Like some other countries, Iceland has scrapped its remaining covid-19 restrictions. Unlike other nations, however, its health ministry coupled this move with a startling announcement: the country will start aiming for herd immunity.
鈥淲idespread societal resistance to covid-19 is the main route out of the epidemic,鈥� the government said in a on 23 February. 鈥淭o achieve this, as many people as possible need to be infected with the virus as the vaccines are not enough, even though they provide good protection against serious illness.鈥�
On 25 February, Iceland lifted all its remaining restrictions, allowing an unlimited number of people to gather indoors and fully opening its border. England and Northern Ireland also recently dropped coronavirus laws, such as those related to mask wearing and self-isolation, with Wales and Scotland set to follow this month. To say people need to get infected, however, is going a step further.
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Iceland has been a world leader in its pandemic response, with a 鈥渮ero covid鈥� approach. This has contributed to it having one of the world鈥檚 lowest covid-19 death rates. On 23 March 2020, when the UK went into lockdown, Iceland recorded no covid-19 deaths , compared with 103 in the UK and 217 in the US.
Death counts are flawed, with countries varying in their testing strategies and definitions of a covid-19 fatality. Nevertheless, Iceland has recorded just 77 covid-19 deaths since the start of the pandemic. This compares with more than 163,000 recorded deaths among the UK鈥檚 population of 67 million and close to 1 million deaths among the US鈥檚 329 million population.
Iceland鈥檚 cases and deaths have ticked up since its restrictions were lifted, with there typically being a lag of two to three weeks between new infections and fatalities. John Hopkins University statistics suggest that 2907 cases and one death were reported in Iceland on 25 February, increasing to 3737 cases and two deaths on 10 March. According to Our World in Data, however, Iceland鈥檚 cases are falling. It is unclear why this discrepancy exists.
The phrase herd immunity is controversial in itself. It has no set definition, but is often associated with allowing the SARS-CoV-2 coronavirus to spread while vulnerable people shield. When the virus has infected most of the population, the hope is outbreaks would fizzle out.
Almost all experts agree this definition of herd immunity cannot be achieved. In January 2021, hospitals in the Brazilian Amazon collapsed under the strain of covid-19, despite the region having had a high infection rate in its first wave. Later that year, it emerged that nearly everyone in Iran had caught the disease at least once, but herd immunity wasn鈥檛 achieved.
Immunity wanes after a person overcomes SARS-CoV-2 or is vaccinated against it. The virus has also mutated into new variants, which somewhat evade past immunity. Nevertheless, a past infection may . This is the population-level immunity that Iceland hopes to harness, says at Iceland鈥檚 Directorate of Health. Individuals aren鈥檛 advised to deliberately get infected and are encouraged to test and isolate, she says.
The lifting of restrictions was partially driven by growing confidence in omicron鈥檚 reduced severity compared with previous variants, says Aspelund. Eighty per cent of people in Iceland have also had two vaccine doses, helping to keep the number of deaths low.
However, while younger people are less at risk of coronavirus complications, they can still develop long covid, says at University College London. 鈥淲e just don鈥檛 know enough about the long-term impact,鈥� she says. 鈥淵ou鈥檙e asking for trouble.鈥�
But the government felt it had little choice, says Aspelund. As well as being milder, omicron is more transmissible than previous variants, so extreme measures would be required to stop its spread. 鈥淲e are talking about severe restrictions on gatherings, on working from home, limiting society for a long time,鈥� says Aspelund. Trying to achieve zero covid-19 cases is no longer possible, she says. 鈥淣ot here, for sure.鈥�
The threat of another variant emerging is a worry for public health experts. 鈥淲e don鈥檛 know what comes after omicron,鈥� says at University College London.
If the next variant is more virulent and people retain some of their immunity, then previously overcoming omicron would be an advantage, says Balloux. Recent studies suggest the strongest protection comes from being fully vaccinated and having had an infection, dubbed .
Yet no one knows if omicron immunity will protect against a future variant. 鈥淭here鈥檚 no guarantee it鈥檚 going to provide similar protection in a few months鈥� time to whatever the next variant happens to be,鈥� says at the University of Edinburgh, UK.
Ultimately, Iceland鈥檚 lifting of restrictions is similar to that in other European countries, says Balloux. In early January, . After falling considerably, cases started ticking up at the end of February, corresponding with restrictions ending on 24 February.
Aspelund is clear the government does not want to encourage infections. 鈥淲e are not telling people to go and have a covid party, but how we look at it here is that it is inevitable that people are going to get it,鈥� she says.
