Coronavirus in the Arctic: A stress test

11 February 2021
One year into the pandemic we speak to two frontline experts on the coronavirus in the Arctic, the Danish infectious disease physician, Dr. Anders Koch, and the American emergency-medicine doctor and wilderness physician, Dr. Stuart Harris.

Greenland has to a large extent been successful in keeping the coronavirus out. In March 2020, the authorities implemented restrictions on travels to Greenland, including mandatory testing before take-off. For a period of time, people additionally had to stay in isolation upon arrival in Greenland and to be tested on the fifth day. Since those strict measures were set in place, Greenland has not had domestic transmission of Covid-19. The credit goes – among others – to infectious disease physician Dr. Anders Koch.

“From the beginning of the epidemic, the possible impacts of the coronavirus were quite clear to the authorities in Greenland. People live in small scattered settlements with a limited health system. There was a genuine concern that if the coronavirus spread to remote settlements, the health system would quickly be overwhelmed,” says Dr. Anders Koch.

He knows what he speaks of. For the past 25 years, Dr. Koch has done research on infectious diseases in Greenland and he is clinically in charge for the national tuberculosis program. As the World Health Organization (WHO) declared the outbreak of the coronavirus a pandemic, he knew that it was imperative to keep the virus out of the country and to flatten out the epidemic in the Arctic.

Ittoqqortoormiit, Greenland (Phottoo: Annie Spratt on Unsplash)

Despite the successes so far, he remains cautious. We spoke to him in January 2021 as mainland Denmark was experiencing a reemergence of the virus with an unexpected high number of new infections. “We have learned from the past year that it only takes a few slips in the precautionary measures to turn a situation into something serious. With such an infectious virus, I think it is of outmost importance that the authorities are constantly aware of the fragility of the situation,” says Dr. Koch.

While Greenland has been able to prevent outbreaks, the issues that people across the Arctic worried about in the beginning of the pandemic are real and Anders Koch has seen them play out in relation to another illness. “Tuberculosis is partly considered to be a social disease that is affected by low social living conditions,” he told us in an interview in March 2020.

Environmental and social factors such as crowded housing conditions, poor hygienic standards and lack of running water, infrastructure deficits and lack of trained personnel are concerns common to many Arctic communities. Covid-19 underscores existing vulnerabilities of Arctic communities and may produce new challenges – as was stated in the Arctic Council’s briefing document for Senior Arctic Officials on Covid-19 in the Arctic, which was released in June 2020.

“The effects of the coronavirus highlight some of the enduring difficulties that people in the Arctic are facing and have faced for a long time. It is a stress test,” says Dr. Stuart Harris, emergency-medicine doctor and founder and Chief of the Massachusetts General Hospital Division of Wilderness Medicine.

Dr. Harris is in a continuous dialogue with his colleagues in Alaska. The dire need for more medical personnel and the challenges posed by conditions that favor a rapid transmission of the virus are well known to him. Yet, he also emphasizes that the pandemic plays to the innate strength of Arctic communities.

For some going out on the land provided safety, well-being and the opportunity to subsistence hunt. (Denali National Park by Jan Kronies on Unsplash)

“There has been an extraordinary sense of community, a sense of we are all in this together,” says Dr. Harris. And the pandemic has fostered a sense of local control. “If you are in New York or Boston the sense of being independent isn’t necessarily high on your list, whereas in communities, where subsistence is still an active part of their lives, you prove to be self-reliant and resilient. The multiple generations of lived knowledge – it’s a real gift that these communities still have.”

Remoteness is likely one factor. The Arctic Council briefing document finds the disease has not been able to spread as quickly into less populous, isolated Arctic towns and villages, in part because even where the national level response has been the key in responding to the pandemic, some Arctic Indigenous communities – especially in North America and Greenland’s self-rule – have closed borders to curtail the spread of Covid-19. This is likely due to the historical awareness of pandemics (notably the 1918 influenza ) and diseases among Arctic Indigenous peoples and regional health authorities, raising the levels of alertness and concern within these communities.

“We have learned that Greenland is a place where you can actually reduce travel, screen people before and after travel. You can undertake large efforts in the population to keep the virus out,” says Dr. Anders Koch. But isolation comes with high social costs to Arctic communities, it is – as anywhere across the globe – a temporary solution.

“I think the only way out of the pandemic is to get as many peoples as possible vaccinated,” says Dr. Koch. The vaccination plan in Greenland currently mirrors the one in mainland Denmark. “Greenland received the same amount of vaccines, relative to the population size of Denmark for the next half year. Prioritized groups are – in the beginning – the same as in Denmark: health personnel and people at high risk of contracting of severe Covid-19 diseases.”

Previous pandemics have taken their toll on Arctic communities (Ittoqqortoormiit, Greenland - by Annie Spratt on Unsplash)

The vaccination program in Alaska is also underway. “It sounds like the federal government has done a fairly good job in getting vaccines to Alaska and there has been an equitable distribution between urban and more remote areas, between the Indigenous people and other communities,” says Dr. Stuart Harris.

He had also just recently received an article citing a woman in Beaver, Alaska, a small village by the Yukon river, which contained some uplifting news. “The woman was saying as they received the vaccine, they were given some discretion on who would get inoculated. When they had a few vaccines left over, they chose speakers of the local Indigenous language as being especially deserving of protection,” Dr. Harris tells.

One year into the pandemic, sharing experiences on the virus, measures taken and vaccination plans remains vital across the Arctic. “Even if you consider the Arctic as one coherent region there are large differences in how you deal with the pandemic. It is important to bring forward the experiences of the different jurisdictions and countries so that others can learn from those experiences. I think the Arctic Council is the right forum for that,” states Dr. Anders Koch.

Dr. Koch was one of more than 50 experts that contributed to the Arctic Council’s Covid-19 in the Arctic briefing document in May 2020. In just five weeks, researchers, knowledge holders, and policy makers from all eight Arctic States compiled and summarized the current knowledge about the virus in the North. Since then, the Arctic Council network has looked into existing and/or potential new projects to advance the Council’s work on Covid-19 – efforts are being spearheaded by the Council’s Sustainable Development Working Group.

Featured photo by Annie Spratt on Unsplash

Listen to the statements of people living in the Arctic and working on Arctic issues on the challenges of the pandemic, the ways it has fostered resilience and on the ways forward in this short video.