Monday Morning News & Notes
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Denmark is doing away with COVID rapid testing. The Danish Agency for Security of Supply says rapid testing sites across Denmark will all be closed by March 6. In making the decision, the agency cites the proliferation of self-testing kits, restrictions being lifted, and coronavirus no longer being categorized as a ‘socially critical disease.’
Director Lisbet Zilmer-Johns says PCR testing sites will continue to operate.
“For over a year, the regions, the private providers, and the many thousands of staff have worked to perform an important societal task, and we owe a big thank you to them for their extraordinary efforts. Now we have come to the point where we can test ourselves at home, and at the same time virtually all restrictions have lapsed, so therefore, we no longer have the same need for rapid test centers. But you will still be able to get a PCR test.”
The agency is encouraging people to use self-testing kits before visiting friends and family, especially if they are at increased risk or among a vulnerable population. It says anyone who has a positive self-test should go get a PCR test immediately.
Currently, Denmark has a daily capacity of 200,000 rapid tests but authorities say on average demand has declined and sits at 112,000 rapid tests being taken daily.
Self-testing kits are being handed out free to families with children in primary school, daycare, and students in youth and adult education programs. They are also widely available for purchase in a number of stores.
Throughout the pandemic, seven billion kroner (about $1.3 billion Cdn) has been spent on rapid tests, according to estimates from the Danish Agency for Security of Supply.
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The latest weekly assessment from the Staten Serum Institut shows that Denmark is still in the throes of the Omicron-turned BA.2 infection wave. The COVID incidence rate per 100,000 increased by 5,105 from week 3 to week 4. The positivity percentage also continued its upward march rising from 24.8% to 29.7% over the same period. Overall infection activity increased by about 15% week to week.
Adolescents continue to bear the brunt of infection activity, with the incidence rate highest among 12 to 15 year olds (11,511 per 100,000), followed by the 6 to 11 year-olds (9,851 per 100,000), but the latest assessment says activity seems to be declining among kids 11 years old and younger as well as among 16 to 19 year olds.
For the first time in a while it is not Denmark’s capital region that is seeing the most impact of the infection activity with the COVID incident rate per 100,000 people now highest in Region Syddanmark (5,431), followed by Region Nordjylland (5,236), with Region Hovedstaden (Metro Copenhagen) (4,829) now seeing the lowest incidence rate.
The SSI says as of week 4, the risk of being hospitalized due to a severe coronavirus infection was 1.7 times higher for someone who was unvaccinated as opposed to those who had two doses, and is 2.8 times higher compared to people who had a booster dose.
Hospitalizations increased among all age groups, with the exception of those 20 to 29 years old where numbers were stable from week to week. Admissions increased the highest in the 40 to 49 year old age group (49.3%) while those 30 to 39 years old continue to make up the largest proportion of infection admissions. They are followed by young children 9 years old and younger. Overall hospitalizations increased 24% week to week while ICU numbers continued to drop.
There were 125 pandemic deaths last week, an increase of 14 from the week before. Even as fatality numbers rise the SSI report found excess mortality (the number of deaths over the average) returned to an “almost normal” level in the last week of January. Although it cautioned there are some delays in death registry numbers so that is not carved in stone yet. Most concerning, deaths among nursing home residents continue to rise, with 48 last week compared to 41 the week before. This goes hand in hand with an increase in COVID infections among seniors in care, with 1,205 cases last week, up from 810 the week prior.
The Omicron sub-variant BA.2 continues its relentless march towards total dominance making up 78% of all sequenced positive test results last week, up from 69% the week before. The Staten Serum has previously estimated the sub-variant will account for nearly 100% of all infections in the country by mid-February. Omicron infections accounted for 98% of all hospital admissions where sequenced positive test results were available. In intensive care the number was 100% last week compared to 90% the week prior.
Last but not least, wastewater COVID testing across Denmark continues to show increasing infection activity.
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The Director of the Staten Serum Institut believes a built-up level of immunity to COVID is why infection rates are falling in Metro Copenhagen.
Henrik Ullum spoke to DR:
“It is a sign that the immunity that is in the population now is starting to work. It is built up through vaccines, and then a layer of infections on top. This means that when the virus tries to infect, the chances are a little greater that it is trying to infect someone who is immune. It is a welcome development.”
Ullum says while COVID rates fall in eastern Denmark, they remain high in the western part of the country for the exact opposite reason.
“This is because in Western Denmark, and especially in rural areas, there has been less infection, so there is more time needed to get the population a greater level of immunity.”
Epidemiologists in Europe have theorized that the Omicron wave could be an exit ramp out of the pandemic. The theory is that induced immunity from vaccinations combined with the sheer number of Omicron infections and resulting antibody protection that as the wave rolls over it could leave behind in its wake some level of herd immunity.
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Denmark added 115,881 COVID infections and 70 more coronavirus deaths over the weekend. It reported 40,179 infections on Friday, 39,190 on Saturday, and then another 36,512 on Sunday.
There were 209,016 total corona tests taken on Saturday, of which 140,398 were PCR tests equaling a positivity percentage of a sky high 26%.
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The weekend began with the first restrictions free Friday night with bars and nightclubs all open in a very long time, and it sounds like people took advantage. Police from North Jutland to Copenhagen reported a very busy evening with more drunks to deal with than seen in a while, along with a few vandalism cases, and of course some fights. But police say there were no major incidents and that generally all went well.
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COVID hospitalizations (1,203) continue to push upward to new record-setting heights (+65) while the number of infected people in intensive care (34) has nudged up (+3) and of those the number on a ventilator (12) is unchanged. The number of infected people being admitted to a psychiatric ward (269) continues to steadily rise (+7).
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The number of infants being hospitalized due to a coronavirus infection continues to remain stubbornly high, with 163 over the past seven days. There were 5,840 COVID infections among infants two years old and younger in the last week, equaling a hospitalization rate of 2.79%.
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On the vaccination front, there were 3,750 total inoculations on Saturday as numbers continue to slow. The number of 1st doses continues to sputter with just 170. That said, Denmark hit another vaccination milestone as the number of booster doses administered passed 60% of the total population.
To date, 82.5% of the total population has one vaccine dose, 80.9% have two, and 61.1% have a booster dose.
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COVID-related absences in schools are mounting to the point where the Danish government is proposing to change legislation governing the timeline for the school year. Under the current law and any missed teaching time has to be made up at the end of the school year. But COVID absences have become so ridiculously high that the government is going to change the law to allow for an exception.
Per the release from Denmark’s Ministry of Education:
“There are currently major challenges in primary school with high absenteeism among staff as a result of a high level of infection through January and expected continued high infection in February. It has therefore become necessary to find a solution for schools to deal with the high infection rates without lessons having to be completed outside normal school hours, eg on weekends and holidays, later in the year.”
As soon as the law is changed for this school year, primary, lower secondary, independent, and private schools, as well as vocational schools, and continuing education can move students through without having to make up for time lost.
The only problem is with students who are graduating, and the ministry advises that schools “are encouraged to have a special focus on ensuring that graduate students have received adequate education to complete their schooling.”
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DR is reporting that a mix-up in expiration dates among hundreds of thousands of vaccine doses Denmark donated to COVAX means they will have to be junked. It seems AstraZeneca listed the expiry date for slightly over 100,000 doses as the end of January instead of the end of February. As a result, the country they were being donated to said no thanks as they wouldn’t be able to use the doses before they expired. The end result is 105,600 doses must be destroyed and there is a risk that about half a million more may have to be thrown out as well. DR says it has heard from Minister for Development Aid Flemming Møller Mortensen who told the station he is not happy about the situation.
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Sweden does not update its COVID numbers on weekends and will provide its first snapshot of the week on Tuesday.
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Hospitals in Sweden’s capital region continue to strain. Region Stockholm says as of Sunday morning there were 636 COVID patients in hospitals across the metro area. That is a number that continues to creep upward. Of those, 38 were in intensive care.
As of Sunday afternoon, the region had 104 empty care beds and the staff to man them, a drop from the 124 that were available on Saturday.
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Sweden’s State Epidemiologist Anders Tegnell is singing a different tune on the idea of herd immunity. In May of 2020, shortly after the first infection wave, Tegnell infamously said “In the autumn there will be a second wave. Sweden will have a high level of immunity and the number of cases will probably be quite low.” The number of COVID cases in Sweden’s second wave ended up being exponentially higher than its first. Tegnell was also the center of controversy a few months later, after reporters got hold of emails he had sent colleagues in the EU pushing for a herd immunity strategy.
But times have changed. Tegnell is speaking about herd immunity a little more carefully these days. He recently spoke to GP:
“In addition to the vaccine immunity that we have, we also get a supplement with immunity from the disease, which has spread insanely faster and more extensively than what we have ever seen before. But, we will never get an immunity in the population that will make this virus disappear; we must be very clear about that. We have never thought so and we still do not think so. The immunity offered by vaccination and infection recovery is not so total. It will not happen. On the other hand, overall immunity will be very important to slow down the spread of infection and, above all, keep down the risk of needing care, that is. It is already doing so now and will of course do more and more in the coming weeks.”
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Sweden’s pandemic strategy has been found wanting by yet another government agency report, this one from Transport Analysis. It has done a fascinating report on “socially important journeys” during the pandemic to better understand the movement of people, infection spread, and what can be done to improve planning for future crises. The study focused on several different professions performing socially critical work examined both from the employee and employer perspective.
The report emphasizes Sweden’s use of voluntary measures by making recommendations with the onus on people to follow them without any actual enforcement. The three key pillars were asking people to work from home whenever possible; avoid crowds and crowded places, and avoid public transport, especially during peak periods.
The study found a number of socioeconomic factors inhibited a section of the population from following the recommendations. Among them was income, access to a car, country of birth, and where they lived. It notes in particular that the correlation between income, housing costs, distance to work, and reliance on public transportation was greatest in cities.
Per the graph below, who were the people in Sweden who were most able to reduce their reliance on public transport during the pandemic? The highest income earners. Who was least able to reduce their use of public transit? The lowest income earners.
In a nutshell, the more money you had, the easier it was to abide by the recommendations, while people on the other end of the financial scale were not able to follow the recommendations to the same extent. The fiscal divide was starkly evident when looking at pandemic deaths, with the lowest income earners having double the risk of dying from a COVID infection than the top earners. The agency says this held true even after accounting for gender, age, country of birth, education, occupation, and area of residence.
Further, the agency identified what it called “a vulnerability for society” with the people least able to minimize infection risk working the most socially critical jobs. They are, for example, healthcare workers, bus and truck drivers, and senior care staff.
The report was especially harsh on the Swedish government’s wishy washy mask mandate. It concluded wearing a mask could have had significant benefits for those who couldn’t avoid public transit and worked socially critical jobs. It notes the Swedish Public Health Agency didn’t implement a mask policy until January of 2021 while previously dismissing their usefulness. Like the Corona Commission report before it, this one also underscores how mixed messaging and sudden policy change created confusion “and hardly contributed to a higher degree of compliance.”
The report is quite extensive and can be found in full (in Swedish) HERE.
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Epidemiologists in Sweden are looking at the explosive growth of the BA.2 variant in nearby Denmark and guessing the situation is very similar in their country, but they just can’t see it.
Swedish health authorities have confirmed 1,087 cases of the Omicron sub-variant.
Karolinska Institutet Professor of Infection Epidemiology Joakim Dillner spoke to SVT Nyheter and said that number is likely highly underreported and he believes the variant is already much more widespread across Sweden.
“The Danes test three times as much and sequence almost everything. They have extremely intensive testing with very reliable answers. In Sweden, we do not test as much. We sequence approximately 10% of the positive test results. The data in Sweden is hardly even useful. Until the New Year, quite a lot of Delta circulated, but it was probably Omicron BA.2.”
With Sweden preparing to return to near-normal this week and a new hyper-contagious variant racing around, he was asked if it was a concerning situation?
“It could be if someone vaccinated is infected and happens to pass the infection on to the unvaccinated. I would have liked to see the infection limited, but now it is such an incredible infection spread that I no longer think it is possible.”
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In Norway, COVID hospitalizations (290) inched upward (+2) while the number of severely infected people in an ICU (45) dropped slightly (-1) and of those the number on a ventilator (28) numbers also declined a little (-1).
The Norwegian Institute of Public Health is now using hospitalization numbers as a better metric of the pandemic situation than infection numbers due to the proliferation of self-testing kits.
Norway added 31,937 new corona cases and had new pandemic deaths since its update on Friday.
So far, 80.1% of Norwegians 12 years old and older have one vaccine dose, 74.2% have two, and 51.3% have had a booster dose.
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Finland does not update its COVID stats on the weekends and will table three days worth of data later today.
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Austria is set to introduce a sweeping vaccination mandate. The country’s Upper House of Parliament has voted to approve compulsory vaccination legislation. Now it will be signed by President Alexander Van der Bellen and Chancellor Karl Nehammer, something that is a formality. Vaccinations could become mandatory in Austria by as early as this week.
The mandate is laid out in three phases. The first, implementation, allows for a window before phase two, enforcement, arrives. Phase two begins on March 15 with the checking of people’s vaccination status and the handing out of hefty fines of €600 (about $850 Cdn) for those without their shots. To really crank up the pressure, the bill sets out a maximum fine of €3,600 (about $5,100 Cdn) for anyone who challenges their fine in court and loses. A third phase will see vaccinations checks being ramped up, but so far there is no detail on what that might look like.
Health Minister Wolfgang Mueckstein spoke to ORF radio:
“I hope that we will not need Phase 3 at all. If (health) experts say that in their assessment it is not necessary, if constitutional lawyers say it is not proportionate, Phase 3 will not happen.”
Roughly 69% of Austria's population is fully vaccinated, one of the lowest rates in Western Europe.
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Spain will lift requirements that masks be worn outdoors this week. The mandate was put into place in December in order to combat the Omicron variant wave. The Spanish government will make it official early this week and lift the mask mandate as of Thursday.
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Portugal is easing entry restrictions. Anyone holding a valid EU COVID Digital Certificate will no longer have to have a recent negative coronavirus test to enter the country. Since December, Portugal has been requiring all travelers 12 years old and older to have a negative COVID test in hand when they arrive at the border, regardless of vaccination status.
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Greece is throwing its doors open to tourists today as it eases entry restrictions. Beginning today, all travelers arriving in Greece with a valid EU COVID Digital Certificate will not be required to have a negative coronavirus test to enter the country.
Health Minister Thanos Plevris says the goal is to roll out the welcome mat to visitors across Europe and allow them some certainty to plan their holiday to Greece.m
“Our country is getting ready this year to welcome visitors for the summer season, earlier than ever before, from March 1.”
Kikilias says Greece is sending out “a strong message of safety” to tourists.
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For a sixth straight week, the EU has seen what is described as “rapidly increasing” COVID infection numbers, according to the latest pandemic assessment from the European Centre for Disease Prevention and Control. It says infection activity is highest among those under the age of 50, but numbers are also rising among older age groups. The agency is forecasting infections and pandemic deaths to keep rising for at least the next two weeks.
The ECDC says the Omicron variant is now dominant across Europe, albeit with lower rates at the moment in parts of Eastern Europe where the wave arrived a little later. It also notes that the infection curve seems to be declining in some southern EU countries and in Finland. Omicron accounted for 92.6% of all sequenced positive test results across Europe from January 10 to 23 with the fading Delta variant registering at just 5.5%.
Across the EU and the broader European Economic Area, the COVID incidence rate per 100,000 continues to rise, going from 3,251 in week 3 to 3,605 in week 4. This is the sixth straight week the COVID incidence rate across Europe has increased. The 14 day pandemic death rate dipped slightly from week to week, going from 50.4 deaths per million population to 48.2, a rate the ECDC says has been stable for ten weeks now. On the hospitalizations side, of the 27 countries reporting admissions data 17 saw increasing numbers.
Looking at the individual EU countries, 13 are assessed as having a pandemic situation of very high concern. They are Belgium, Bulgaria, Croatia, Czechia, Denmark, Estonia, France, Hungary, Iceland, Latvia, Portugal, Romania, and Slovenia. 14 nations have a COVID situation of high concern including Austria, Germany, Norway, Sweden, and the Netherlands. Just three countries, Cyprus, Finland, and Spain, are assessed as being a moderate concern.
The cumulative uptake for two vaccination doses among the total population in the EU/EEA is 70.4%. For those with two doses and a booster, it is 45.2%.
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Canada continues to see what the Public Health Agency of Canada calls “widespread activity across the country” in its latest pandemic assessment. It notes that testing capacity across the country is overwhelmed and that infection numbers are no longer an accurate barometer of the epidemic situation.
“Reported case numbers underestimate the true number of infections.”
The agency says there were 13,977 new infections in the last week, a 24% decrease from the week before. But the national positivity percentage is sitting at 18%, which it says is one of several indicators showing that the country is not out of the woods yet.
PHAC says hospitals continue to strain under increasing COVID admissions compounded by high numbers of healthcare workers getting infected and isolating. It says the latest numbers show an average of 9,951 coronavirus-infected people were hospitalized each day of the last week. The good news is that is an 8% week to week decrease. The bad news is that it is still a number that exceeds all previous infection peaks. On average, 1,170 severely infected people are being treated in intensive care each day. And an average of 142 lives have been lost every single day from January 28 to February 3.
The public health agency says vaccinating everyone who has yet to receive their shots “remains a top priority.” Over 79% of the total population has two vaccine doses. As of the end of January PHAC says 88% of those 12 years old and older have one dose and 83% are fully vaccinated. Among children 5 to 11 years old, 55% have at least one dose. There are still 6-million Canadians who need one or more doses to complete their primary two dose vaccination.
As of February 3, over 15 million booster doses had been administered. Over 79% of seniors over the age of 70 have been boosted as have 69% of those between the ages of 50 to 69 years old.