While Europe battles the deadly pandemic, not one person has yet died from corona in Greenland, the world's largest island, and not one is in intensive care — at least not at the time of writing.

The pandemic may yet strike hard — dangerously hard — in Greenland with its scattered population of some 57,000 and a limited health care system.

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But so far only 11 people have been found to be bearers of the virus and all of them in Nuuk, the capital. All of these have been quarantined or let go again because they have come through and are now virus-free.

Meanwhile, Greenland's capital city is closed off. No ordinary people are allowed to enter or leave Nuuk without special permission, not even in private boats or by snowmobile.

And any sale of alcohol is temporarily banned.

A grim history of deadly epidemics brought to Greenland in the 18th and 19th century by European colonisers has fuelled fears that the coronavirus, if not checked, will fast reach the many small outlying villages, thereby creating urgent and impossible demands for emergency air transport and intensive care in Greenland's small hospitals.

It would take relatively few seriously-ill patients to outrun the capacity of the nation's health services.

As the death toll in Europe mushrooms, Greenland outside of Nuuk is still completely corona-free, but crucial questions now beg for answers: How long can you keep an entire nation sealed of from the rest of the world? How long will people cope with isolation? How long should the government let the economy bleed — and how quickly will the virus spread when the the lock-down is loosened?

No entry

Travelling to Greenland is now close to impossible.

No flights, ship or other means of travel to Greenland is available unless one travels with special permission, and no ordinary people are allowed to leave the island.

The few planes and helicopters that still fly between Greenland's 72 towns and villages, none of which are connected by railways or roads, carry only mail and the odd healthcare official.

The question is now — what's next?

From Saattut, a fishing village of some 250 people in the far northwestern part of Greenland, Apollo Mathiassen, a fisherman, explains over the phone that the village is almost without physical contact with the rest of the world, including the nearest larger town of Uummannaq, population approximately 1,500 - and which is normally only 45 minutes by snowmobile or dog sled away.

"The snow mobile tracks to Uummannaq are normally wide and very much used. Now they have almost disappeared," he tells me.

He has no idea how long the lock-down will remain in force.

"On Friday it will be two weeks that we have been careful and still nobody here shows any signs of illness. If nobody is infected, I think it will be sensible to allow a more relaxed way of being together here in Saattut, but I don't know what the plan is. Perhaps they will relax the rules after Easter," he prophecies.

Lockdown for a year?

Further south in the town of Sisimiut on Greenland's west coast, population 6,000, Ove Rosing Olsen, a former medical doctor, expects the lockdown to last much longer, perhaps a whole year.

In 1992, Ove Rosing Olsen became Greenland's first minister of health as the home rule government in Greenland took over responsibility for the health system from Denmark, the former colonial power, which still holds sovereignty over Greenland.

Later, he served as head of the health services in the central part of Greenland.

"Our capacity to deal with respiratory insufficiency is limited. If the system is overrun by too many patients with severe symptoms, many who could have been saved with the right treatment, will die. Instead of allowing the virus to spread, it is all about keeping it at bay until a vaccine is available. I believe we will have to have very little contact with others for a longer time, perhaps for another twelve months," he says.

He worries that many Greenlanders could eventually be exposed to dangerously heavy doses of coronavirus, causing severe illness, because many large families live in small apartments or in small houses.

In 1801, a smallpox epidemic killed some 80 percent of Sisimiut's citizens; measles took a heavy toll as late as 1954.

"Most lately, we dealt with the swine-influenza in 2009 that had almost the whole of Sisimiut lying down. One child died. That was a serious epidemic, and now corona is, from what I understand, much worse. I think we will still be partly isolated for at least six months and perhaps a whole year," he says.

Telemedicine

The authorities in Nuuk have not yet disclosed any details on how or when they will reopen schools or lift the bans on travel.

"I am sure they are working on that right now, just like governments all over the world.

"Our strategy, as in other countries, is to make sure the health care system is not overwhelmed. The difference is that we have more options for isolating the country. The problem is that if we don't get a vaccine or a really good way to treat patients who get seriously ill, we don't know what will happen when we open the country again," says Gert Mulvad, a medical doctor at the health care centre of Queen Ingrid's Hospital, Greenland's only larger medical facility.

Anders Koch, who is a medical epidemiologist in Copenhagen, as well as a university professor in Greenland and past president of the International Union for Circumpolar Health also looks to the near future with some concern.

"The reason why we are particularly concerned with Arctic communities is not that we necessarily consider their populations more susceptible to more severe courses of the diseases," he said.

"The main problem is that the health systems are not geared for such a challenge. They are vulnerable, have a limited amount of staff, hospital beds and ventilators that are not spread out across the region. If you need ventilator treatment in Greenland, you have to be transferred to the capital Nuuk – and three quarters of the population live outside of Nuuk.

"So, the health system is not adaptive in the same ways as the Danish system," he said in an interview with the Arctic Council's website.

Should the number of patients demanding intensive care eventually outgrow Greenland's own capacity, patients may be flown the 3,500km to hospitals in Denmark, as Greenlanders are still Danish citizens.

From Nuuk, Gert Mulvad explains how Queen Ingrid's Hospital is urgently establishing the technical facilities needed for corona-testing.

Until that is in place all tests have to be send to Denmark for analysis.

Also, he and other professionals are rapidly gaining new knowledge on how to deliver long-distance telemedicine. Looking forward, he is still optimistic: "If we handle this correctly, we will have handled yet another epidemic, and it will not be the end of the world.

"Meanwhile, we will have learned a lot that will benefit us in the long run," he says.