of today, all travelers five years old and older, regardless of vaccination status, will need a negative COVID test to travel to Greece. A PCR test can be no more than 72 hours old and a rapid test no more than 24 hours old. The Greek government already mandates that inbound travelers pre-register before arrival on a government website for contact tracing purposes.
The country is being rocked by an Omicron variant infection wave pushing daily COVID numbers to record highs. On Sunday, Greece reported 18,592 new infections and another 66 pandemic deaths.
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Across Europe the Omicron variant continues to drive daily infection numbers to heights never seen before.
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Infection numbers are rising rapidly across Europe, according to the latest weekly assessment from the European Centre for Disease Prevention and Control. The agency rates the epidemic situation in Europe as a high or very high concern. The COVID incidence rate across Europe in the last week of 2021 was 1,253 per 100,000 people, a significant jump from the incidence rate of 859.8 the previous week. However, week-to-week virus deaths in the EU/EEA declined, going from a death rate of 55.7 deaths per million population to 50.6. The ECDC says this was the first week to see fatalities dip.
Of 28 EU countries reporting hospital and ICU admissions data 12 ended the year seeing increasing numbers in-hospital or ICU admissions or both.
The ECDC rates 10 counties in week 52 as being a very high COVID concern, they are Denmark, Estonia, Finland, France, Greece, Iceland, Ireland, Latvia, Luxembourg, and Malta. 18 countries including Norway, Sweden, Germany, Italy, Spain, and Belgium are considered a high concern. Just two countries, Austria and Romania, rank as a moderate concern.
Across the European Union and European Economic Area, the cumulative uptake for one vaccine dose is 84.2%, while 80% have two doses, and 34.8% have a booster dose. Numbers will, of course, vary widely from country to country.
As of the end of December, the Omicron variant was dominate in three of the 22 EU countries who have, in the ECDC’s estimation, adequate testing and sequencing regimes. Overall across Europe it accounted for 22% of all positive test results and continues to spread like wildfire.
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The United Kingdom passed a grim pandemic milestone over the weekend.
The UK is the seventh country in the world to record 150,000 or more pandemic related deaths, behind United States, Brazil, India, Russia, Mexico and Peru.
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The British Ministry of Defense has deployed more military personnel to shore up the beleaguered National Health Service. 40 army medics and 160 general duty personnel will be deployed in hospitals across London beginning today.
Hospitals in London and across the UK are reeling from staffing shortages due to the Omicron infection wave sending so many people home sick. About one out of every eight hospitals in England have declared a COVID-related ‘critical incident” meaning they are in danger of being overwhelmed to such a degree that the ability to deliver core services is threatened.
There are now about 1,800 armed forces personnel shoring up NHS hospital operations and other pandemic response operations across the country.
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The United Kingdom reported 141,472 new infections and 97 more coronavirus deaths on Sunday. Over the last seven days COVID cases, deaths, and hospitalizations have all increased. Hospital admissions have risen by 57.7% in the last week, or by 15,812 more corona patients.
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British officials have lifted the travel requirements for a pre-departure COVID test and isolation on arrival pending a negative test result. The UK government now feels the Omicron variant is so widespread that efforts to try and control it are futile. Travelers to the United Kingdom are still required to take either a PCR or rapid test within 48 hours of arrival. They do not have to isolate waiting for a result. Also., a pre-departure contact tracing form must still be filled out even for those just transiting through the UK en route to another destination.
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Canada’s Chief Public Health Officer, Dr. Theresa Tam is warning that hospitalizations and ICU admissions, already being driven up by a severe Omicron-driven infection wave, will likely continue to rise.
“While surveillance/recent studies indicate that risk of hospitalization is lower for Omicron compared to Delta, sudden acceleration Omicron with an enormous volume of cases is driving up severe illness trends.”
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Just a reminder due to maxed out testing capacity and in some cases the total collapse of the testing system, we will be focusing on hospitalizations and the positivity percentage as a more accurate assessment of the pandemic in the provinces.
Of the provinces that reported COVID numbers over the weekend:
In Ontario, hospital admissions jumped up to 2,594 on Saturday before dropping to 2,419 on Sunday. That is a net drop of 53 patients from Friday. There are 412 people in intensive care (+74). 91.1% of people in Ontario 12 years old and older have one dose and 88.4% have two doses. The province has a positivity percentage of 27.7%.
Hospitalizations in Quebec are rising rapidly, with 2,436 COVID hospital admissions (+203 from Friday) that includes 257 in an ICU (+12). The province has a positivity percentage of 28.05%
There are 119 people in hospital in Saskatchewan (+14 since Friday) and 13 people in intensive care (+2). The province has a positivity percentage of 28.6% and it has been increasing for at least the last four days.
In New Brunswick, the province recorded a record-high 80 hospitalizations on Saturday, a number that inched down to 79 on Sunday. There are 16 people in intensive care and of those 10 are on a ventilator. The province has a positivity percentage of 19.1%.