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Iceland is one of the most vaccinated countries in the world. But that didn’t stop the tiny island nation from catching many of COVID in recent weeks.
While the natural and immediate response to this news may be panic, experts who spoke to the Daily Beast said the recent increase in infections in Iceland – fueled by the new Delta variant of the novel coronavirus – is likely a sign that the collective immunity is at hand. the.
What is currently happening in Iceland could be one of the last steps in the long and often painful process by which a country obtains some form of herd immunity at the population level against a dangerous virus.
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Once COVID vaccines hit the market early this year, Iceland quickly got enough doses for almost everyone. And people dutifully lined up to get their shots. Today, the country has administered 477,000 doses and 275,000 people have received at least one vaccine, or 77% of the total population. Add in people with natural immunity to a past infection, and it’s likely that over 80% of Iceland has some level of protection.
The 20% of Icelanders who have not been vaccinated or who have not already had COVID are those now catching Delta, with the exception of a few groundbreaking cases of people vaccinated. (Children under 16, who are not yet eligible for vaccination, make up the bulk of the unvaccinated group.) A few thousand people have tested positive in recent weeks, with a spike in cases far exceeding the worst. weekly case rate from 2020.
But hospitalizations have not increased to the same degree as cases in this latest Icelandic wave. This is because older Icelanders, as a group, are highly vaccinated. Younger people, who as a group are less vaccinated, are now infected. They have a better chance of surviving COVID without severe symptoms. And the antibodies and T cells produced by their immune system could represent the last or almost the last brick in the Icelandic wall of immunity.
Now consider what happened in the United States as Iceland strove for minimal immunity at the population level.
Tragically, the United States is probably several, several months away from obtaining the same collective immunity. And as it does, the latest wave of infections could be much deadlier. This is because Iceland has done almost everything to achieve collective immunity with as little pain as possible. The United States, on the other hand, has done almost everything wrong.
The Icelandic health service did not respond to requests for comment. Likewise, epidemiologists from Iceland’s largest universities either did not respond or declined to comment. But US experts were eager to weigh in on what they described as an effective response to the pandemic. “It’s a success story for Iceland,” Eric Bortz, virologist and public health expert at the University of Alaska at Anchorage, told The Daily Beast.
To be clear, no one knows for sure what proportion of a population needs to get vaccinated, or become infected and recover, before SARS-CoV-2 runs out of transmission routes. In other words, no one knows exactly where collective immunity really begins. Epidemiologists once speculated that with the new coronavirus, it could take two-thirds of the population. New, more aggressive lines that started appearing at the end of last year have convinced some experts to exceed their expectations. Perhaps population-level immunity would require vaccination or natural immunity in three-quarters of people, they argued. Delta’s rapid spread from this summer has forced some epidemiologists to revise their threshold estimates even further.
“There’s no question that the Delta variant changed the goalposts,” Lawrence Gostin, a global health expert at Georgetown University, told The Daily Beast.
Whatever the threshold, 80%, 90%, whatever, Iceland is much closer to crossing it than the United States. Indeed, Iceland could cross that threshold at this time. Bortz said Iceland, along with the UK, is one of the few countries where “minimal herd immunity against severe infection may be achievable” in the short term.
Getting there required discipline, sacrifice and mutual care on a national scale. When the pandemic first struck in the spring of 2020, the Icelandic government responded quickly. “By letting the virus spread freely in society, no one has said that,” said Þórólfur Guðnason, the country’s chief epidemiologist. “We need to have restrictions both at the border and at the national level. “
Authorities have restricted travel in the rocky and volcanic country and have been busy tracing contacts and quarantining exposed residents while enforcing strong social distancing measures. Wearing the mask was widespread and not controversial.
There have been waves of infection, but they have never been very serious. The first wave, in the spring of 2020, resulted in a few thousand confirmed cases. A second wave in the fall added a few thousand more. At the start of its third and final wave from mid-July, the country had recorded around 7,000 cases (2% of the population) and only 30 deaths (0.008%).
Meanwhile, as Iceland stranded, Americans took to the streets to protest even the most modest social distancing measures. Where Icelanders dutifully wore masks, the right-wing media in the United States convinced millions of followers that masks were symbols of oppression.
As this summer’s delta wave approached, the United States had recorded 34 million confirmed infections (10% of the population) and about 600,000 deaths (0.18%). Cases and deaths were an order of magnitude worse in the United States than in Iceland.
While Iceland regularly vaccinated three-quarters of its population, the US vaccination campaign started strong, then hit a wall of stubbornness from the right. The same disinformation hawkers who blasted the masks have also duped millions of Americans – southerners, westerners and conservatives, for the most part – into believing the vaccines were part of a liberal conspiracy.
Today, only 59% of the American population has received at least one jab. The United States sits on tens of millions of unused doses of world-class vaccines while the poorest and least privileged countries virtually demand access to vaccines.
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Now it is true that tens of millions of Americans have caught COVID and have recovered. Their antibodies and T cells count for herd immunity. But even taking into account generalized natural immunity, about 100 million Americans – a third of the population – have no immunity. No vaccine. No antibodies or T cells. Nothing.
Icelanders are so strongly vaxxed – and so open to the country’s ongoing vaccination campaign – that a few thousand cases, mostly mild, could push the population towards herd immunity at any time.
With as many as one in four American adults say they will never get vaccinated, millions more infections could be needed for the United States to cross that same threshold. Anyone can guess how long it will take for Delta or a future bloodline to spread so widely, and how much damage it will cause when it gets there.
It is possible, if not likely, that most of these infections are mild. But even a low rate of critical illness could kill thousands of Americans and leave thousands more with long-term complications, known as “long-term COVID.”
“We need to be careful about our expectations for herd immunity,” Jeffrey Klausner, former professor of medicine and public health at UCLA, told The Daily Beast.
And during the time it takes for the United States to accumulate the additional infections it needs to achieve collective immunity, the new coronavirus could produce variants – “lineages” is the scientific term – that are even more transmissible. and virulent than Delta. It is even possible that a future line could partially escape the vaccines, thus endangering the vaccinated individuals alongside the unvaccinated.
“By allowing the virus to test a myriad of new variants in unvaccinated individuals, we can naturally select the worst strains putting us all at risk, in the United States and abroad,” Elias Sayour, professor of neurosurgery and pediatrics at the University of Florida. and director of the school’s Pediatric Cancer Immunotherapy Initiative, told The Daily Beast.
“We are in trouble,” Bortz said. “The vaccination rate in the United States is far from what is necessary for broad immunity in the population, to limit the spread and consequences of [variant-of-concern] Delta and other COVID-19 variants. “
As Americans brace themselves for another infectious fall, many might glance at Iceland with envy. It was not a given that the United States, despite all the material advantages, would fail so badly to establish widespread immunity against the novel coronavirus.
It was possible to do better. Iceland proves it.
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