Iceland had low COVID mortality despite lighter restrictions

Iceland recorded one of the lowest age-standardised mortality rates among OECD countries in 2020 to 2022, while its average score for formal COVID-19 restrictions was the lowest among 15 countries compared. The figures are outlined in a contributed article by Karl G. Kristinsson published by mbl.is.

Kristinsson writes that international data now make it possible to assess pandemic responses after the fact, following years in which governments had to make decisions amid considerable uncertainty. Restrictions affected daily life, schools, businesses, travel and social contact, and prompted questions about whether measures went too far.

Iceland’s mortality rate fell

OECD figures adjusted for countries’ age structures show that Iceland’s average mortality rate in 2020 to 2022 was 3.9 per cent lower than its 2015 to 2019 average. The rate fell by 4.4 per cent in New Zealand and 3.8 per cent in Norway. It rose by 5.7 per cent in the United Kingdom, 6.2 per cent in Germany, 8.4 per cent in Italy and 11.7 per cent in the United States.

A separate OECD analysis that also accounts for changes in population size and age structure found that New Zealand had the lowest mortality, with Iceland second-lowest among OECD countries.

Lower overall mortality does not mean that COVID-19 caused no deaths, Kristinsson notes. It does show that Iceland’s age-standardised overall mortality was lower in 2020 to 2022 than in the five years before the pandemic.

An international study involving Iceland also found a substantial decline in life-threatening invasive infections caused by pneumococcus, Haemophilus influenzae and meningococcus. The decline was considered linked to pandemic restrictions and changes in behaviour that reduced the spread of respiratory infections.

Restrictions were less stringent than elsewhere

The Oxford COVID-19 Government Response Tracker recorded government measures and calculated a Stringency Index from zero to 100. It includes factors such as school and workplace closures, limits on gatherings and travel restrictions. A higher score indicates stricter formal measures, but does not measure their effectiveness or public compliance.

Recalculations using the tracker’s final daily data for all 1,096 days in 2020 to 2022 gave Iceland an average score of 30.6, the lowest among the 15 countries compared. Finland scored 32.5 and New Zealand 34.7, while the United States scored 48.4 and Italy 52.3.

A peer-reviewed Nordic study comparing the countries from January 2020 to April 2022 reached a similar conclusion. Iceland had the lowest average Stringency Index among the Nordic countries and the lowest excess mortality during the study period.

Kristinsson notes that the restrictions could feel burdensome in Iceland and were substantial at times.