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Vaccination rollout has been going too slow in much of the world. If enough vaccines were available, Iceland could vaccinate its entire population cheaply in a matter of days. This is how. I am a CEO of a regional healthcare institution. Thread.
Iceland, with its 340 thousand inhabitants, experienced two waves of coronavirus, one in March/April and another in October/November. Both have been quashed without having to resort to extended or draconian lockdowns.
Iceland is a part of EU/EEA joint effort to procure vaccines from Pfizer, Moderna, AstraZeneca, Janssen, CureVac and Sanofi. Also, Iceland is a part of the Covax effort to bring vaccines equitably around the globe. Iceland follows the EMA authorisation system.
On December 28th, the first shipment arrived in Iceland, with 10.000 doses. Half of those were distributed around the country and half put in the freezer for a second dose in January.
In the following two days, all 5000 doses were delivered, first to frontline healthcare workers (see picture) and all nursing homes residents around the country. With enough vaccines, we could vaccinate the whole country in a matter of days. Here are five pillars of the approach:
1. The healthcare system is mostly state-run and almost entirely financed by the state. Cooperation is facilitated with regular meetings between healthcare providers, the central government, directorate of health and the state epidemiologist. https://www.covid.is/covid-19-vaccine
2. Prioritization rules have been imposed with age being the primary criteria, but with the most essential frontline healthcare workers being put into the mix. It is not possible to get ahead in the line. (Picture shows delivery of a batch at our small hospital in Ísafjörður).
3. The primary care clinics administer the vaccine. People receive a text message and a message to a secure healthcare communication platform (Heilsuvera). The message includes time and place. This is connected to a central registry of vaccination, tracking all Icelanders.
4. Scenarios have been developed for the wide-scale rollout. One uses schools with 10 people in each room and a team of nurses circulating to deliver the injection. Each school would have a person scanning the barcodes, a doctor and volunteers to ensure the orderly flow of people
4b. Each school, running 10 hours a day with 50 classrooms, could serve 10.000 people a day. Doing this around the country, in different forms depending on location, we could vaccinate the whole population in a matter of days. https://translate.google.com/translate?hl=&sl=is&tl=en&u=https%3A%2F%2Fwww.frettabladid.is%2Ffrettir%2Fgaetu-bolusett-tugthusundir-manna-daglega%2F
5. With the cost of the pandemic being exorbitant, the cost of vaccination is not an issue. Working weekends or paying overtime is worth it. Despite this, the scenarios and plans are very cost-effective and efficient.
Weekly deliveries from Pfizer are planned later this month and when Moderna gets its approval, the deliveries will speed up. Authorities hope herd immunity will be reached by the summer, with the production and distribution of vaccines abroad being the bottleneck.
Given the capacity of vaccinating the whole population in a matter of days, the state epidemiologist Þórólfur Guðnason has been in talks with Pfizer to explore the possibility of running a phase 4 trial.
A recent poll shows that 92% of the population intends to accept the offer of vaccination, a testament to clear and science-based communication by health authorities and media. https://translate.google.com/translate?sl=is&tl=en&u=https://www.ruv.is/frett/2021/01/02/92-prosent-landsmanna-likleg-til-ad-thiggja-bolusetningu
Given this, the only bottleneck is the production of vaccine and its delivery to Iceland. It is a shame countries around the world have not been able to provide the this basic service to its population more efficiently. //End
(Bump for my earlier thread on our fight against coronavirus and winter storms. https://twitter.com/GylfiOlafsson/status/1255838116558123008)
