Iceland has done a first-class job of rolling out a large-scale COVID-19 testing strategy across its population. Although it's is only a small nation, their approach is already providing some fascinating insights into the COVID-19 and the current pandemic.
Iceland health authorities, together with private biopharmaceutical company deCode Genetics, have so far administered 12,615 tests across the country, accounting for almost 3.5 percent of the total population. For context, the US has tested around 540,252 people, around 0.16 of the population.
Unlike most other countries, Iceland has been offering free screening among the general population even if they don’t have any symptoms. This testing has identified up to 802 confirmed COVID-19 infections, at least 253 of which were obtained by a foreign traveler.
You can see all of the testing results on the health ministry’s COVID-19 live data page.
What can we learn from this data? Well, first thing’s first: these are preliminary results, for the time being, so we can't take them as gospel. Equally, every country has a unique infrastructure, culture, and social structure, so each country’s outbreak may not necessarily “behave” like Iceland’s.
The most interesting revelation is that Iceland’s data suggests around half of people who tested positive for COVID-19 in the country did not display any symptoms.
“Early results from deCode Genetics indicate that a low proportion of the general population has contracted the virus and that about half of those who tested positive are non-symptomatic. The other half displays very moderate cold-like symptoms,” Thorolfur Guðnason, Iceland’s chief epidemiologist, told Buzzfeed News.
The work has also allowed researchers to understand how the novel coronavirus SARS-CoV-2 has mutated within the country. In one unique situation, it even appears that one Icelandic person was infected with two different variants of SARS-CoV-2 with subtly different genetic material.
“We have found 40 island-specific virus mutations. We found someone who had a mixture of viruses," explains Kári Stefánsson, director of deCode Genetics speaking to Danish newspaper Information. "They had viruses from before and after the mutation, and the only infections traceable to that person are the mutated virus.”
While this number of mutations is slightly higher than other estimates, it’s nothing to worry about. According to Nathan Grubaugh, an epidemiologist at the Yale School of Public Health, mutations are a natural part of the virus lifecycle and “we shouldn’t worry when a virus mutates during disease outbreaks.” By and large, preliminary data suggests SARS-CoV-2 has a relatively stable genome.
Iceland's small population means it's in a unique situation to carry out this kind of testing strategy, but every country would be doing this in an ideal world. The World Health Organization (WHO) has maintained that all countries need to start widespread testing for COVID-19, even among people who don't have symptoms. If we don't have the data, they say, the pandemic cannot be fought effectively.
“You cannot fight a fire blindfolded and we cannot stop this pandemic if we don't know who is infected. We have a simple message for all countries; test, test, test," Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said on March 16.