Policy responses for Iceland - HSRM

Iceland


Policy responses for Iceland

1.3 Isolation and quarantine

24.6.20

Travelling and borders - New regulations regarding quarantine for individuals arriving in Iceland

On June 2nd the Government of Iceland confirmed its plans of offering the option of a COVID-19 test from June 15th June to all international arrivals as an alternative to the two-week quarantine requirement, in place since April. This is in line with the recommendations of the Chief Epidemiologist and the economic impact assessment from the Ministry of Finance. As of June 2nd, there were only two active cases of COVID-19 in Iceland.

On June 5th the government announced that the tests for COVID-19 on arrival will be free of charge for an initial two-week period, from June 15 to July 1st. From July 1st and beyond, passengers can choose to pay ISK 15 000 [EURO 97,4 at the rate of June 19th] for a single test or 14-day quarantine. Children born in 2005 or later are exempt from both testing and quarantine. Furthermore, the Chief Epidemiologist has published information for all passengers arriving in Iceland from 15 June. Testing will be available for passengers arriving in international airports and ports. Travellers are required to fill out a pre-registration form before arrival, adhere to rules regarding infection control, and are encouraged to download the tracing app, Ranking C-19.

On June 12th, Iceland announced that will continue to implement the EU/Schengen travel restrictions, which had been extended until 1 July. EU, EFTA, and UK nationals will continue to be able to enter Iceland under the condition that they preregister and undergo either a test or a two-week quarantine upon arrival. While the EU/Schengen travel restrictions have now been extended until 1 July, the exemptions have been broadened, allowing students and experts from third countries to enter Iceland. In general, these restrictions apply to foreign nationals other than those from the EU, EFTA, and the UK.

On June 15th, Iceland started to offer voluntary testing for COVID-19 for passengers arriving in Iceland, as an alternative to a 14-day quarantine. This was the first step in a carefully managed process to open the country to the flow of international travel. This same day, new and amended regulations regarding on quarantine, isolation, testing for COVID-19 took effect.

July 1, 2020:

Since June 5 Iceland has offered all international arrivals the opportunity to undergo COVID-19 testing at their point of entry as an alternative to a 14-day quarantine. The rule does not apply to minors (born 2005 and later) who are exempt from both quarantine and testing requirements. Due to the nature of COVID-19, there is a possible risk of an infection escaping detection if the test is performed in the first few days after infection. As of July 1, two such cases were thought to have led to what currently appears to be a minor cluster of infections in the Reykjavík region. Five individuals had tested positive after an Icelandic national returning from the United States tested positive, a few days after initially testing negative at the border. The previous strategy of extensive testing, preventative quarantining and contact tracing for any new infections in Iceland is still adhered to, which allowed the COVID-19 team to respond so effectively at the beginning of the epidemic. By testing at the border and continuing an extensive program of testing at healthcare clinics, the aim is a very early detection of any potential new outbreaks. Each infection discovered immediately activates the contact tracing capabilities to direct anyone with the possibility of infection into quarantine. All passengers arriving in Iceland are encouraged to download the country’s contact tracing app regardless of their test results or quarantine period to facilitate contact-tracing in case of infection. The app, which has been developed in line with the strictest privacy standards, stores the user’s location locally on the phone and is only shared with the authorities with the consent of the user in case of infection. The app also provides important information and updates for travellers and allows them to contact health authorities through an online chat, if needed.
Daily life has mostly returned to normal since the beginning of May. Some restrictions remain on mass gatherings (500 at the most) and nightlife operating hours (must close by 11 pm). Limits on very large gatherings and nightlife are likely to remain throughout the next few months.
Iceland did not close primary schools during the epidemic, most businesses have remained open and the use of masks is rare and not recommended by the authorities.
 
July 3 2020: Revised border screening regulation

In the Chief Epidemiologist's recommendations to the Minister of Health, the experience of border screening has revealed a risk of false-negative results in recently infected individuals. This posed a risk of cluster infections, especially in the case of individuals with an extensive network in Iceland. Therefore, the Chief Epidemiologist proposed that the revised rules only apply to Icelandic citizens and residents in Iceland, but not to tourists. The Minister of Health agreed to the Chief Epidemiologist’s recommendations to revise the current border-screening regulations, to be issued and effective no later than July 13. The revision will only apply to Icelandic citizens and residents of Iceland who choose to be tested at the border. They would be required to self-quarantine for five days and undergo a second test, free of charge, to eliminate the risk of a false-negative result. As before, it is possible to choose to self-quarantine for 14 days instead of undergoing a test at the border.

September 16, 2020: New screening measures

On September 11, 2020, the Minister of Health accepted a proposal from the Chief Epidemiologist to extend the existing rules on more comprehensive screening measures from August 19 until October 6. This means that all arriving passengers must then choose between a 14-day quarantine or a double testing procedure along with a quarantine for 5-6 days until October 6.
On September 14, 2020, the Minister of Health accepted a proposal from the Chief Epidemiologist to allow people to complete quarantine in connection with COVID-19 in 7 days if a test at the end of that time comes back negative. Upon completing quarantine, people will still be required to observe precautions against infection and to avoid contact with vulnerable individuals. Testing arrangements will be organised by the Chief Epidemiologist and will be free of charge. The new arrangements apply to infection precautions within Iceland, not to persons arriving at the border.


Sources:
Government of Iceland, News, June 2nd 2020. Testing for international arrivals starts June 15th. https://www.government.is/news/article/2020/06/02/Testing-for-international-arrivals-to-start-on-15-June/ 
Government of Iceland, News, June 12th 2020. Regulation on quaratine, isolation and testing for COVID-19 at the border. https://www.government.is/news/article/2020/06/12/Regulation-on-quarantine-isolation-and-testing-for-COVID-19-at-the-border-/
Government of Iceland, News, June 5th 2020. Ministry of Health, Ministry of Industries and Innovation, Ministry of Justice, Ministry for Foreign Affairs. Information for travellers arriving in Iceland from 15 June 2020.  https://www.government.is/news/article/2020/06/05/Information-for-travellers-arriving-in-Iceland-from-15-June-2020/ 
Government of Iceland, News, June 15th 2020, Ministry of Health, Ministry of Industries and Innovation, Ministry for Foreign Affairs. Travellers to be tested at border - Science to guide path to the easing of travel restrictions. https://www.government.is/news/article/2020/06/15/Travellers-to-be-tested-at-border-Science-to-guide-path-to-the-easing-of-travel-restrictions/ 
https://www.government.is/news/article/2020/07/01/Few-active-COVID-19-cases-found-in-border-tests/
Government of Iceland, News, September 11th 2020, Ministry of Health, Rules on border screening remain unchanged until October 6th. https://www.stjornarradid.is/efst-a-baugi/frettir/stok-frett/2020/09/11/Obreyttar-reglur-um-skimanir-a-landamaerum-til-6.-oktober/ [Icelandic]
  Government of Iceland, News, September 14th 2020, Quarantine shortened from 14 days to 7, ending with test. https://www.government.is/news/article/2020/09/14/Quarantine-shortened-from-14-days-to-7-ending-with-a-test/

As per April 8, quarantine is mandatory when a person is possibly infected but is not yet symptomatic. On February 28th the CE, authorised under the Act on Health Security and Communicable diseases, announced on the DoH website that Icelanders arriving to Iceland from defined high-risk areas of infection (see listed on chapter 1.1) and individuals who had been in contact with a confirmed case of COVID-19 should be in home-based quarantine for 14 days.

As of March 19th, the CE ordered that all residents of Iceland that enter the country are obligated to go into 14 days of quarantine, regardless of where they were arriving from. The same applied to those who had been in contact with a COVID-19 infected individual. Individuals should register themselves in quarantine on a platform (Heilsuvera.is) which is a joint information and communication website of the Directorate of Health and Primary Care in the Capital Region providing the residents of Iceland access to their own medical records. Information goes directly into a central database at the CE and the DCPEM. Alternatively, they are asked to register by phone with their primary health care centre. A person in a home-based quarantine is ordered to stay at home with minimum direct contact with other persons. Quarantined individual must not: leave their home unless necessary, use public transport, attend school or work where others attend, go out for supplies, stay in shared closed spaces and may not welcome guests in the home. Quarantined individuals are allowed to use a private balcony or garden and go for a walk, always keeping at least 2 m distance from other pedestrians. They are allowed to drive their private car.

On March 26th the MoH issued a specific regulation on quarantine and isolation authorized in Act no. 19/1997 on Health Security and Communicable. The rules specified in the regulation strengthen the CE authoritative power already stipulated in the legislation to enforce quarantine and isolation orders. On March 27th State Prosecutor issued orders defining the level of penalty involved for violations of the Act and rules on quarantine and isolation introduced to tackle the COVID-19 outbreak.

Isolation is a more severe measure than quarantine and requires more restricted behaviour than the rules of quarantine state. Isolation applies to patients with symptoms of infectious disease. Individuals that are suspected to have the COVID-19 infection or are laboratory confirmed and do not require hospital stay, should be isolated at home or at locations specified by the DCPEM or the health care system. Primary care clinics contact isolated individuals on a daily base. Isolation for COVID-19 can be lifted by a doctor when both the following criteria are met: (a) 14 days have passed from the confirmation of COVID-19 illness and (b) the patient has been symptom free for at least 7 days.

Sources:
Directorate of Health February 28th News and Announcements    https://www.landlaeknir.is/um-embaettid/frettir/frett/item39280/fyrsta-tilfelli-covid-19-koronaveiru-greinist-a-islandi
Directorate of Health March 19th News and Announcements  https://www.landlaeknir.is/um-embaettid/frettir/frett/item39945/utvikkun-ahaettusvaeda-vegna-covid-19 
DoH and DCPEM joint information website, Covid.is https://www.covid.is/categories/how-does-quarantine-work
Government of Iceland, Regulation on quarantine and isolation due to COVID-19, https://www.stjornartidindi.is/Advert.aspx?RecordID=fbef62c4-3171-44eb-afc2-2ebb568fe1fe 
State prosecutor, Fines due to violation of Act no. 19/1997 on Health Security and Communicable diseases , March 27th    https://www.rikissaksoknari.is/media/arsskyrslur/RS-4-2020-Sektir-fyrir-brot-gegn-sottvarnarlogum.pdf  
DoH Q&A regarding the coronavirus, first published January224th 2020, updated April 2nd 2020 https://www.landlaeknir.is/um-embaettid/greinar/grein/item38808/Questions-and-answers-regarding-novel-coronavirus-in-China