Politicians are desperate to find a balance of sanctions that flatten the curve to flatten the economy or upset residents who are eager to reunite for the holidays.
“The main question now is to determine what is the optimal package of policies to maximize health benefits at the least cost,” said Thomas Hale, Associate Professor of Public Policy at the University of Oxford. “However, this ‘magic formula’ will vary across countries and populations, and of course the virus will grow or regrow over time.”
It is a complex and ever-changing calculus, and every country is different.
But the perspectives of three countries – Finland, Norway and Denmark – show, in recent months, a CNN analysis. The analysis, which monitors data from the University of Oxford and Johns Hopkins University, found that while the three countries implemented some of the continent’s most restrained combinations, they managed to keep average daily deaths low – less than one per million – For a period of three months from 1 September to 30 November.
Denmark’s success may come to an end. In late November, for the first time since May, Danish death rates exceeded one million in Danish Hopkins data show. On Friday, the number of newly reported cases topped 4,000. Earlier in the week, officials expanded restrictions and announced a nationwide lockout aimed at reducing growing infections.
But what is the reason for the success of the three countries in the decline?
Denmark, Finland and Norway responded quickly to a slight increase in infection, which allowed them to virtually eradicate the virus during summer and withstand autumn, according to interviews with six scholars. Experts said it was also important to have clear guidance and follow the will of the residents. And ramping testing and contact-tracing capacities and providing paid leave leaves helped keep any outbreaks local.
How to be the best (or how to be finland)
In recent months, Finland had Europe’s lowest average infection and death per capita, Johns Hopkins data show. It succeeded in preventing local outbreaks, preventing some of the most relaxed restrictions on the continent. Internal movement was not prohibited, requiring schools and workplaces to be individually involved, and wearing a mask was not mandatory.
“Nothing like that is magical – we only have a practical approach,” said Pakke Nuorti, an epidemiology professor at the University of Tampere, who has worked for public health agencies for more than 25 years.
Northery said cultural, political and geographical factors – such as low population density, low travel and high confidence in government – were helpful, but it was the job of the nation’s health agencies.
During the summer, Finland created “tried-and-true field epidemiological practices”, Nuroti said: testing, isolation, contact tracing, quarantine and prevention of incidents at the local level.
Data from the Ministry of Health shows that the average daily test volume increased from 2,900 samples in May to 11,300 in August. In late November, Finnish laboratories conducted 23,000 tests a day, or 90% of current capacity.
Finland Mika Salminen, director of health safety at the Finnish Institute for Health and Wellness, said that she used the summertime to prepare for the new wave by responding with preventive measures instead of lockdowns. He said that the success of Finland declined for most of the summer by banning international travel.
To help isolate people and stay home, the government provided financial assistance. Salminen said that thousands of people who were exposed could quarantine as the government offered compensation for their lost income.
“It’s not like we didn’t have an outbreak,” Nuorti said. He said that Finland had local flare and super spreader programs, but local health authorities, coordinated by the central government, were able to use real-time data. But as the case grows in numbers, identifying all transmission sources becomes increasingly difficult, Nuorti said.
If the situation worsens, Salminen said, a full lockdown has not been ruled out.
Norway is the way
Across the border, the Norwegian authorities increased their focus on addressing the most vulnerable.
Norway’s spring lockdown was the strictest in Scandinavia. The country’s oil and gas industry was able to provide a large economic buffer to soften the impact on people’s purses, but the government soon faced a growing mental health crisis and the authorities relaxed their restrictions.
Knowing what you have to do, you’re told
Three experts interviewed by CNN stated that a key factor in Denmark’s early success was clear and that there was a need for consistent messaging and behavioral change about the risks. He attributed the country’s achievement to its history of mutual trust between residents and government.
Peterson said that two factors determine whether people behave to avoid infection. There is a motivation: are they worried about being infected. The second is whether they know what to do to prevent the spread of the disease, which hinges on communication from health officials and politicians, Petersen said.
One of the officials who led the Danish pandemic response echoed that point.
“Dealing with the epidemic is about human behavior,” said Søren Broström, general director of the Danish Health Authority.
Human behavior helps spread diseases, and controlling it is where the solution lies, Brostrom said. He said that physical disturbances, not drugs or vaccines, are the “medical magic bullet” that everyone hopes for.
Brostøm spoke to CNN before Denmark’s recent increase in cases. But at a press conference on Wednesday, Prime Minister Mateo Frederickson addressed the country’s deteriorating situation.
“In the end, only one thing works against Corona,” Fredrickson said. “It is if you and I and all of us take responsibility for ourselves and each other.”
Silence of restrictions
But as the epidemic grows tired, people become more reluctant to follow strict new measures, experts told CNN.
Bronstom said that frequent social distance is not long-lasting. A country needs only enough restrictions to be able to control the epidemic.
“I think we found that we have actually made quite a good balance in this country in this regard,” he said.
Even in Denmark, a misconception can have a detrimental effect on trust and then compliance, experts said.
But the government’s excesses shook Danish unity, Peterson said.
“Right now, we are seeing an increased polarization. We are seeing a decrease in support for government strategy. And the question we face in Denmark is, ‘What will be its consequences for the epidemic in the next months?'” Peterson said.
Rules vs. Recommendations
The Danish authorities’ willingness to implement stern steps when standing opposite Sweden, where the authorities first tried with a light hand and prevented the epidemic.
A veterinarian professor of epidemiology at the University of Edinburgh, Roland Cao, said “there was more emphasis on voluntary measures and without extreme ‘shutdown’ measures in Denmark (in the spring).”
“Other Nordic countries are in line with the rest of Europe,” Cao said. “He had a tight lockdown in the spring and soon did it.”
Cao said that this approach has increased Sweden’s affairs in June, when most other European countries were recovering, unavoidable. And in November, Sweden was hit by a nationwide outbreak, despite having a higher average hardness score than other Scandinavian countries.
“When Kovid-19 arrived in our country, we all agreed to take responsibility,” Lofven said. “This autumn, many of us have also neglected to follow advice and recommendations.”
When it comes to a disease that spreads so fast, Cao, an Edinburgh professor, said that very little difference in how things are done can bring all the changes in the world.
How CNN reported this story
For this story, we sought to examine the relationship between government sanctions and the death of Kovid-19 during the period from 1 September to 30 November, when many countries were in a state of resurgence.
To do this, we analyzed data from Johns Hopkins University to calculate daily new deaths per million inhabitants in 31 European countries. For example, we used the average moving average due to delayed reporting on weekends, or due to changes in data collection methods, which may result in a sudden increase in daily figures. We used new deaths instead of new cases because the reporting criteria for deaths are more consistent across countries than in cases, which is a fraction of the trial volume.
We then plotted the new mortality rate against each country’s stringent scores, which we found using Oxford University’s Stringink Index. The index score measures on a scale of one to 100 in response to the countries Kovid-19.
We analyzed 27 European Union members, the United Kingdom and free trade countries (Iceland, Liechtenstein, Norway and Switzerland). We excluded Liechtenstein because stringent scores were not available for that country.
After interviews with experts, we defined countries with low infection rates with one or fewer deaths per million inhabitants. We defined less restrictive countries as those with a stringent score less than 60 because it was the minimum score for countries with complete lockdown in October and November, according to data compiled on the lockdown status of European countries at the time.
We focused on Finland, Norway, and Denmark as they were the only countries to maintain a consistently low 60% mortality rate (one million or less) and levels of rigidity during the period 1 September to 30 November. Other countries also maintained lower mortality rates, but we did not focus on them because they either implemented a strict lockdown (Ireland) or had a high stringency score (Cyprus).
Antonia Mortensen, Samantha Tapfumanei, Nina Avramova, Sharon Braithwaite and Amy Cassidy contributed to this story.