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There are two countries at the top of the league tables in testing their populations for SARS-CoV-2: the Faroe Islands, a self-governing archipelago north of Scotland that belongs to the Kingdom of…
There are two countries at the top of the league tables in testing their populations for SARS-CoV-2. One of them is not quite an independent sovereign state: it’s the Faroe Islands, a self-governing archipelago north of Scotland that belongs to the Kingdom of Denmark.
The other is Iceland. Each of these North Atlantic neighbours has tested about 10 per cent of its entire citizenry for the COVID-19 virus, and has benefited from having such complete coverage. Canada, by comparison, is at about one per cent ― and we’re still well ahead of the U.S. These are small countries: only 52,000 people live in the Faroes. But their success lends itself to storytelling, because in each case it is attributable to one person. In the case of Iceland the person is world-famous. It’s Kári Stefánsson, the founder and CEO of the Reykjavik-based company known in English as deCODE Genetics. It is not quite enough to say that Stefánsson is a controversial figure in his homeland. An Icelandic novelist once wrote a satirical book which included a lightly disguised portrait of Stefánsson as a villainous national Faust, and in the movie adaptation Stefánsson himself appeared in the role. Because of Stefánsson, Iceland was very well-prepared to meet the challenge of pandemic disease. He returned to his native country in 1997 after an impressive career in American medicine. He had caught the fever for gene-based personal medicine that was sweeping the biotech world at that time, and he had a grand scheme for sequencing the DNA of every person in Iceland, matching those data with the country’s unified database of health records, and matching those data, in turn, with Iceland’s incredibly extensive genealogical records. This would transform the country ― fantastically isolated, and never subject to much immigration over the past thousand years or so ― into a research superpower. It seemed possible to mass-produce exotic details of the human genome and create myriads of corresponding treatments for chronic disease. If there’s one thing geothermally-heated, aluminum-smelting Iceland understands, it’s turning natural heritage to human advantage. This plan didn’t quite live up to Stefánsson’s wishes: life’s like that for visionaries. The country revolted against his idea for state co-operation in mass, undifferentiated data-linkage. And personalized medicine didn’t pan out according to everyone’s Nineties dreams. Very few conditions have turned out to conceal a lone genetic master key, or anything like one. deCODE went bankrupt in 2010. But the dream survives with a few tatters in its garments. It turned out that Icelanders were quite prepared to assist a compatriot with genetic research on the simple condition that they were asked nicely and assured of privacy. deCODE has records of whole genomes for something like 60,000 Icelandic adults. The company hired a partner to build an online family tree covering just about every human of Icelandic descent known to have existed, and made it public. It is all linked up, as Stefánsson hoped, with government health records. And the modified scheme has, in fact, yielded enormous amounts of information about the human genome ― just not in an easily monetizable form. When deCODE sank commercially, it was bought by a U.S. biotech consortium more or less out of gratitude on behalf of Earth’s geneticists, and Stefánsson was kept on. That’s why Iceland was ready for battle with a virus ― and how it might now help meaningfully with everybody else’s effort. Already deCODE’s testing capacity has given the world the first truly random test for presence of the virus in asymptomatic individuals, demonstrating that SARS-CoV-2 infections outnumber cases of COVID-19 illness about two to one in Iceland. Within days we should know how many of the asymptomatic Icelanders eventually got sick. And this initial dataset is likely to be crucial in estimating the effects of age and of underlying health conditions. All right, you say: that explains Iceland. Some of you will have read about Stefánsson before, in Wired magazine or some such place. It’s a small country that has one brilliant, possibly slightly megalomaniac pioneer of genetics. But what about the Faroes?It’s a humbler story, suited to a country even humbler in dimension than Iceland. Reporter Daniel Boffey told it in the Guardian on Wednesday. The Faroes have a National Reference Laboratory for Fish and Animal Diseases ― it is not really a coincidence that islands are good at this sort of thing ― and Debes Christiansen, its boss, became convinced of the peril from SARS-CoV-2 very early. He was the right person to do so. The lab’s fancy DNA-sequencing equipment is devoted to animal disease, but the machines don’t know of any differences between your mother-in-law and a turbot. Christiansen just had to obtain suitable SARS-CoV-2 samples and some control reagents, and it was off to the races. His main bottleneck, he told the Guardian, is having enough assistants to take and run samples from Faroese people. One senses that regulatory static was not a problem for a “reference laboratory.” What, like COVID-19 isn’t an “animal disease”?
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