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I see a lot of the "Sweden is sacrificing the elderly for money"-arguments in media. But of course that's not the intent. What options do countries have? Any v

I see a lot of the "Sweden is sacrificing the elderly for money"-arguments in media. But of course that's not the intent. What options do countries have? Any vaccine or cure is at least one year away, if not more. There is no miracle cure (Tweets don't count). Let's say you are a country with SARS-CoV-2. So, your goals are A. stop the spread, and B. protect the most vulnerable and C. try to keep the number of hospital visits low enough to not collapse the healthcare system, so that people ending up in hospitals have a chance of making it out alive. Do you 1. lock down the country hard; or 2. keep the country (semi) open, reaching for herd immunity, or 3. do nothing? If you do #1: prepare to be locked down until a vaccine/cure exists and gets deployed. This is at least 1.5 years. Are you ready for this? Sure, this keeps the death rate low. If you open the lockdown early, people start dying again. Prolonged lockdown hurts the economy, and the healthcare system will also suffer greatly. If the economy collapses, things go to shit really fast, and don't expect help from the hospitals. And, in general, any immunization within the population will proceed slowly if at all. If you do #2: some people in the risk groups will die because the virus is everywhere. And, for this choice to work, immunization must be a possibility, so that herd immunity can develop in the first place. Over time, the population may resist the virus. If you do #3: many people in the risk groups die, the healthcare system collapses and you'll be in a really bad place. The population may become resistent, though. Option #3 is not really good. Assume you choose #1, i.e. total lockdown. Once you open up the lockdown, you'll be in situation #2. So why not do #2 directly? If you don't believe that immunization through exposure to the virus can happen, then #1 is the only choice -- hope for a vaccine and be prepared for economic carnage. But, in all other cases #2 is the saner alternative. I think this is why Sweden is doing what it's doing.

akmarinov 7y ago
Option #2 sounds great if you know what immunity means in this case. We don’t know how long immunity lasts or what it looks like, there are even reports of reinfection. There are also severe complications to the heart, lungs and liver after the disease, which wouldn’t occur with option #1
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ivanonymous 7y ago
An outright cure at a year strikes me as unlikely, given the record with anti-virals. But improvements in supportive care (anticoagulants?) and lucky repurposing might win meaningful reductions in morbidity (some permanent) and mortality within months. I'm not sure how to weight that possibility. (Metaculus has settled on a likely ~5% relative risk reduction for chloroquine, which is no game changer.) But it seems underweighted in general in discussions about different paths to herd immunity.
Yetanfou 7y ago
The advantage of a #1->#2 strategy is that it gives time for the healthcare providers to prepare for the eventual inrush of SARS2-patients. They can get needed materials, information on how to best treat those who are infected and build out and/or reorganise to be able to give the type of care typically needed for SARS2 cases. It might even end up being less destructive for the economy since a relatively short lockdown followed by a progressive opening-up to a level where health care can cope with the case load probably gives more confidence in a good outcome and with that a higher consumer confidence. Given that #1 is the policy followed Sweden's neighbours while Sweden follows #2 it will be interesting to see how the respective economies fare after the pandemic is over.
benjymo 7y ago
The strategy isn't even that different from e.g. Germany or Austria (I use these countries because I've been following them more closely). Yes Germany and Austria closed more shops at the beginning to stop exponential growth. Now they start to slowly open stores again with the goal to not overwhelm the health care system. I think almost no country tries to go for zero infections, only to spread the infections out over a longer period. No infections would also seems a bit unrealistic for most countries.

akmarinov 7y ago

Option #2 sounds great if you know what immunity means in this case. We don’t know how long immunity lasts or what it looks like, there are even reports of reinfection. There are also severe complications to the heart, lungs and liver after the disease, which wouldn’t occur with option #1

deleted 7y ago

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ivanonymous 7y ago

An outright cure at a year strikes me as unlikely, given the record with anti-virals. But improvements in supportive care (anticoagulants?) and lucky repurposing might win meaningful reductions in morbidity (some permanent) and mortality within months. I'm not sure how to weight that possibility. (Metaculus has settled on a likely ~5% relative risk reduction for chloroquine, which is no game changer.) But it seems underweighted in general in discussions about different paths to herd immunity.

Yetanfou 7y ago

The advantage of a #1->#2 strategy is that it gives time for the healthcare providers to prepare for the eventual inrush of SARS2-patients. They can get needed materials, information on how to best treat those who are infected and build out and/or reorganise to be able to give the type of care typically needed for SARS2 cases. It might even end up being less destructive for the economy since a relatively short lockdown followed by a progressive opening-up to a level where health care can cope with the case load probably gives more confidence in a good outcome and with that a higher consumer confidence. Given that #1 is the policy followed Sweden's neighbours while Sweden follows #2 it will be interesting to see how the respective economies fare after the pandemic is over.

benjymo 7y ago

The strategy isn't even that different from e.g. Germany or Austria (I use these countries because I've been following them more closely). Yes Germany and Austria closed more shops at the beginning to stop exponential growth. Now they start to slowly open stores again with the goal to not overwhelm the health care system. I think almost no country tries to go for zero infections, only to spread the infections out over a longer period. No infections would also seems a bit unrealistic for most countries.