Get it over with

Dr Fahim Chand | Monday March 14, 2022 06:00

If one were to gather passports, a fair amount of the United Nation's members would be represented. The northern winter dictates that thick Gore-Tex jackets protect the fragile skin but as the night breeze kisses the exposed cheeks of all present, there are smiles all around. High fives are offered as the bus appears exactly on time. As the driver navigates the city's quiet streets, a glance at the watch whispers 11pm. Minutes later as the city lights fade away, one can see that this is a land of wild beauty and limitless space.

Laughter and good cheer infuses the air as the witching hour approaches. A glance through the frosty glass reveals snow covered mountains shimmering in the still winter night. A cascading waterfall seemingly moves in slow motion as it reflects the moon's amber light. As the bus navigates the twisty mountain pass, it finally slows as the final destination beckons. There is a nervous energy as the anticipation mounts. The crowd gathers and looks to the heavens. There is a collective hush as the stratospheric performance commences. Green ribbons dance across the sky and illuminate the winter wonderland. These are the magical Northern Lights.

There are hugs all around as a champagne cork is popped to celebrate in style. Is this a scene prior to the COVID-19 pandemic? Not exactly, this could be a scene that takes place tonight. On February 25 Iceland lifted all restrictions against COVID-19; no quarantine for the infected, no testing at the border and no size limits on gatherings. Do Icelandic leaders think the pandemic is over? Well on that particular day 4,300 cases were recorded, breaking the single day record. On that same day Landspitali, the country's largest hospital declared it was at emergency levels as 55 COVID-19 patients were admitted with three of them in the ICU.

Surprisingly, the government had made the move to drop restrictions without consulting the hospital. Not everybody agreed with the decision. The hospital's epidemic committee indicated that the move was too abrupt and was expecting a spike in infections. The idea behind this move as indicated by Thorolfur Gudnarson, Iceland's chief epidemiologist is to achieve natural herd immunity, or when people are immune to the virus, it's transmission ceases. His subsequent words shocked the nation. He said in order to achieve this "as many people as possible need to be infected with the virus" because vaccines alone are not enough. Approximately 80% of Iceland's population are fully vaccinated. His argument is if the healthcare system is not overwhelmed and the Omicron wave ends in a few weeks as he is projecting, it may be worth a brief spike "to get it over with". His words were met with fear and anger by some of the Icelandic community.

He seemed to have forgotten about what danger this might put the elderly and immuno-compromised members of the population. This would mean that with no mask mandate and restrictions, the world outside their homes would become a no go zone.

Iceland is one of an expanding list of European countries that are abandoning almost all of their COVID-19 restrictions. Denmark was the first country, then Sweden, Switzerland and Austria. What's bizarre is the fact that infection rates were soaring at the time. But is herd immunity achievable? Total halt of transmission or herd immunity most experts agree is a pipe dream because neither vaccines nor natural infection offer lifelong immunity or entirely stop transmission.

The idea that this is a viable way to end the pandemic has been widely criticised. The World Health Organisation has deemed it unethical to allow a dangerous virus that is not fully understood to spread. Rather we should be aiming for population immunity, where a certain percentage of the population have antibodies against the virus, either from vaccination or natural infection or both so that an infection or re-infection doesn't lead to severe illness. In this scenario the virus still circulates but causes less damage.

Achieving population immunity through vaccination is likely the safest route and would also likely reduce the likelihood of long COVID-19 in those who get it. While it comes down to each country and the risks they are willing to take, it would seem prudent and indeed safer to wait for numbers to come down before easing restrictions. All the while the prospect of more dangerous variant still looms. Is it premature to declare victory? I'll put my mask back on.