Iceland is Doing Science — ~50% of People with COVID-19 Not Showing Symptoms, ~50% Have Very Moderate Cold Symptoms [UPDATED]

March 21st, 2020 by Zachary Shahan

Update: The Government of Iceland has updated data here. I plan to write a followup article on Iceland once the findings are updated again.

Update March 28: The study added to the bottom of this article out of China (not the results from Iceland) has apparently been retracted due to errors in methodology/findings.

Science: do it.

Iceland has decided to jump right into proper scientific methodology in response to the COVID-19 pandemic, rather than “panic now and evaluate later.” The country, which has followed similar social distancing strategies as other European nations, has been conducting a random sample (i.e., scientifically useful) test of its population — with results from 1.5% of its population so far. This means it is testing a true representative portion of its population.

Disclaimer: we don’t know the full results yet. Time is also important in a test like this, and we will have to wait for the broadest and most firm conclusions. Nonetheless, there are some positive findings so far, so read on.

If you haven’t noticed, almost every time a medical professional talks about this coronavirus, they note that we don’t know enough — don’t have enough data — to make firm conclusions on a variety of different matters. The data we do have is quite problematic because it mostly comes from testing sick people, rather than a representative portion of the population. Just for extra emphasis for anyone who has never taken a stats course (which is most of the population): if you aren’t testing a representative portion of the population, your results are pretty close to rubbish on certain topics — like how much of a risk this virus poses to humanity.

Relatively speaking (per thousand people or per million people), the number per million tested in Iceland is almost 4× the number per million tested in South Korea. (South Korea was testing 10,000 people a day before the US had even tested 5,000 — despite both countries having their first case confirmed on the same day — and appears to be second in regards to number of people tested per million. The country has tested approximately 268,000 people, or about 1 out of every 200 people.)

OK, let’s get to the results.

“deCode has published the results of a total of 5,490 tests. Those have yielded 47 positive results (0.86%) indicating that the prevelance (sic) of the virus is modest among the general population,” the Government of Iceland reports. “A total of 409 cases have been identified in Iceland since the first case on February 28th. One person with COVID-19 has died. Six individuals with COVID-19 are hospitalized, one in intensive care.”

The country is following social distancing guidelines several other countries and states have been following.

“About a third (36.4%) of cases can be traced to overseas travel, mostly to high-risk areas identified in the European Alps. More than a quarter (27.9%) of cases have been traced to domestic transmission. The rest (35.7%) have not been conclusively traced to a source of transmission. …

“The results of the additional tests performed by deCode have given an indication that efforts to limit the spread of the virus have been effective so far. In Iceland, these measures have focused on testing, contact tracing of infections, social distancing, public efforts to increase basic awareness of hand sanitation, voluntary self-quarantine measures (currently about 4,200 individuals), and strict measures at healthcare institutions, nursing homes and the likes. Of the 409 cases identified 10 are individuals over age 70, considered to be the most at-risk group.

“A ban on gatherings of 100 people or more took effect on March 15 and are planned to remain for four weeks. Secondary and tertiary education institutions have closed, but primary schools and kindergartens will remain open with specific measures implemented to limit infection risks. Icelanders abroad have been advised to return home early, and Iceland has decided to join the EU/Schengen ban on non-essential travel from outside the area.

“It will remain the focus of Icelandic authorities to slow down the spread of the virus in order to protect the infrastructure of the healthcare system. Iceland will also focus on using its geographic location and high testing capabilities to provide information and data to the global scientific community in order to contribute to a better understanding and help limit the damage being done by the pandemic.”

Importantly, approximately half of the people who tested positive for COVID-19 are non-symptomatic, according to Gudnason as reported by BuzzFeed. The other half is mostly showing “very moderate cold-like symptoms.”

These results echo the results of another statistically helpful case. The small Italian town of Vo is where the virus was first identified in Italy. All 3,300 people living there were tested after being put into lockdown. A total of 66 people, 3% of the population, tested positive for the virus. Perhaps most importantly, most of the infected had no symptoms. After two weeks of self-isolation, 6 people still tested positive but were without symptoms, meaning that prevalence of the virus had dropped by 90% (from 66 people to just 6 people) and all symptoms of the virus were gone.

BuzzFeed adds: “A study published on Monday in the magazine Science found that for every confirmed case of the virus there are likely another five to 10 people with undetected infections in the community. The scientists, which based their model on data from China, reported that these often milder and less infectious cases are behind nearly 80% of new cases.”

South Korea has widely been cited for its good practices regarding testing and containing the virus.

South Korea & U.S. had first case on same day. South Korea took immediate action & slowed infection rate. Trump downplayed the threat & yelled at journalists. U.S. will soon be hardest hit country in the world.#TrumpMeltdown pic.twitter.com/MUdCQSxOTa — Peace Is Active (@peaceisactive) March 21, 2020

Commenting on the country’s good results, South Korean Foreign Minister Kang Kyung-wha told the BBC, “Testing is central because that leads to early detection, it minimises further spread and it quickly treats those found with the virus. That is the key behind our very low fatality rate as well.”

It has been said many times: Test, test, test.

Unfortunately, the United States has been one of the worst — if not the worst — for testing for COVID-19.

We will keep you informed on the results of testing and analysis in Iceland, South Korea, and other countries as we find it. In the meantime, enjoy your self-isolation/extended spring break and do your best to create a positive future right now and every day.

Update March 28: The following study has been retracted. It’s not clear why, but I presume something must be wrong with the methodology and findings.

Update March 25: It appears that generally speaking the false positive rate in testing is quite high. If this is the case in Iceland as well, we have a major problem with the findings above (as elsewhere).

Up to 80% false positive — Elon Musk (@elonmusk) March 21, 2020

Featured photo: 5th President of Iceland, Olafur Grimsson, by Zach Shahan (me)











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