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The whole thing is clearly an attempt at a graceful exit. The original strategy was herd immunity. The argument being made was that Sweden was gonna get infect

The whole thing is clearly an attempt at a graceful exit. The original strategy was herd immunity. The argument being made was that Sweden was gonna get infected anyways, so better to get it out of the way sooner rather than later, while protecting the at risk. And this would reduce economic harm as well. However, the Swedish decision makers seemed completely unaware of asymptomatic carriers, which led to the at risk (largely old people) being heavily exposed anyways due to the asymptomatic younger workers around them infecting them. Further, the Swedish people, reflecting normal human behavior, shut down economic activity anyways. The result was a slight linear short term economic benefit but an exponential, potentially long term, downwards public health situation whose economic effects itself will likely dwarf the direct economic benefit anyways. So now that their plan has failed both in concept and execution they are changing their story saying that it was a Swedish cultural thing, where they trusted individual Swedes to take personal responsibility, because of the exceptional Swedish character.

tinus_hn 6y ago
There are a number of options: * lockdown until there is a vaccine or treatment * slow down the spread * do nothing A vaccine or treatment is at least half a year away so unless your country is exceptionally rich the first option is not feasible. Slowing down the spread can help making sure the demands to healthcare are met. This is not an issue in Sweden. It can help because treatment right now is better than treatment a month ago. And in theory at a certain moment there might be herd immunity. Or there may not be. Ultimately either a large amount of people or everyone will get ill anyway and then they will get better and immune or die. Doing nothing means a lot of people get ill and then get better and immune or die and the country keeps running. Sweden chose the last option because the first option is not realistic and the advantages of the second option are, in their opinion, not worth it. In my opinion this is at least a defensible position to take. If a country does not have enough healthcare capacity the second option has to be chosen for as long as necessary. The first option, barring exceptional circumstances (your country is a self sustaining island that can handle losing all tourism and trade) is not viable. I’m not sure what you mean by a downwards public health situation whose economic effects will dwarf the direct benefits. It’s terrible if a lot of old people die but realistically the economy will get over it rather quickly.
- henrikschroder 6y ago
  > There are a number of options: >* lockdown until there is a vaccine or treatment >* slow down the spread >* do nothing > Sweden chose the last option No, Sweden did not choose that option.
  - tinus_hn 6y ago
    So what did they do? Note that with doing I don’t mean issuing advisories etcetera.
    - henrikschroder 6y ago
      Sweden chose (and is still choosing) option number 2. Universities are closed, high schools are closed, elementary schools are half-empty, people that can work from home do so, a lot of employees have been furloughed, restaurants have switched to mostly take-out, bars are closed, large events are cancelled, grocery stores reserve hours in the morning for senior citizens, elder care homes don't accept visitors, travel is way down, and people generally self-isolate and self-quarantine. Field hospitals have been constructed, recently retired healthcare workers have been asked to come back to work, vodka producers have shifted to making hand sanitizer, and other companies have shifted to making PPEs, etc. Yes, Sweden is one of the least locked down countries de jure, but it's de facto locked down pretty well. The actual difference between Sweden and other European countries is much smaller than you think.
      - eveningcoffee 6y ago
        I think it is not well locked down because their death rates are close to Italy (per capita, not per infected which are also similar but depend on testing protocol). If you investigate the graphs then you may notice that it is a general rule that when when number of daily infected tops, it takes some time for the number of daily deaths to top. I have not run statistical analysis yet but from eying it I would say that it is about a week or more. From this point on the number of deaths will double or grow even higher. For Sweden it will mean that even when the growth of daily infected stops today, the number of daily deaths will top when it is the number of deaths is around 3000 from what follows that the total number of dead will be around 6000 (assuming that the growth of daily infected stops). It is more per capita then in Italy.
uvesten 6y ago
> However, the Swedish decision makers seemed completely unaware of asymptomatic carriers, which led to the at risk (largely old people) being heavily exposed anyways due to the asymptomatic younger workers around them infecting them. Not unaware, but actively denying that asymptomatic carriers exist and trying to discredit reports saying that asymptomatic carriers play a role in the spread of covid-19. https://www.svt.se/nyheter/vetenskap/tegnell-domer-ut-italiensk-forskning-om-symptomfria-smittbarare https://www.svt.se/nyheter/vetenskap/tegnell-domer-ut-italie... https://www.svd.se/oklart-om-viruset-smittar-aven-utan-symptom https://www.svd.se/oklart-om-viruset-smittar-aven-utan-sympt...
- htfu 6y ago
  Disingenuous. A belief that asymptomatic carriers aren't the primary drivers of the epidemic may well be incorrect, but in no way is it equivalent to "actively denying [they] exist", or saying they don't at all contribute to the spread. It's important to stick to the facts in the material when linking. Doubly so when sources are behind paywall and/or in a language understood by very few.
zucker42 6y ago
> Further, the Swedish people, reflecting normal human behavior, shut down economic activity anyways. If people are shutting down the economy and avoiding contact anyways, doesn't it mean that an imposed lockdown is unnecessary?
deft 6y ago
This is pretty much the opposite of what's happening. The herd immunity strategy is working, antibody testing shows around 30% of Stockholm is already immune, with their mortality rate comparable to many other countries and lower than a few too. The media that wants to paint this strategy as terrible and ineffective (despite all evidence to the contrary) is now scrambling to come up with an alternative explanation that allows them to say "but it wouldn't have worked here". A special culture is the perfect explanation.
- greedo 6y ago
  I wouldn't put as much faith in current antibody tests, especially where "In a low prevalence area for previous Covid-19 infection, which is most of the country, a positive antibody result could be a true positive or a false negative."[1] [1] - Michael Osterholm https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-interview-two-opinion/index.html https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-int...
  - Kiro 6y ago
    This is a new test from Karolinska Institute that can only have false negatives, not false positives. With that said they had to retract the test results but that was due to other reason (accidentally including people who gave blood due to being infected).
    - greedo 6y ago
      Is that even possible to have a serological test that can't give false positives? Field contamination etc would seem to be something that can't be prevented.
      - Kiro 6y ago
        No idea but that's what they say: https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmarna-har-antikroppar-mot-covid-19 https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmar... Google Translate: > Karolinska University Hospital and Karolinska Institutet have collaborated to produce a new antibody test in the fight against covid-19. > - We are happy to have a test that we know is okay. It is not 100 percent sensitive, it has sensitivity of 70-80 percent. Some will test negative even though they have had it. But no one will test false positively. Those we have tested that should be negative have been, says Jan Albert. (Google Translate translates chief physician to consultant for some reason but other than that the translation seems fine)
SpicyLemonZest 6y ago
I think you've been misinformed here. Their strategy is still herd immunity. Some officials have said that's a bad way to characterize it - that their strategy consists of the things they do to mitigate harm, not the epidemiological fact that will eventually bring the outbreak to an end. (And I think that's fair - nobody calls the strategies that were applied during the Spanish Flu "herd immunity".) But they don't have any plan for ending the outbreak other than lots of people catching it and becoming immune.
- DiogenesKynikos 6y ago
  Trying to suppress transmission until a vaccine is available is another option - one which potentially saves a lot of lives.
  - SpicyLemonZest 6y ago
    Swedish officials, rightly or wrongly, don't believe that can be done.
    - DiogenesKynikos 6y ago
      Yet transmission has been suppressed in several countries in Asia.
      - esailija 6y ago
        It can be physically done yes but it cannot be done because of political and cultural issues. A critical mass of people will continue thinking it's less serious than the flu (these retracted studies not helping it) until it gets so bad that it becomes impossible (e.g. everyone knows someone they really care about who died). That's when proper lockdowns are politically possible.
      - SpicyLemonZest 6y ago
        It has, but nobody really knows why they've been successful. The people who say it's just testing and contact tracing are misleading. Sweden was testing and contact tracing, like most countries were, but it failed to contain the virus. And we should be cautious about even the idea that they've been successful; people used to believe Japan and Signapore had contained it too.
jeltz 6y ago
As someone who is opposed to his plan I feel the other way round. The more data we get the more it seems to have worked. And Tegnell has increased in popularity. Was his plan the best one? I am skeptical, but it is far from as stupid as I originally thought.
- senderista 6y ago
  It would be a more convincing strategy if they actually effectively isolated vulnerable populations, which by his own admission they didn't do. You can't have it both ways. Either lockdown applies to everyone or you lock down vulnerable populations even more rigidly than a general lockdown would require (since those populations are far more exposed to infection than they would be under a general lockdown).
  - jacobush 6y ago
    He is not a general to order that by decree. He can only urge actors to act appropriately.

tinus_hn 6y ago

There are a number of options: * lockdown until there is a vaccine or treatment * slow down the spread * do nothing A vaccine or treatment is at least half a year away so unless your country is exceptionally rich the first option is not feasible. Slowing down the spread can help making sure the demands to healthcare are met. This is not an issue in Sweden. It can help because treatment right now is better than treatment a month ago. And in theory at a certain moment there might be herd immunity. Or there may not be. Ultimately either a large amount of people or everyone will get ill anyway and then they will get better and immune or die. Doing nothing means a lot of people get ill and then get better and immune or die and the country keeps running. Sweden chose the last option because the first option is not realistic and the advantages of the second option are, in their opinion, not worth it. In my opinion this is at least a defensible position to take. If a country does not have enough healthcare capacity the second option has to be chosen for as long as necessary. The first option, barring exceptional circumstances (your country is a self sustaining island that can handle losing all tourism and trade) is not viable. I’m not sure what you mean by a downwards public health situation whose economic effects will dwarf the direct benefits. It’s terrible if a lot of old people die but realistically the economy will get over it rather quickly.

henrikschroder 6y ago
> There are a number of options: >* lockdown until there is a vaccine or treatment >* slow down the spread >* do nothing > Sweden chose the last option No, Sweden did not choose that option.
- tinus_hn 6y ago
  So what did they do? Note that with doing I don’t mean issuing advisories etcetera.
  - henrikschroder 6y ago
    Sweden chose (and is still choosing) option number 2. Universities are closed, high schools are closed, elementary schools are half-empty, people that can work from home do so, a lot of employees have been furloughed, restaurants have switched to mostly take-out, bars are closed, large events are cancelled, grocery stores reserve hours in the morning for senior citizens, elder care homes don't accept visitors, travel is way down, and people generally self-isolate and self-quarantine. Field hospitals have been constructed, recently retired healthcare workers have been asked to come back to work, vodka producers have shifted to making hand sanitizer, and other companies have shifted to making PPEs, etc. Yes, Sweden is one of the least locked down countries de jure, but it's de facto locked down pretty well. The actual difference between Sweden and other European countries is much smaller than you think.
    - eveningcoffee 6y ago
      I think it is not well locked down because their death rates are close to Italy (per capita, not per infected which are also similar but depend on testing protocol). If you investigate the graphs then you may notice that it is a general rule that when when number of daily infected tops, it takes some time for the number of daily deaths to top. I have not run statistical analysis yet but from eying it I would say that it is about a week or more. From this point on the number of deaths will double or grow even higher. For Sweden it will mean that even when the growth of daily infected stops today, the number of daily deaths will top when it is the number of deaths is around 3000 from what follows that the total number of dead will be around 6000 (assuming that the growth of daily infected stops). It is more per capita then in Italy.

uvesten 6y ago

> However, the Swedish decision makers seemed completely unaware of asymptomatic carriers, which led to the at risk (largely old people) being heavily exposed anyways due to the asymptomatic younger workers around them infecting them. Not unaware, but actively denying that asymptomatic carriers exist and trying to discredit reports saying that asymptomatic carriers play a role in the spread of covid-19. https://www.svt.se/nyheter/vetenskap/tegnell-domer-ut-italiensk-forskning-om-symptomfria-smittbarare https://www.svt.se/nyheter/vetenskap/tegnell-domer-ut-italie... https://www.svd.se/oklart-om-viruset-smittar-aven-utan-symptom https://www.svd.se/oklart-om-viruset-smittar-aven-utan-sympt...

htfu 6y ago
Disingenuous. A belief that asymptomatic carriers aren't the primary drivers of the epidemic may well be incorrect, but in no way is it equivalent to "actively denying [they] exist", or saying they don't at all contribute to the spread. It's important to stick to the facts in the material when linking. Doubly so when sources are behind paywall and/or in a language understood by very few.

zucker42 6y ago

> Further, the Swedish people, reflecting normal human behavior, shut down economic activity anyways. If people are shutting down the economy and avoiding contact anyways, doesn't it mean that an imposed lockdown is unnecessary?

deft 6y ago

This is pretty much the opposite of what's happening. The herd immunity strategy is working, antibody testing shows around 30% of Stockholm is already immune, with their mortality rate comparable to many other countries and lower than a few too. The media that wants to paint this strategy as terrible and ineffective (despite all evidence to the contrary) is now scrambling to come up with an alternative explanation that allows them to say "but it wouldn't have worked here". A special culture is the perfect explanation.

greedo 6y ago
I wouldn't put as much faith in current antibody tests, especially where "In a low prevalence area for previous Covid-19 infection, which is most of the country, a positive antibody result could be a true positive or a false negative."[1] [1] - Michael Osterholm https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-interview-two-opinion/index.html https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-int...
- Kiro 6y ago
  This is a new test from Karolinska Institute that can only have false negatives, not false positives. With that said they had to retract the test results but that was due to other reason (accidentally including people who gave blood due to being infected).
  - greedo 6y ago
    Is that even possible to have a serological test that can't give false positives? Field contamination etc would seem to be something that can't be prevented.
    - Kiro 6y ago
      No idea but that's what they say: https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmarna-har-antikroppar-mot-covid-19 https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmar... Google Translate: > Karolinska University Hospital and Karolinska Institutet have collaborated to produce a new antibody test in the fight against covid-19. > - We are happy to have a test that we know is okay. It is not 100 percent sensitive, it has sensitivity of 70-80 percent. Some will test negative even though they have had it. But no one will test false positively. Those we have tested that should be negative have been, says Jan Albert. (Google Translate translates chief physician to consultant for some reason but other than that the translation seems fine)

SpicyLemonZest 6y ago

I think you've been misinformed here. Their strategy is still herd immunity. Some officials have said that's a bad way to characterize it - that their strategy consists of the things they do to mitigate harm, not the epidemiological fact that will eventually bring the outbreak to an end. (And I think that's fair - nobody calls the strategies that were applied during the Spanish Flu "herd immunity".) But they don't have any plan for ending the outbreak other than lots of people catching it and becoming immune.

DiogenesKynikos 6y ago
Trying to suppress transmission until a vaccine is available is another option - one which potentially saves a lot of lives.
- SpicyLemonZest 6y ago
  Swedish officials, rightly or wrongly, don't believe that can be done.
  - DiogenesKynikos 6y ago
    Yet transmission has been suppressed in several countries in Asia.
    - esailija 6y ago
      It can be physically done yes but it cannot be done because of political and cultural issues. A critical mass of people will continue thinking it's less serious than the flu (these retracted studies not helping it) until it gets so bad that it becomes impossible (e.g. everyone knows someone they really care about who died). That's when proper lockdowns are politically possible.
    - SpicyLemonZest 6y ago
      It has, but nobody really knows why they've been successful. The people who say it's just testing and contact tracing are misleading. Sweden was testing and contact tracing, like most countries were, but it failed to contain the virus. And we should be cautious about even the idea that they've been successful; people used to believe Japan and Signapore had contained it too.

jeltz 6y ago

As someone who is opposed to his plan I feel the other way round. The more data we get the more it seems to have worked. And Tegnell has increased in popularity. Was his plan the best one? I am skeptical, but it is far from as stupid as I originally thought.

senderista 6y ago
It would be a more convincing strategy if they actually effectively isolated vulnerable populations, which by his own admission they didn't do. You can't have it both ways. Either lockdown applies to everyone or you lock down vulnerable populations even more rigidly than a general lockdown would require (since those populations are far more exposed to infection than they would be under a general lockdown).
- jacobush 6y ago
  He is not a general to order that by decree. He can only urge actors to act appropriately.