Iceland Does It Right

Iceland has done a good job of controlling COVID-19, despite keeping its borders open because of the country's heavy reliance on tourism. This article from Nature explains what Iceland has done and details some of the findings that researchers there have made about the disease.  

In a nutshell, they relied on extensive testing, contract tracking, and quarantines of people who tested positive. Some lockdowns were necessary, but are being relaxed as infections decline.

I found this especially interesting, and concerning.

In early spring, most of the world’s COVID-19 studies focused on individuals with moderate or severe disease. By testing the general population in Iceland, deCODE was able to track the virus in people with mild or no symptoms. Of 9,199 people recruited for population screening between 13 March and 4 April, 13.3% tested positive for coronavirus. Of that infected group, 43% reported no symptoms at the time of testing. “This study was the first to provide high-quality evidence that COVID-19 infections are frequently asymptomatic,” says Jade Benjamin-Chung, an epidemiologist at the University of California, Berkeley, who used the Iceland data to estimate rates of SARS-CoV-2 infection in the United States. “It was the only study we were aware of at the time that conducted population-based testing in a large sample.”

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A smaller population study, carried out in an Italian town, came to similar results on asymptomatic infection months later. When a 78-year-old man died in the northern Italian town of Vo’, Italy’s first COVID-19 death, the region’s governor locked the town down and ordered that its 3,300 citizens be tested. After the initial round of government testing, Andrea Crisanti, head of microbiology at the University of Padua in Italy, asked the local government whether his team could run a second round of testing. “Then we could measure the effect of the lockdown and the efficiency of contact tracing,” says Crisanti, who is currently on leave from Imperial College London. The local government agreed. On the basis of the results of the two rounds of testing, the researchers found that lockdown and isolation reduced transmission by 98%, and — in line with Iceland’s results — that 43% of the infections across the two tests were asymptomatic.

That would certainly explain why there is so much community spread and reinforces the message to "wear a mask".