Coronavirus DK: More infections, restrictions and testing

 Like many other European countries, Denmark has seen Covid-19 infections rise (DK) and has resumed restrictions on social and business activity. In the past week, new daily infections have risen above 500, which is higher than the peak of the first wave. They have subsided somewhat in the past week. As before, the number of hospitalizations and deaths remain low. In the past two weeks, daily hospitalizations have risen to double digits and there have been 13 deaths. The reproduction number has fallen slightly to 1.3.

Restaurant sign showing reduced capacity and hours. Photo: Lisbeth Janniche.

Partial lockdown
The restrictions (DK) that were implemented in Greater Copenhagen now apply to the entire country until October 4:

• Restaurants, bars and cafes must close by 10 pm.
• Gatherings are limited to 50 people. Attendance at sporting and cultural events are limited to 500 people.
• Masks must be worn by people over the age of 12 on public transportation, including taxis; by employees and visitors at hospitals, nursing homes and doctors’ offices; and by employees and customers at restaurants and cafes when they are not sitting at tables (not yet at stores and businesses, although health authorities say they will be covered too if the infection rate rises further).
• Alcohol is banned on buses (including so-called “party buses).
• Strict rules apply to visits to hospitals and nursing homes.

Additional recommendations.

• Avoid public transportation at rush hour; ride a bicycle or walk instead.
• Both public and private employees who are able to work at home are urged to do so.
• People are advised to limit their social contacts as much as possible.
• While daycare centers, schools and universities remain open, social arrangements at them are discouraged.

Low mortality rate
Some good news: the mortality rate for patients at Danish hospitals (DK) is relatively low. During the first wave, that is, in the period ending May 19, some 63 percent of ICU patients recovered. In many other countries, including the US, the UK and Italy, the rate was around 50 percent. The average age of the patients was 68. Around 30 percent had no preexisting illness. 

The breakdown by sex in total mortality rate of 37 percent was 42 percent men and 29 percent women. The breakdown by age in the total mortality rate was 5 percent for the 50-64 age group and 64 percent for patients over 80. 

More testing and longer waiting
The administration has promised that testing would be increased significantly for months, and lately the number of test centers and the number of tests administered have increased. Around six weeks ago, the number of daily tests reached 30,000 per day, and in the past week, it has exceeded 40,000 and 50,000. The goal was that 80 percent of requests for tests should be granted within 24 hours and the subjects should receive the results within 24 hours. 

Nevertheless, there are long waiting periods at many test centers (DK). On September 23, it was possible to be tested within 24 hours at only three of the 48 test centers across the country. In a few places, the delays were up to seven days, and sometimes when people appear for test they must wait in line up to six hours before they are tested. The Opposition parties are criticizing the administration for not fulfilling the agreement that was made as a condition for phase 4 of the reopening plan, and Prime Minister Mette Frederiksen reiterated the government’s commitment to the 24-hour framework.

Self-testing for antibodies
The government also has an ambitious plan to test 2 million people for antibodies (DK) during the autumn and in the beginning of the new year. That would be 35 percent of the population. Test kits will be sent to people’s homes, and they will administer the tests themselves by pricking a finger and letting a drop of blood on a testing strip. The result will appear in 15 minutes. 

Coronavirus DK: Infections up and restrictions back

Denmark has seen a steady rise in infections (DK) in the past month, although the number of hospitalizations and deaths remain low. For three months, from the beginning of May to the beginning of August, the number of daily infections was below 100. Since the beginning of September, it has been above 200, rising to 300 this past week. Hospitalizations number 47, 4 in ICUs, and deaths total 631. The reproduction number has fluctuated between 1.0 and 1.5 since mid-July, and it is back at 1.5. Testing has also increased significantly.

The number of deaths per million is now 109. In comparison, the figure is 588 in Italy, 589 in the US, and 616 in the UK. The other Nordic countries: 49 in Norway, 582 in Sweden, and 61 in Finland. 

New restrictions but no return to a general lockdown
Tighter restrictions (DK) went into effect last week. In 18 municipalities, almost all of them in Greater Copenhagen, the limit on gatherings was reduced from 100 to 50 and bars had to close by midnight instead of 2 a.m. The limit on spectators at major sports events was reduced to 500. Face masks have been required on public transportation for two weeks now. 

The number of infections per 100,000 inhabitants has risen above 20 in 39 municipalities, and the mayors of several of them are asking that similar restrictions be implemented there. Many of them have placed limits on visits to nursing homes. But virologist Allan Randrup Thomsen (DK) does not think it is necessary in every case. The absolute number of infections is what matters most, and in some municipalities with a small number of inhabitants, the infections have come from individual incidents.

For example, if an infection is discovered in a school, it may be sufficient to close the school or class temporarily without setting restrictions on the entire community. Future restrictions will probably be implemented locally. One of the next likely measures is requiring face masks in supermarkets and shopping centers. 

Copenhagen Sunday evening. Photo: Ólafur Steinar Rye Gestsson / Ritzau Scanpix.

Young people can’t stop partying
One of the main reasons for the rise in infections, besides the loosening of earlier restrictions, is that young people are holding parties and frequenting bars and parks without observing social distancing measures. Persons from 20 to 30 account for large portion of new infections. At a press conference on Saturday (DK), Police Chief Thorkild Fogde issued a warning that if young people do not become more careful, the police will need to reinvoke tighter restrictions.

It has already made two parks in the Nørrebro district of Copenhagen off-limits, and a violation of the ban is subject to a fine of DKK 2,500 (about $400). Patrols have broken up so-called “pirate parties” at several locations on the weekends. The further restrictions could be requiring masks at bars, closing bars earlier in the evening, and banning gatherings in other areas. Several universities have suspended social activities involving more than 50 attendees. 

Economy is relatively sound
Prime Minister Mette Frederiksen (DK) issued a statement on September 11, exactly six months after the government announced lockdown restrictions. She emphasized that the Danish economy has recovered much faster than it did after the financial crisis. The number of unemployed has fallen from a peak of 45,000 to 25,000. Housing prices have risen since March, particularly for vacation homes. Consumer spending has recovered. Certain industries, such as hospitality and travel, have suffered long-lasting damage, but others, such as the DIY segment, have thrived during the epidemic.

As in the rest of the world, the stock market has rebounded from the initial selloff. Exports have not recovered yet because they are dependent on the economies of other countries. The recovery has been owing to the government’s relief package, and it is difficult to predict its long-term effects. Economist Michael Svarer expects the recovery to continue. He does not expect a deep second drop, as a in W-shaped pattern, but rather something resembling Nike’s swoosh logo.

Coronavirus DK: Resurgence in infections

In recent weeks, Denmark has seen a rise in coronavirus infections (DK), and the trend is accelerating. On Wednesday, 112 new cases were registered. That is the largest number since May 7. The increase has come particularly in two areas. Some 42 of the new cases occurred in Aarhus, Denmark’s second-largest city, and most of them arose among the city’s Somalian population. Several bus drivers were also found to be infected (DK), and hundreds of passengers may have been exposed to them. A large crowd gathered to celebrate the local soccer team’s bronze medal, but thus far no significant number of infections has been traced to it.

Aarhus soccer fans celebrating. Photo: Mikkel Berg Pedersen, Ritzau Scanpix.

The other hotspot is the Danish Crown slaughterhouse in Ringsted, a smaller city on the island of Sjælland. In the past week, the municipality has had an infection rate of 178 per 100,000 inhabitants, in comparison with 10 in Copenhagen and 40 in Aarhus. 

No jump in fatalities
The number of infections had averaged below 30 for most of July. Since July 27, it has been generally above 60. Despite the rise in cases, the number of hospitalizations and deaths has hardly increased. Yesterday, there were 23 patients hospitalized, 2 in ICUs, and a total of 616 had died. There may be a lag between the increase in infections and a rise in hospitalizations and deaths. Officials have warned previously that there is a risk of a second wave in September, after people have returned from summer vacation.

Phase 4 reopening questioned
The new wave comes at a time when the country has planned to increase the limit on gatherings (DK) from 100 to 200. The transition to phase 4 of the reopening is scheduled to take place on Saturday, but some health officials are warning that it should be postponed. Minister of Health Magnus Heunicke and Kåre Mølbak of SSI, the agency for preparedness against infectious diseases, are against opening concert halls and night clubs now.

Kirsten Normann Andersen, health spokesperson of the Socialist People’s Party, believes it is very risky to allow large gatherings that can result in superspreader events. Many Members of Parliament are on vacation now, and some representatives of the Opposition say that the prime minister and the administration should be taking action. The next meeting on the reopening is not scheduled to take place until August 12, after the increase in the ceiling will have taken effect.

Return to restrictions possible
There are also discussions about returning to lockdown conditions (DK) in several areas that have opened up. The most likely venues to be closed are sports stadiums and fitness centers. The likelihood of postponing the opening of schools and universities and of closing day-care centers is lower, as is the closing of restaurants, shopping centers and foreign borders. 

The outbreak in Aarhus
The municipality of Aarhus has already closed nursing homes for visits (DK), and the mayor and the police have warned that they will implement further restrictions if necessary. Pia Kjærsgaard (DK), the founder of the Danish People’s Party, called for restrictions to be placed on the city’s districts with large Somali populations: “We must close the ghettoes, where the great majority of them live, for a period.” She speculated that the Somalis did not follow the news or understand the precautions that everyone is supposed to observe: “It doesn’t help if you sit and watch foreign TV when you should be informed of what is happening in the country where you live.”

Abdirahman M. Iidle (DK), the spokesperson for AarhuSomali, an association of Somali organizations in the city, did not know why the outbreak has occurred in that community. “We have not held any large arrangements, parties or religious holidays,” he said. The only large gathering was a funeral last week for a man who was shot, and that was attended by many people of other ethnic backgrounds as well. Like members of other minority groups, many Somalis hold jobs with high exposure to possible infection, such as healthcare assistant, cleaning staff and bus driver. 

Aarhus Mayor Jacob Bundsgaard says that the muncipality will focus preventive efforts on the neighborhoods with large Somali populations.

Coronavirus DK: Second wave or paranoid gossip?

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.

Coronavirus DK: Halftime for a divided Parliament

On Monday, Parliament held its last session (DK) before the summer break, and as usual, all the parties took the podium to sum up their concerns. Prime Minister Mette Frederiksen began, saying, “With our shared strength, we have won the first half of the battle against corona. . . . We can be grateful. We can be proud. Denmark has done well. But we are not finished.” She urged the unemployed to take advantage of the educational and supplementary training opportunities in the stimulus package. 

Jakob Ellemann-Jensen, chairperson of the Liberal Party, attacked the administration (DK) for its management of the coronavirus crisis. It has usurped some of the powers that should rest with Parliament, he said. “Denmark is in the middle of an economic crisis. We don’t know how deep it will be, but the government has made it worse” with its hesitant and fumbling reopening policies.

The usual bickering

Ellemann-Jensen criticized the latest stimulus package and particularly the DKK 1,000 payment to people who are not working and do not qualify to draw on vacation savings. Pia Olsen Dyhr from the Socialist People’s Party, which supports the administration, called the latter criticism “grotesque” because the Liberal Party had not opposed the package and the one-off payment when they were deliberated.

Aside from that exchange, very little of the closing debate concerned the pandemic. It covered the many topics that have gotten less attention than usual during the crisis: taxes, the climate agreement, immigration policy, the EU and racism. The latter topic, occasioned by the local BLM demonstrations, led to the most heated disagreements, with the right-wing parties denying that racism was a serious problem in Denmark.

The dreaded second wave

Some doctors are warning that, even though the epidemic is under control in Denmark, a second wave is likely (DK). “We shouldn’t believe that the virus is gone and will never return,” says Lars Østergaard, a specialist in infectious diseases at Aarhus University Hospital. Along with two other researchers, Østergaard wrote in an opinion piece that “a second wave seems unavoidable.”

Opinions have been divided about the likelihood of a relapse. In a press conference in May, Kåre Mølbak, the head of SSI, the agency responsible for preparedness against infectious diseases, said that a second wave was very unlikely. The organization itself had actually taken the opposite position in a report before the press conference. 

The three researchers note that the low infection rate in the country leaves a vast majority of the population – 98 percent – still vulnerable to the virus. “With so few people infected, it is in any case likely that there will be a second wave if we don’t prepare ourselves that it could come.”

Elusive network effects

More than 300,000 people have downloaded the Smittestop app (DK), which is intended to track and control the spread of the virus. The app, which is based on technology from Google and Apple, had been delayed because of concerns about privacy. It is unknown what percentage of the population needs to use the app for it to be effective in containing the virus. 

A study from Oxford concluded that 60 percent is necessary. It will be difficult to attain that degree of usage in Denmark because many people appear to think that the epidemic has passed and are returning to their pre-coronavirus behavior. Despite minor recent outbreaks, there are now only 37 people hospitalized and seven ICU patients in the country.