Editing DeCODE genetics (section)

== Response to COVID-19 pandemic ==
In March 2020, as the SARS-CoV-2 virus began to spread widely in Iceland, deCODE temporarily redirected its clinical research, laboratory staff and operations to conduct large-scale testing for [[Coronavirus disease 2019|COVID-19]]. This effort marked the company's deepest and most direct ever involvement in public health and constitutes an important component of one of the most intensive and successful containment strategies of any country in the early months of the global pandemic.<ref>Tests per million by country at Wiki page [[Template:COVID-19 testing by country]]; by late April, eight weeks after testing, tracing and isolation began, virtually no new cases were being detected, as can be seen on https://www.covid.is/data {{Webarchive|url=https://web.archive.org/web/20200403102907/https://www.covid.is/data |date=3 April 2020 }}</ref>

The response of Iceland's health authorities to the pandemic was notable for being an early, transparent and effective example of best-practice 'test, trace and isolate' epidemiological control. In late January 2020, the National Directorate of Health began testing people arriving in Iceland from high-risk areas or showing possible symptoms of infection, and, with the Department of Civil Protection and Emergency Management, activated a system to isolate anyone diagnosed with the virus and to trace and quarantine all of their contacts.<ref>The best source of information on the official response, from historical timeline to the latest data, is the government's official site,  covid.is, available in Icelandic, English and many other languages. The Wikipedia page ''[[COVID-19 pandemic in Iceland]]'' builds on this with additional sources, links and graphics.</ref> Iceland's first case was diagnosed on 28 February, a month after targeted testing began, and within days dozens of people were testing positive every day. Little more than two months later, Iceland was virtually free of active infections.<ref>See data and graphs on the official data page https://www.covid.is/data {{Webarchive|url=https://web.archive.org/web/20200403102907/https://www.covid.is/data |date=3 April 2020 }}</ref>

The foundation of this response and the data to guide it was testing. Yet while the official testing effort was prompt and energetic, it was focused on those who were either symptomatic or at high risk due to having likely been in contact with infected people. In early March, deCODE's CEO Kari Stefansson became concerned that without also screening the population at large there was no way to understand the virus' spread or its fatality rate, crucial information for holistically addressing the epidemic.<ref>Elizabeth Kolbert, "How Iceland Beat the Coronavirus," ''[https://www.newyorker.com/magazine/2020/06/08/how-iceland-beat-the-coronavirus The New Yorker]'', 1 June 2020</ref> In this "all-hands-on-deck" moment, and with the know-how, people and equipment to rapidly turn the company's genetics research lab into a PCR diagnostic testing facility,<ref>A useful schematic of what this testing entails is in Clive Cookson and Camilla Hodgson, "What coronavirus tests does the world need to track the pandemic?," ''[https://www.ft.com/content/0faf8e7a-d966-44a5-b4ee-8213841da688 Financial Times]'', 1 April 2020.</ref> he offered to put the company's capabilities to work to screen the general population under the auspices of the Directorate of Health.<ref>Þórunn Kristjándóttir, "„Eðlilegt“ og „sjálfsagt“ að leggjast á árarnar," ''[https://www.mbl.is/frettir/innlent/2020/03/06/edlilegt_og_sjalfsagt_ad_leggjast_a_ararnar/ Morgunblaðið]'', 6 March 2020</ref> deCODE staff worked swiftly to put together workflows for everything from sample collection to running the tests to privacy-protected reporting, and to get the swabs and reagents ready to begin large-scale testing. On Thursday 12 March 2020, the company opened its website to book appointments for testing and within hours 12,000 people had signed up. Testing began the following morning, free of charge.<ref>"Tólf þúsund bókað tíma í skimun," ''Morgunblaðið'', 13 March 2020</ref>

The deCODE effort scaled up quickly to a capacity of over 1000 samples per day. From the beginning of population screening, fewer than 1% of those taking part were found to be infected, indicating that the health authorities' containment strategy was working.<ref>[https://www.government.is/diplomatic-missions/embassy-article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/ Press release], "Large scale testing of general population in Iceland underway," Icelandic Ministry of Foreign Affairs, 15 March 2020.</ref>{{Primary source inline|date=August 2020}} From mid-March to the end of May 2020, the company conducted an average of 600 tests a day, complementing the health authorities' 250 tests per day at the National-University Hospital.  Those testing positive in deCODE's screening were similarly isolated and their contacts traced and asked to quarantine themselves. In total, by the beginning of June more than 60,000 tests had been conducted in Iceland, equivalent to 18 percent of the population. Powered by this combined testing strategy and tracing and isolation follow up, the number of infections in Iceland peaked in the first week of April and dropped steeply off by the end of the month. By mid-May, there were only a handful of active infections in the country, although deCODE and the health authorities continued to conduct as many as 200 tests per day thereafter to try to detect any fresh outbreaks.<ref>Complete statistics on testing by health authorities and deCODE by date, as well as the number of active infections, from 28 February to 14 June can be found in English at https://www.covid.is/data-old</ref>

In tandem with its screening work, deCODE used its genetics capabilities to sequence the virus from hundreds of infected individuals, and to draw a kind of genealogy of the different clades of the virus in the country. This showed how during the early weeks of the pandemic the virus had entered the country with people infected in different countries and then spread within Iceland.<ref>[https://www.decode.com/iceland-provides-a-picture-of-the-early-spread-of-covid-19-in-a-population-with-a-cohesive-public-health-response/ Press release], "Iceland Provides a Picture of the Early Spread of COVID-19 in a Population With a Cohesive Public Health Response," deCODE genetics, 14 April 2020</ref>{{Primary source inline|date=August 2020}} In April 2020, with colleagues from the Directorate of Health and the national hospital, the company published in the ''[https://www.nejm.org/doi/full/10.1056/NEJMoa2006100 New England Journal of Medicine]'' a paper detailing what the spread of COVID-19 looks like across a population, and how a robust policy of testing, tracing and isolation could effectively contain it. In May, the company began work to develop and carry out antibody testing in the population, and early results showed that around one percent of the general population that had not been diagnosed with infection carried antibodies for the virus. This meant on the one hand that the virus had been swiftly and well contained, but also that nearly three times had been infected as had been officially diagnosed since the end of February and also that the population was still more than 98% naive.<ref>"Þrisvar sinnum fleiri smit en greindust," ''[https://www.mbl.is/frettir/innlent/2020/06/05/thrisvar_sinnum_fleiri_smit_en_greindust/ Morgunblaðið],'' 5 June 2020</ref> That indicated that large-scale testing would need to continue to detect later outbreaks as the country reopened its borders to travel by its own citizens and others coming to Iceland.<ref>Dagny Hulda Erlendsdóttir, "Mikill minnihluti landsmanna með mótefni við COVID-19," ''[https://www.ruv.is/frett/2020/05/28/mikill-minnihluti-landsmanna-med-motefni-vid-covid-19?fbclid=IwAR01coNpAxWwD5xJ1tO-LcIlJ9zBGnKQBgNjiJKx9pDeL2Z73VGTTVPk3Vo RUV]'', 28 May 2020</ref> In June, the company said that it was working with Amgen's unit in British Columbia to use white blood cells from recovered Icelandic COVID patients to begin to manufacture antibodies for the virus, which could be used either prophylactically or therapeutically.<ref>"Einkaþotan mætt að sækja blóðkornin," ''[https://www.ruv.is/frett/2020/06/06/einkathotan-maett-ad-saekja-blodkornin RUV]'', 6 June 2020</ref>