On March 6, Kári Stefánsson was driving to work at deCODE when he heard a news report on the radio that caught his attention. The report cited a World Health Organization estimate that 3.4% of infections with SARS-CoV-2 led to death. “I was surprised,” he recalled, “because to do that calculation, you need to know the distribution of the virus in the population in general, not just in those who got seriously ill or were in the high-risk groups. I felt that it was necessary to know the spread of the virus in the general population.”
Within days and with Amgen’s full support, deCODE had worked out a two-track approach for widespread testing with Iceland’s health authorities. The National University Hospital would test people with COVID-19 symptoms or risk factors, such as contact with someone infected or foreign travel. DeCODE scientists would screen volunteers from the general public with no known risk factors, and later, randomly recruited Icelanders. By June, that amounted to more than 40,000 tests—about two-thirds of the total in Iceland at that time.
Through this strategy of widespread testing and contact tracing, with isolation and quarantines as needed, Iceland largely eliminated the first wave of the virus without the need for a major national shutdown. The same strategy is now being used to allow a resumption of international travel to Iceland and limit the size of any subsequent outbreaks.
In addition to testing, deCODE used its genetic expertise to sequence the viral RNA from every positive test in Iceland. The hundreds of mutations detected were useful in mapping the spread of the virus, and these data are also informing research into vaccines and neutralizing antibody therapies that block as many strains of the virus as possible. Moreover, since deCODE has in-depth health and genetic data on all those infected in Iceland, it is probing these data for factors that might determine the risk of infection and serious illness.