Monday Morning News & Notes
COVID hitting Europe hard again while Denmark’s return to normal appears to be over
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The European Centre for Disease Control and Prevention says the EU ended October with rapidly increasing infections and its forecast over the next few weeks is for more of the same. While the COVID situation varies from country to country, the ECDC says “countries with lower vaccination uptake continue to be severely affected.”
Of 29 European countries sharing data on hospital and ICU admissions, the agency says 20 are reporting increasing numbers. Over the next two weeks, the ECDC is forecasting that the number of hospitalizations, ICU admissions, and coronavirus deaths across Europe will all increase.
Specifically, ECDC is forecasting infection rates to continue to increase over the next two weeks in 24 countries including the Scandinavian nations of Denmark, Finland, Norway, and Sweden.
It also forecast hospitalizations to continue to rise over the same period in 18 European nations including Denmark, Germany, Norway, and Sweden.
As for COVID deaths, 17 EU nations are forecast to see increasing fatalities into week 45, including Austria, Germany, Ireland, Poland, and the Netherlands.
The Delta variant is absolutely dominant across Europe as numbers march upward. The agency’s data found the variant in 99.4% of all sequenced positive tests across the European Union and the extended European Economic Area.
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Signs are mounting that COVID restrictions are about to make a return in Denmark. On Friday, Health Minister Magnus Heunicke asked the Epidemic Commission to assess whether COVID should again be designated a ‘socially critical disease.’ The designation is important because it gives a legal basis for the government to levy restrictions. On September 10, the designation was removed and all remaining restrictions with it as the country returned to near-normal.
Now infections are the highest they have been since the Alpha variant wave last fall and winter, Denmark’s worst infection wave of the pandemic. Hospitalizations are also rising rapidly.
Heunicke spoke to DR on Friday and said he expects a response from the commission “relatively soon.”
“We have seen recently a sharp increase in infections, and we have seen that it has led to more hospital admissions with a large increase over a short time period. And now we have estimates of hospital capacity into the winter, which call for us to be sure that we are doing the right thing and that we are doing enough.”
Then on Sunday night, Danish Prime Minister Mette Frederiksen took to her social media channels to say the government is following the COVID situation “with increasing seriousness and concern.”
“The disease is once again beginning to have a more serious impact on our society and healthcare system. Therefore, I also expect that initiatives will be needed that can break chains of infection. So infections are kept down. And so we prevent hospitalizations. The government expects the Epidemic Commission to very soon come up with recommendations to the government and Parliament.”
Frederiksen urged people who have not been vaccinated to “book an appointment now.”
“We can see that the infection is spreading from those who have not been vaccinated to those who have been vaccinated including the elderly and people at risk.”
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As for what restrictions might make a return, it looks like critical mass has been reached on reintroducing the coronapas.
Staten Serum Institut Director Henrik Ullum spoke to DR:
“We are looking with concern at the increasing infections, and coronapas is one of the good options we are looking at. We hope and believe that the coronapas can put a suitable damper on infection activity, so it might not be necessary to do more, but it is difficult to predict the future.”
When asked when the coronapas requirement should be reimposed Ullum was blunt.
“Better tomorrow than in a week.”
The Director General of the Danish National Health Board, Søren Brostrøm issued a similar call last week that he would like to see the coronapas requirement return.
“Based on our health professional assessment, a reintroduction of the corona passport would be an effective tool for breaking chains of infection, while allowing us to keep society open.”
As for the health minister, Magnus Heunicke was asked about reintroducing the coronapas and seemed to indicate that the door was wide open.
“There are no instruments that are foreign to me, because it is about us going through this winter safely and securely, and we will do what we can to keep Denmark as open as possible. And if something needs to be done at the moment that can ensure that Denmark stays open, then of course I listen to what the experts come up with.”
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COVID hospitalizations (285) continued to increase (+5) while the number of infected people in an ICU (40) also rose (+4) and of those the number on a ventilator (23) edged upward as well (+3).
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As infections surge the Danish National Health Board is concerned about the increasing strain on hospitals. The board is warning that pressure on hospitals will continue to rise in December and January. It says increasing coronavirus infections are driving up hospitalizations, and it expects the situation to be further exacerbated by rising influenza and other respiratory infections.
Director Søren Brostrøm:
“We are concerned about the strain on hospitals to come during December and January. It is expected that autumn and winter will result in an increase in the number of infectious diseases. With both the risk of infection with COVID, influenza, and other infectious diseases, we risk overloading hospitals.”
Brostrøm says having no COVID restrictions is a double threat resulting in more coronavirus infections and the easier spread of other viruses and infections.
“We already see now that the country's hospitals are very busy and that staff are working hard. At the same time, we do not have the robustness that we have had in the past, because there has been pressure for a long period now.”
The Sundhedsstyrelsen has prepared four possible scenarios for the coming months. The scenarios range from a hospital system able to juggle both increasing corona admissions and other patients to a situation where it “may be necessary to postpone a significant number of the planned operations.”
The health board is urging people to get vaccinated in order to reduce the strain on the hospital system.
With the majority of COVID hospitalizations in Denmark’s capital region concerns are growing that hospitals could become overwhelmed. Bispebjerg and Frederiksberg Hospital Director Kristian Antonsen spoke to DR:
“It is definitely a scenario we can potentially see because we see an infection curve that, despite vaccinations, has the same steepness as last year.”
Hvidovre Hospital Infectious Diseases Department Chief Physician Gitte Kronborg echoes the concern:
“If we get more and more corona patients admitted to our ward with the few nurses we have, then we will hit maximum capacity.”
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Over the weekend, Denmark added 6,764 COVID infections and 16 more coronavirus deaths. New infections remained at over 2,000 on Friday, Saturday, and Sunday. On Sunday 2,416 new coronavirus cases were reported, which is a bad sign as numbers usually take a notable dip on Sundays.
With 133,504 PCR tests administered yesterday, that equaled a positivity percentage of 1.81%.
As you can see in the map below Denmark continues to sink into deep shades of red, which is indicative of areas of high COVID transmission.
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On Friday, the Danish Agency for Patient Safety ordered students in grades 0-6 at Herstedøster School in Albertslund Kommune, to stay home “due to a major COVID outbreak in several classes.” It does not specify exactly how many students have been impacted. The agency says the classes will remain offline until at least November 12.
Then on Sunday the agency ordered the temporary closure of grades 0-6 at Dyvekeskolen in Copenhagen Kommune again “due to a major outbreak in several classes.” Students in grades 0-6 at the school will stay home until at least Nov 14.
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Make it six. Tårnby Kommune has become the latest municipality where infection rates have crossed a threshold triggering COVID measures.
Tårnby and the other five kommunes are all seeing targeted increases in testing capacity and initiatives to bolster vaccination levels. Kids in school must stay within their own classes and not mingle with others, even on breaks. This applies to daycares as well. Children 9 to 11 years of age who haven’t had a recent infection should get tested twice a week. The same applies to children 12 years old and older who have not been vaccinated or who have not had a recent infection.
Tårnby Mayor Allan S. Andersen says the infection numbers are too high, especially among children.
“We can see that it is especially children from 6 to 11 years old who are affected and in turn infecting their household. It's really important that we get the chains of infection broken now. Therefore, we need to pay close attention to symptoms and go get tested. Also remember to keep your distance and ventilate indoor spaces. If children have symptoms, they should stay home until they have been tested.”
Albertslund, Ishøj, Brøndby, Glostrup and Dragør are the other five kommunes that have breached infection activity thresholds.
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On the vaccination front, the number of 1st vaccine doses administered continues to stay above 1,000 even on a Sunday where there were just 6,625 total inoculations done.
So far, 76.5% of Denmark’s total population has one vaccine dose, 75.3% have two, and 6.5% have had a 3rd booster shot.
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The Danish National Health Board has updated its COVID recommendations and is now advising people who are at increased coronavirus risk to take all precautions. High-risk groups include seniors, nursing home residents, people with chronic diseases, those who are obese, or who are immunocompromised, and pregnant women. Along with the basics of pandemic hygiene practices, they are advised to stick to social distancing, avoid crowded places, and to mask up if it isn’t possible to ensure safe distance from others.
Deputy Director Helene Probst says this applies to those considered high-risk, even if they are fully vaccinated.
“Now that the infection is rising, it is a good idea to take extra care if you are at an increased risk of a serious illness. But it is important to emphasize that there is no reason to isolate oneself at home. We have gathered some good advice on how everyday life can be maintained in the best possible way. We recommend that people at increased risk keep a distance from people they do not know and that they generally avoid places where there is crowds and congestion. It is also a good idea to wear a mask if it is not possible to keep your distance, for example on the bus or on the train.”
Probst also advises those in vulnerable groups to be “extra aware” in places where they could run into other people, like in supermarkets or on public transit.
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Denmark is now offering a 3rd dose to even more people with a plan to revaccinate everyone who already has two doses coming early next month. At first booster shots were offered to certain high-risk groups and now the door is open for a 3rd dose to everyone who has had a second dose up until June 1. This would cover high priority groups in the initial vaccination process. Invitations for that group are arriving weekly via eBoks six months and two weeks after a person receives a second shot.
The National Health Board says it will table a plan to offer everyone 18 years old and older a booster dose by early December. It cautions though, that the gap between the second and third doses may be increased from the current six months and two weeks.
It says more than 95% of nursing home residents in Denmark have had a booster shot.
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More than a month after Denmark launched a mammoth influenza vaccination campaign, there have been over a million flu shots given out. However, the National Board of Health says those numbers are well short of where they had hoped to be at this point. While influenza vaccination uptake is high among seniors and elderly people in care inoculation numbers are lagging for people with chronic disease, healthcare staff, and children 2 to 6 years old.
Chief Physician Bolette Søborg
“We would very much like to have as many people vaccinated as possible before the flu season really takes off. We are heading into a winter where we are very worried that many will get sick, and also seriously ill, from the infections that are circulating. Vaccination against influenza helps prevent serious illnesses in vulnerable populations. If fewer people become seriously ill it can help relieve pressure in our healthcare system.”
Most people can be vaccinated at special inoculation sites, at pharmacies, or by their own Doctor. Children two to six years old can only get the influenza vaccine nasal spray at their doctor.
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An emergency medical team from Denmark is in the Romanian capital of Bucharest to help, however they can as the country battles its biggest COVID infection wave of the pandemic yet.
The surge in infections has swamped Romania’s hospital system. At least two COVID patients have been evacuated from Romania to Denmark over the weekend. They were admitted to Aarhus University Hospital according to TV2 Østjylland.
According to the wire service TT, Sweden is also standing by and ready to take patients from Romania. Per the Swedish Municipalities and Regions (SKR) in an email.
“Romania has asked EU countries for help in receiving and caring for seriously sick patients. Sweden's 21 regions have received the question via the National Board of Health and Welfare and have jointly made the assessment that Sweden has the opportunity to help. An assessment will be made for each specific request based on the current situation. At present, no request has been received to receive specific patients from Romania to the regions."
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Add Iceland to the list of countries where COVID restrictions have made a return. The country is seeing another coronavirus infection wave. It has reimposed mask mandates and banned events with over 500 people. Restaurants must also stop all alcohol sales at 11pm.
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Sweden will update its COVID statistics for the first time this week on Tuesday.
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Tomorrow, November 9, marks the beginning of the Swedish influenza vaccination effort. First up are high-risk groups and vulnerable populations. Then on November 22 phase two begins with health and senior care staff get their turn. The flu shots are free in Sweden and can be administered at the same time as a COVID vaccination.
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Region Stockholm is still seeing rising numbers of coronavirus infections, with 1,545 more cases last week than the week before. There are 76 people in hospital and of those nine are in an ICU.
Infection Control Dr. Maria Rotzén Östlund:
“We see that the number of people infected with COVID has increased in the last two weeks, albeit from low levels. We must reverse that trend. We do this by the person who is not vaccinated going and getting vaccinated. Elderly people and people in risk groups should take their refill dose. Those who are not vaccinated should keep their distance from others and avoid contact with people in risk groups and those who are 70 years or older. The rest of us should act with the knowledge that the pandemic is really not over. Wash your hands often and thoroughly and stay home if you are ill
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Region Stockholm says they are also seeing many young children being infected with the RS virus, which is contributing to a growing strain on the region’s hospitals. The health authority is urging parents and caregivers to be extra vigilant to protect their children.
Chief Physician Elda Sparrelid says children in preschool are getting infected with the virus and then bringing it home, a potentially dangerous situation if there is an infant at home. The region is going as far as to advise parents to keep older siblings, who go to daycare, home as a precaution.
“If you have children younger than 6 months whose older siblings go to preschool, it may be wise to keep the older child home from preschool for a few weeks to reduce the risk of infecting the little sibling with RS virus. We know that many babies are infected by their older siblings.”
The region also stresses that diligent hand-washing is a must. It also advises anyone with an infant to avoid contact with people who have cold or flu symptoms, even if they are other family members.
It is also recommending that parents with young children limit social contacts and stay away from crowded indoor spaces including public transit.
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Norway continues to battle its second-largest COVID infection wave of the pandemic as it recorded 3,566 infections and had no new corona deaths since Friday’s update.
COVID hospitalizations (171) ICU numbers (40) and those on a ventilator (19) are all unchanged since Friday.
To date, 78.09% of Norwegians 12 years old and older have had one vaccine dose and 69.62% have had both doses.
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The Finnish Institute for Public Health doesn’t update COVID statistics over the weekend. It will table three days worth of data later today.
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Finland will hit a vaccination milestone today as it will pass the 80% full vaccination mark for everyone 12 years old and older in the country. As for the total population, 4,245,507 people (75.7%) have one shot, 3,931,306 (70.3%) have both doses, and 107,189 booster shots (1.9%) have been administered.
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The Finnish National Advisory Committee on Vaccines is expected to render its decision on extending vaccinations to children five to 11 years old by later this month or early next month. The European Medicines Agency has yet to authorize vaccinations for young children in Europe.
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German Health Minister Jens Spahn says it is a matter of when, not if, that everyone in Germany who has had two vaccine doses will get a third. After meeting with his counterparts in the 16 German states, he says a third dose would be offered about six months after the second shot. He also urged everyone to stick to the basics, maintain social distancing, and get vaccinated. There are about three million Germans over the age of 60 who have yet to start the vaccination process.
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On Friday, Germany recorded its highest ever number of daily infections in the pandemic yet, with over 36,000 new COVID cases. Yesterday it reported 26,131 infections and another 78 deaths.
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Austria’s capital city is tightening coronavirus restrictions and opening vaccinations up to children aged five to 11 years old, despite the European Medicines Agency having not yet approved vaccine use among young children. Vienna is restricting entry to bars, restaurants, hotels, hairdressers, and others only to people who are fully vaccinated or who have had a recent infection. Previously, a recent negative test would have done the trick. Vienna is seeing the highest infection rates of the pandemic and concerns are growing hospitals will become overwhelmed.
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If you are planning a ski holiday in France, make sure you pack some face masks and it might be a good idea to keep your vaccination passport handy. France has made face masks mandatory while in line to catch a ski lift and inside an enclosed gondola. For skiers on outdoor lifts, the mask can come off once you are seated on the chairlift. France has also tied mandatory vaccine passport requirements to infection rates. If the COVID incidence rate rises above 200 per 100,000 residents, then everyone must prove their vaccination status.
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The European Medicines Agency says it will issue a decision next month on Pfizer/BioNTech’s application to authorize its vaccine for use on five to 11 year olds in Europe. The decision will likely come early in the month to allow EU countries to start getting kids vaccinated before Christmas holidays.
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The EMA says it has also received additional data from Novavax allowing it “progress in the review of this vaccine.” The agency says it will table its decision on whether to authorize the vaccine for use in the EU “in the coming months.”
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It also sounds like a decision on Merck’s COVID treatment pill is also imminent. The EMA is reiterating the promising results of clinical trials preventing hospitalization and death among coronavirus-infected people. It adds that it is ready to give advice to European Union member states “so that they can make this new treatment available for emergency use, ahead of a marketing authorisation.” Last week, the United Kingdom became the first country to issue an authorization of use for the drug molnupiravir, the first ever oral COVID treatment.
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As of today, the United States is opening its land border crossings to Canadians heading south but the COVID testing requirement coming home remains a sore point, especially for very short trips of 72 hours or less. In those situations Canadians can get tested in Canada to cross the border into the U.S. then present the same test results to return home three or fewer days later.
Co-Chair of a Federal COVID Advisory Panel Dr. Irfan Dhalla:
“I'm not sure I understand the rationale for testing travellers who are going to the U.S. for a very short trip. Even if we were going to require tests from these travellers, a test taken in Canada before the trip even starts would not be helpful."
He says it would make much more sense to test Canadians coming back from short trips across the border within a few days after returning home.
The other issue is cost with Canada only accepting a PCR test no more than 72 hours old to cross the border. In the United States, such a test can cost hundreds of dollars.
As of today, Canadians can travel south into the U.S. by land but they must be fully vaccinated and be prepared to prove their vaccination status at the border.
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Canada’s Chief Public Health Officer Dr. Theresa Tam said the most recent COVID modeling shows that they are wrestling the infection curve down, but progress has slowed recently. Tam warned of a “bumpy road” ahead as cold winter weather pushes people inside where COVID has an easier time spreading. For the first time in the pandemic, she says, across Canada most coronavirus infections are among children under the age of 12 who cannot yet be vaccinated. Tam says less than 1% of those cases among children have resulted in a serious case resulting in hospitalization.