Chief Epidemiologist Þórólfur Guðnason sent a memo to the Minister of Health, presenting nine options for border operations in the future.
According to a report by Vísir, 30 individuals have been diagnosed with an active infection at the border since the country reopened on June 15th. Two strains of the virus managed to go undetected however and consequently spread in the population. It was not specified if these two strains which entered the country came from Icelandic residents, who have been able to come and go from the country since well before June 15th, or from tourists.
Þórólfur is quoted saying that border screening still “provided good information about the risk of infection from tourists and was also effective in preventing the virus from coming into the country.”
In his memo, he lists the options as follows:
1. Access for tourists to the country will be unrestricted.
Þórólfur highly discourages this options at the moment, especially in light of the fact that the epidemic is growing rapidly in many parts of the world.
2. Strict restrictions will be applied on the arrival of individuals in Iceland.
He deems it unlikely that it will be possible to close the country completely to all long-term arrivals and believes that such measures will not completely prevent the spread of the virus here and will not prevent its spread within the country.
3. All individuals who come to Iceland will be required to go on a 14-day quarantine without screening.
Þórólfur points out that such a measure would probably significantly reduce the number of tourists to Iceland and it would be difficult to monitor whether people follow quarantine.
4. Screening of everyone at the border upon arrival in Iceland.
These measures would probably not have a major impact on the flow of tourists, but would reduce the likelihood of the virus coming here. The screening capacity would limit the number of people that could come here and there would still be the risk of newly infected people testing negative upon arrival.
5. Screen everyone at the border, quarantine for 4-6 days, and subsequent sampling.
This arrangement is in place today for those who intend to stay in the country for more than ten days and are coming from risk areas. Two individuals have been detected in a second sampling who had not been detected in the first sampling. This operation is therefore probably the most sensitive method of preventing the virus from entering Iceland. However, it requires a great deal of research, organization and manpower in many parts of the country and is also costly. It could be difficult to monitor whether individuals stay quarantined. This action would probably also significantly reduce people’s willingness to travel to Iceland.
6. Screening of all at borders coming from high-risk areas but individuals from low-risk areas would be omitted.
This method has been used in the country and has prevented the spread of infection. However, there have been group infections caused by two subspecies of the virus despite the screening and it’s unclear how the virus entered the country. This method therefore reduces the chance of the virus getting in but does not completely prevent it. This method is feasible today in terms of screening capacity.
7. Screening of all individuals at the border, quarantine for 5-7 days for individuals from risk areas, and then a second sampling of individuals in quarantine.
This is described as a derivative method from what is described in the fifth point. The probability of infection entering the country is higher here than described in point 5, but this option is easier and cheaper to implement. Also, this method would probably not have as great an effect on the flow of tourists as described in point 5. This advantage is therefore considerable, but the number of tourists would be limited to screening capacity.
8. Quarantine everyone for seven days and then take a sample.
This method would probably detect almost everyone who is actually infected, but they may have infected others during their time in quarantine. Additionally, the number of tourists is likely to decrease significantly. It would be difficult to monitor whether individuals stay quarantined and a large amount of manpower is needed for this, and then presumably in many parts of the country. This option is not as promising as various other options and the number of tourists would be limited to screening ability.
9. Screening of individuals from low-risk areas but quarantine individuals from risk areas for 14 days.
This method is said to be feasible but will probably significantly reduce the number of passengers from high-risk areas. This option reduces the likelihood of the virus entering the country but is not as effective as some of the other operations that have been mentioned. Passengers from high-risk areas would probably decrease, but it would be difficult to classify passengers by region.
Þórólfur points out that none of these measures can completely prevent the coronavirus from entering the country. Border screening can limit the number of tourists and at the same time reduce the likelihood of the virus getting here. In his opinion the fifth option would be the most effective. The other methods have different advantages and disadvantages but are not as effective. It is now up to the Minister of Health to decide which way to go.
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