There have been several local outbreaks of the coronavirus in the past couple of weeks since restrictions have been relaxed. More than 40 people at the Vendelbocentret nursing home in northern Jutland were infected. Entire school classes and their teachers have been quarantined, and half of the people who attended a large party at a restaurant in northern Zealand have tested positive. Is this the start of the second wave?
Most researchers and officials say no (DK). The number of new cases per day has been in the double digits for six weeks, usually below 50. That’s far below the peak of 473 on April 3. “As long as the virus isn’t eradicated, we must get used to these small outbreaks,” says Jan Pravsgaard Christensen, Professor of Immunology at University of Copenhagen. “Apart from the concentrated outbreaks, there are only minor instances.”
Mantra: Test, trace and isolate
“The problem with such infections is that if you don’t do anything, they have exponential growth,” says Claus Thorn Ekstrøm, Professor of Biostatistics at University of Copenhagen. The key is to trace contacts and break the chain of infection. Danes have behaved well, but we must not let ourselves be lulled to sleep before the “last, difficult mile,” says Thea Kølsen Fischer, head of research at North Zealand Hospital, who notes that a second wave arose in South Korea at a nightclub one weekend in May.
Known unknowns and unknown unknowns
The researchers warn that the summer season brings unknown factors that can increase infections: the heat, more socializing and drinking, tourists from abroad. “A superspreader may be someone who sheds a large volume of the virus or someone who speaks with many people,” continues Christensen. “No one knows for certain yet.”
Pandemic rumors
The researchers’ optimism may not give much comfort to some of the employees of Vendelbocentret, who have been subject to behavior "bordering on harassment" (DK). One was told to leave a supermarket, and the husband of another was sent home from work. “We are both angry and disappointed that our employees are getting such bad treatment,” says Arne Boelt, Mayor of Hjørring Municipality, who notes that the staff are working under difficult conditions and taking many precautions.
When people are insecure, they begin to seek information, says Michael Bang Petersen, Professor of Infection Psychology at Aarhus University, “and we know that they also have a tendency to get carried away with rumors.” The best protection against corona gossip, Bang Petersen advises, is for the authorities to give out as much information as possible.
Local suppression strategy
Since the outbreak, the municipality, which has also identified outbreaks at schools and mink farms, has taken intensive measures to contain the virus (DK). Nursing home employees work in heavy protective outfits. Some 20 medical students have been trained to conduct tests and have been sent to visit 3,000 elderly people who live at home. The municipality wants to test as many as possible twice, so the project will take two or three weeks to complete.
As I’ve reported before, even though the COVID-19 epidemic is under control in Denmark and the number of new infections and deaths continue to decline, the danger of the infection spreading is not gone. There have been at least three episodes recently that concern the health authorities and the crisis task force.
Nursing home in remote region
Until last week, northern Jutland was one of the safest places in the country if you wanted to stay out of the way of the coronavirus. But now, in the town of Hjørring, at least 29 residents at a nursing home (DK) and a total of 50 in the municipality have been identified as infected. Two schools and one company have also identified infections. The municipality is working to limit the outbreak.
All health care staff and nursing home residents in the municipality will be tested, and staff at the nursing home where the outbreak occurred will be tested every week. Visits to the nursing home have been stopped temporarily. The classes with infected pupils have been dismissed for the last few weeks of the school year, and the employees at the company, Novo Nordisk, have been sent home. The municipality has been praised by researchers for its strategy to contain the outbreak. “Hjørring will be a litmus test” for responding to new outbreaks, says Søren Ris Paludan, Professor of Virology at Aarhus University. “The big task ahead of us is to minimize the infection while keeping society open.”
BLM demonstration, as predicted
According to he Danish Patient Safety Authority, which is in charge of contact tracing, at least one person at the Black Lives Matter demonstration (DK) on June 7 has been identified as infected with the coronavirus. Minister of Health Magnus Heunicke has asked everyone who attended, some 15,000 people, to get tested, even if they do not have symptoms. Many people stood very close together, few of them wearing face masks, and it is a classic situation that is vulnerable to superspreaders. The attendees had already been encouraged to be tested, and some have done so. Now all of them are urged to be tested again because the infection sometimes does not manifest itself for several days. There were also smaller demonstrations in other cities in Denmark during the same week.
Import from South Asian hotspot
The Patient Safety Authority reported that six passengers on a flight from Pakistan (DK) to Copenhagen on June 6 were infected. At least four of them were infectious during the flight, and the Authority is in the process of tracing their contacts and all the passengers who sat close to them. Travelers from countries other than Germany, Norway and Iceland are urged to undergo quarantine for 14 days after their arrival.
“It may be several days from the time a person is infected to the time he or she tests positive, and the person can infect others in that period,” says Anette Lykke Petri of the Authority. The week before, 20 persons of Pakistani ancestry in a single municipality were found to be infected, and since then nine others have been identified. The Authority cannot comment on the possible relation between the passengers and the earlier cases.
We will have to live with these “micro-outbreaks” (DK) for some time, says Paludan, and if we can react quickly and contain them, we won’t need to roll back the reopening. We must still observe social distancing guidelines, he adds, and be especially careful if the infection comes into our proximity.
The traditional May Day gatherings were canceled and the speeches by left-wing leaders were sent remotely. Prime Minister Mette Frederiksen of the Social Democrats held her speech at the Workers Museum in Copehagen and used the occasion to announce the government’s first large employment project (DK). It will spend around DKK 4.5 billion ($650 million) to renovate subsidized housing units. The project will be “fair, economically sensible, and green,” said Frederiksen. It will improve living conditions for renters, provide jobs for people who have lost them during the crisis, and bring the buildings up to environmentally sound standards, for example by replacing old oil furnaces. The initiative is to be seen as signalling a shift in focus from healthcare issues to economic issues as well as a shift to more sustainable infrastructure projects. It will begin before the end of the year.
Frederiksen summed up the measures taken during the crisis to support employees and businesses. Some 150,000 people have received wage compensation and avoided being laid off, and 25,000 businesses have received aid. In the question and answer period after the speech, Frederiksen said that she was concerned about the increase in the reproduction number (R0) to 0.9 since the first phase of the reopening but that she expected the second phase to begin as planned (DK) on May 10. Negotiations with the other parties on the next steps of the exit from lockdown restrictions continue.
Antifa silenced, nursing home residents to get visits
Frederiksen also noted with a smile that the room was very quiet. That was a reference to the traditional May Day gathering last year in Copenhagen’s largest park, when she had been drowned out by protesters from the Autonomist Movement, the local version of Antifa. Before the corona virus outbreak, she had declined to appear at the gathering this year.
Parliament has also reached a broad agreement on an aid package to help nursing home residents (DK) and other elderly people return to more normal conditions. The plan, which will cost DKK 165 million ($24 million), was approved by all the parliamentary parties except for the Liberal Party, which believed it did not go far enough. It is intended to reestablish the standard service level for cleaning and cultural activities and to redress loneliness and anxiety among the elderly who have been isolated, including those with dementia, by promoting volunteer activities, for example. A key element of the plan is setting up outdoor facilities where the elderly can receive visits from their families while minimizing the risk of infection.
Infection-risk rankings from libraries to discos
A new factor in the negotiations that came to light yesterday is a confidential memorandum sent to MPs by SSI, the agency responsible for preparedness against infectious diseases. It contained an extensive list of institutions and organizations according to their risk levels (DK) for Parliament to use in determining the next steps in the reopening of the economy on May 10. In the low-risk category are outdoor eating facilities, libraries, museums and outdoor zoos. In the medium-risk category are higher educational institutions, theaters, restaurants, churches, shopping centers, workplaces where social distancing is possible, and outdoor sports facilities. High-risk locations include middle schools and high schools, bars and concert halls. In the very-high-risk category are boarding schools, fitness centers, nightclubs, and (indoor) visits to nursing homes and hospitals.
The SSI noted that the ranking was “uncertain and simplistic” and that the organizations selected for reopening should depend on the degree of spread of the virus on May 10 and on the other organizations that are allowed to open at the same time. The decision will be made by the government in consultation with the other political parties, not the SSI or the Health Ministry.
