Coronavirus in Denmark: Preparing for reopening

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.)

Coronavirus in Denmark: First do no harm

Let’s look at a different aspect of the situation today. Denmark has done fairly well in managing the coronavirus epidemic. I don’t want to give the impression that everything is going perfectly smoothly, though. It has also made some mistakes in the choice and timing of its emergency measures. But part of its relative success may be attributable to avoiding certain mistakes, for things it has not done.

It could be instructive to consider some things that are not happening in Denmark:

• Bureaucratic delays in starting testing.

• Doctors prohibited from complaining about lack of protective equipment.

• Workers fired for complaining about lack of soap.

• Spring breakers holding coronavirus parties where 20 or 40 get infected.

• Churches holding services in defiance of stay-at-home orders.

• Crowding in subway systems.

• People crowding together to watch the arrival of a hospital ship to treat people who don’t observe social distancing.

• A governor who says that senior citizens can be sacrificed so that businesses can reopen.

• A ban on KN95 masks from China despite shortages.

• States banning abortions during the crisis.

• A boom in gun sales and the prepping and home bunker business.

• A popular news outlet claiming that the virus – no more harmful than the flu – is being used “to score cheap political points.”

• A head of state denying that the virus is a threat and claiming it will disappear “like a miracle”; falsely claiming that anyone who wants a test can get one and that a vaccine will be ready “relatively soon”; defending using an ethnic epithet for the virus despite warnings that it encourages hate crimes; etc. etc. etc. etc.

• Death threats being made against an expert who finally persuaded the head of state that the virus isn’t a hoax.

• And this incident, reported on April 2, not on April Fools Day: An engineer derailed a train and drove it toward US Navel Ship Mercy, a hospital ship that had docked in Los Angeles. He said he thought the ship had “an alternate purpose … related to a government takeover…. People don't know what's going on here. Now they will.”

The head of state’s predecessor got a lot of criticism for his pithy foreign policy slogan – “Don’t do stupid shit.” Maybe it’s not such a bad operating principle in a crisis. 

Coronavirus in Denmark: Day 21 of the shutdown

On Wednesday, Søren Brostrøm, Director General of the Danish Health Authority, held a press conference. He reported that 224 healthcare employees (DK) in the Greater Copenhagen and Zealand Regions have now been infected with the coronavirus. They represent 10 percent of all the infected. This is becoming a critical factor in several countries. First, doctors, nurses and others on the front lines should be able to go to work without risking their lives. Second, patients should be treated by healthcare personnel who aren’t a threat themselves. Third, if many of the staff become sick and cannot work, the system may not be able to care for all the sick patients. Fourth, the staff should be tested regularly and frequently. And finally, the need for employees to take cautious measures can put pressure on the supply of personal protective equipment available. Brostrøm expressed concern about all of these things. The vice chair of the Regions reported that the supplies of PPE were not in abundance but were sufficient.

Brostrøm also reported that it will be easier for people with mild symptoms to be tested. They can be referred to testing directly (DK) from the GPs instead of being evaluated first by a hospital. People who live with a person in a high-risk group, such as those over 80, and people who live in close proximity to others, such as those in a nursing home, can also be tested. The objective is now to test 5,000 per day, but it has not been possible to process that number yet because of a shortage of tests. Brostrøm acknowledged that Denmark previously had not been testing as extensively as the WHO recommended and said that they were working hard to increase capacity.

Coronavirus in Europe

Neighboring Sweden has followed looser policy (DK) than the other Scandinavian countries. It has not required or advised people to stay at home and isolate themselves. This has caused concern in Denmark because many Swedes commute to work in Denmark over the Øresund Bridge and the ferry from southern Sweden. The coronavirus seems to have arrived in the country slightly later than in Denmark, and the figures on infection and deaths had been roughly comparable, until this past week. Yesterday, it saw 59 deaths, while 14 occurred in Denmark; Sweden’s population is about twice as large as Denmark’s. Sweden has now implemented tighter restrictions and made recommendations on social distancing. According to Søren Riis Paludan, Professor of Virology and Immunology at Aarhus Universitet, however, one cannot simply conclude that Sweden’s strategy was wrong. It may result in a steeper infection curve, achieve herd immunity sooner, and return to normal activity sooner. But it may also put greater pressure on the healthcare system.

Southern European countries that are suffering the most from the pandemic have been asking the other EU member states for help. This has become a sore point in the EU again, with some of the northern countries in particular rejecting calls for the issuance of EU “Corona bonds,” for example. Several Danish political parties are now discussing ways in which Denmark could aid Italy (DK), the hardest hit, either by sharing equipment, by sending healthcare workers, or by taking patients. This will probably be sensitive issue throughout Europe for some time to come as each country needs to ensure that it has sufficient capacity to manage the epidemic within its borders.

Postponing amusement but keeping the news channels open

Parliament passed a bill to give 180 million kroner ($26 million) to the media industry as partial compensation for a drastic drop in advertising revenue (DK).

Tivoli, the world’s oldest amusement park, which is located in central Copenhagen, was supposed to open today. It has postponed the opening (DK) until May 1. Did it really wait until now to make that decision? Will we be ready to share a roller coaster seat with others by May Day?

Deaths per day in the period March 23-31: 6, 6, 6, 10, 12, 9, 8, 10, 12.

The pattern of confirmed infections is similar: the curve is indeed flattening, but it has not yet flattened out. In all their announcements, Søren Brostrøm, spokespersons for police and other officials remind people not to relax the social distancing practices that are showing that they work.