24 March 2020An interview with epidemiologist Dr. Anders KochDr. Anders Koch is an infectious disease physician by training, a medical epidemiologist and a university professor in Greenland. He has done research on infectious diseases in Greenland for the past 25 years and currently wears four hats: He works as a consultant for the national epidemiologic institute of Denmark, the department of infectious diseases at the Rigshospitalet in Copenhagen, and for the Greenlandic health system, where he is an active clinician for infectious diseases and involved in planning work – being clinically nationally responsible for tuberculosis. In addition, Dr. Koch is involved in the work of the International Circumpolar Surveillance System for Infectious Diseases. We asked him about coronavirus in the Arctic and the impact on small Arctic communities. We discussed the current situation regarding coronavirus in Greenland, the measures being put in place to flatten the curve of infections to protect Arctic communities against coronavirus and how similar infectious outbreaks have impacted Arctic communities in the past. How are small communities in the Arctic prepared for a pandemic? If you take the circumpolar region as a whole that is probably very varied. In large parts of the Arctic, the communities are small and scattered and health planning is hampered by the disperse geography and the scattered and limited resources compared with e.g. Denmark and Norway. Thus, you don’t have the same possibilities and means to prepare for and act on a pandemic in small communities as you do in our capitals. That is mainly due to two things: the lack of testing facilities and the difficulties associated to handling an infected person. For Greenland there are of course plans in place but they are hampered by logistic challenges and the lack of staff. It’s important to note that the Greenlandic health system is independent from Denmark. Of course, Denmark helps Greenland – for example with laboratory testing of the coronavirus. At present, Greenland does not have its own facilities to test for the novel coronavirus. As the testing procedure is technically challenging to introduce to a lab, all samples from Greenland are being sent to Denmark at the moment. This results in a delay of one to two days or more. There is also a continuous flow of medical staff from Denmark. At present, the number of persons coming to Greenland is highly limited, but from this weekend on, we offer corona test to all such persons going to Greenland, irrespectively of whether they have symptoms or not. The main priority is to not bring the coronavirus into the country. What is the current situation in Greenland in relation to the coronavirus? As of today, there are four cases. The first case appeared about two weeks ago. This case was travel related and complete contact tracing was carried out. Place of infection for the second case that was diagnosed last week was unclear, and this case might have resulted in local transmission. Therefore, a number of public health means were established inclusive of shutting down the capital Nuuk from the outside. Only selected people are allowed to travel to Nuuk and domestically. Over the weekend we had two more cases in Greenland and one of them was related to the self-rule government, so there’s a risk that the person might have infected people within the administrative system.