On Friday Prime Minister Mette Frederiksen announced that on June 15, Denmark would allow tourists from Germany, Norway and Iceland to visit Denmark as long as they stayed at least six nights outside of Copenhagen. Danes likewise could travel to these three countries and were advised to avoid large cities. The plan drew criticism from the opposition parliamentary parties and the Copenhagen tourism industry. The reactions continued yesterday.
Summerhouse rental agencies in Jutland (DK) were suddenly overwhelmed with bookings from both Germans and Danes. Meanwhile, tourism officials in Copenhagen tried to tote up the damage to the capital because of the ban on overnight stays. Mikkel Aarø-Hansen, the managing director of Wonderful Copenhagen, estimates that it will cost the city DKK 1.3 billion in revenue ($185 million) and will affect 1,400 jobs. That comes on top of a loss of DKK 4.25 billion ($600 million) already in the three months since the lockdown began.
Some healthcare researchers approve
“If you want to avoid people crowding together in the evening – since that is the situation we have seen in superspreader events,” says Jens Lundgren, Professor of Infectious Disease Medicine, “there is a good argument on healthcare grounds (DK) for not allowing tourists to stay overnight in the city.” Allan Randrup Thomsen, Professor of Virology, agrees: On a nice day, you see many people out at Nyhavn and Strøget (the main pedestrian street). You have to add tourists to them. Copenhagen has been the hotspot, and you don’t want to make it a larger one.
Danes must stick to the countryside
Danes also began to make vacation plans according to the restrictions (DK) on their travel to the three countries. Those who visit a city with more than 750,000 inhabitants must self-isolate for 14 days after returning. That limitation is irrelevant for Norway and Iceland, where there are no cities of that size, but it affects five cities in Germany, including Berlin and Munich. This is a travel advisory, not an absolute prohibition, says Erik Brøgger Rasmussen of the Ministry of Foreign Affairs. “There will be no control of where people have been by the police at the airport. . . . But we expect that Danes will listen to the advice and guidelines as they have done throughout the coronavirus crisis.”
Danish tourists are also advised to follow the local guidelines on precautions when they travel. For example, in Germany people must cover their mouths and noses with masks or scarves when they enter shops and use public transportation, but in Norway there is no requirement on wearing a mask. The rules and recommendations may also vary from locality to locality within the countries, for example the limit on gatherings.
Swedish annoyance
In Sweden, the reaction (DK) to the country’s exclusion from the border policy met disappointment, as expected. Niels Paarup Petersen, a Danish-born member of the Swedish parliament, called it “a little hypocritical” that Denmark cannot tolerate its neighbors from Skåne (the southern region of Sweden), which has not been hurt badly by the pandemic. “Many Danes are running around in Skåne, and it is apparently not dangerous. But if some people from Skåne come to Denmark, it is dangerous.”
By far the greatest number of infections in Sweden, which has not ordered a strict lockdown, have occurred in Stockholm. The infection rate is actually lower in Skåne than in Zealand, the island where Copenhagen is located, says Mikael Damberg, Swedish Minister for the Interior. The Swedish Foreign Minister, Ann Linde, says that the country had hoped for a joint Nordic solution and is continuing its dialogue with the other countries in the region.
At the same time, the Swedish Minister for Social Affairs, Lena Hallengren, acknowledged that the country is still in the midst of the crisis (DK). The number of deaths rose to 4,395, in contrast to 571 in Denmark. Anders Tegnell, the state epidemiologist who designed the laissez faire policy, admitted that it was a mistake not to test skiers who returned from Ischghl, the Austrian hotspot.
At a press conference yesterday, Prime Minister Mette Frederiksen announced the government’s policy on opening the border (DK). Like the earlier steps in the reopening of society and the economy, it takes a gradual, controlled approach and it also drew criticism.
Beginning on June 15, tourists from Germany, Norway and Iceland may enter Denmark, but they must be able to document that they have booked a stay for at least six nights outside of Copenhagen. They may make day trips to Copenhagen, which has had by far the most infections in Denmark, but must sleep elsewhere. Germany has had an infection rate similar to Denmark's, and the rate in the two other countries has been lower.
Tourists from other countries, including Sweden, are excluded. Officials in Sweden, which has not had a strict lockdown and has a much larger number of infections, have complained about lack of access to Denmark. Many Swedes work in Denmark, and many Danes have summer houses in southern Sweden. After the summer, the government expects to open the border to Schengen countries and the UK, said Frederiksen. She added that it may try to find a regional solution to the issue of Sweden.
No Mediterranean beaches for Danes
Tourists will be asked to be tested for the coronavirus when they cross the border, but it will not be compulsory. If they have visible symptoms, they will be refused entry. There will be test centers at popular vacation spots, and if tourists test positive, they may stay in the country subject to the Health Authority’s general guidelines on isolation.
For people traveling abroad from Denmark, the same restrictions apply. On June 15, they may travel to the same three countries, where they are urged to avoid large cities. The government advises against travel to other countries until August 31. That includes countries in southern Europe where many Danes spend their summer vacations. Frederiksen expressed regrets (DK) that people cannot travel to warm beaches and urged them to vacation in Denmark this year and help support hotels, restaurants and other local tourist sites that are suffering economically because of a lack of customers. If people travel to other countries, they may be subject to restrictions there or become stranded. In any case, they are urged to quarantine themselves for 14 days when they return.
SSI, the agency for preparedness against infectious diseases, believes that the border opening will lead to an increase in the number of infections (DK). It estimates that 400-1,500 asymptomatic persons with the coronavirus will enter the country. Independent healthcare researchers were divided (DK) about the plan. Some think it is sensible, and others believe that tourists from additional countries should be allowed entrance.
Strange, incomprehensible, shocking
Not surprisingly, the plan drew criticism from the opposition (DK), which has been agitating for an earlier border opening. Jacob Ellemann-Jensen of the Liberal Party calls the restrictions in the plan strange and arbitrary: “Why is it six days? And what is so dangerous about sleeping in Copenhagen? It is hard to see the rationale in the necessity of hurting hotels in Copenhagen and Frederiksberg. I hope there is a justification on the basis of healthcare considerations.”
Criticism also came from Frederiksen’s fellow Social Democrats. “Sad and incomprehensible,” said Jonas Bjørn Jensen, spokesperson for the party in Copenhagen. “It is Copenhagen that generates the most money for tourism, so if you want to benefit the industry, you should start there.”
Representatives of the tourism industry of course agreed. “I am shocked,” said Peter Haaber, head of the Zleep Hotels chain. “It is almost a compulsory lockdown.” The head of VisitDenmark, Jan Olsen, however, acknowledged the loss of income to hotels in Copenhagen but noted that only about 10 percent of tourists from the three countries in question stay in the city. Most stay along the coasts, and they have already begun to book rooms.
Only 24 of the people in Denmark who have died of COVID-19 did not have a chronic illness. That is the main finding of an evaluation by SSI (DK), the agency for preparedness against infectious diseases. It covered 9,519 cases and 524 deaths related to the coronavirus as of last week (since then, the number has risen to 568). It shows that there is very little risk of dying for infected people who are not elderly and do not have chronic illness. That is, the risk is not high even for patients who are 80 years and do not have a chronic illness or for those who are under 60 and have a chronic illness.
Of the 9,519 who tested positive, 22 percent were hospitalized and 6 percent died. The researchers caution that the estimate of the number of infections is closer to 100,000 than 10,000, so the fatality rate in the population is around 0.6 percent rather than 6 percent.
Average age at death perfectly normal
Three-quarters of those who died were over 75 years old, and 82 percent of them had more than one chronic illness. The average age of death is 82, which is the same as overall life expectancy in Denmark. The danger related to chronic illness is similar to that of ordinary influenza, says Reimer Thomsen, head doctor at Aarhus University Hospital who took part in the review, but the difference with COVID-19 is that it is very infectious. It can thus overwhelm hospitals, and more patients die because there are not enough beds in ICUs, as occurred in Italy.
Results from COVIDmeter
Six weeks ago, SSI launched a voluntary survey of persons who report symptoms (DK) once a week. Some 120,000 have participated by answering three simple questions on a website called COVIDmeter: Have you had symptoms in the past week? Have you been in contact with someone who is infected? Have you been tested? SSI has released the first set of results, and they show that the number of people with symptoms has fallen sharply over the period, from around 1.3 percent to around 0.25 percent. Since the survey is voluntary and not everyone has been aware of it, the results are approximate and subject to a margin of error.
The purpose of the survey was to serve as a supplement to the testing program and get an estimate of the number of infections among people who have not been tested. The people who reported symptoms were spread fairly evenly across age groups, and the trend in symptoms has generally followed the falling trend in hospitalizations of those tested.
Symptoms declined during Easter parties
The number with symptoms fell most sharply, to about 0.6 percent, during the first week of the survey, which ended on Easter Sunday. That is an interesting development, because officials had warned that people might have a tendency to relax their observance of social distancing guidelines in order to gather with their families on Easter weekend. See the charts showing a breakdown of the results (DK).
Soccer and amusement parks are back
In other news (DK), the Tivoli and Bakken amusement parks are opening today, albeit with limitations on the wildest roller coasters in order to prevent infections from screaming riders. Soccer play resumed in the Danish Superliga as the AGF club used the Zoom videoconferencing platform on a large screen at the Ceres Park stadium in Aarhus to create a "virtual grandstand." The match with Randers ended in a 1-1 tie.
Today is the beginning of the Easter holidays, when families gather from across the country for parties and people travel to their summer houses. Yesterday, the two main officials in the government’s crisis management team gave brief interviews in which they urged people to stick to the program.
Prime Minister Mette Frederiksen (DK) said that is the next phase will be just as difficult as the past month. It is important that the reopening takes place in stages so that the authorities can follow the development of infections and cautiously so that the country does not risk wasting the progress made in the lockdown.
Director General of the Danish Health Authority Søren Brostrøm (DK) was asked whether he could promise that the infections will not get out of control after schools and day-care centers reopen next week. He warned that they could if everyone does not continue to follow the government and Health Authority’s recommendations on social distancing, washing hands, etc. Reiterating the PM’s exhortation, he said that people must demonstrate over the Easter weekend that they can maintain their discipline because it is our collective responsibility to make the controlled reopening a success.
Not so fast
Meanwhile, there are several other developments as the country moves toward the next stage of the epidemic.
Most of the country’s 20 largest municipalities report that they are not ready to reopen (DK) their schools fully on April 15. The schools and day-care centers need to make new arrangements in order keep the children at distance from one another, to clean the facilities more frequently than usual, and so on. Fourteen of them say if they reopen on the target date they will need to do it gradually because they cannot manage the usual number of children.
A few days ago, there was a report on the percentage of blood donors who were found to have coronavirus antibodies, and it was used to make an estimate of the actual number of infections above the official figures. Since then there has been a boom in blood donations (DK) because people want to find out whether they have been infected and developed immunity. Officials explain that, while testing for antibodies gives a rough indication of the spread of the virus in the general population, it is not intended to determine whether individuals have antibodies and the individual tests are not reliable. The first results from testing on Monday were presented yesterday. They showed that 22 of 1,487 tested positive for antibodies. That would correspond to 127,000 infected persons in the country, as opposed to the 5,386 confirmed cases.
New monitoring tool
I wrote a few days ago that a group of IT people had launched a volunteer initiative to develop a self-reporting tool to monitor people’s symptoms (DK). Yesterday, the Ministry of Health unveiled its own solution for the same purpose, Covidmeter. As many people as possible are urged to report once a week on their health status, their contacts and whether they have been tested. The information will give the authorities a better idea of whether the level of infections is being kept at a manageable level. You can access the reporting app with a secure logon at sundhed.dk (DK), and the information is anonymized.
Hospitals may not be able to care for all of their patients because of extra cases of Covid-19. General practitioners have offered to take on patients and complete their treatment if they need to leave the hospital early. According to an agreement between the Danish Medical Association (PLO) of Zealand and the Zealand Region, they will charge double their normal fees (DK). This has been criticized for being greedy and unsympathetic by spokespersons of the parliamentary parties across the political spectrum. A PLO representative defended the agreement as fair because of the degree of responsibility entailed and added that GPs have seen their income decline about 40 percent during the crisis.
European solidarity
On April 1, Italy sent a request to Denmark for help in managing the Covid-19 outbreak. Yesterday, the administration announced that it would send Italy aid (DK) in the form of a number of respirators, an unstaffed field hospital and EUR 1 million to be used for protective equipment and ambulance operations.
(Note: During the coronavirus crisis, this blog has become daily digest of news from Denmark. Since the situation has stabilized, it will probably also take an Easter break for the next couple of days unless there is something urgent to report.)
