The Evening Report - Feb 1
Denmark’s hospitals struggle with COVID caused staffing shortages
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“The curve seems to be breaking.”
Denmark’s Health Minister Magnus Heunicke says the COVID contact number (reinfection rate or R0) has dropped from 1.2 last week to 1.0 this week. Heunicke says nationally the epidemic is “stable” but he adds, the picture is a little more muddled regionally. He says the infection wave may have peaked in Region Hovedstaden (Metro Copenhagen) and Region Sjælland; however, things are still “uncertain” in the other three regions.
Heunicke says infection numbers have been easing among those 19 years old and younger, something that may be another sign the Omicron wave is loosening its grip. He says this is more evidence supporting his government’s decisions to lift virtually all restrictions as of Tuesday.
“COVID does not disappear from society along with the restrictions. We still need to take care of each other and especially the vulnerable and the elderly. Remember to get a test before you visit, for example, nursing homes and hospitals. And get vaccinated if you have not already.”
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A study from Denmark’s Staten Serum Institut, Statistics Denmark, and the University of Copenhagen is shedding more light on the threat posed by the Omicron sub-variant BA.2. The study found the sub-variant is more contagious but vaccinated people are less likely to become infected and pass it on.
The study examined household infection spread between homes where one person was infected with either the sub-variant BA.2 or the parent Omicron strain BA.1. It found that the sub-variant outcompeted the parent Omicron strain by a full 10 points, with a secondary infection risk within one week (spread to another person in the home) of 39% compared to 29%. Researchers examined 8,541 households with 17,945 residents over a one month period.
The evidence also suggested BA.2 may have more immune escape compared to the parent Omicron strain. The study found BA.2 infection risk was highest among the unvaccinated, but those with two doses plus a booster are much better protected against infection. However, it also found BA.2 had a higher breakthrough rate than the original Omicron among vaccinated people.
The study also examined how contagious someone with a BA.2 infection was, whether they were unvaccinated or vaccinated. Researchers found a large disparity with vaccinated people having a much reduced risk of passing the infection on, while those unvaccinated with a BA.2 infection had a significantly increased risk of contagion.
SSI Dr. Camilla Holten Møller:
“The analysis show that both unvaccinated and vaccinated people are generally more susceptible to BA.2 than BA.1, and that unvaccinated people are more often transmitted with BA.2 compared to BA.1. This indicates that BA.2 has an inherently higher infectivity compared to BA.1. But the study also shows that vaccinated and especially booster vaccinated people become infected to a much lesser extent and that vaccinated people also continue to be infected to a lesser extent, and this applies to both the BA.1 and BA.2 variants.”
The study is a preprint and has not yet been peer-reviewed. It can be found HERE.
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Danish Prime Minister Mette Frederiksen made the media rounds today to trumpet the country’s return to near normal. While Frederiksen hailed the lifting of virtually all COVID restrictions, she also cautioned this might not be goodbye, but rather see you later.
The Prime Minister was speaking to Go ‘Morgen P3:
“I dare not say that it is a final goodbye to restrictions. We do not know what will happen in the fall. Whether there will be a new variant or not.”
She also said she understands if not everyone is super enthusiastic about the return to normal.
“For many, it is strange and paradoxical that we are opening up while we have the highest infection rate ever in the pandemic. But this is largely due to the fact that the Danes have been so good at getting vaccinated.”
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Even though the majority of COVID restrictions have been lifted in Denmark, the Danish National Board of Health is reminding people they aren’t off the hook yet. The health board says people still need to follow all the recommendations and take personal responsibility to keep themselves as safe as possible.
Department Head Bolette Søborg:
“Now that the infection is very high and society is completely open, it is a good idea to take extra care and continue to remember the six recommendations. We still have to wash our hands often, ventilate indoor spaces, and stay at home when we are ill.”
She says the recommendations apply regardless of vaccination status noting vaccines offer really strong protection against severe infection, hospitalization, and death.
“It is especially important that people at increased risk keep their distance from others they do not know, and that they generally avoid places where there are crowds.”
And while restrictions are lifted across most of society, the health board is reminding people masks and coronapas mandates remain in force for people visiting hospitals and senior care homes.
“There is a general need for us all to be a little extra aware of each other, especially when we are in places where there are many people, or in a hospital, or nursing home where we want to keep infection out as much as possible. Therefore, visitors and relatives can wear a mask and if they are feeling sick they should stay home.”
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The Danish National Board of Health says influenza rates remain low compared to past seasons but also warns lifting COVID restrictions could allow the seasonal bug to take off.
The health board attributes the low influenza rates to COVID restrictions, people amping their hand washing game, and high rates of influenza vaccination, especially among the elderly. However, it also adds as society returns to near normal and people increase their social contacts “increasing influenza infection must be expected in Denmark.” It also notes that the flu season usually peaks in February.
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Denmark is reporting 45,366 COVID infections, including 2,515 reinfections, and another 15 coronavirus deaths in the last day.
Yesterday, there were 330,544 total COVID tests done, of which 159,049 were PCR tests, equaling a positivity percentage of a soaring 28.52%.
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COVID hospitalizations have risen over 1,000 mark (1,070) for the 1st time ever in the pandemic (+42) while the number of severely infected patients in an ICU (28) keeps falling (-4) and of those on a ventilator (14) inched down (-1). Psych ward admissions (243) up (+5).
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COVID-related staffing shortages are now the biggest problem facing Denmark’s hospitals, not infection patients, according to the latest report from the Danish National Health Board.
The report, the 35th of the pandemic, found that despite record infection and hospitalization numbers, many hospitals are in a position to scale down pandemic related emergency operations. The report says the biggest hurdle in doing so for a lot of them is a continued staffing shortage crisis, with many either infected or in isolation. It says efforts to return to normal operations “are not realistic in the coming weeks” solely due to so many staff being out sick.
The agency notes that ICU numbers have now completely uncoupled from a soaring infection curve, the first infection wave of the pandemic to see that happen. But it says due to “high vaccine-induced immunity in society” increasing infection numbers will no longer translate to an equal corresponding number of severely infected people needing care.
Deputy Director Helen Probst:
“Even though the number of infected people is rising, we also see that the number of people admitted to the intensive care unit is falling and that fewer patients are having a serious illness. It is very encouraging that we are still experiencing a decline in intensive care units. This is due to the Omicron variant causing lower respiratory tract infection to a lesser extent, and that the Danish vaccination effort is working. This can probably be attributed to the rapid roll-out and high uptake of booster doses in Denmark. As a result of the large number of vaccinations and the high level of societal infection, Denmark currently has a high population immunity to Omicron infection.”
But not all hospitalization news is so good. The health board says the number of infected children being admitted has been increasing. About 6% of hospitalizations have been admitted to one of two pediatric specialities. It blames the increase on record high COVID numbers and the sheer extent that Omicron is tearing through the country. That said, it notes that like other hospitalizations kids are largely experiencing mild symptoms and hospital stays are brief.
Another concern that is unique to this infection wave is increasing numbers of infected people being admitted to psychiatric wards. The health board says there has been a “marked increase” in psych ward admissions. In order to be admitted to psychiatric care, an infected person also requires treatment for a mental illness. The agency does not table any reasons for what might be driving these numbers up.
The other lagging concern continues to be a major backlog in delayed and postponed procedures accrued due to the pandemic and last year’s nurses strike. Efforts to tackle the backlog have been thwarted by staffing shortages.
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On the vaccination front, there were 9,646 total inoculations yesterday with most (7,612) being booster doses.
To date, 82.5% of the total population have one vaccine dose, 80.8% have two, and 60.8% have a booster shot.
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The return to near normal has triggered a workplace war of words. Denmark’s largest industry group, Danske Industri, says despite restrictions, like coronapas mandates, being lifted, employers can still demand their workers have to prove their vaccination status to come to work. However, the Trade Union Movement doesn’t agree, firing off a press release Tuesday to say business groups can’t both lobby the government to remove restrictions and demand their employees still have to show a coronapas to get to work.
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Sweden has added 113,454 infections and another 106 corona deaths since its last update on Friday.
To date, 86.5% of the population 12 years old and older have one vaccine dose, 83.5% have two, and of those 18 years old and older 48.8% have a booster shot.
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As Sweden sees soaring numbers of COVID infections as the Omicron variant tears through the country, the Swedish Public Health Agency is taking steps. It has cut the interval between the 2nd and 3rd vaccine doses down to three months.
State Epidemiologist Anders Tegnell:
“With an earlier booster dose, we can put another brake on the infection spread of infection. It is good to take your refill dose as soon as the region offers it. Anyone who has both had COVID and is vaccinated has very good protection, there is no reason to wait.”
Sweden currently recommends vaccine booster shots for everyone 18 years old and older who has already had two vaccination doses. It uses either a half-dose of the Moderna vaccine or a full dose of Pfizer/BioNTech. For those under the age of 31, only a Pfizer dose is recommended.
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Hospitals in Sweden’s capital region continue to strain as admissions continue to rise. Region Stockholm says there are now 650 infected people in hospital, a week-over week increase. As of Tuesday afternoon, the region had 95 empty care beds and the staff to man them.
Chief Physician Johan Bratt:
“The pressure on hospitals is still high due to the combination of many patients with COVID at the same time as many of the employees in hospitals and health centers and other care units are off-sick. There is care for those who need it. Caregivers in the region continue to work together to ensure that as many people as possible receive the care they need.“
The region says for the first time since November the number of infections from one week to the next has declined. The number of COVID cases went from 63,029 in the 3rd week of January to 48,935 in the last week of the month. But, Infection Control Doctor Maria Rotzén Östlund cautions to not read too much into that because of the lack of testing.
“The rate of increase may have stopped, but it is too early to say as testing patterns have changed in recent weeks, we need a little more time to say for sure that it is a trend.”
She emphasizes the infection risk remains very high and people shouldn’t let their guard down.
Last week, Region Stockholm had a positivity percentage of a whopping 56.45%. The positivity percentage for Monday this week was 52.66%.
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Finland has registered 3,244 infections and had no new virus deaths in the last 24 hours.
COVID hospitalizations (669) are unchanged day to day.
So far, 78% of the total population has one vaccine dose, 73.7% have two, and 44.8% have a booster dose.
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Finland’s Prime Minister Sanna Marin says the country will stick to its plan to dismantle all COVID restrictions this month. Parliamentary parties will meet on Wednesday to discuss how to go about it. But, even as they do, some measures are already being eased. Beginning Tuesday, restaurants and cafes can stay open until 9pm, while bars and nightclubs still face sharply curtailed operating hours. As well, entry restrictions for travelers coming from Schengen-area countries and non-Schengen European Union member states will be lifted.
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Finnish health authorities are confirming more cases of the Omicron sub-variant BA.2. Last week, ten variant infections were confirmed in Southwestern Finland and on Tuesday morning five more cases were found in the Helsinki and Uusimaa Hospital District.
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Norway has added 18,819 infections and had no new pandemic deaths since yesterday’s update.
COVID hospitalizations (267) are up (+10) while the number of severely infected people in intensive care (47) is down (-4) and of those on a ventilator (30) numbers also dipped (-2).
To date, 80% of Norwegians 12 years old and older have one dose, 74% have two, and 49.8% have a booster.
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Beginning Tuesday night, Norway has begun to phase out its COVID restrictions over the next two weeks.
Norwegian Prime Minister Jonas Gahr Støre:
“The virus [Omicron] variant causes less severe infection than previous variants. And although many more are infected, fewer are hospitalized. We are well protected by vaccines.”
But the Prime Minister also sounded a warning note asking Norwegians to brace themselves for some challenges times ahead.
“The time ahead will be demanding. Many of us will be infected. The Norwegian Institute for Public Health estimates that perhaps as many as between three and four million people can be infected with Omicron before the summer, and we must plan for up to 20% sick leave. We therefore retain some measures to prevent too many people from becoming ill and being away from work.”
Norway will keep social distancing measures in place as well as the requirement to wear a face mask in crowded places.
That said, schools return to near normal, all limits on guests in private homes, and all caps on indoor and outdoor events are scrapped. Social distancing requirements are lifted for people attending movie theaters, churches, and other similar venues with seated guests. Alcohol and serving bans and limitations are gone. Colleges and universities can return to full classroom capacity. Organized sports and leisure activities can return to normal. Amusement parks, playgrounds, and casinos can reopen with infection control measures in place. People no longer need to work from home.
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Germany is reporting 162,613 infections and 188 more corona deaths since Monday’s update.
There have been 1,215 more coronavirus hospitalizations, while ICU numbers (2,300) jumped (+32). As a percentage of total ICU care beds across the country, pandemic patients are using 10.4% of them.
To date, 75.8% of the total population have one dose, 74% have two, and 53% have a booster.
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A hopeful study out of the United Kingdom suggests being vaccinated against the coronavirus significantly lowers the chances of suffering from long-COVID, which is defined as suffering symptoms three months or more after recovering from infection. Study participants were between the ages of 18 to 69 years old and had received two vaccine doses at least two weeks before having a COVID infection. The study found a 41.1% decrease in cases of long-COVID 12 weeks and longer after infection recovery compared to a similar test group of unvaccinated people. The study also found no evidence of differences between viral vector vaccines (AstraZeneca and Johnson & Johnson) and those that are mRNA (Pfizer and Moderna).
However, there are some big unanswered questions as the study has not assessed the impacts of both booster doses and any potential effect of the Omicron variant.
“Furthermore, the observational nature of the analysis means that we cannot say whether COVID-19 vaccination caused subsequent changes in the likelihood of self-reported long COVID.”
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Pfizer is taking the first step towards possibly beginning vaccinations for children under the age of 5. The pharmaceutical company has begun submitting data to the US Food and Drug Administration. It will be a rolling submission involving the first two doses of a planned three dose series. Each pediatric dose for kids that young will about 1/10 that of the adult strength dose.
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Canada reported 10,721 COVID infections while suffering another 151 pandemic deaths. Remember, infection numbers are likely very underreported due to testing systems being overrun or collapsing completely across the country.
COVID hospitalizations continue to rise across Canada as admissions increased again in the week from January 17 to 24. There were 464 coronavirus hospitalizations pushing the total number to 11,052. It was much the same story for severely infected people being admitted into intensive care as numbers rose from 1,180 to 1,232, an increase of 252. Of those, the number on a ventilator also jumped by 65 to 638.
The Canadian vaccination effort has so far administered 31,924,192 1st vaccine doses (83.49% of the total population) while 30,140,174 people (78.83%) have two doses, and of those, 15,655,987 people are fully vaccinated with three doses.
Ontario saw hospitalizations (3,091) rise (+72) while ICU numbers (568) were down (-18). The province lost another 63 lives to coronavirus. It has a positivity percentage of 16%
Quebec has a positivity percentage of 12.58%. Hospitalizations (2,852) were down (-43) while ICU numbers (218) dropped (-15). The province lost another 63 lives to the pandemic. The province is scrapping its plans to levy a tax on the unvaccinated.
Nova Scotia hospitalizations (95) crept up (+3) and ICU numbers (13) inched down (-2). The province recorded one more pandemic death. It has a positivity percentage of 10.4%.
In Newfoundland and Labrador, hospitalizations (25) have hit a new record high (+2) with 11 people in intensive care. The province has a positivity percentage of 12.2%
In New Brunswick there are 162 people in hospital (-3) with 17 in an ICU (+4). The province also saw five more deaths. It has a positivity percentage of 10.76%
Manitoba saw hospitalizations (737) increased (+22) while those in intensive care (114) rose (+4) to set a new pandemic high. Seven more people have died in the province. It has a positivity percentage of 30.1%.
Saskatchewan saw hospitalizations (370) rise (+21) setting a record high. There are 39 people in an ICU. The province had one more pandemic death. Its positivity percentage is 31%.
Alberta hospitalizations (1,581) reached another record-high (+112) while ICU numbers (109) crept up (+3). The province saw another 13 pandemic deaths. Its positivity percentage is 40%
In B.C. hospitalizations (1,035) declined (-13) and ICU numbers (138) crept up (+1). The province had 9 more COVID deaths.