The Evening Report - Feb 10
Denmark’s COVID epidemic moves out of the cities and into the countryside
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COVID cases continue to rise in the west and fall in the east in Denmark, according to the latest weekly situational report from the Staten Serum Institut. Overall, new infections decreased last week compared to the week before, with the national COVID incidence rate per 100,000 people falling to 5,061. However, the positivity percentage is going in the other direction, rising from 29.7% in week 4 to a pandemic record high of 35.4% in week 5. The SSI says this likely means there are a number of coronavirus infections out there that are not being caught with testing.
Regionally, the lowest COVID incidence rate is in Metro Copenhagen (4,070 per 100,000 people) and the highest is in Region Midtjylland (6,054), which also has the highest positivity percentage (39.1%) of the five Danish regions. The institut also notes infections are easing across Region Sjælland and are lower in the larger cities than they are in the surrounding municipalities.
Another indicator of the East/West pandemic divide is COVID wastewater surveillance where in week 5 testing showed declining virus rates in Region Hovedstaden and Region Sjælland but not in the rest of the country.
Nationally, by age, the COVID incidence rate (per 100,000 people) is highest among 12 to 15 year olds (9,802), followed by 6 to 11 year olds (8,130).
Concernedly, coronavirus cases continue to rise among nursing home residents going from 1,205 to 1,647 week over week. Rising along with infections are nursing home deaths, which increased from 48 to 61 over the same period.
There were 2,391 hospitalizations with a coronavirus infection last week, an increase from the week before. While hospitalizations increased across all age groups, the highest increases were seen among those 70 to 79 years old, followed by those 80 to 89 years old. Overall, those 30 to 39 years old made up the largest proportion of pandemic hospitalizations. The SSI points out that the number of those admitted due to a coronavirus infection has dropped from 60% to 55% as of week 3. 49.4% of admissions were people admitted due to non-pandemic reasons who tested positive. It is the opposite story with intensive care admissions, where the proportionate number of people needing care due to a COVID infection has risen from 62% in week 4 to 71% last week.
COVID deaths were stable week to week with 138 fatalities last week compared to 136 lives lost the week before. The institut says excess mortality (deaths above the average) has almost reached a “normal level” but it also advises taking the numbers with caution. The SSI has been trying to clarify pandemic deaths to get a more accurate picture separating those dying from COVID to those dying for another reason but who had an infection. Last week, it estimated that 33.7% of coronavirus-related deaths were the result of something non-pandemic related.
The Omicron sub-variant, BA.2 has spun off another strain (BA.2_H78Y) that is also seeing steadily increasing numbers, approximately 24% of all sequenced positive test results. Together, the two variants account for 85% of all cases, while the parent Omicron strain continues to dwindle.
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The Omicron variant and its sub-variant, BA.2 have broken through the first line of vaccine defense against symptomatic infection, even while vaccines still offer strong protection against severe illness, hospitalization, and death. Staten Serum Institut data shows that a small but growing group of people have battled more than one COVID infection. Some 90,000 people in Denmark have been infected more than once and some have had it three or four times.
Aarhus University Chief Physician, and Professor, Lars Østergaard spoke to DR and said this might be something we need to adjust too.
“On the one hand, Omicron is more contagious, and on the other hand, it is widespread across society. And the immune system that has been built up by previous infections or vaccines does not work as effectively against the new variant like Omicron.”
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Denmark reported a record high 55,120 COVID infections on Wednesday and then followed it up with a very high 53,747 on Thursday. Reinfections remain high with over 3,200 on each of the last two days. There were 50 more lives lost to the pandemic over the last 48 hours.
Worth noting Denmark also set a record high number of infections as measured by testing date. Of all the corona tests taken on Monday February 7, a record-high 53,978 came back positive.
Yesterday there were 279,682 total #COVID tests done, of which 172,183 were PCR tests equaling a positivity percentage of 31.21%.
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COVID hospitalizations keep setting new record highs (1,354) as numbers march upward (+22) while severe cases in an ICU (33) inched down (-1) of those on a ventilator numbers (12) edged up (+1) psych ward admissions (329) also rose (+16).
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Region Nordjylland says its efforts to return hospitals to normal operations and begin to tackle backlogged surgeries are being hampered by the sheer number of Omicron infections. A stream of COVID patients being admitted to hospitals and staffing challenges due to so many being out, sick or isolating as close contacts are slowing efforts to get hospitals back on track.
Regional Council Chairman Mads Duedahl
“Staff are working hard to keep up with the hospital numbers, and they are giving it a great effort. We hope that we can soon be back to normal activity, and can then begin tackling the backlog of procedures. We will be able to do this as fewer people are admitted with corona, and infected staff can once again take care of their normal tasks.”
The region has millions of Danish kroner earmarked to address the backlog of postponed surgeries and procedures over each of the infection waves and in last year’s nurses strike.
“It is important to me that we shave down the waiting times. With the new grant, we are emphasizing that we are setting all sails to help the many patients who have had their hospital appointments postponed as soon as possible. However, it will take time before we are through the lists, and I can not guarantee anything other than that we will do our best.”
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On the vaccinations front, there were 3,322 booster doses administered yesterday and just 24 people had their 1st dose.
To date, 82.5% of the total population has one vaccine dose, 80.9% have two, and 61.3% have a booster dose.
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As of next week, Region Hovedstaden (Metro Copenhagen) will scale down its vaccination infrastructure. All privately run vaccination sites operated by Copenhagen Medical and Practio will be closed. Opening hours at the remaining vaccination centers will also be reduced. The region says 83% of the people in the region have been fully vaccinated and boosted, which means vaccination capacity can be cut back.
Capital Region Health Committee Chair Christoffer Buster Reinhardt:
“We have a high vaccination rate in the Capital Region and are heading towards spring, which will also help us escape the pandemic. Therefore, we are adjusting the capacity now and will continue to do so in the future in line with the authorities announcements. It's great what we can do when we come together, when it really matters.”
Beside the remaining vaccination sites people in Metro Copenhagen can also get their shots at selected pharmacies and at their family doctors.
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Region Syddanmark is closing private vaccination clinics and ending its agreement with private providers Carelink and VaccineDanmark. As of February 13, private vaccination clinics in Varde, Grindsted, Assens, Brørup, Haderslev, and Fredericia.
Just over 800,000 people in Southern Denmark have been vaccinated and boosted. The region says in January demand began to fall sharply. Last week, 11,000 vaccinations were administered, well below the weekly capacity of 50,000.
The region says there are still plenty of options for people still needing to be vaccinated. It says work is also underway with municipalities to see if there is interest in local vaccination days. Bringing a large group of people together for a special one-off vaccination effort.
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Denmark’s Queen Margrethe II has tested positive and according to the Danish Royal House is experiencing mild symptoms. The Queen is isolating herself at Amalienborg Palace and has cancelled a vacation to Norway that was scheduled to begin this week.
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As of midnight Wednesday COVID restrictions in Greenland had come to an end. This means life returns to near-normal across the country with the ability to go shopping, eat in restaurants, enjoy events, and work out in a gym without having to wear a mask or show a coronapas. Greenland’s National Medical Office says the Omicron wave has peaked in large urban areas.
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As of Wednesday, Sweden followed Denmark’s lead and scrapped its COVID recommendations returning life to near normal. This means travel from Denmark and other European countries into Sweden no longer requires a recent negative COVID test, although you should keep your coronapas handy.
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Sweden has added 37 coronavirus deaths and 16,395 infections since yesterday’s update. On Wednesday, Sweden ended COVID testing for the general public and will now only test those in senior care and those who are hospitalized. This means Sverige’s infection numbers, which were already very underreported, will now be totally detached from reality.
Infection-related ICU admissions grew by 23. A hospitalization chart is below.
So far, 86.6% of the population 12 years old and older have one dose, 83.8% have two, and of those 18 years old and older 54.4% have a booster dose.
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On Wednesday, Sweden lifted all COVID recommendations returning the country to near normal. The change included ending all COVID testing for the general public, with tests restricted to seniors in care and people who are hospitalized. The Swedish Public Health Agency is selling the move as the pandemic “entering a new phase.”
Director Karin Tegmark Wisell:
“A stable society can only be built on the good health of its population, with equal conditions for everyone. It has been central throughout the pandemic to protect those who are considered high-risk from the most serious consequences of infection, and will continue to be so.”
Wisell says in this new phase, being vaccinated “remains the single most important thing” to aid in the return to normal life and help insulate the population against threats from new infections waves and any new variants that might appear.
People in Sweden 12 years old and older are encouraged to get vaccinated. Anyone who is sick or has coronavirus symptoms should stay home and avoid contact with other people. And anyone who is not vaccinated is being urged to take special precautions including avoiding crowded places, especially if they are indoors.
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The number of hospital admissions has dipped in Sweden’s capital region. Region Stockholm says there are 580 coronavirus patients in the region’s hospitals, a decline of 33 since Wednesday. Intensive care admissions also dropped, going from 32 to 25.
The number of staffed empty care beds jumped day to day, going from 62 to 120.
On Wednesday, Region Stockholm had a positivity percentage of 48.21%.
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Swedish epidemiologists are concerned about a study from the United States that found monoclonal antibody treatment isn’t as effective against the Omicron BA.2 variant.
Magnus Gisslén, professor of infectious diseases at Sahlgrenska Academy, and chief physician at Sahlgrenska University Hospital, spoke to Dagens Nyheter.
“It is of course worrying. This can be of great importance for the treatment of patients.”
Researchers at New York’s Columbia University tested mRNA vaccines as well as the monoclonal antibody sotrovimab against the Omicron variant and found it was much less efficient in treating a BA.2 infection as opposed to BA.1.
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In Norway hospitalizations (324) are down (-2) while ICU numbers (41) are also down (-4) and of those on a ventilator (28) rose slightly (+2).
There has been one pandemic death and 25,683 new infections in the last 24 hours. Keep in mind infection numbers are likely underreported.
So far, 80.2% of Norwegians 12 years old and older have one dose, 74.3% have two, and 52.1% have a booster shot.
The Norwegian Institute of Public Health has updated vaccination rates across age groups.
12 to 15 years olds - 53% have one vaccine dose.
16 to 17 year olds - 83% have one dose and 41% have two.
18 years old and older - 63% have had a 3rd dose.
45 years old and older - 80% have had a booster dose.
65 years old and older - 89% have been boosted.
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Norway’s Omicron-fueled infection wave will continue to remain at high levels or even increase slightly for at least the next few weeks before reaching a “low level” by the end of March. That is the latest pandemic forecast from the Norwegian Institute of Public Health.
NIPH Director Camilla Stoltenberg:
“We estimate that the winter wave will infect three to four million people, and that around half a million could be infected in the worst weeks. We believe that a few thousand will be hospitalized, but that hospitals will never have more than a thousand patients at any one time with about a hundred patients simultaneously on a respirator.“
Stoltenberg says to some degree the Omicron wave has been impacted by (now lifted) COVID restrictions and behavioral changes of a nervous population looking to protect themselves.
“The consequences of the Omicron infection wave for society is particularly seen with increased strain on doctors, nursing homes, and hospitals. But it has also meant many more people have to be away from work due to being sick or having to isolate.”
The NIPH is cautioning that while it forecasts the Omicron wave will ebb by late March and the pandemic situation overall will improve as summer arrives, COVID will return next fall and winter. But it adds “the basic immunity of the population is likely to protect well against serious illness, regardless of variant.”
“In a short time, society can return to normal everyday life without special infection control measures against the coronavirus.”
That said, the agency is also asking for patience as hospitals and other healthcare services take a little longer to return to normal as they catch up on surgical backlogs.
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Norway could be seeing signs it’s Omicron-driven infection wave may be at or nearing its peak. According to the latest weekly assessment from the Norwegian Institute of Public Health, the reinfection rate (R0) has dropped from 1.3 to 1.0 over the last two weeks.
There were 462 patients admitted to hospital last week who had tested positive, of which 215 (47%) were hospitalized because of a COVID infection. That is a very slight (-2) week-to week decline. Overall, the NIPH says the hospitalization rate is estimated to be a very low 0.13% of all reported coronavirus cases. It suspects the reason is that the Omicron variant generally causes less severe illness and that the majority of Norway’s population is also well vaccinated. Intensive care admissions treaded water week to week, with 16 in each of the last two weeks.
Last week, the hospitalization rate per 100,000 people was highest among polar opposite ends of the age spectrum both among infants under the age of one and among seniors over the age of 85. In the last four weeks, 42% of hospitalizations involving children under the age of 18 have been due to a COVID infection. Although the NIPH notes hospital stays are “generally short-lived” and that with infants there is a “lower threshold” for parents to take their child to hospital. It also adds that COVID hospitalization numbers for children under 18 are still “significantly lower” than what occurred during the RS virus outbreak of a few months ago.
Of concern, the institute says pandemic-related deaths, which had been “relatively stable” for the first four weeks of the year, increased to 35 last week, 9 more than the previous week. The median age for coronavirus deaths last week was 86.
The NIPH is paying more attention to hospitalization numbers as a better barometer of the pandemic and downplaying infection numbers due to the widespread use of self-testing. As well, the agency notes a 24% decrease in the number of tests administered last week. That said, 128,127 corona cases were reported last week, a 5% decrease from the week prior. Again, case numbers are likely very underreported.
The NIPH says like its Nordic neighbours the Omicron sub-variant BA.2 is taking over. From week 4 to week 5, the share of sequenced positive test results coming back as the new variant increased from 6% to 16%. In Oslo, BA.2 numbers doubled in a week to 19.5% of all sequenced positive test results. The agency says, as in Sweden and Denmark, BA.2 will soon be the dominant variant.
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The Norwegian Institute for Public Health says rates of non-COVID respiratory infections have been “relatively stable” for the last three weeks. It says this indicates any flu season will be minimal with levels about where they were a year ago but well below what would normally be seen in the years prior to the pandemic.
Director Camilla Stoltenberg:
“It is very unusual that at the beginning of February we have not yet seen the start of the flu epidemic.”
The agency says there was some flaring up of influenza cases prior to Christmas, but those quickly stagnated by the end of December, likely due to COVID restrictions. Although it also speculates that “viral interference” may also be playing a role with immune systems already fighting COVID, possibly having significant defenses against influenza.
It says COVID accounts for almost half (47%) of all respiratory infections at the moment, with lower respiratory infections trailing just behind at 43%, upper respiratory infections at 9%, and the RS virus and influenza cases each at 1%.
“It is now likely that the flu epidemic and the disease burden it causes will be small this winter as well. Even if the epidemic were to be small, it could cause more serious illness among those infected, especially in young children. There are now more children who have never encountered the flu virus before.”
The NIPH also warns if we avoid another influenza season due to the COVID pandemic, it heightens the risk that the seasonal flu will come roaring back next winter at “significantly higher” levels due to low natural immunity in the population.
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Finland registered 12,805 infections and 15 more virus deaths since yesterday.
COVID hospitalizations (712) are unchanged.
So far, 79.2% of the total population have one vaccine dose, 74.9% have two, and 47.8% have a booster dose.
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The hospitalization situation in Finland has stabilized and intensive care numbers are dropping according to the latest snapshot from the Finnish Institute for Health. The agency says there were 347 people being treated in specialized healthcare as of Tuesday this week, which is almost the same number as the week previous. The number of new COVID ICU admissions has dropped by half from mid January to the first week of February.
The health agency says 25% of COVID-related admissions were people hospitalized for some other reason than an infection. In intensive care, that number is 20%.
In the last two weeks, Finland has suffered 232 more pandemic deaths, with 83% of those fatalities being people over the age of 70, according to the institute.
On the variant front, the agency says the Omicron sub-variant BA.2 is spreading rapidly across the country, with the proportion of cases testing positive for the new strain growing fastest in the Helsinki Uusimaa Hospital District.
The institute stresses vaccination is key in this next phase of the pandemic, while COVID self-testing kits will also play a crucial role in managing the epidemic.
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The Finnish Institute for Health has reviewed vaccine data and is satisfied that two doses and a booster offer strong protection against severe infection, hospitalization, and death. It says that population-level vaccine protection remains good and a fourth round of vaccinations for the general public is at this point not needed.
“In the light of current data, there is no significant additional benefit in boosting the vaccine response to the fourth dose in the general population, as protection against serious disease remains good after the third dose”
That said, the agency says a second booster dose may need to be administered to a small group of people who are immunocompromised or belong to a high-risk group.
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Germany recorded 247,860 infections and another 238 pandemic deaths since yesterday’s update.
It added 1,675 more COVID hospitalizations while ICU numbers (2,398) edged up (+8).
To date, 76% of the total population have one vaccine dose, 74.6% have two doses, and 55% have a booster shot.
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“We are at the beginning of the end of the pandemic.”
That is according to Poland's Health Minister, Adam Niedzielski, who has reduced the isolation period for people infected with the coronavirus from ten days down to seven as of February 15. Vaccinated people also no longer have to isolate if they are in close contact with an infected person who they are not living with.
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The European Centre for Disease Prevention and Control has issued its latest COVID risk assessment map of the European Union. Once again, the EU is painted in deep high-risk crimson.
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Canada suffered another 149 pandemic fatalities yesterday and reported 11,139 more COVID infections. Case numbers in Canada are very underreported due to testing systems being overrun or testing access restricted across the country.
Over the last seven days, Canada has had a positivity percentage of 16.1%.
The Canadian vaccination effort has so far administered 32,099,184 1st vaccine doses (83.95% of the total population) while 30,495,110 people (79.75%) have two doses, and of those 16,632,514 have had a booster shot.
In Ontario, COVID hospitalizations (1,897) have dropped (-357) while the number of severe infections in intensive care (445) declined (-29). Another 44 pandemic deaths were reported. The province has a positivity percentage of 14.27%.
Quebec saw hospitalizations (2,312) drop (-68) while the number of severe infections in an ICU (173) also fell (-5). There were 35 more corona deaths. The province has a positivity percentage of 10.57%.
Newfoundland and Labrador has 25 COVID patients in hospital, tying a record-high, while eight are in an ICU. The province has a positivity percentage of 18.5%
In Nova Scotia hospitalizations (90) are down (-1) while there are 11 people in intensive care (-3). It also reported one more corona death. The province has a positivity percentage of 13.4%.
New Brunswick saw hospitalizations (140) drop (-11) while ICU numbers (15) declined (-2). The province reported three more pandemic deaths on Thursday. It has a positivity percentage of 22.95%.
Manitoba added three more corona deaths. COVID hospitalizations (661) dipped (-36) while the number of infected people in an ICU (42) inched upward (+2). The province has a positivity percentage of 23.2%.
Saskatchewan has tied its record for highest hospitalizations (384) which jumped (+52) since the province ended daily COVID updates. It did not provide ICU or fatality numbers in its first once-weekly pandemic data dump. The province has a positivity percentage of 31%.
Alberta has a positivity percentage of 29.3%. It reported another 22 deaths on Monday. COVID hospitalizations (1,586) dropped (-97) while the number of people in an ICU (126) dipped (-2).
B.C. saw COVID hospitalizations (867) fall (-119) while the number of people with severe infections in an ICU (138) also dipped (-8). There have been five more pandemic deaths in the last day. The province has a positivity percentage of 17.5%.