Information about COVID-19

What is the coronavirus/COVID-19?

Coronavirus is a family of viruses that can cause mild colds and serious infections in air respiratory passages. In December 2019, an outbreak of a type of coronavirus not seen before in humans occurred in China. The WHO has called this new coronavirus COVID-19 (Corona Virus Disease 2019).

Common COVID-19 symptoms

The typical symptoms from COVID-19 are similar to symptoms from other respiratory infections, such as a cold or the flu. Usually, symptoms are mild to begin with.

Typical symptoms

Typical symptoms are:

• Fever
• Dry cough
• Difficulty breathing
• Fatigue
• Loss of sense of taste or smell
• Sore throat
• Runny or stuffy nose

Some people can experience different symptoms, e.g. nausea and vomiting.

The symptoms can vary from person to person and whether you have a fever or not, does not mean you do not have COVID-19.

Overview of symptoms

In table 1 below the most common symptoms are given together with the less common symptoms. For each symptom, it is stated how often this symptom occurs among people who are infected with the coronavirus.

Common symptoms	Frequency	Information
Fever	77%	Fever may be absent or only momentary for children.
Dry cough	68%	Coughing is less common among children, however it is a very common symptom among infants. For adults, the cough may continue for several weeks after the first symptom.
Difficulty breathing	38%	Difficulty breathing typically occurs 5-8 days the first symptoms.

Less common symptoms	Frequency	Information
Loss of sense of taste or smell	41%	Most people regain their senses within four weeks.
Fatigue	30%	Fatigue and exhaustion are very dominant and long-lasting symptoms for some people.
Chest pain	23%
Gastrointestinal problems	20%	Especially symptoms such as loss of appetite, nausea and vomiting.
Muscle ache	17%
Joint pain	11%
Spitting when coughing	18%
Sore throat	16%
Headache	16%
Dizziness	11%
Neurological symptoms	11%
Eye symptoms	11%	Eye symptoms are often mild and last 4-14 days without any further complications.

COVID-19 infection process

Incubation period

The incubation period is the time that elapses from the moment you are infected until you develop symptoms. It will typically be 5–6 days. However, the incubation period can last for 1–14 days.

Infection paths

The coronavirus infects people in the same way as the cold or the flu infects people, with the virus spreading from respiratory passages in an infected person to another person’s mucous membrane in the eyes, nose or mouth in one of the following ways:

Infected through droplets
An infected person can, for example, by coughing, sneezing or shouting, spread droplets that contain the virus. The small droplets from coughing and sneezing spread through the air to a distance of 1–2 m. The droplets can be breathed in by another person and enter the mucous membrane in their nose, eyes or mouth, thus infecting them. Most of the droplets fall to the ground within 1–2 m and in general, the risk of being affected by droplets is therefore reduced by keeping to a distance from other people.

There is no evidence that the virus can infect people by the virus remaining in the air. In other words, the virus is not considered to be “airborne”.

Poorly ventilated spaces increase the risk of being infected form the droplets in the air because the density of droplets increases and because the droplets stay in the air for longer. Therefore, there is generally greater risk of becoming infected indoors, when for example many people meet in small spaces and or remain in an area for a long time where there is poor ventilation.

Infection through contact
Infection can occur by direct or indirect contact.

Direct contact
Direct contact is where an infected person transfers the virus by e.g. spitting or blowing their nose into their hands and then spreading the virus to other people by e.g. shaking hands. The next person can transfer the infection to their own mucus membranes in the nose, eyes or mouth. It is therefore important that you wash your hands often and thoroughly and avoid touching your face with your hands.

Indirect contact
Indirect contact occurs when an infected person coughs, sneezes or shouts, or touches surfaces with unclean hands, leaving the virus on the surfaces of things like handles and handrails. The next person who touches such surfaces can transfer the virus to the mucus membrane in their nose, eyes or mouth and become infected.

It is not certain what percentage of people infected with COVID-19 are infected through different respiratory passages.

Infection without symptoms

You can infect other people even though do not have any symptoms or even know that you are sick.

In general, the evidence is that infected people infect other people when they cough or sneeze a lot. How many people get infected depends on how much virus you spread, how intense the symptoms are and how sick you are. If you have a lot of the virus in your respiratory passages and cough or sneeze, there is a greater risk that you will infect others with the virus. This is why you should isolate if you show symptoms or if you test positive for COVID-19.

People without symptoms can spread the virus without actually knowing this and without finding out before some of the people they have infected have become ill. However, you must be close to a person without symptoms to become infected. The fact that people can become infected with COVID-19 without the infecting person feeling ill, has meant that COVID-19 has spread quickly around world. An infected but apparently healthy person (called a “healthy carrier”) who meets or interacts with a lot of people, can infect a lot of people. Therefore, the authorities recommend that you limit your physical contact with other people, even when they appear healthy. It is necessary that we keep to distance from other people and avoid spitting, shaking hands, embracing, etc.

Infection via surfaces

The virus can be transferred by physical contact but is important to remember that you do not necessarily become infected just by touching an item that has the virus on it. The virus must come into contact with the mucous membrane in the mouth, nose or eyes for a person become infected. Therefore, you should not be afraid to touch things, but you must remember to wash your hands. We recommend you wash your hands often and thoroughly and always when you arrive home. In addition, it is important that you do not touch your face while you are outside because your hands may not be completely clean.

Types of infection

Pre-symptomatic infection

There is a lot of evidence to show that you are most contagious to those around you on the day you get symptoms. However, in the days leading up to getting symptoms, you can still be contagious and thus infect others by what is known as pre-symptomatic infection.

Asymptomatic infection

Some people are contagious and infect others even when they never develop symptoms. This is called asymptomatic infection.

Symptomatic infection

The risk of infecting other people is greatest when an infected person develops symptoms, i.e. symptomatic infection. However, in relation to the general spread of the infection in society, infection can spread from people who have very mild or no symptoms, i.e. pre-symptomatic and asymptomatic infection, can be significant.

Super spreader events

In a situation where there is a degree of infection protection and thus control of the epidemic, individual and random events can have the potential to be major causes of the epidemic flaring up, both locally and nationally. In connection with this there is focus on “super spreader events”, which describe events where one or a few infected people infect a lot of other people during a single event.

Super spreader events can arise due to different factors related to the event, including the number of people present, distance, duration, risk factors for infection from droplet like singing, the infected person(s) viral disease, etc.

Super spreader events can explain how a small number of infected people can be responsible for infection of a large part of society. If super spreader events can be prevented, you can better maintain control of the epidemic.

Testing for the COVID-19

There are several types of tests available for the coronavirus. The test result is only valid for the time it was taken and therefore it is important that you continue to follow the infection prevention recommendations, regardless of what your test result is.

Test types

	PCR test		Antigen test	Antibody test
Aim	A PCR test detects coronavirus RNA and can detect even a single virus particle in a mucus sample.		An antigen test/a quick test detects virus proteins in a sample using a immunochemical test.	An antibody test detects antibodies for coronavirus.
Sensitivity	The test is highly sensitive and is considered reliable.		The test is less sensitive than a PCR test and therefore less reliable.	It is not known how long you can detect antibodies after infection.
Test procedure	The test is carried out by taking a sample of secretions from the throat or nose.		The test is carried out by taking a sample of secretions from the nose.	The test is carried out by taking a blood sample.
Use	This test is used by the Greenlandic Health Service.		This test can be used as a supplement to a PCR test in situations where a quick result is important or a PCR test is not available. It can also be used for self-testing.	This test is not used by the Greenlandic Health Service, except for in some purely clinical situations.

1. PCR test

A PCR test is a very sensitive test method that detects coronavirus RNA. The test is carried out by taking a sample of secretions from the throat or nose and it is this method that has the most reliable test result.

To learn more about PCR testing visit the Statens Serum Institut (SSI) website.

The test result is only valid for the time it was taken and therefore it is important that you continue to follow the infection prevention recommendations, even if your test result is negative.

2. Quick test

A quick test (also called among other things, an antigen test, rapid test), detects virus proteins in a sample using a chemical test and the sample is taken from the nose. A quick test is less sensitive than a PCR test and therefore is less reliable. However, you can get a result back in approximately 15 minutes and it can there help to break chains of infection faster. 

A quick test result is only valid for the time it was taken and therefore it is important that you continue to follow the infection prevention recommendations, even if your test result is negative.

3. Antibody test

We know that most types of viruses that cause infections in the respiratory passages, e.g. influenza and other types of coronavirus, lead to immunity for a period of time. When you are immune to a virus, you cannot be re-infected. Current knowledge indicates that most people build up immunity to COVID-19 after they have been infected and become well again. Test have been developed that can detect antibodies that fight the coronavirus in the blood. Antibodies are what the body forms to defend itself against a virus. Unfortunately, we do not yet know to what degree antibodies protect against re-infection or for how long immunity lasts after you have become well again. Therefore, an antibody test, which is taken as a blood sample, does not indicate whether you can be re-infected or not.

The Greenlandic Health Service only tests for antibodies in completely special clinical situations.

Coronavirus mutations

It is completely natural that the virus changes and new mutations evolve as the virus spreads. Most mutations do not change the way the virus works and are therefore insignificant. Some mutations can weaken the virus while other variants contain mutations that change the virus’s biological properties and e.g. make the virus more infectious, more able to cause disease or more able to avoid antibodies from vaccines or from previous coronavirus infections.

Some types of mutations must we watched carefully by scientists. The authorities pay extra special attention to mutations with the following characteristics:

• More infectious
• Cause more serious illness
• Spread from animal to human and vice versa
• Reduce the effect of vaccines

Infection via foods

The Veterinary and Food Authority in Greenland (VFMG) is part of the Ministry for Fisheries and Hunting and Agriculture. The legal basis for the work done by VFMG is set out by the Greenlandic and Danish authorities. The veterinary relationship is organised in Denmark and explained in more detail by the Ministry of Food, Agriculture and Fisheries: Ministry of Food, Agriculture and Fisheries (foedevarestyrelsen.dk).

Below you can read about COVID-19 in relation to food and animals. All of the information comes from the Danish authorities’ websites, which you can find links to below or from the more general links that are given above.

For citizens relating to foods, purchasing and preparation

There are no reports about infection of COVID-19 via foods or food packaging. It is generally recommended that you always maintain good hygiene in the kitchen, including rinsing fruit and vegetables and washing your hands regularly. For example, it is always advisable to wash your hands before you prepare food and before you eat.

For food companies and kitchens in institutions, schools, restaurants, etc.

In general, there are no reports about infection of COVID-19 via foods or food packaging.

It is recommended that customers follow the shop/company’s instructions relating to hygiene and use the protective equipment that is made available. It is also the customer’s responsibility to keep to a safe distance and follow the advice that is issued by the National Board of Health in Greenland (“Landslægeembedet”).

It is recommended that there is extra focus in areas where customers personally handle food, e.g. pick and mix sweet counters, bread and cake counters, salad bars/buffet counters. These should be cleaned regularly and it must be ensured that the customers use gloves, spoons or tongs when selecting items. In addition, companies should pay attention to the tendency of people to congregate in these areas.

Ensure that good hygiene is maintained when handling foods. As an extra precaution, VFMG recommends that employees who come into direct contact with ready-to-eat foods (e.g. sushi, salads, sausages or similar) should wear gloves.

More information:

Coronavirus and foods – cafés, restaurants and take aways (foedevarestyrelsen.dk)

Coronavirus and foods – retail, supermarkets and production companies (foedevarestyrelsen.dk)

Coronavirus (foedevarestyrelsen.dk)

Animals and COVID-19

Experimental studies have shown that dogs, cats, ferrets, rabbits and hamsters can be infected with the coronavirus (COVID-19). COVID-19 has been found in dogs, cats and mink in Denmark and COVID-19 has also been found in mink in the Netherlands. Across the world and including in Denmark, it has been reported that coronavirus (COVID-19) has been found in pets (dogs and cats) and it is believed that they were infected with COVID-19 from humans. The spread of the virus chiefly occurs through droplets between the people when an infected person coughs or sneezes. There is yet no evidence to show that pets play a role in the spread of the coronavirus.

It is recommended that you also follow the general advice relating to hygiene when you are in contact with your pet. For example, avoid sharing food with pets and do not allow the animal to lick your face. In addition, you should wash your hands every time you have been in contact with your pet.

If it is confirmed you are infected with COVID-19, it is also strongly recommended that you limit your contact with animals. If possible, you should let someone else in your household take care of your pets when you are ill.

More information:

https://www.foedevarestyrelsen.dk/Leksikon/Sider/Coronavirus-og-k%C3%A6ledyr.aspx

Long-term symptoms/late complications from COVID-19

Most people who have had COVID-19 become well again without any treatment and can return to normal daily life, even though it may take some time. However, a small group of people experience symptoms for a longer period of time and some people experience late complications.

What are long-term symptoms of/late complications from COVID-19?

There is no official definition of late complications. It is therefore difficult to distinguish between long-term symptoms and symptoms in the long term that are reasoned to be late complications from COVID-19.

Regardless of whether you experience long-term symptoms or late complications, it does not in itself mean that you require attention from the health service. The decision will always be based on an assessment of the complexity and seriousness of the symptoms.

What are the most common long-term symptoms/late complications from COVID-19?

COVID-19 can cause a number of different long-term symptoms, whose seriousness varies from person to person and can affect the individual person’s ability to function differently. Different long-term symptoms have been reported (which last longer that four weeks after the illness started). The most common are:

• Difficulty breathing and coughing
• Chest pains, a tight chest and palpitations
• Fatigue and fever
• Cognitive problems such as difficulty concentrating and remembering things, headaches, sleep disorders, peripheral neuropathy (reduced/changed sense of touch), dizziness and delirium (state of confusion, often seen in the elderly)
• Stomach pains, nausea, diarrhoea, anorexia/reduced appetite (in the elderly)
• Joint and muscle pain
• Symptoms of depression and angst
• Loss of sense of taste/smell, tinnitus, earache, sore throat, dizziness
• Skin rash

It should be noted that there is still very little knowledge about most of the reported symptoms.

Who gets long-term symptoms/late complications from COVID-19?

It is estimated that approximately 10% of the people who are infected with COVID-19 experience long-term symptoms (which last for more than four weeks after the start of the illness). It is still not known how many of them continue to experience symptoms after 12 weeks and therefore have late complications.

Long-term symptoms/late complications in connection with COVID-19 are seen in people of all ages. It can be seen in people who have had mild symptoms and in people who experienced serious illness with hospitalisation.

How much do we know about long-term symptoms/late complications?

Since COVID-19 is still a relatively new disease, knowledge about long-term symptoms and late complications is limited. There may be different reasons why some people experience long-term symptoms or late complications from COVID-19. Some reasons are known, e.g. if you were on a respirator, but other reasons are still unknown. Long-term symptoms or late complications are however not a new phenomenon, since corresponding long-term symptoms and late complications for other coronavirus like SARS and MERS have already been described.

Can I be treated for long-term symptoms or late complications from COVID-19?

As the individual person can experience different long-term symptoms or late complications, there will be different needs for attention and treatment. Most people are expected to recover under their own efforts even though for some people it will be a long process.

Regardless of whether you experience long-term symptoms or late complications, it does not in itself mean that you require attention from the health service. There may be lighter symptoms, which also last for several months, which slowly lessen and eventually disappear. On the other hand, you may require attention from the health service before the 12 weeks have passed. The decision will always be based on an assessment of the complexity and seriousness of the symptoms and the impact on the individual’s functional level, as to whether the health service should provide treatment.

Can late complications from COVID-19 become chronic?

It is too early to say anything about the duration of late complications, but the assessment is that they lessen gradually in most people who have them, even if it can take a long time. There is therefore nothing to suggest that you will not recover over time. Thus, if you experience long-term symptoms/late complications that last longer than 12 weeks, it does not mean you have a chronic condition.

Who do I speak to if I believe that I have long-term symptoms/late complications from COVID-19?

If you experience symptoms for a longer period of time in connection with having been ill with COVID-19 and are worried, you can contact your local health service and get a preliminary examination. The local health service can treat patients who experience late complications – both those previously admitted to hospital and those who were not non-admitted patients. In the case of unexpected and/or complex and long-term complications, you can contact Dronning Ingrids Hospital for further examination.

Risk groups and highly vulnerable people

The health authorities have devised the following guideline which contains good advice and special precautions for persons in risk groups and highly vulnerable people.

People who are at increased risk of becoming seriously ill from COVID-19

It is always an individual assessment as to whether you are at risk of a serious illness with COVID-19 and the whole situation must be included in the assessment. However, in general, elderly people who also have several and serious chronic conditions are at a higher risk than people who only have a single mild chronic condition. There may also be social circumstances, for example, your abode situation, which overall can mean you are in a higher risk group.

People who are 80 years old or older

If you are 80 years old or older and have a chronic disease or condition, you are at an increased risk even if you are otherwise healthy and well.

People aged 65 to 79 years

Many healthy and well people in the age group 65 to 79 years, are not an increased risk, but you will be at higher risk if:

• You have a chronic disease
• Are mentally and physically frail

People aged less than 65 years

Only a few people who are aged 65 years old or younger are at a higher risk, but people in this age group are at a higher risk if they:

• Have certain diseases
• Have a chronic disease that is difficult to control
• Are overweight with a BMI of 35 or greater
• Are immunocompromised

Certain children and young people with chronic disease

Diseases and conditions that lead to a higher risk in adults, cannot be directly applied to children and young people. Children and young people who may be at a higher risk are typically children who also before the COVID-19 had to follow special rules, e.g. special conditions in connection with school/day care. These children are typical followed by a special clinic and thus receive individual assessment and advice.

Residents in assisted living residences and homes for the elderly

Residents in assisted living residences and homes for the elderly are at an increased risk as they are often elderly and have chronic diseases, poor functional ability and frail health.

Pregnant women

Pregnant women are considered to be at a higher risk in consideration of both the pregnant woman and the unborn child.

Good advice for people at a higher risk

In general, if you are someone who is at a higher risk, you can continue to do the things you did before the COVID-19 pandemic, e.g. go to work, participate in leisure activities and take care of your grandchildren.

If before the COVID-19 pandemic, you had to follow special precautions in your daily life to avoid being infected with an infectious disease, e.g. you have a special condition and are immunocompromised, you should continue to follow those precautions.

The National Board of Health in Greenland (“Landslægeembedet”) recommends the following for persons who are at a higher risk:

• Get re-vaccinated
• Follow the recommendations from the Office of the Medical Director of Health and ask others to be mindful
• Avoid large events and gatherings of people where you can’t keep a distance to other people
• Consider using a face mask in public spaces where you can’t keep a distance to other people
• Consider talking with your workplace about how to ensure that you can go to work safely

The older you are – the more and more serious chronic diseases have – the more attention you need to pay to following the recommendations. You must naturally take your quality of life into consideration, when you place limits on your life.

Contact your local health service or the doctor who treats you if you are unsure of what you need to do in relation to your overall situation.

Good advice for relatives of people who are at a higher risk

As the relative of someone who is at a higher risk, it is quite natural that you can become worried.

We recommend the following for relatives of people who are at a higher risk:

• Pay particular attention in complying with the general advice relating to infection prevention that is issued by the National Board of Health in Greenland (“Landslægeembedet”). Also help your parents and other people who you live with to remember the advice – also children.
• Pay careful attention for any symptoms that could be COVID-19. Immediately isolate if you develop symptoms. This also applies to mild symptoms or if you are a close contact or are infected with the coronavirus. If you are infected with the coronavirus and live with another person who is at a higher risk, you may be provided with isolation accommodation outside the home.

Contact the Corona Secretariat to learn more.

Focus on mental health

The coronavirus pandemic can be quite difficult to live through. Outbreaks of infectious diseases like the current coronavirus pandemic, can affect your well-being and mental health. Worries about becoming infected and about the economy can lead to loneliness and symptoms of stress, depression and burn-out.

Below is some good advice about how you and your loved ones can get through the coronavirus pandemic.

Look after yourself

Look after yourself
Try to avoid bad habits like irregular sleep, too much alcohol and smoking.

Try to sleep well and keep to a normal 24-hour rhythm
The less you sleep the more likely you are to become worried and anxious.

Eat healthy and varied foods
You will gain better energy and be better able to deal with the challenges of daily life.

Create structure in your daily life

It is a good idea to have a form of predictability and structure in your daily life. Therefore, make a plan or a schedule of activities for the day or the week. Try to establish routines that mark the day’s progress. If you work at home, try to work during the same period of time, and stop working when you would normally stop working.

Take a break

Relax and take a break from worrying now and then. It is a good idea to limit how often and much time you spend watching or reading the news. It is good to stay informed but select only a few news sources. It is also important that you do something that forces you to concentrate on something else and which feels pleasant and relaxing. This counteracts stress.

Do not blame yourself or others

Do not blame yourself or other people for becoming infected with COVID-19. Remember the illness is the fault of a virus and not people. Coronavirus is very infectious and can infect other people through contact and items.

Do not blame yourself if you are ill – regardless of whether you are infected with the coronavirus or another illness. If you know someone has become infected or is unwell, help them by offering support and help to reassure them.

Stay physically active

Physical activity does not have to be strenuous activity to benefit your health and improve your mood. Everyday activities, such as skiing and walking also count. You will find many different exercises on the internet that you can do at home on the living room floor, and you can download many good apps that have exercises. Play some good music and dance around the room – it can also be a great source of laughter.

Prioritise going outside and moving around in the fresh air on a daily basis, if this is possible without coming into close contact with our people. Daylight improves your mood. Go out and ski or go for a run or take a walk.

Stay mentally active

Keep your mind working by doing different activities. Read a book or magazine, solve a Sudoku puzzle, do a jigsaw puzzle, listen to music or play a game. In other words, do something that requires concentration.

Keep a diary or write down one thing every evening that you are thankful for, regardless of whether it is a small thing or big thing.

If you like to draw, write, paint, play an instrument or in some other way be creative, research has shown this can also help to promote mental health.

Remember not to spread rumours about COVID-19

People who are infected can be blamed for having behaved irresponsibly or for being anti-social and many people can also blame themselves if they become infected. It is important to remember that the illness is the fault of a virus and not people. Coronavirus is very infectious and can infect other people through contact and objects.

Everyone can help to prevent the stigmatisation that is related to COVID-19, by knowing the facts about the disease and how it infects other people – and by sharing this knowledge in their network.

If you hear or read something that is discriminatory or is a factually incorrect statement, reject it. This counteracts myths arising and misinformation.

More information about coronavirus

NB: the links go to other websites.

• https://coronasmitte.dk/
• European Centre for Disease Prevention and Control(English)
• https://www.ssi.dk/
• UNICEF: How to talk about the coronavirus with your child(Danish)
• World Health Organization(English)

Last updated Friday 4. february