It is Wednesday in Copenhagen — and it is like being in a pre-pandemic time-warp. There isn’t a mask to be seen: not in the sleek glasshouse of the Torvehallerne food market; not in Illum, the luxury department store; not on the busy metro; and not in the German-style Christmas market on Nytorv square, just off the lengthy pedestrianised shopping street, Strøget.
ou have to look hard to find any reference to Covid-19. With the exception of the odd yellow sign on the street marking the location of free antigen testing, there’s no indication of a global pandemic. You won’t find stickers on the floors of shops and restaurants urging social distancing or the sort of cautionary posters we have become so used to seeing in Ireland.
Some shops have a bottle of antibacterial gel at the door, which most customers seem to ignore. In restaurants and cafés, there is a small, discreet notice advising people that they most show a ‘Coronapas’, proof of vaccination, if they wish to dine indoors.
It takes quite a bit of adjusting, but Copenhagen residents are used to it. Denmark had far shorter lockdowns than Ireland and, in September, it reopened fully, becoming the first country in Europe to do so.
Rising case numbers over the past few weeks led to the reintroduction of the Coronapas. From Monday, people will be asked to wear masks on public transport, in supermarkets and in hairdressers. But life, largely, has returned to the way it was in the winter of 2019.
Lone Simonsen, professor of epidemiology and the director of the PandemiX centre at Roskilde University, is one of Denmark’s foremost experts on the Covid response.
“There was no surprise that the [case] numbers would go up once the country reopened and the schools and universities went back, she says. “And when you factor in the seasonal effect, rising numbers were to be expected.
“What was very nice is that severe outcomes did not go up the same way. Deaths are very steady and at a low number. Same too with numbers in ICU. Hospitalisations are climbing up towards our pain level, but I am not alarmed yet. We are rolling out third doses to the elderly. Half of hospitalisations are from the elderly and that’s because it was too long ago [since they had their second dose].”
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Mask-free: The Christmas market in the centre of Copenhagen. Photo by John Meagher
With a population of 5.83 million, Denmark has 835,000 more people than the Republic of Ireland, but the hospital figures are much lower. On Thursday, 435 people were in hospital with Covid in Denmark, with 49 of those in ICU. In Ireland, on the same day, 598 coronavirus patients were in hospital with 132 of those in intensive care. The total number of cases since the pandemic began is about 462,000 in Denmark and 542,000 in Ireland. For deaths, the latest available figures on Thursday were 2,829 and 5,652 respectively.
Simonsen says the success of Denmark’s vaccine programme has ensured that, for many, life has returned to a sort of normality. “We’ve had 95pc of people over 50 who are fully vaccinated,” she says. “That’s a very high response rate. The message has got through.”
She says there is no talk about a nationwide lockdown, no discussion about whether Christmas can be “saved”. She is puzzled by such sentiments in Ireland, when told of the mood here, and says Denmark’s approach from the outset has been cool, calm and measured.
“There’s a high level of trust in this country,” she says. “People will follow the advice from the government and the health officials and if they’re advised to wear masks again, for instance, they will do that.”
Antigen testing has been a key part of the Danish response for most of the year. Around the time that senior Nphet member Philip Nolan was dismissing antigen kits as “snake oil”, Danes were embracing them. Simonsen says in the early days of antigen testing, around the time that the vaccine rollout started to speed up, “one in 10 people were tested every day — and that really helped to keep numbers down”.
While Ireland’s politicians and senior health officials debate the pros and cons of antigen testing and to what extent they should be subsidised, in Denmark both antigen and PCR tests have long been available free of charge.
The numbers of PCR and antigen tests in Denmark are mind-boggling — more than 47 million of the former and 44 million of the latter have been taken. It amounts to an average of eight of each tests for every man, woman and child in the country, and a considerable expense to the Government. But, then, Danes pay high levels of tax and expect their money to go to good use.
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Strong buy-in: Medical staff carry out a PCR test on a ‘Partybus’ in Ishoj
One of the first sights to greet the visitor to Copenhagen Airport, once they have been through the arrivals gate, are booths offering free Covid tests.
Jens Lundgren is professor of infectious diseases at Copenhagen University and a senior consultant at Denmark’s largest hospital, Rigshospitalet. “Generally, we have been doing OK,” he says. “We have never had an absolute crisis situation. The [early] restrictions were able to dampen transmissions, but those restrictions have been a tough cure.
“We’ve always thought that PCR was better than antigen, but with the way the testing strategy evolved, it became clear the system couldn’t cope. Also, people needed immediate answers — you can do that with antigen tests.”
Lundgren says there has been a strong buy-in from the Danish population because at every stage in the pandemic, measures taken have been clearly and effectively communicated to them. Take mask-wearing.
“At all time points, you have to consider that if the transmission load is pretty low and few people are infected in society, having a lot of people wearing a mask isn’t of much benefit,” he says. “But if transmission levels are pretty high, the number who need to wear masks becomes meaningful. People understand that and, generally, change their habits if there are new recommendations.”
Lundgren says there has been consistent communication during the pandemic — which, to Irish ears, feels remarkably smooth compared with the often haphazard and disjointed messaging from the Government and Nphet.
Reopening
He believes, in retrospect, that Danes were oversold the reopening of the country in September. “There will always be a discussion on whether or not the rhetoric back then was too much in favour of saying, ‘We don’t have Covid any more’. Maybe that was a mistake that people thought we were over the pandemic. Not that I disagree with lifting the restrictions — back then, I thought that was a reasonable thing to do.”
Lars Igum Rasmussen is a health journalist with Politiken, a broadsheet newspaper. “I think there’s been a good response to the pandemic here,” he says. “In Denmark, we don’t have these pockets of unvaccinated elderly people like you see in the US and in parts of eastern Europe.
“The government and the experts and the healthcare system here has succeeded in convincing people in voluntarily getting the vaccine — it’s been a success, especially among old people. There have been breakthrough infections in the past weeks in nursing homes, but the booster vaccine has helped stabilise the situation and it is thought that into December the number in hospitals will reduce.”
Rasmussen believes history will show that one thing Denmark got wrong was the communication at the end of this summer that the pandemic was in effect over. One of the most eye-catching symbols of the reopening was a restriction-free concert in Copenhagen’s Tivoli Gardens.
“There was a perception in the population and among some of the politicians that we were done with the pandemic,” says Rasmussen. In September, some of the finest experts made a report about how to live in an open society with the pandemic but it didn’t get much attention because we all thought we were out of it, especially when all of the restrictions were lifted.”
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Comparison of Covid-19 deaths between Denmark and Ireland. Graphic by Shane Mc Intyre
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Comparison of Covid-19 cases between Denmark and Ireland. Graphic by Shane Mc Intyre
The journalist says it was “a minor shock to the Danish population” when cases started to rise in the autumn. “I don’t think it was communicated well enough that this time of year you should expect the infection rate and hospitalisations to rise,” he says.
Rasmussen says there has been little pushback to restrictions from the populace at large. There have been protests on restrictions but nothing on the frequency and scale of those witnessed elsewhere in Europe.
He talks about Søren Brostrøm, the director general of the Danish Health Authority — effectively Denmark’s answer to chief medical officer Tony Holohan or HSE director general Paul Reid. “Nobody knew him outside of health circles before the pandemic, but now he’s really famous,” he says.
“He’s gay, and on Saturday he was awarded a [person of the year] award by the LGBT community here.
“At the beginning of the pandemic, when his star was on the rise, there was this joke in Denmark: ‘When Søren Brostrøm asks you to jump, you don’t say, ‘Why?’, you say, ‘How high?’”
There was chaos in the early days of the pandemic. “That was the case for the first month or so,” he says, “but after the first wave here, the health authorities and the government made sure to communicate the same message. It was very much in the same direction. The government has succeeded in getting almost all the political parties to agree on the measures they’re taking. A couple of weeks ago, when Covid-19 was upgraded to a society-critical disease once again, all parties in the parliament, except for one, supported it. And it’s been supported right across Danish society.”
Voluntary compliance
Michael Bang Petersen is a professor of political science at Aarhus University and he led the country’s largest behavioural Covid project, Hope: How Democracies Cope With Covid-19, and advised the Danish government.
“Overall, if we look at mental health and feelings of fatigue, Danes haven’t been that severely effected as they have been in other countries,” he says. “We don’t have data on Ireland specifically, but we can see that in relation to other places, Danes have managed to get through this point of the crisis without too severe effects on general mental health and they have felt much less lonely.”
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Professor of political science at Aarhus University, Michael Bang Petersen
Petersen believes there are two reasons for this. “Firstly, there has been very high support throughout the pandemic in terms of the government’s response. We humans are strange creatures in that we can bear a lot of suffering if we can see a meaning to it. When we have engaged in distancing and sitting at home watching Netflix, it felt that we were doing something meaningful.
Visit our Covid-19 vaccine dashboard for updates on the roll out of the vaccination program and the rate of Coronavirus cases Ireland
“The other part of it is that there has been large voluntary compliance with the advice coming from the authorities and that’s meant that the restrictions have been less severe simply because the Government expected people to comply with whatever was in place. What you’re seeing now is an example of that.
“Right now, there’s no mask mandate, so people don’t wear masks. If there’s a mask mandate next week, people will be wearing masks. Interestingly, we can see from our data that there is pretty large support for the introduction of this mandate, but people don’t do it for themselves.”
It is a sentiment echoed by Christian and Stine, a couple sitting next to Review at the Coffee Collective café in the centre of Copenhagen. “There is a very high level of trust of government in this country,” Stine says. “We may not like the politician or vote for them but we believe they are there to do good for the country.”
Her husband warms to the theme. “No politician or health expert would ever dare speak down to the people,” he says. “We are not treated like children. When they make decisions — whether it’s about Covid or something else — they explain the reasons for it. If those decisions are reasonable, people support them.”
Clare man Billy O’Shea is a Trinity College Dublin graduate who has lived in Denmark for 40 years. A Danish-English translator, he is married to a Dane and has three adult children. “To the Danish government’s credit, they did get a pretty firm grip on it from the start,” he says, “and that’s meant the number of deaths has been relatively low, certainly compared to Sweden.”
The big difference between Ireland and Denmark, he says, “is that the Irish love a good argument, a fight, and the Danes are exactly the opposite. The Danes have a horror of open conflict. They will always seek consensus if they can and that’s been very apparent in this pandemic. There’s an awful lot of political parties here, but pretty much all of them have been in agreement. They said, ‘Look, this is what we’ve got to do’ and, by and large, people said, ‘OK’. We have our anti-vaxxers here too, but 95pc of the population, at least, got fully behind it.”
There’s another key reason why O’Shea believes Denmark has managed Covid better than Ireland.
“Ireland is streets ahead when it comes to culture — music and literature and so on — but one area where the Danes are ahead is that they’re extremely good at organisation. They had the [Covid test] tents set up in the parks within a week or so. You’re in and out in 10 or 15 minutes and you get your response by SMS about 20 minutes later. It’s all been so efficient. And it is aspects like that that help give this sense of normality, even if it might be illusory.”
