6 ms·

Being a swede it's hard but I don't know if non-swedish epidemiologists make the same mistakes and claims. Giesecke has claimed less than two weeks ago that at

Being a swede it's hard but I don't know if non-swedish epidemiologists make the same mistakes and claims. Giesecke has claimed less than two weeks ago that at least 600k people in Stockholm (pop 950k) have had it. We did viral and antibody tests that came up with 11%(and had to be retracted because it was based on blood donors and included all donors who had recovered and were specifically asked to donate plasma with antibodies, so 11% is above max) and 2.5% respectively. This claim and Gieseckes claim that deaths are <0.1% were was then the basis of a study published to show the Swedish policy was right, which had to be retracted because it put the population of Sweden to be >3*45million. Gieseckes claims and articles starting to disappear/overwritten on same URLs made me back up 4000 news articles yesterday. I think we are close to one of our famous overnight 180 degree public opinion turns from the media starting to question any claims at all. A large anti body study was supposed to be released yesterday, and I'm waiting to see what it says. We seem to be very far off the herd immunity Gieseckes strategy is based on.

SiempreViernes 7y ago
Where does Giesecke propose a strategy of heard immunity? Does every set of restrictions that leave out total lockdown count as a "herd immunity" strategy?
- ewidar 7y ago
  I only see one of these three options: 1. He's aiming for herd immunity, using the people who are the less likely to have severe cases to protect the most vulnerable 2. He believes the death toll will really not be that high to justify the actions that we are taking to prevent the virus from spreading 3. He does not care about the deaths, and the faster they die, the faster we can go back to normal Of course I don't think he believes in number 3, which is quite horrible in my opinion. Regarding 2, the numbers emerging of the population that has actually contracted the virus seem to be much smaller than what Giesecke was assuming. So it would seem correct to assume that the death toll is going to be much higher than he was anticipating based on a wrong hypothesis. To me it only leaves number 1 as a potentially valid approach that does not rely on quarantine.
  - SiempreViernes 7y ago
    Thanks for clarifying that your attribution of this strategy to Giesecke is entirely your own invention.
    - tapland 7y ago
      It wouldn't make much sense to use population who have antibodies as the main goal, and view the peak as desired but reached without further restrictions because of increased resistance in thebpopulation as an argument otherwise. He isn't arguing for lowering infection rates as long as healthcare holds, but for increased immunity. That's not something to be mad about.
      - SiempreViernes 6y ago
        Folkhälsomyndigheten has now spent over a month outright denying that the strategy is aiming for herd immunity: the strategy is purely dedicated to keeping the pressure on the health services manageable. This isn't really an issue about where you personally think it's the correct strategy, rather it's a about whether you believe what the authorities tell you. The most credible connection to FHM this strategy has is that a former employee wrote a mail explaining the reasoning of not closing the schools to a friend who is a politician working on local school issues, the friend then (with permission) shared the text further on FB. > Den tidigare statsepidemiologen Annika Linde hade inte tänkt ge sig in i diskussionen om Folkhälsomyndighetens strategi för att bekämpa det nya coronaviruset. > > – Jag halkade in på ett bananskal, säger hon. > > Bananskalet var en fråga den 12 mars från en lokal skolpolitiker som ville ha hjälp att förklara varför det är rätt av Sverige att inte stänga skolorna. > > Varför säger inte Folkhälsomyndigheten bara att flockimmunitet är planen, undrar folk i sociala medier upprört efter Lindes inlägg. Andra tycker att planen låter rimlig. > > – Sedan förnekade Folkhälsomyndigheten att det var tänkt så, säger Annika Linde. > [...] > > Den tidigare statsepidemiologen Annika Linde tänker inte så mycket på att hennes budskap om den svenska strategin tog sig hela vägen till Vita huset, säger hon. Däremot tänker hon fortfarande att flockimmunitet är målet för Sverige, i väntan på ett vaccin. Men hon försöker låta bli att kommentera sina efterträdares arbete. > > – Det finns något som kallas ”lösa kanoner på däck”. De skjuter lite hit och dit och kan träffa skeppet och sänka det helt och hållet och sedan inte ha något ansvarstagande. Så jag nöjer mig numera med att svara på enstaka frågor, som nu från dig om att jag inte höll tyst där i början. https://www.dn.se/nyheter/sverigebilden-under-coronakrisen/ https://www.dn.se/nyheter/sverigebilden-under-coronakrisen/
acqq 7y ago
> A large anti body study was supposed to be released yesterday, and I'm waiting to see what it says. Also be aware that there are false positives, especially significant with these antibody tests, so with the low numbers of positives it's extremely important to evaluate if the claimed values are more than noise artifacts of the tests themselves. It is also important to be aware of the scenarios for which the use of the apparent test results is not reasonable. Moreover, here's what happened in the UK a few weeks ago: https://www.theguardian.com/world/2020/apr/09/uk-government-urged-to-abandon-poor-finger-prick-antibody-tests-coronavirus https://www.theguardian.com/world/2020/apr/09/uk-government-... "None of 3.5m home tests ordered have so far been accurate enough to detect coronavirus immunity" UK got 3.5 million(!) unusable antibody tests. https://www.bmj.com/content/369/bmj.m1449 https://www.bmj.com/content/369/bmj.m1449 "John Newton, Public Health England’s director of health improvement, said:" "A number of companies were offering us these quick antibody tests, and we were hoping that they’d be fit for purpose, but when they got to test, they all worked but were just not good enough to rely on. “The judgment was made [that] it’s worth taking the time to develop a better antibody test before rolling it out, and that is what the current plan is.”" "Newton told the committee that the tests trialled so far had lacked sufficient sensitivity to identify people who had been infected. “We set a clear target for tests to achieve, and none of them frankly were close.”"
- nchie 7y ago
  Are you sure there are false positives with the serological tests they're using? As far as I've read, there are tests with only false negatives, and if I don't misremember they were the ones used for the Swedish statistical study released (and retracted) last week.
  - acqq 7y ago
    > Swedish statistical study released (and retracted) last week I don't know any details about that specific study, or why it was retracted etc, so any links to more info appreciated! I was writing about the general problems existing when there are little actual positives, and also about the known or maybe somewhere less mentioned issues.
matthiasl 7y ago
I also share your concern about claims made by Gieseke. The article quotes Gieseke as saying "The real death toll, he suggested, will be in the region of a severe influenza season — maybe double that at most". Sweden's official death toll was 2270 yesterday (2020-04-28). The three worst influenza seasons in Sweden since 1969 killed 807, 674 and 652 people[1]. So we've already passed his "at most" claim. The only way I can see that working out is if he feels that none of the influenza seasons in the past 50 years count as "severe". [1]: numbers taken from the Swedish wikipedia entry on influenza. I didn't bother to check wikipedia's source. An average Swedish influenza season kills about 200.
- alkonaut 7y ago
  > he only way I can see that working out is if he feels that none of the influenza seasons in the past 50 years count as "severe". Or that he doesn't think deaths in past influenza seasons were all attributed to influenza but rather just "normal" deaths. The excess all-cause deaths will be the figure to look at, but it will take quite a while before those numbers are reliable.
  - gizmo 7y ago
    But the excess death data will also be tainted because people, especially older people, avoid going to hospitals out of fear of catching covid19. Cancer screenings are way down, and fewer people go to the ER with heart attacks and the like. This will inevitably lead to excess mortality down the road --even among otherwise healthy people--, but it will be very hard to determine the magnitude of this second-order effect. Of course it's also very hard to distinguish between people dying with covid19 and dying because of it. And we've never even made a serious effort to track the cause of death of the elderly. Meaning we don't know how many people die each year from the flu, and we don't know how many people are dying of covid19. When you add it all up, it will be very difficult to learn the right lessons from this pandemic.
    - DanBC 7y ago
      That's not what excess mortality means. They don't say "this many extra people died, I guess it must be covid" -- they're not fucking idiots. When cancer patients die because their cancer treatment was cancelled they die of a cancer related cause, and that's how their death will be recorded, and that's how their death will be reported. > And we've never even made a serious effort to track the cause of death of the elderly. It's hard to understand your "we" here. Which country doesn't try to track cause of death for elderly people? > Meaning we don't know how many people die each year from the flu, But we can count the deaths the same way. We can look at deaths of people confirmed to have the disease, we can look at death certificates, we can look at excess mortality combined with community surveillance. The errors for all three are going to be similar for flu and covid-19.
deleted 7y ago
[deleted]
alkonaut 7y ago
> Giesecke has claimed less than two weeks ago that at least 600k people in Stockholm (pop 950k) have had it Stockholm has 2.34 million inhabitants. (Stockholm in this context is always stockholm area, not the city). That makes a 600k estimate much less outlandish although still optimistic (25%). Self-selecting hospital workers showed 20% in yesterdays publication, which seems like it should be an upper bound for the general population. It's also important to remember that when people make the claim that "X had it" they also simultaneously estimate that perhaps X/2 would show up as positive in serological tests (because the rate of infection and delay of antibodies would create a lag) so a person claiming 20% having been infected isn't contradicted by a serological result of 10% positive.
- tapland 7y ago
  > Stockholm has 2.34 million inhabitants. (Stockholm in this context is always stockholm area, not the city). I agree, counting only Stockholm city isn't reasonable. But I've found the 'Metropolitan Stockholm' number is seldom used as well, but looking at the definitions it should be more common. What is more commonly used is the number for the Stockholm urban area (I'll link the Swedish wiki article since it contains a lot more data, https://sv.wikipedia.org/wiki/Stockholm_(tätort) https://sv.wikipedia.org/wiki/Stockholm_(tätort) ). It's interesting to compare the metropolitan areas. In Stockholm is stretches so far that it includes areas that feed to (and somewhat off) some of the other large cities (mostly Uppsala I guess), but in Skåne the metropolitan area only covers a few municipalities although commuting by car is more commonplace and there seems to be a lot more commuting by train from Helsingborg and Kristianstad to Malmö (it's also extremely handy by train) than from Uppsala to Stockolm (no hard numbers, but I commuted Uppsala -> Stockholm for five years and Helsingborg -> Malmö for a while). So it does make more sense to use the 'Greater' areas for all the major cities.
  - alkonaut 7y ago
    > But I've found the 'Metropolitan Stockholm' number is seldom used as well, but looking at the definitions it should be more common. The county (region, or formerly "län") is the area responsible for healthcare so it's natural that this area is used for all things healthcare related. https://en.wikipedia.org/wiki/Regions_of_Sweden https://en.wikipedia.org/wiki/Regions_of_Sweden https://en.wikipedia.org/wiki/Stockholm_County https://en.wikipedia.org/wiki/Stockholm_County

SiempreViernes 7y ago

Where does Giesecke propose a strategy of heard immunity? Does every set of restrictions that leave out total lockdown count as a "herd immunity" strategy?

ewidar 7y ago
I only see one of these three options: 1. He's aiming for herd immunity, using the people who are the less likely to have severe cases to protect the most vulnerable 2. He believes the death toll will really not be that high to justify the actions that we are taking to prevent the virus from spreading 3. He does not care about the deaths, and the faster they die, the faster we can go back to normal Of course I don't think he believes in number 3, which is quite horrible in my opinion. Regarding 2, the numbers emerging of the population that has actually contracted the virus seem to be much smaller than what Giesecke was assuming. So it would seem correct to assume that the death toll is going to be much higher than he was anticipating based on a wrong hypothesis. To me it only leaves number 1 as a potentially valid approach that does not rely on quarantine.
- SiempreViernes 7y ago
  Thanks for clarifying that your attribution of this strategy to Giesecke is entirely your own invention.
  - tapland 7y ago
    It wouldn't make much sense to use population who have antibodies as the main goal, and view the peak as desired but reached without further restrictions because of increased resistance in thebpopulation as an argument otherwise. He isn't arguing for lowering infection rates as long as healthcare holds, but for increased immunity. That's not something to be mad about.
    - SiempreViernes 6y ago
      Folkhälsomyndigheten has now spent over a month outright denying that the strategy is aiming for herd immunity: the strategy is purely dedicated to keeping the pressure on the health services manageable. This isn't really an issue about where you personally think it's the correct strategy, rather it's a about whether you believe what the authorities tell you. The most credible connection to FHM this strategy has is that a former employee wrote a mail explaining the reasoning of not closing the schools to a friend who is a politician working on local school issues, the friend then (with permission) shared the text further on FB. > Den tidigare statsepidemiologen Annika Linde hade inte tänkt ge sig in i diskussionen om Folkhälsomyndighetens strategi för att bekämpa det nya coronaviruset. > > – Jag halkade in på ett bananskal, säger hon. > > Bananskalet var en fråga den 12 mars från en lokal skolpolitiker som ville ha hjälp att förklara varför det är rätt av Sverige att inte stänga skolorna. > > Varför säger inte Folkhälsomyndigheten bara att flockimmunitet är planen, undrar folk i sociala medier upprört efter Lindes inlägg. Andra tycker att planen låter rimlig. > > – Sedan förnekade Folkhälsomyndigheten att det var tänkt så, säger Annika Linde. > [...] > > Den tidigare statsepidemiologen Annika Linde tänker inte så mycket på att hennes budskap om den svenska strategin tog sig hela vägen till Vita huset, säger hon. Däremot tänker hon fortfarande att flockimmunitet är målet för Sverige, i väntan på ett vaccin. Men hon försöker låta bli att kommentera sina efterträdares arbete. > > – Det finns något som kallas ”lösa kanoner på däck”. De skjuter lite hit och dit och kan träffa skeppet och sänka det helt och hållet och sedan inte ha något ansvarstagande. Så jag nöjer mig numera med att svara på enstaka frågor, som nu från dig om att jag inte höll tyst där i början. https://www.dn.se/nyheter/sverigebilden-under-coronakrisen/ https://www.dn.se/nyheter/sverigebilden-under-coronakrisen/

acqq 7y ago

> A large anti body study was supposed to be released yesterday, and I'm waiting to see what it says. Also be aware that there are false positives, especially significant with these antibody tests, so with the low numbers of positives it's extremely important to evaluate if the claimed values are more than noise artifacts of the tests themselves. It is also important to be aware of the scenarios for which the use of the apparent test results is not reasonable. Moreover, here's what happened in the UK a few weeks ago: https://www.theguardian.com/world/2020/apr/09/uk-government-urged-to-abandon-poor-finger-prick-antibody-tests-coronavirus https://www.theguardian.com/world/2020/apr/09/uk-government-... "None of 3.5m home tests ordered have so far been accurate enough to detect coronavirus immunity" UK got 3.5 million(!) unusable antibody tests. https://www.bmj.com/content/369/bmj.m1449 https://www.bmj.com/content/369/bmj.m1449 "John Newton, Public Health England’s director of health improvement, said:" "A number of companies were offering us these quick antibody tests, and we were hoping that they’d be fit for purpose, but when they got to test, they all worked but were just not good enough to rely on. “The judgment was made [that] it’s worth taking the time to develop a better antibody test before rolling it out, and that is what the current plan is.”" "Newton told the committee that the tests trialled so far had lacked sufficient sensitivity to identify people who had been infected. “We set a clear target for tests to achieve, and none of them frankly were close.”"

nchie 7y ago
Are you sure there are false positives with the serological tests they're using? As far as I've read, there are tests with only false negatives, and if I don't misremember they were the ones used for the Swedish statistical study released (and retracted) last week.
- acqq 7y ago
  > Swedish statistical study released (and retracted) last week I don't know any details about that specific study, or why it was retracted etc, so any links to more info appreciated! I was writing about the general problems existing when there are little actual positives, and also about the known or maybe somewhere less mentioned issues.

matthiasl 7y ago

I also share your concern about claims made by Gieseke. The article quotes Gieseke as saying "The real death toll, he suggested, will be in the region of a severe influenza season — maybe double that at most". Sweden's official death toll was 2270 yesterday (2020-04-28). The three worst influenza seasons in Sweden since 1969 killed 807, 674 and 652 people[1]. So we've already passed his "at most" claim. The only way I can see that working out is if he feels that none of the influenza seasons in the past 50 years count as "severe". [1]: numbers taken from the Swedish wikipedia entry on influenza. I didn't bother to check wikipedia's source. An average Swedish influenza season kills about 200.

alkonaut 7y ago
> he only way I can see that working out is if he feels that none of the influenza seasons in the past 50 years count as "severe". Or that he doesn't think deaths in past influenza seasons were all attributed to influenza but rather just "normal" deaths. The excess all-cause deaths will be the figure to look at, but it will take quite a while before those numbers are reliable.
- gizmo 7y ago
  But the excess death data will also be tainted because people, especially older people, avoid going to hospitals out of fear of catching covid19. Cancer screenings are way down, and fewer people go to the ER with heart attacks and the like. This will inevitably lead to excess mortality down the road --even among otherwise healthy people--, but it will be very hard to determine the magnitude of this second-order effect. Of course it's also very hard to distinguish between people dying with covid19 and dying because of it. And we've never even made a serious effort to track the cause of death of the elderly. Meaning we don't know how many people die each year from the flu, and we don't know how many people are dying of covid19. When you add it all up, it will be very difficult to learn the right lessons from this pandemic.
  - DanBC 7y ago
    That's not what excess mortality means. They don't say "this many extra people died, I guess it must be covid" -- they're not fucking idiots. When cancer patients die because their cancer treatment was cancelled they die of a cancer related cause, and that's how their death will be recorded, and that's how their death will be reported. > And we've never even made a serious effort to track the cause of death of the elderly. It's hard to understand your "we" here. Which country doesn't try to track cause of death for elderly people? > Meaning we don't know how many people die each year from the flu, But we can count the deaths the same way. We can look at deaths of people confirmed to have the disease, we can look at death certificates, we can look at excess mortality combined with community surveillance. The errors for all three are going to be similar for flu and covid-19.

deleted 7y ago

[deleted]

alkonaut 7y ago

> Giesecke has claimed less than two weeks ago that at least 600k people in Stockholm (pop 950k) have had it Stockholm has 2.34 million inhabitants. (Stockholm in this context is always stockholm area, not the city). That makes a 600k estimate much less outlandish although still optimistic (25%). Self-selecting hospital workers showed 20% in yesterdays publication, which seems like it should be an upper bound for the general population. It's also important to remember that when people make the claim that "X had it" they also simultaneously estimate that perhaps X/2 would show up as positive in serological tests (because the rate of infection and delay of antibodies would create a lag) so a person claiming 20% having been infected isn't contradicted by a serological result of 10% positive.

tapland 7y ago
> Stockholm has 2.34 million inhabitants. (Stockholm in this context is always stockholm area, not the city). I agree, counting only Stockholm city isn't reasonable. But I've found the 'Metropolitan Stockholm' number is seldom used as well, but looking at the definitions it should be more common. What is more commonly used is the number for the Stockholm urban area (I'll link the Swedish wiki article since it contains a lot more data, https://sv.wikipedia.org/wiki/Stockholm_(tätort) https://sv.wikipedia.org/wiki/Stockholm_(tätort) ). It's interesting to compare the metropolitan areas. In Stockholm is stretches so far that it includes areas that feed to (and somewhat off) some of the other large cities (mostly Uppsala I guess), but in Skåne the metropolitan area only covers a few municipalities although commuting by car is more commonplace and there seems to be a lot more commuting by train from Helsingborg and Kristianstad to Malmö (it's also extremely handy by train) than from Uppsala to Stockolm (no hard numbers, but I commuted Uppsala -> Stockholm for five years and Helsingborg -> Malmö for a while). So it does make more sense to use the 'Greater' areas for all the major cities.
- alkonaut 7y ago
  > But I've found the 'Metropolitan Stockholm' number is seldom used as well, but looking at the definitions it should be more common. The county (region, or formerly "län") is the area responsible for healthcare so it's natural that this area is used for all things healthcare related. https://en.wikipedia.org/wiki/Regions_of_Sweden https://en.wikipedia.org/wiki/Regions_of_Sweden https://en.wikipedia.org/wiki/Stockholm_County https://en.wikipedia.org/wiki/Stockholm_County