How Denmark Decided COVID Isn’t a Critical Threat to Society

Posted by on February 4, 2022 6:00 am
Categories: Everything Else

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On February 1, Denmark became the first country in the European Union to lift all pandemic restrictions. Indoor mask mandates? Gone. Vaccine passports at bars, restaurants, and stadiums? See ya. Mandatory isolation for infected individuals? Farvel.

Reading this news, you might assume that Denmark succeeded in eliminating COVID. But its infection rate is currently higher than every other country’s in the world—except one: the South Pacific archipelago nation of Palau.

“If you are following Denmark’s infection numbers, this seems like a very, very strange thing to do,” Michael Bang Petersen, a Danish researcher who led a global survey of COVID attitudes and advises the Danish government, told me. But Petersen defends the decision. Because of falling ICU admissions and shorter hospital stays, he said, COVID is no longer a socially critical sickness in Denmark.

[Read: The coronavirus will surprise us again]

On Wednesday, Petersen and I talked about Denmark’s decision, how the country maintains the trust of the public during confusing times, why it’s smart to announce an expiration date for COVID restrictions, and why so many in Denmark are strongly pro-vaccine but also strongly anti–vaccine mandate. This conversation has been edited for clarity and length.

Derek Thompson: Denmark just lifted all COVID restrictions. What justifies this decision?

Michael Bang Petersen: Our hospitals are not being overwhelmed. We have excellent data surveillance of our hospital system in Denmark, and when we look at the number of people in ICUs, it’s dropping. We have a lot of people in hospitals with positive tests, but most of them are testing positive with COVID rather than being there because of COVID. They’re also in the hospital for a much shorter duration than previous waves. The number of people being treated for pneumonia is a critical indicator, and that’s going down as well.

The decoupling of cases and hospitalizations comes from two things. First, Denmark has very high vaccine uptake, with 81 percent of the adult population having two doses and 61 percent having received a booster shot. Second, Omicron is a milder variant. That combination of high vaccine coverage plus a milder variant means this wave isn’t stressing our hospital systems as much.

[Derek Thompson: Is Omicron milder?]

Thompson: Why lift restrictions now? Why not wait until the Omicron wave is over in a few weeks or a month?

Petersen: In order for the Danish government to keep restrictions in place, the disease has to be classified as a threat to the critical functions of society. That is a temporary classification. It only lasts for a few months at a time. The government must purposefully decide to extend the classification every time.

The latest extension was set to end in February. The government had a deadline. We had to decide: Can we really make the case that COVID is a threat, at this moment, to the critical functioning of society? This is a black-or-white decision for us—either COVID is critical or it’s not—and we couldn’t make the case that this poses a societal threat. That’s why we decided to lift all restrictions, including the mask mandate, effective February 1.

It’s important to be clear that waiting to remove restrictions is not a cost-free decision. A pandemic is not just a public-health disaster. It affects all parts of society. It has consequences for economic activity, for people’s well-being, and for their sense of freedom. Pandemic restrictions put on pause fundamental democratic rights. If there’s a critical threat, that pause might be legitimate. But there is an obligation to remove those restrictions quickly when the threat is no longer critical. So, from a purely epidemic perspective, it might have made sense to extend Denmark’s restrictions another two weeks to ensure that we are on the other side of the Omicron peak. But that decision would have come with cost too. Waiting is not free.

Thompson: Is public opinion part of the government’s decision making here?

Petersen: There is support among the public for removing restrictions. But that doesn’t mean people have been strongly opposed to restrictions in general. It seems that what people care about in Denmark is that the hospital system not be overwhelmed. People here support restrictions not only when they’re personally afraid but also when they fear the societal consequences of spread and what it does to the hospital system.

Thompson: What’s been the international reaction to this decision?

Petersen: The reaction has been confusion or disbelief. And I can understand that. If you are following Denmark’s infection numbers, this seems like a very, very strange thing to do. But that is why it’s so important to understand what’s happening in our hospital wards, and all the data coming in from our excellent hospital-data infrastructure shows that this is not a critical threat anymore.

Thompson: One variable that won’t show up in hospitals is the risk of long COVID. Is that a consideration for health authorities or the public?

Peterson: We have clinics for treatment of long COVID here. It’s something we’re factoring into the recommendation. But it’s not something that plays a big role in Danish-government discussions or public discussions about this pandemic, and the general message from health authorities—especially with the vaccines—is that it is rare to have severe cases of long COVID. Most people can expect to have only short-term loss of smell and taste, for example.

Thompson: Denmark removed restrictions in September only to reimpose them a few months later. Is there a risk to the government’s credibility in too much swinging back and forth between restrictions and freedom?

Petersen: On September 10, COVID was declassified, for the first time, as a critical threat. The situation was slightly different than it is now because restrictions had been slowly removed, one after another, for a couple of months. So September didn’t feel like a watershed moment.

Then, in late fall, cases began to build up and people were admitted to hospitals in large numbers. In November, COVID was reclassified as a critical threat, and some milder restrictions were reintroduced—first, the use of COVID passports to get access to various areas. Then Omicron came, and that led to tighter restrictions. I think the government built a lot of trust with the public by making all pandemic restrictions temporary and then lifting them when circumstances changed.

Thompson: My last question for you is about vaccine mandates. I was struck by Søren Brostrøm, the director general of Denmark’s Health Authority, saying, “I do not believe in imposed vaccine mandates. It’s a pharmaceutical intervention with possible side effects. I think if you push too much, you will have a reaction. Action generates reaction, especially with vaccines.” In the U.S., it’s less common to find people who are strongly pro-vaccine but also loudly anti–vaccine mandate. How common is this view in Denmark?

Petersen: In Denmark, people are in favor of vaccines, with more than 81 percent of adults doubly vaccinated, but also very opposed to vaccine mandates. There are no political parties in Parliament that are loudly advocating for vaccine mandates. When the legal framework for pandemic restrictions was formulated, there was a big discussion about vaccine mandates, but that provision was ultimately taken out. I think this is partly related to the fact that our vaccine coverage is so high, so people might feel less of a need to force people to be vaccinated. But also, research suggests that vaccine mandates might enhance what makes people anti-vaccine in the first place, like distrust of authorities and feeling like they’re being forced to do something that’s bad for them.

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