These diagnoses were made using PCR tests conducted by the virology departments at Landspítali University Hospital and Akureyri Hospital, primarily among patients in emergency departments and inpatient wards, with fewer cases identified in primary care.

This pattern is reminiscent of spring 2024, which preceded a wave of infections in July and August. At the peak of that wave, in week 28 (July 8–14), 70 individuals were diagnosed (see Figure 1). While it is too early to determine whether a similar wave is developing, the possibility cannot be ruled out.

Recent data from the European Centre for Disease Prevention and Control (ECDC) do not show an increase in COVID-19 cases across EU/EEA countries.

Hospitalizations at Landspítali

Because most samples for COVID-19 testing are collected in hospital settings (emergency departments and inpatient wards), the number of diagnoses generally correlates with the number of hospitalized patients. At Landspítali, inpatient cases of COVID-19 increased in late May, reflecting the trend in diagnoses above.

Most of these cases were associated with a hospital outbreak among patients and staff. That outbreak has now subsided. Few serious illnesses were reported, including among elderly individuals.

Community Surveillance of Infections

The Chief Epidemiologist has also received reports of suspected COVID-19 infections in the community, where individuals believe they may have contracted the virus. Physicians are reminded to also document clinical diagnoses in the medical record, even when the diagnosis is not confirmed by PCR, such that the Chief Epidemiologist can monitor case numbers and outbreak trends. PCR test results from the microbiology and virology departments at Landspítali and Akureyri Hospital are submitted directly to the Chief Epidemiologist.

COVID-19 Vaccinations

This past winter, COVID-19 vaccinations were offered to the similar target groups as in the autumns of 2022 and 2023. Vaccines remain available, and physicians can advise at-risk patients to seek vaccination at their local health clinic if an infection wave appears to be emerging, even if not yet reflected in formal surveillance data. New vaccination guidelines are expected from the Chief Epidemiologist later this summer and will likely narrow the definition of target groups:

• The age threshold for general recommendations may increase from 60 to 80 years.

• The definition of risk based on underlying health conditions may be significantly tightened.

According to infectious disease specialists at Landspítali, five years after COVID-19 first appeared in Iceland, the risk of hospitalization now primarily affects individuals with bone marrow suppression - due either to disease or cancer treatment - or other forms of severe immunosuppression, such as following organ transplantation or treatment with the B-cell–depleting drug rituximab, which halts antibody production.

The Chief Epidemiologist is currently preparing a detailed review of which underlying conditions should continue to be considered risk factors in the context of COVID-19.

The Chief Epidemiologist