Surveillance Open Access
Like 0



The COVID-19 pandemic was of major concern in Greenland. There was a high possibility of rapid transmission in settlements, and an increased risk of morbidity and mortality because of comorbidities in the population and limited access to specialised healthcare in remote areas.


To describe the epidemiology of the COVID-19 pandemic in Greenland and evaluate the effects of a strict COVID-19 strategy until risk groups were immunised.


We studied the epidemiology during March 2020 to June 2022. We describe the non-pharmaceutical interventions (NPIs), PCR-confirmed COVID-19 cases and vaccination coverage with data from the registries of the Greenlandic health authority.


We found 21,419 confirmed cases per 100,000 inhabitants (54% female, 46% male), 342 per 100,000 were hospitalised and 16 per 100,000 were admitted to the intensive care unit. The COVID-19 mortality rate was 39 per 100,000, all those affected were aged above 65 years. No excess overall mortality was observed. The vaccination coverage by June 2022 was 71.67 and 41% for one, two and three doses, respectively.


SARS-CoV-2 circulation in Greenland was low, given strict restrictions until all eligible inhabitants had been offered immunisation. The main impact of the pandemic was from May 2021 onwards with increasing numbers of confirmed cases. This occurred after introduction of the vaccine programme, which may have had an influence on the severity of the associated morbidity and mortality experienced. Halting community transmission of SARS-CoV-2 with NPIs until the majority of the population had been immunised was a successful strategy in Greenland.


Article metrics loading...

Loading full text...

Full text loading...



  1. Wu F, Zhao S, Yu B, Chen Y-M, Wang W, Song Z-G, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9.  https://doi.org/10.1038/s41586-020-2008-3  PMID: 32015508 
  2. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-207.  https://doi.org/10.1056/NEJMoa2001316  PMID: 31995857 
  3. World Health Organization (WHO). WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Geneva: WHO; 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  4. Li H, Wang S, Zhong F, Bao W, Li Y, Liu L, et al. Age-dependent risks of incidence and mortality of COVID-19 in Hubei Province and other parts of China. Front Med (Lausanne). 2020;7:190.  https://doi.org/10.3389/fmed.2020.00190  PMID: 32426363 
  5. Deiana G, Azara A, Dettori M, Delogu F, Vargiu G, Gessa I, et al. Deaths in SARS-CoV-2 positive patients in Italy: The influence of underlying health conditions on lethality. Int J Environ Res Public Health. 2020;17(12):4450.  https://doi.org/10.3390/ijerph17124450  PMID: 32575825 
  6. Karmakar M, Lantz PM, Tipirneni R. Association of social and demographic factors with COVID-19 incidence and death rates in the US. JAMA Netw Open. 2021;4(1):e2036462.  https://doi.org/10.1001/jamanetworkopen.2020.36462  PMID: 33512520 
  7. StatBank Greenland. Population July 1st 2011-2022. Nuuk: Greenland Statistics; 1 Jun 2022. Available from: https://bank.stat.gl/pxweb/en/Greenland/Greenland__BE__BE01__BE0140/BEXSTM1.PX/
  8. Koch A, Bjørn-Mortensen K, Johansen MB, Homøe A-S, Homøe P. [Infectious diseases with public health impact in Greenland]. Ugeskr Laeger. 2020;182(24):V12190689. Danish. PMID: 32515334 
  9. Bjerregaard P, Lyngsø Svarta D, Viskum Lytken Larsen C. Social ulighed i sundhed. Statens Institut for Folkesundhed 2023. Copenhagen: Statens Institut for Folkesundhed; 21 Mar 2023. Available from: https://www.sdu.dk/da/sif/rapporter/2023/social_ulighed_i_sundhed_i_groenland
  10. Homøe P. Otitis media in Greenland. Studies on historical, epidemiological, microbiological, and immunological aspects. Int J Circumpolar Health. 2001;60(sup2) Suppl 2;1-54.  https://doi.org/10.3402/ijch.v60i0.18306  PMID: 11725622 
  11. Hansen H, Noahsen P. Sundhed og Sundhedsvæsen I Grønland år 2020. Menneske sundhed, samfund og kultur. Klim. 2020:35-50.
  12. World Health Organization (WHO). International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10 Version:2019). Geneva: WHO; 2019. Available from: https://icd.who.int/browse10/2019/en
  13. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045.  https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045  PMID: 31992387 
  14. Statens Serum Institut (SSI). COVID-19: PCR-test. Copenhagen: SSI. [Accessed: 2 Dec 2021]. Available from: https://covid19.ssi.dk/diagnostik/pcr-test
  15. O’Toole Á, Hill V, Pybus OG, Watts A, Bogoch II, Khan K, et al. Tracking the international spread of SARS-CoV-2 lineages B.1.1.7 and B.1.351/501Y-V2 with grinch. Wellcome Open Res. 2021;6:121.  https://doi.org/10.12688/wellcomeopenres.16661.2  PMID: 34095513 
  16. Petrov AN, Welford M, Golosov N, DeGroote J, Devlin M, Degai T, et al. The "second wave" of the COVID-19 pandemic in the Arctic: regional and temporal dynamics. Int J Circumpolar Health. 2021;80(1):1925446.  https://doi.org/10.1080/22423982.2021.1925446  PMID: 34125008 
  17. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. Geneva: WHO. [Accessed: 1 Jun 2022]. Available from: https://covid19.who.int
  18. Baker MG, Wilson N, Anglemyer A. Successful elimination of COVID-19 transmission in New Zealand. N Engl J Med. 2020;383(8):e56.  https://doi.org/10.1056/NEJMc2025203  PMID: 32767891 
  19. Grout L, Gottfreðsson M, Kvalsvig A, Baker MG, Wilson N, Summers J. Comparing COVID-19 pandemic health responses in two high-income island nations: Iceland and New Zealand. Scand J Public Health. 2023;51(5):797-813.; Online ahead of print.  https://doi.org/10.1177/14034948221149143  PMID: 36717984 
  20. Cuschieri S, Pallari E, Hatziyianni A, Sigurvinsdottir R, Sigfusdottir ID, Sigurðardóttir AK. A year of Covid-19: experiences and lessons learnt by small European island states-Cyprus, Iceland and Malta. Eur J Public Health. 2022;32(2):316-21.  https://doi.org/10.1093/eurpub/ckab217  PMID: 34978569 
  21. Noahsen P, Larsen HL. [Health and healthcare in Greenland]. Ugeskr Laeger. 2020;182(24):V12190693. Danish. PMID: 32515331 
  22. Volz E, Mishra S, Chand M, Barrett JC, Johnson R, Geidelberg L, et al. Assessing transmissibility of SARS-CoV-2 lineage B.1.1.7 in England. Nature. 2021;593(7858):266-9.  https://doi.org/10.1038/s41586-021-03470-x  PMID: 33767447 
  23. Dabrera G, Allen H, Zaidi A, Flannagan J, Twohig K, Thelwall S, et al. Assessment of mortality and hospital admissions associated with confirmed infection with SARS-CoV-2 Alpha variant: a matched cohort and time-to-event analysis, England, October to December 2020. Euro Surveill. 2022;27(20):2100377.  https://doi.org/10.2807/1560-7917.ES.2022.27.20.2100377  PMID: 35593163 
  24. National Board of Health in Greenland. Første coronadødsfald: ældre mand I Upernavik afgået ved døden. [First corona death: Elderly man in Upernavik deceased]. Nuuk: National Board of Health in Greenland; 2021. Danish. Available from: https://corona.nun.gl/da/2021/11/20/forste-coronadodsfald-aeldre-mand-i-upernavik-afgaet-ved-doden
  25. Liu Y, Rocklöv J. The reproductive number of the Delta variant of SARS-CoV-2 is far higher compared to the ancestral SARS-CoV-2 virus. J Travel Med. 2021;28(7):taab124.  https://doi.org/10.1093/jtm/taab124  PMID: 34369565 
  26. Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, et al. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study. Lancet Infect Dis. 2022;22(2):183-95.  https://doi.org/10.1016/S1473-3099(21)00648-4  PMID: 34756186 
  27. Araf Y, Akter F, Tang YD, Fatemi R, Parvez MSA, Zheng C, et al. Omicron variant of SARS-CoV-2: Genomics, transmissibility, and responses to current COVID-19 vaccines. J Med Virol. 2022;94(5):1825-32.  https://doi.org/10.1002/jmv.27588  PMID: 35023191 
  28. Nyberg T, Ferguson NM, Nash SG, Webster HH, Flaxman S, Andrews N, et al. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022;399(10332):1303-12.  https://doi.org/10.1016/S0140-6736(22)00462-7  PMID: 35305296 
  29. Alaska coronavirus vaccination progress. Available from: https://usafacts.org/visualizations/covid-vaccine-tracker-states/state/alaska
  30. Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis. 2022;22(9):1293-302.  https://doi.org/10.1016/S1473-3099(22)00320-6  PMID: 35753318 
  31. Pires SM, Redondo HG, Espenhain L, Jakobsen LS, Legarth R, Meaidi M, et al. Disability adjusted life years associated with COVID-19 in Denmark in the first year of the pandemic. BMC Public Health. 2022;22(1):1315.  https://doi.org/10.1186/s12889-022-13694-9  PMID: 35804310 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error