7 ms·

"as the weather got warmer, people in the capital were beginning to ignore social-distancing rules" So much for the argument that Sweden's approach was working

"as the weather got warmer, people in the capital were beginning to ignore social-distancing rules" So much for the argument that Sweden's approach was working because Swedes are so much better than the rest of world at voluntary compliance. Overall, it looks like Sweden is moving toward doing the same as every other country, but quietly so they don't have to admit it's a change of course.

option 7y ago
we would only know which approach worked best after the end of pandemic. An integral (e.g. total number of deaths) of the curve matters as much if not more as its shape.
belorn 7y ago
Alternative one can see it as they first tried the carrot, and now when there is sign that some people did not get the message they are using the stick. It should be noted that this is just the capital, which currently has something like 10x infection compared to most other areas of Sweden, and almost 20x the number of dead. To give some number, Stockholm has in the latest report 7k infected and 1200 dead. Malmö (or rather the region around it), which is Sweden third largest city, has 600 infected and 60 dead. Population wise, Stockholm has about 2x compared to Malmö. People are not sure why stockholm has the number it has compared to other regions.
- dumbfounder 7y ago
  I think overall size of a population and population density have to be the contributing factors. More people means more people have traveled there from other places to spread the virus. More density means a higher R value. The death rate per capita in Sweden is not much higher than the US. At ~33x the population the US has ~25x the deaths. Given the US had only double the total cases on March 6 as Sweden that seems like a positive indicator for Sweden's approach. It's like saying it doesn't really matter what you do so you might as well stay open. The timeline of when you started taking things seriously is also a big factor of course. I think it's way too early to declare anything yet, but I think it's good there are different approaches being taken to learn from.
  - im3w1l 7y ago
    Stockholm has a lot of affluent people who went skiing in Italy and brought covid home. So many that contact tracing was very quickly overwhelmed. Government warned about traveling to Italy way too late.
  - tonyedgecombe 7y ago
    I’m not sure making a per-capita comparison makes sense in the early stages of an epidemic.
    - SpicyLemonZest 7y ago
      I don't think we're in the early stages anymore, though. A significant fraction of the population has been infected.
      - tonyedgecombe 7y ago
        We don't know that yet.
        SpicyLemonZest 7y ago
        I disagree. It's unreasonable to doubt that at this point.
    - notacoward 7y ago
      Disease spread is too complex for either total-number or per-capita comparisons to capture it well, but total numbers are even more misleading.
- im3w1l 7y ago
  With 1200 dead, that means on the order of 100k cases. Stockholm has about 1-2m people depending on how you count. It cannot grow exponentially for much longer, so the peak is close. This is the most logical time to take measures, except for maybe the very beginning when it could possibly have been stopped.
  - adventured 7y ago
    The big problem with Sweden's approach, is that the duration of immunity is entirely unknown when it comes to SARS-CoV-2. We don't yet know what antibody level is required to generate that hypothetical immunity, including whether asymptomatic and mild-case persons (which will be the vast majority of Sweden's herd) are going to have the required level of antibodies. They're taking a swing in the dark, with the potential risk of a very high per capita mortality rate. If the duration of immunity is short, they could kill a lot of people for little gain. They're currently running at seven times the per capita mortality rate of Finland.
- tapland 7y ago
  In Malmö you have no (proper) metro. The Stockholm metro had about 800k trips per day iirc. IF you work in Stockholm you probably commute by commuter train and or bus into the city, where in Malmö you can walk through the city center in 15 minutes so biking or owning a car to commute with is the norm. In Malmö most stores close at 5pm, and malls much earlier than in Stockholm so they are visited on weekends instead of whenever (this also sucks since there is nothing to do after work), FNM starts at something like 15:30. It's just a lot fewer crowds and situations with close contact in general.
- rsynnott 7y ago
  I suppose one caution on this would be "capital/world city explodes, then growth shifts to the regions" is a pretty common pattern worldwide, for whatever reason.
soperj 7y ago
On a per capita basis, some days this week where sweden had 172 and 180 deaths in a day would be the equivalent of the US having 5600 and 6100 deaths a day. Their approach is absolutely not working.
- londons_explore 7y ago
  If they get it all over with in 30 days, when the USA takes 300 days to get it over with, they are still looking smart... What matters is deaths overall, not deaths per day.
  - soperj 7y ago
    It's not likely going to be over until a vaccine comes. The US and Sweden are handling it equally well.
    - munk-a 7y ago
      I agree with the sentiment that Sweden isn't handling it particularly well, the writing on the wall was showing that a full lockdown has been a good idea for quite some time. That said, the US is a great example of how to handle the situation absolutely terribly - with a major political party probably funding and at least endorsing movements violating the lockdown and terribly unclear messaging. No, I don't like the US's approach. Canada has had it's good and bad points and Vancouver was basically acting like Florida for a while, but the governments response has been well focused, even if we don't have the resources to throw at the problem that the US does - and the messaging has been extremely comforting and clear.
  - notacoward 7y ago
    > If they get it all over with in 30 days Time's already up. As I've had to point out many times, "get to herd immunity faster" doesn't just mean let everyone get sicker sooner. The whole "flattening the curve" thing is not about an alternative to herd immunity. It's about getting there in a humane way that doesn't overwhelm health care and disproportionately affect some groups - the elderly, minorities, people with other health conditions, people who have no choice but to work and expose themselves more. "Let the chips fall where they may" is a recipe for excessive and unevenly distributed suffering. And worst of all, it might not even help reduce the total deaths over the long term. That's highly speculative and dependent on other factors.
INTPenis 7y ago
Yeah I don't know where that sentiment came from. Imho people here in Sweden just hadn't felt the heat from the fire yet. That's the main reason why most of them are out and about, enjoying the spring weather after a long and dark winter. Once this virus starts affecting people you know, that's when folks will start to react. Me personally I haven't heard of a single case until last week when I heard that one of my co-workers had it, along with his wife. They had it, and overcame it. But they live in another city and we had already started working from home at that point. So I never saw him other than on Teams.
ashtonkem 7y ago
Winter is its own natural social distancing of sorts. This of course is unsurprising. Even random street violence drops during winter, as cold temperatures drives everyone inside and away from each other.
- CydeWeys 7y ago
  And yet the cold and flu thrive in winter, so there's more to it than that.
  - ashtonkem 7y ago
    That’s a very good point.
  - makomk 7y ago
    Driving people inside is probably precisely the problem here - coronavirus, like other diseases, doesn't seem to transmit well at all outdoors, especially in warmer weather.
    - CydeWeys 7y ago
      Well in a normal winter, people are driven inside places full of other people. In a coronavirus "winter", people simply stop going anywhere or associating with anyone they don't already live with.
- deleted 7y ago
  [deleted]
- antonkm 7y ago
  Sweden's strategy isn't only about deaths by Covid-19. It's about preventing total number of deaths including deaths caused by the things we do to prevent the spread of the virus. The line is to keep things as open as possible. Quarantine is problematic if you take things such as suicide, alcohol and substance abuse, child and spouse abuse and depression into account. The list goes on. And yeah, people are idiots for going to bars.
davidgay 7y ago
The argument never seemed to match the figures either - currently 10th on the per-capita death rate :-( https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- TomK32 7y ago
  Those numbers are impossible to compare because countries are one different points one the infections-per-capita scale which is not know to us because we can't test all the population all the time.
- otippat 7y ago
  It's important to note that there are discrepancies between countries in how the deaths are reported. Interesting read regarding unexplained increases in the number of deaths in some countries here: https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
- gindely 7y ago
  The argument wasn't that fewer people would die. It's that everyone who was going to die would do it sooner. The Swedish gamble is that this is an unstoppable disease that will go to completion in every country anyway.
gindely 7y ago
I think the argument was that Sweden doesn't have a legal avenue towards general lockdown - only quarantines of specific facilities - and since they assumed everyone was going to get it anyway, voluntary compliance would be good enough, so they didn't regard it as a particular priority to change their law or even constitution. There wasn't any Sweden exceptionalism in the official characterisations I've heard - maybe in the mouths of some redditors.
duxup 7y ago
There were a lot of early clickbaity conclusions that frankly seemed like someone just logiced it out in their head got a lot of attention... but IMO didn't really have much data to support them in any way. Lots of "Why in this country is?" "This place is doing well because." And then a few weeks later the data shows that's simply not the case and you realize the concussions in those articles had little to zero data supporting it. Personally I look forward to hearing about good data years from now about this pandemic.
- davidw 7y ago
  That's what's so tough: we're all flying blind, but our actions have very, very real consequences. In the Lombardy region of Italy, they kept the bars and restaurants open and had this Milano non si ferma! (Milan doesn't stop!) campaign. The results are tragic. In the Veneto region of Italy, the governor listened to some experts, and the results have been significantly better.
thatguyagain 7y ago
> because Swedes are so much better than the rest of world at voluntary compliance" I haven't heard a single swedish person utter this nonsense IRL. Sounds like a clickbait headline from Vice or something similar.
- notacoward 7y ago
  It's right here on HN. I've been in threads where that sentiment was expressed. Don't gaslight.
  - munk-a 7y ago
    Has it been expressed by Swedes or by people who are propping up the swedish approach because they support premature reopening of the economy?
    - notacoward 7y ago
      I don't know. Can't know. At least one had a possibly-Swedish name, but that doesn't mean all that much. I do suspect that more are Americans, momentarily enamored of Sweden because of this one issue. I'm even more sure that any such will forget their love of Sweden as soon as they realize that Swedish attitudes on just about any other politico-economic subject aren't so convenient to their cause.
jsjolen 7y ago
>[...] but quietly so they don't have to admit it's a change of course. Where exactly does this come from? Sweden has no need to save face. We've been transparent and had open discussion from the beginning with the spoken assumption that we may, in fact, not be doing the right thing and that we may have to alter course as the situation changes. The ones who need to save face are the ones which are committing to full lockdown right now. They're the ones who are making a big sacrifice and need to motivate it with the fact that "it's a necessity", seeing Sweden succeed otherwise would be a big blow to their egos and their personal sacrifices. I will also say that voluntary compliance is still occurring here, which is notable both in what private companies are doing in adapting to the situation, and how the average person has changed their behaviour. This doesn't mean 100% compliance for everyone, which is unfortunate.
- casefields 7y ago
  Just like abortion or guns, Republicans vs Democrats, there are 2 chunks of people on opposite sides that have staked out their bunkers. They are now at war.
  - jsjolen 7y ago
    It is absolutely not the same, since Sweden may change their position because they are not inherently opposed by some inherent moral absolutism to do so.
- davidw 7y ago
  > The ones who need to save face are the ones which are committing to full lockdown right now. That's quite the assertion. The very word quarantine comes to us from when there was a Republic of Venice. The notion of shutting things down in times of plague is an old one. Yes, it's a very blunt instrument, and you'd hope we could do better these days - and some places like South Korea and Taiwan appear to be managing that - but locking things down works.
  - jsjolen 7y ago
    I'm not saying that because the lockdown has been a failure you need to save face. Is there something unclear in my reasoning from the rest of my comment that you'd like me to re-word?

option 7y ago

we would only know which approach worked best after the end of pandemic. An integral (e.g. total number of deaths) of the curve matters as much if not more as its shape.

belorn 7y ago

Alternative one can see it as they first tried the carrot, and now when there is sign that some people did not get the message they are using the stick. It should be noted that this is just the capital, which currently has something like 10x infection compared to most other areas of Sweden, and almost 20x the number of dead. To give some number, Stockholm has in the latest report 7k infected and 1200 dead. Malmö (or rather the region around it), which is Sweden third largest city, has 600 infected and 60 dead. Population wise, Stockholm has about 2x compared to Malmö. People are not sure why stockholm has the number it has compared to other regions.

dumbfounder 7y ago
I think overall size of a population and population density have to be the contributing factors. More people means more people have traveled there from other places to spread the virus. More density means a higher R value. The death rate per capita in Sweden is not much higher than the US. At ~33x the population the US has ~25x the deaths. Given the US had only double the total cases on March 6 as Sweden that seems like a positive indicator for Sweden's approach. It's like saying it doesn't really matter what you do so you might as well stay open. The timeline of when you started taking things seriously is also a big factor of course. I think it's way too early to declare anything yet, but I think it's good there are different approaches being taken to learn from.
- im3w1l 7y ago
  Stockholm has a lot of affluent people who went skiing in Italy and brought covid home. So many that contact tracing was very quickly overwhelmed. Government warned about traveling to Italy way too late.
- tonyedgecombe 7y ago
  I’m not sure making a per-capita comparison makes sense in the early stages of an epidemic.
  - SpicyLemonZest 7y ago
    I don't think we're in the early stages anymore, though. A significant fraction of the population has been infected.
    - tonyedgecombe 7y ago
      We don't know that yet.
      - SpicyLemonZest 7y ago
        I disagree. It's unreasonable to doubt that at this point.
  - notacoward 7y ago
    Disease spread is too complex for either total-number or per-capita comparisons to capture it well, but total numbers are even more misleading.
im3w1l 7y ago
With 1200 dead, that means on the order of 100k cases. Stockholm has about 1-2m people depending on how you count. It cannot grow exponentially for much longer, so the peak is close. This is the most logical time to take measures, except for maybe the very beginning when it could possibly have been stopped.
- adventured 7y ago
  The big problem with Sweden's approach, is that the duration of immunity is entirely unknown when it comes to SARS-CoV-2. We don't yet know what antibody level is required to generate that hypothetical immunity, including whether asymptomatic and mild-case persons (which will be the vast majority of Sweden's herd) are going to have the required level of antibodies. They're taking a swing in the dark, with the potential risk of a very high per capita mortality rate. If the duration of immunity is short, they could kill a lot of people for little gain. They're currently running at seven times the per capita mortality rate of Finland.
tapland 7y ago
In Malmö you have no (proper) metro. The Stockholm metro had about 800k trips per day iirc. IF you work in Stockholm you probably commute by commuter train and or bus into the city, where in Malmö you can walk through the city center in 15 minutes so biking or owning a car to commute with is the norm. In Malmö most stores close at 5pm, and malls much earlier than in Stockholm so they are visited on weekends instead of whenever (this also sucks since there is nothing to do after work), FNM starts at something like 15:30. It's just a lot fewer crowds and situations with close contact in general.
rsynnott 7y ago
I suppose one caution on this would be "capital/world city explodes, then growth shifts to the regions" is a pretty common pattern worldwide, for whatever reason.

soperj 7y ago

On a per capita basis, some days this week where sweden had 172 and 180 deaths in a day would be the equivalent of the US having 5600 and 6100 deaths a day. Their approach is absolutely not working.

londons_explore 7y ago
If they get it all over with in 30 days, when the USA takes 300 days to get it over with, they are still looking smart... What matters is deaths overall, not deaths per day.
- soperj 7y ago
  It's not likely going to be over until a vaccine comes. The US and Sweden are handling it equally well.
  - munk-a 7y ago
    I agree with the sentiment that Sweden isn't handling it particularly well, the writing on the wall was showing that a full lockdown has been a good idea for quite some time. That said, the US is a great example of how to handle the situation absolutely terribly - with a major political party probably funding and at least endorsing movements violating the lockdown and terribly unclear messaging. No, I don't like the US's approach. Canada has had it's good and bad points and Vancouver was basically acting like Florida for a while, but the governments response has been well focused, even if we don't have the resources to throw at the problem that the US does - and the messaging has been extremely comforting and clear.
- notacoward 7y ago
  > If they get it all over with in 30 days Time's already up. As I've had to point out many times, "get to herd immunity faster" doesn't just mean let everyone get sicker sooner. The whole "flattening the curve" thing is not about an alternative to herd immunity. It's about getting there in a humane way that doesn't overwhelm health care and disproportionately affect some groups - the elderly, minorities, people with other health conditions, people who have no choice but to work and expose themselves more. "Let the chips fall where they may" is a recipe for excessive and unevenly distributed suffering. And worst of all, it might not even help reduce the total deaths over the long term. That's highly speculative and dependent on other factors.

INTPenis 7y ago

Yeah I don't know where that sentiment came from. Imho people here in Sweden just hadn't felt the heat from the fire yet. That's the main reason why most of them are out and about, enjoying the spring weather after a long and dark winter. Once this virus starts affecting people you know, that's when folks will start to react. Me personally I haven't heard of a single case until last week when I heard that one of my co-workers had it, along with his wife. They had it, and overcame it. But they live in another city and we had already started working from home at that point. So I never saw him other than on Teams.

ashtonkem 7y ago

Winter is its own natural social distancing of sorts. This of course is unsurprising. Even random street violence drops during winter, as cold temperatures drives everyone inside and away from each other.

CydeWeys 7y ago
And yet the cold and flu thrive in winter, so there's more to it than that.
- ashtonkem 7y ago
  That’s a very good point.
- makomk 7y ago
  Driving people inside is probably precisely the problem here - coronavirus, like other diseases, doesn't seem to transmit well at all outdoors, especially in warmer weather.
  - CydeWeys 7y ago
    Well in a normal winter, people are driven inside places full of other people. In a coronavirus "winter", people simply stop going anywhere or associating with anyone they don't already live with.
deleted 7y ago
[deleted]
antonkm 7y ago
Sweden's strategy isn't only about deaths by Covid-19. It's about preventing total number of deaths including deaths caused by the things we do to prevent the spread of the virus. The line is to keep things as open as possible. Quarantine is problematic if you take things such as suicide, alcohol and substance abuse, child and spouse abuse and depression into account. The list goes on. And yeah, people are idiots for going to bars.

davidgay 7y ago

The argument never seemed to match the figures either - currently 10th on the per-capita death rate :-( https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/

TomK32 7y ago
Those numbers are impossible to compare because countries are one different points one the infections-per-capita scale which is not know to us because we can't test all the population all the time.
otippat 7y ago
It's important to note that there are discrepancies between countries in how the deaths are reported. Interesting read regarding unexplained increases in the number of deaths in some countries here: https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
gindely 7y ago
The argument wasn't that fewer people would die. It's that everyone who was going to die would do it sooner. The Swedish gamble is that this is an unstoppable disease that will go to completion in every country anyway.

gindely 7y ago

I think the argument was that Sweden doesn't have a legal avenue towards general lockdown - only quarantines of specific facilities - and since they assumed everyone was going to get it anyway, voluntary compliance would be good enough, so they didn't regard it as a particular priority to change their law or even constitution. There wasn't any Sweden exceptionalism in the official characterisations I've heard - maybe in the mouths of some redditors.

duxup 7y ago

There were a lot of early clickbaity conclusions that frankly seemed like someone just logiced it out in their head got a lot of attention... but IMO didn't really have much data to support them in any way. Lots of "Why in this country is?" "This place is doing well because." And then a few weeks later the data shows that's simply not the case and you realize the concussions in those articles had little to zero data supporting it. Personally I look forward to hearing about good data years from now about this pandemic.

davidw 7y ago
That's what's so tough: we're all flying blind, but our actions have very, very real consequences. In the Lombardy region of Italy, they kept the bars and restaurants open and had this Milano non si ferma! (Milan doesn't stop!) campaign. The results are tragic. In the Veneto region of Italy, the governor listened to some experts, and the results have been significantly better.

thatguyagain 7y ago

> because Swedes are so much better than the rest of world at voluntary compliance" I haven't heard a single swedish person utter this nonsense IRL. Sounds like a clickbait headline from Vice or something similar.

notacoward 7y ago
It's right here on HN. I've been in threads where that sentiment was expressed. Don't gaslight.
- munk-a 7y ago
  Has it been expressed by Swedes or by people who are propping up the swedish approach because they support premature reopening of the economy?
  - notacoward 7y ago
    I don't know. Can't know. At least one had a possibly-Swedish name, but that doesn't mean all that much. I do suspect that more are Americans, momentarily enamored of Sweden because of this one issue. I'm even more sure that any such will forget their love of Sweden as soon as they realize that Swedish attitudes on just about any other politico-economic subject aren't so convenient to their cause.

jsjolen 7y ago

>[...] but quietly so they don't have to admit it's a change of course. Where exactly does this come from? Sweden has no need to save face. We've been transparent and had open discussion from the beginning with the spoken assumption that we may, in fact, not be doing the right thing and that we may have to alter course as the situation changes. The ones who need to save face are the ones which are committing to full lockdown right now. They're the ones who are making a big sacrifice and need to motivate it with the fact that "it's a necessity", seeing Sweden succeed otherwise would be a big blow to their egos and their personal sacrifices. I will also say that voluntary compliance is still occurring here, which is notable both in what private companies are doing in adapting to the situation, and how the average person has changed their behaviour. This doesn't mean 100% compliance for everyone, which is unfortunate.

casefields 7y ago
Just like abortion or guns, Republicans vs Democrats, there are 2 chunks of people on opposite sides that have staked out their bunkers. They are now at war.
- jsjolen 7y ago
  It is absolutely not the same, since Sweden may change their position because they are not inherently opposed by some inherent moral absolutism to do so.
davidw 7y ago
> The ones who need to save face are the ones which are committing to full lockdown right now. That's quite the assertion. The very word quarantine comes to us from when there was a Republic of Venice. The notion of shutting things down in times of plague is an old one. Yes, it's a very blunt instrument, and you'd hope we could do better these days - and some places like South Korea and Taiwan appear to be managing that - but locking things down works.
- jsjolen 7y ago
  I'm not saying that because the lockdown has been a failure you need to save face. Is there something unclear in my reasoning from the rest of my comment that you'd like me to re-word?