76 ms·

Anders Tegnell defends Sweden's virus approach

152 points by whydoyoucare 6y ago

whydoyoucare 6y ago
BBC, WaPo and NPR have conflicting titles, but I found this to be better worded and balanced article.
- vesinisa 6y ago
  Tegnell has previously categorically denied any mistakes were made, but is now saying a stricter approach should have been taken in hindsight. In Swedish political culture, it seems to be a big thing if even a hint of a mistake is admitted by an authority figure. Directly criticizing public policies is almost a taboo for ordinary civilians.
  - hedora 6y ago
    Tegnell has been openly discussing mistakes they made for at least a month: https://www.businessinsider.com/coronavirus-sweden-lockdown-chief-says-high-death-toll-was-surprise-2020-5?op=1 https://www.businessinsider.com/coronavirus-sweden-lockdown-... Today’s article is consistent with the statements he made last month. As others have pointed out, we won’t know if the approach was successful until after we see post-reopening trends.
    - vesinisa 6y ago
      Note that back then he only acknowledged that there has been more deaths than they thought. But he did not back then think having adopted a different strategy would have necessarily saved any lives, because many of the deaths were in elderly homes. In yesterday's press meeting, he admitted that given what they know now Sweden would have actually adopted a different strategy. It was at perceived as the first actual admission that the adopted policy was in fact too open. Given that the policy mistake might have at this point lead to thousands of preventable deaths, he understandably treads very carefully.
  - zlorch 6y ago
    > Directly criticizing public policies is almost a taboo for ordinary civilians. This could possibly be the worst lie I've heard this week. And I've listened to Trump.
    - jojje2k 6y ago
      That struck me as an odd statement as well. If anything, the amount of criticism used by grass root movements on social media is bordering being an issue. A self-fueling fire.
    - null_object 6y ago
      There have now been several articles documenting the attacks that have been the consequence of questioning Tegnell's decisions in public. This is one example (in Swedish) https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-er-for-att-tysta-coronadebatten https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-er-f... But in DN (behind a paywall) there have been other articles where those that questioned Sweden's policy have even been personally threatened. Tegnell has been wrong about pretty much everything - from saying that the pandemic had reached its "peak" in Sweden when we had 137 cases[1] to being consistently wrong about how far we've supposedly come with 'herd immunity' - which was supposed to be around 50% by the beginning of June, but which has shown itself to be only around 7-10% in the worst-affected areas in Stockholm. There is also a lot of finger-pointing in articles and comments by Swedes, accusing other Nordic countries of purposely under-estimating their covid figures - whereas the actual statistics[2] show that Sweden itself is the only Nordic country with massively under-estimated deaths. [1] https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiologen-toppen-kan-vara-nadd-nu https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiolog... [2] https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
      - jojje2k 6y ago
        Regarding [1], it sounds more like Aftonbladet is either misquoting him, quoting out of context or The title claims he said we had reached the peak, giving the impression of peak infections across the whole population, but the contents only covers a specific group of people who had returned from their vacations in Italy. I'm not saying he didn't mean or say peak total infections in the interview. I'm just saying that particular article is all over the place. Edit: On the contrary, according to the article he said we could very well be hit by a new wave from new arrivals.
  - samsari 6y ago
    I assume you've never looked at a Swedish newspaper then, they've all been full of criticisms and discussions since the start.
    - vesinisa 6y ago
      As a fellow Nordic citizen our media monitors the situation in Sweden very closely. One point that has been raised is the "consensus culture" of Swedish political discourse where no one seems brave enough to openly question the chosen policies. Even the hermit opposition party Sweden Democrats toed the government's line loyally. In lieu of domestic alternate voices, we have other Nordic health officials questioning the Swedish strategy instead: https://www.thelocal.no/20200520/interview-my-belief-is-that-we-wont-have-a-big-second-wave https://www.thelocal.no/20200520/interview-my-belief-is-that... Is Tegnell really the only credible epidemiologist in Sweden? Given that pretty much all of Europe has adopted a different strategy, that does not seem plausible. But is there anyone in the Swedish public sphere actually challenging Tegnell's ideas?
      - mongol 6y ago
        Yes there have been quite many. But the sad thing is that they have been shouted down because their rethorical skills were not that good. So the discussion turned dishonest, not interpreting their viewpoints with the best intent.
        vesinisa 6y ago
        Exactly. Life and death of thouands of people should not be decided based on someone's charisma alone. Even if something is done in the name of a scientific experiment - like Tegnell's unique policy - it is outregeously unethical if this causes avoidable mass death to innocent civilians. Sadly Sweden is no stranger to application of questionable and unethical scientific experiments to the masses. The country had an extensive Nazi-inspired eugenics programme from 1930s all the way up to the late 1970s: https://www.theguardian.com/world/1999/mar/06/stephenbates https://www.theguardian.com/world/1999/mar/06/stephenbates The very existence of this programme was a secret until the early 2000s, and to this day continues to be a taboo in Sweden.
  - lostmyoldone 6y ago
    There is a strong culture of reaching for consensus, and to (in most cases) follow rules and recommendations, but it's nothing even close to a taboo to criticize public figures. We generally criticize everything, and everyone, but there are very few screaming matches. What is scalding criticism in Swedish eyes might not always register as such unless you are aware of the culture. It's (probably) to some extent down to how written Swedish works in concert with our predominantly protestant culture. Swedish is reasonably good for factual discourse, and quite awesome for writing a dramatic epic with words that soar. Hitting the space in between, without sounding ridiculous, is rather hard. Most love songs and poems written in modern day Swedish are very indirect because of this, as they would risk sounding ridiculous otherwise. Life is rarely epic on the scale of the sagas. This also makes public discourse sometimes seem a bit odd, because as the last thing you want to do is to make yourself and your criticism sound inane. Scalding criticism might look more like a slight disagreement if you read it in a newspaper and considered the words at face value.
- KarlKemp 6y ago
  Every other report highlights his admission that he would do things differently knowing what he knows now. And that angle to the story actually makes it a story, while "we still believe what we previously believed" really isn't something that, by itself, would warrant an article. But sure, this outlier is "better worded" and "balanced". Oh, and note the URL of this article: www.startribune.com/scientist-admits-sweden-could-have-battled-virus-better/570980492/
rfrey 6y ago
Seems to me that we won't really know if the Swedish approach was a disaster or not until economies are reopened, second waves happen or don't, etc. The game isn't over.
- alkonaut 6y ago
  Indeed. The strategy if it works perfectly was never going to have fewer deaths than a lockdown strategy after 3 months. That much should be obvious. The criticism early on was "Oh my god look at these simulations you'll have 25k ICU beds needed and you have only 1k", 50k will die before july! When that didn't happen, somehow now the message is that 4k dead and emergency hospital capacity never even used is a complete failure - because Norway has fewer deaths? I think if anything we should be happy that most of Europe managed to actually contain this disease and people weren't left to die without ventilators as the early alarms said. Whether 500 or 5000 die in a country is a big difference, but remember we were fearing tens of thousands in every countruy.
- oska 6y ago
  Economies are already re-opening to each other and Sweden is being excluded. So no, Sweden has already failed.
viburnum 6y ago
It’s still too soon to tell but it seems like the economic impact of a thorough lockdown (New Zealand) isn’t much greater than most people staying home voluntarily (Sweden). The difference seems worth it to control the pandemic. Two weeks from now it looks like New Zealand (with zero cases left) with have fewer restrictions than Sweden.
- Mediterraneo10 6y ago
  New Zealand is an island. It knew that it could pursue the full eradication option because it had few cases and could fully close its borders. European countries with their large numbers of infected and more porous borders (economy requiring movement of migrant workers for agriculture, etc.) never pursued full eradication, only curve-flattening.
  - viburnum 6y ago
    So what if New Zealand is an island? How many people are walking to Sweden?
    - renewiltord 6y ago
      That's actually a fair point. Why does the islandness matter?
    - Mediterraneo10 6y ago
      Few people might be walking on foot to Sweden (though in Tornio/Haparanda, some do walk over the border), but Sweden has land borders with two countries and a bridge to a third. Traffic has continued to move over those border crossings during the time of the pandemic. In fact, there has been a steady flow of traffic over most European border crossings along major motorways, though that traffic has consisted of only drivers and passengers who could show they are moving around for work purposes etc. The only common way into New Zealand is a flight or an occasional ship. NZ has no immediately neighboring countries that it runs freight trucks to and from day in and day out, and it doesn't need to move large numbers of agricultural workers around internationally. Therefore, for New Zealand traffic is obviously going to be smaller and easier to control than European countries.
ptero 6y ago
The guy is a scientist and his answers have to be viewed from that angle. A politician goes for spin and tries to project confidence; "I am not sure this is the right approach" from a politician usually means "hell, no!". Tegnell's answer means just that -- he is not sure. Which is a normal way for a scientist to feel as there are always uncertainties and when we choose an action we are often not sure for a while if that action is optimal or not. I personally feel a lot of respect to Tegnell. Sweden might have taken a better or a worse approach than, say, France but it is clearly not catastrophic: there are no mountains of corpses on the streets there are a number of countries with lockdowns and worse per capita death rates; second wave, if appears, will likely go much easier on Sweden, etc. I think other countries should take a page out of Tegnell's book and instead of trying to exorcise dissent and label opponents, admit to uncertainties in their policies. This will not make their argument weaker; it might still mean that lockdowns are a better option. But it would also open policies for discussion and debate. Good policies will still win. But then they win by merits, not because of trying to silence any opposition. My 2c.
- KarlKemp 6y ago
  Sweden has the highest per-capita rate of deaths from COVID. In Sweden, 4,500 people have died. In neighbouring Norway, 237 people died. Even adjusted for population, Sweden has 10x the deaths. I'm a scientist as well and my math skills say their strategy sucks.
  - prepend 6y ago
    Finland also only has 300 deaths. Sweden is not the highest in Europe, per capita, it’s fifth [0]. So it’s pretty bad out of 31 countries but better than Belgium. [0] https://www.statista.com/statistics/1111779/coronavirus-death-rate-europe-by-country/ https://www.statista.com/statistics/1111779/coronavirus-deat...
    - timwaagh 6y ago
      Lies greater lies and statistics... Belgium counts people who die in nursing homes as covid 19 deaths. They say Belgiums figure would be twice as small if they counted the way others did. Removing that anomaly the only countries higher are Spain, Italy and UK. The first two were hit very hard very early and the last had similar issues as Sweden, reacting very late.
geoffreymcgill 6y ago
Making a comparison of Sweden (10,094,432 population) vs Czech Republic (10,707,502 population) seems to reveal a very different story. New cases (7 day average): https://i.imgur.com/fciq4Ra.png https://i.imgur.com/fciq4Ra.png Total deaths: https://i.imgur.com/do9Zbvn.png https://i.imgur.com/do9Zbvn.png
- pedrosorio 6y ago
  Masks can do wonders
  - alkonaut 6y ago
    If there is a clear sign of the mask requirement being introduced in graphs from various countries (e.g. these graphs) I can't see it... I think there is a lot of "I believe X would give outcome Y and I see outcome Y therefore X must work". This mistake is called Affirming the Consequent. Without clear signs of causation we can't know.
    - heracles 6y ago
      Thank you. There's sooooo much "I think like this therefore I will find two variables out of 10000 and link them" going around. The easy with which one could argue the exact opposite using some two other variables seems to go unnoticed by the original makes of the claim, whatever it was.
thawaway1837 6y ago
Sweden’s strategy failed on its own terms. There is absolutely no arguing that. Their first goal was to protect the vulnerable, and they failed miserably at that. Fundamentally because Tegnell resisted the fact that asymptomatic carriers existed. One could argue, like some Iraq war proponents do, that the idea was ok for Sweden, but the failure was in execution. But one can not argue that it wasn’t a significant failure.
- jmauritz 6y ago
  We're barely 3 months into this and your calling it a failure? could it be done better: yes, it is failure? no. "no arguing", "can not argue" Yes, you very much can, and we'll see in a few years what the "correct" choice was.
  - dpau 6y ago
    the comment was referring to failure in execution, not necessarily failure in choosing the correct approach. it's hard to argue that sweden shouldn't have been more careful with its elderly and vulnerable, even if going for herd immunity.
    - svrtknst 6y ago
      It's fairly impossible to say "Sweden should hav ebeen more careful with its elderly" - The measures put in place by Sweden were designed with that in mind. That's why elderly care facilities were the first, if not only ones, to face quarantine. However, when you have years of poor management of elderly care, and elderly care companies that refuse to heed the recommendations, there's not much "Sweden" can do in the moment wihtout severe effort.
      - addicted 6y ago
        Right, and it had nothing to do with Tegnell’s resistance to the idea of asymptomatic carriers and hence his guidance that care workers were free to go into work as long as they didn’t show symptoms. Edit: Also, your comment basically justifies the lockdowns in every other country. Tegnell’s whole argument was that the enlightened Swedes didn’t need a mandatory lockdown because they would simply do the right thing without the government telling them. And there is some truth to that in a society that is wealthy, well educated, and highly trusting of its government. Despite that, it’s citizenry failed to achieve what Tegnell said they would. How in the world would you expect other countries’ citizens to voluntarily do what the government was recommending when Sweden couldn’t? His criticism of lockdowns in other countries was completely unwarranted based on his own reasoning for why Sweden didn’t need a lockdown (which also, as you point out, turned out to be wrong).
scott_meyer 6y ago
Just watch this chart for a couple years: https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&deathsMetric=true&totalFreq=true&aligned=true&perCapita=true&smoothing=0&country=USA~SWE https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
somewhereoutth 6y ago
Sweden made some very bad choices and a lot of people died unnecessarily. Compare with Portugal, same population, right next to Spain, lower GDP, a fraction of the deaths. There is no excuse, no 'second wave', no economic payoff, no wait and see. Scientists are trained to make judgments based on experimentation and evidence. In a fast moving novel pandemic situation, where there is no time to carry out experiments, where evidence is confused and hard to corroborate, their utility is much reduced. That is why politicians exist, to make these hard decisions. It is unfair to pillory scientists such as Tegnell, as it is the politicians who abdicated responsibility in the face of this crisis that should rightfully face condemnation. Except of course, there was evidence, from China, Taiwan, South Korea and elsewhere. It was clear what needed to be done, and how to do it. Shame on Sweden, and other places, for not heeding that guidance.
- dependenttypes 6y ago
  I was under the impression that quarantine was an option only to "flatten the curve" (and make it easier for the hospitals to treat people) and that the same amount of people would die regardless (from the virus), is this wrong?
  - quelltext 6y ago
    > that the same amount of people would die regardless Maybe "be infected", not "die"? Otherwise there's little reason to flatten the curve (meant to allow for better treatment).
  - kqr 6y ago
    This is one of the assumptions underlying the Swedish approach, yes. The knob you can fiddle is how soon people die: with relaxed response, people who would have died a few months or a year from now might die of the pandemic tomorrow. (But of course, strict countermeasures also have their long-term costs, which are harder to quantify in terms of lives, although that's definitely a component of it.)
  - kalleboo 6y ago
    It was, yes, under the early assumption that the virus spread rapidly but had a relatively low death rate. It turns out it's the opposite - it's surprisingly easy to stop the spread, but the death rates are higher. So countries that locked down under the plan that they were just flattening the curve still managed to nearly eradicate the virus despite that not being the original strategy.
contemporary343 6y ago
Scientists are human and prone to as many cognitive biases as anyone. As one myself, I see here an effort to contort oneself and one’s model/framework to somehow explain the data. When the data seems fairly clear that this has been a failure for Sweden. That being said, I think our failures here in the US have been vast and worse.
ReticentVole 6y ago
Deaths in Sweden are at their highest level since 1993: https://www.reuters.com/article/us-health-coronavirus-sweden-toll/coronavirus-pushes-swedish-deaths-to-highest-since-1993-in-april-idUSKBN22U1S4 https://www.reuters.com/article/us-health-coronavirus-sweden... What happened in 1993? A Flu Pandemic... That no one has ever heard about, that seemed to have no lasting impact, and occurred when the population was younger and 25% smaller (thus having a proportionally much greater impact). Without the media panic, COVID-19 would have come and gone as a unusually deadly flu wave, nothing more.
- chrisco255 6y ago
  Yeah, agreed. The whole point of shutdowns was to prevent hospitals from being overrun, and with the exception of the few states in the U.S. that compromised their nursing home population by sending sick patients back there, the vast majority of hospitals experienced lower-than-average patient count for the past 3 months.
- WildParser 6y ago
  In the Gompertz-Model (that worked perfectly for China) Sweden is converging to R~0,8 - with a total death-count <6000. Germany is going to R~0,7 / <9000. Given the explosive dynamics of COVID-19 that soon converges to R<1 going for herd immunity was most likely a bad choice. For Germany cutting the flu in half worked - while the bad math of the epidemiologists-community seems to last forever...
  - alkonaut 6y ago
    > going for herd immunity was most likely a bad choice. I think this has been repeated a lot. No one is "going for herd immunity". Every country including sweden has two goals: having as few as possible infected and preventing healthcare from being overwhelmed. If partial or full immunity makes the virus go away that's a fortunate side effect of slow burn, not the "goal".
- hansbo 6y ago
  Perhaps, but seeing as Sweden has had quite large changes in behavior (most people who can work from home, do; people are much better at washing their hands; the subways of Stockholm are significantly less crowded, going from being crowded while standing up, to always being sparse even during rush hour), it's not hard to consider the death rate being much higher than in 1993 without the media panic.
ggrrhh_ta 6y ago
Other countries in Europe also have lead epidemiologists and scientists (or technical bodies) making the recommendations that then get turned into policy. Those scientists in Denmark, Germany, Switzerland, Finland, Norway, France, Spain, Italy are as good as Tegnell is. Also, the medical approach to people getting sick with COVID-19 has significantly improved over the first month (e.g., early hospitalisation instead of sending a sick person to isolate themselves at home, weeding out drugs that did not work from those that worked, introduction of drugs to control trombosis and secondary damage from the virus, better approaches to when and how use ventilators, etc.). That means that a number of the deaths that have occurred within the Swedish policy could have been avoided by delaying the infection. More importantly, Sweden's approach has not even achieved a significant level of immunity, as Swedes have been self-imposing social distancing and even a 'lockdown' (working from home). In an interview in "unherd", Giesecke estimated that the deaths in UK without lockdown would be in the 12,000 (when they where 13,000), then corrected himself to 24,000 (they are almost 40,000 now), and then said they will not be 10x 12,000. On freedom. The lockdown for reasons of public health is a limitation of our freedom that has been accepted (except in Sweden) by their citizens in their respective contracts as a society (constitutions, laws, etc.). So, per se, it's a limitation akin to not driving over a certain speed in certain roads. Moreover, many people (and students) have reported that the lockdown has been "liberating" - and for others have been depressing (it never rains to everyone's liking) On ending the lockdown. Tegnell and Giesecke repeat and repeat and repeat that countries imposed a lockdown without a strategy out. Well that's just dire false. When the lockdown was being discussed, the press was already pointing that issue and several strategies were being considered (press from March already discusses the measure by measure approach). But, whereas other countries are looking conservatively with the evidence (that could be flawed because it is small and incomplete) that they already have, Sweden is relying in an evidence that will only be apparent in the future (if the events turn out to be advantageous for that approach). If each country had been given an "ant population" with some infected individuals and their epidemiologists needed to manage the epidemic long term while a cure for the ant's illness is found, maybe, the Sweden's approach would have made more sense... At least, most people wouldn't have had much feelings for those ants that could have lived a couple of days longer.
- DanBC 6y ago
hyperpallium 6y ago
Sweden's economy, which relies heavily on exports, is expected to shrink 7% in 2020 [neighbours] dropping mutual border controls but would keep Sweden out Sometimes it's better to go with the crowd, even if you're right.
dr_dshiv 6y ago
How would one rationally model and determine a multifactor policy on covid lockdown, balancing for health, economy, and overall wellbeing? Is it even possible to balance those, if it means making x lost life years equal to y many bankruptcies or z lost jobs, etc?
- alkonaut 6y ago
  This is what authorities like the FHM (the public health authority does every day). You use tools like counting QALY, for example.
  - dr_dshiv 6y ago
    But how do you equate or make commensurable those different measures? How many job losses equal a lost life year?
    - alkonaut 6y ago
      That’s the difficult part, but that’s the job of the public health authority. Same thing with missed semesters of a school. How many add up to an 80 year old dying? And so on and so forth. I don’t envy those that have to do this arithmetic, but it can’t be avoided.
      - dr_dshiv 6y ago
        I don't see how it is arithmetic nor the job of a public health authority. It's a philosophical, ethical and political issue. There are bounding conditions, like research showing that job loss increases rates of suicide. [1] But we still argue about whether it is fair to treat the life of a 12 year old as more valuable than the life of a 92 year old. So it isn't just arithmetic. [1] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30141-3/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
nounaut 6y ago
90% of all covid-19 deaths in Sweden have been people over the age of 70 [1] which is the only group of the population which have been quarantined. So it's arguable what difference a nation wide quarantine would have made. Of those over 70, half of the deaths were in care homes and another 26% had home care [2]. Many of the workers in care homes have reported that their companies/bosses won't allow them to stay home when they're showing symptoms and some have been forced to work without protective equipment. There have "only" been 42 deaths under the age of 50 [2]. [1] https://www.svd.se/90-procent-av-alla-doda-i-covid-19-over-70-ar https://www.svd.se/90-procent-av-alla-doda-i-covid-19-over-7... [2] https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-over-70-ar-med-coronasmitta-bodde-pa-sarskilda-boenden https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-over...
- ptx 6y ago
  Those numbers are a month old. There have now been 64 deaths[1] under the age of 50. In the age group between 50 and 70, which you didn't directly mention, 455 people have died. [1] https://www.svt.se/datajournalistik/har-sprider-sig-coronaviruset/ https://www.svt.se/datajournalistik/har-sprider-sig-coronavi...
  - nounaut 6y ago
    Doesn't change the fact that the high death toll have been among the part of the population that were in fact in quarantine and would most likely have been the same had Sweden chosen a more common tactic.
    - addicted 6y ago
      They were in “quarantine”. Tegnell didn’t believe in the existence of asymptomatic carriers so younger care workers were allowed to visit them freely as long as they didn’t show symptoms. He made a huge mistake but is simply unwilling to admit it.
      - nounaut 6y ago
buboard 6y ago
I think epidemiologists shoot themselves in the foot as a profession when they started talking about herd immunity, which is the one situation we are trying to to avoid in infections, and really the entire reason their profession exists. We could reach herd immunities without them but the toll is dramatic and untenable. Politicians mistook the term to mean some kind of solution and made it a buzzword, but it really is the worst solution. Swedens situation is not the worst in the world, but they really did not win much with their "strategy" either. Talk of "reaching herd immunity in a few months" was irresponsible and heavily fatalistic. As a country with a big public sector they could easily have followed a slightly more conservative approach. An "initial freeze, then plan accordingly" would be a more rational way to go. It was also irrational to assume that their economy can "rebound faster" when most of the rest world is shut down. Epidemiology did not wear its best suit in this pandemic, and will lose a lot of respect in the eyes of many[1]. Scientists have a duty to inform people when their results are being misused or misinterpreted 1. https://marginalrevolution.com/marginalrevolution/2020/04/what-does-this-economist-think-of-epidemiology.html https://marginalrevolution.com/marginalrevolution/2020/04/wh...
acd 6y ago
I am happy we let our expert government agency in this matter make the decision and not the politicians. There will be an autumn. Countries which let politicians shutdown early have numbers that look good now, but there is autumn and there is shutdown stamina. If you shutdown early there is little herd immunity in the autumn. There is also psychological effects of keeping people in total isolation for too long. In prison isolation is a punishment which I do not wish upon anyone. Then has to see that its also a group decision from the health authorities in Sweden where there is consensus on the direction board on how to act. Its not a one person decision.
- glangdale 6y ago
  But you didn't achieve herd immunity, and you're going to be in the same place as everyone else (except with more dead). There might be a marginal advantage but antibody studies show Sweden is nowhere near even the more generous estimates of what herd immunity might require. Everything about the Swedish approach is a failure, and the amazing thing is that not only was the approach bizarre, but the Swedes have a very low testing rate relative to the number of cases - which seems like a weird move (innovate both in approach and in terms of "not knowing what's going on"). Positively 3rd world cases:deaths ratio - it's just embarrassing.
raverbashing 6y ago
More important seems to be his previous statement (which is also quoted in the article): > Tegnell's statement to reporters came after more contrite comments earlier in the day to Swedish radio in which he said “I think there is potential for improvement in what we have done in Sweden, quite clearly.” > Asked if the country’s high death toll has made him reconsider his unique approach to the pandemic, Tegnell told Swedish radio “yes, absolutely.”
butler14 6y ago
Tegnell was wrong. He predicted that the virus was circulating many times more widely than people thought (20-25%) -- and posited much of his strategy on that. In reality that appears to be closer to 7%. He was also particularly wrong in attacking other countries - and the underlying Imperial College study that influenced them - for locking down in the way they did. 18.1m people came in and out of the UK between January and March in the UK -- nearly twice the entire population of Sweden. What was optimal for Sweden would never have been optimal for others.
- notahacker 6y ago
  > 18.1m people came in and out of the UK between January and March in the UK -- nearly twice the entire population of Sweden. What was optimal for Sweden would never have been optimal for others. Yep. This is critical. The UK originally wanted to follow the Swedish strategy, but it was a disastrous failure that left us with the highest per capita excess death rates in the world, only brought under control by lockdown. Sweden was somewhat more isolated hence the initial growth of the disease was slower, and was considerably more isolated over everybody else's lockdown period.
- sbt 6y ago
  The 20-25% immunity was for the Stockholm area, not for the country as a whole. In reality they were off by something like 5%.
  - butler14 6y ago
    The 7% figure is also for the Stockholm area
confuseshrink 6y ago
I find it very surprising that someone would rely on unvalidated mathematical models for this, that goes for the Imperial College people as well as Sweden. Are they even able to fit the parameters in retrospect? Anyone with a background in mathematical modelling should be extremely cautious of applying models in situations where there are serious ramifications to getting the wrong answer. Hubris.
- alkonaut 6y ago
  > serious ramifications to getting the wrong answer. I think "locking millions of people inside" is one of the most serious ramifications you can imagine too. It's like we lost all grip of what suffering and cost is so long as we save lives. I'm not saying we should value lives highly but we sure didn't value them this highly last year and we probably won't next year...
misja111 6y ago
To me it seems that there is only one fundamental assumption that determines how to handle the pandemic: do you believe that we can have a lockdown until a vaccin is on the market, or do you think the vaccin will take too long. If you believe the first, then yes a lockdown like in Denmark or Norway is the best choice. If you believe it will take too long, then what matters is to minimise economical damage by containing the virus just enough making sure that the health system is not overwhelmed and to protect the most vulnerable groups. This is what Sweden chose and what most countries believed in as well in February. Sweden's health system was never overwhelmed, so the higher death rate in Sweden must be due to the higher infection rate in combination with the fact that they could have protected their elderly people better. But if the vaccin takes too long then neighbour countries will catch up.
hkai 6y ago
It's mind blowing how the media spinned his defense, with headlines like "Sweden admits they were wrong and should have locked down", whereas he said exactly the opposite. He said: we should have had more labs, locked down retirement homes, but we shouldn't have asked students to stay home.
nickbauman 6y ago
There's a deep problem of all these comparisons of economies with public health policies: Markets and money are vehicles for making agreements. They are all about negotiation. They are imminently and manifold fungible. They are contrivances. A deadly virus is not. Let's also not forget for every death from C19 there are a handful-dozen people who survive to lifelong health problems from the episode. That has a cost, too.
hajderr 6y ago
Also the way countries report deaths may be different.
yogthos 6y ago
That same guy who now admitted that his strategy to fight Covid-19 resulted in too many deaths, after persuading his country to avoid a strict lockdown. https://www.bloomberg.com/news/articles/2020-06-03/man-behind-sweden-s-virus-strategy-says-he-got-some-things-wrong https://www.bloomberg.com/news/articles/2020-06-03/man-behin...
- andreasley 6y ago
  Actually, both articles are based on the same quotes – just very different interpretations and headlines.
  - heracles 6y ago
    This is the situation in a nutshell. Would be comical if the topic was different.
nickthemagicman 6y ago
The irony of demonizing Sweden...is that as we speak...every single other country in the world is starting to do what Sweden is doing and opening its economy with basic social distancing. The model of exponential infections used to justify quarantine and flattening the curve has not happened any of the places opening up. Coronavirus appears to reach a steady-state in the rate of infections in populations, just like numerous other infectious diseases. The people in my town are absolutely terrified. Unemployment has skyrocketed poverty riots. This is a sad failure of leadership and science. Sweden and Tegnell appear to have been right.
eveningcoffee 6y ago
I think that Sweden mistake has been to not react to the realities and keep the line and cover their mistakes by propaganda. This and complete failure to increase testing capacity and find even essential PPE. For example people who took the swab samples whore nothing more than a visor.
DeonPenny 6y ago
I'm glad he came out against that Bloomberg article it was a obvious misquote. You could tell. not only did they not attached the audio. He literally has interviews about a week or 2 before talking about how well it was going. Regardless about how you feel about Sweden's strategy Bloomberg's obvious manipulation is garbage.
heracles 6y ago
The amount of misinformation (or the very least, confused statements) in this thread is high for being HN. Soo many people know much about Sweden without ever setting their foot here. Interesting that. The world's apparent obsession with the Swedish strategy isn't about Sweden at all. It is about their own strategies, trying to prematurely pat themselves on the back for doing the right thing, whatever that was. There's myriads of variables that differ between Any two countries.
- zosima 6y ago
  A large part of this confusion has been caused by Tegnell and folkhälsomyndigheten (FHM). Tegnell and folkhälsomyndigheten (FHM) have clarified their strategy as: Keep the number of infected people down at any one time to not overwhelm the health system. Groups at risk for severe disease should quarantine themselves. But they have also repeatedly indicated that they don't want to stop the spread of infection completely. And that they are not running a strategy aiming at herd immunity, though when most people have been infected there will be herd immunity. That sort of communication leads to confusion, as the difference between a strategy that aims for herd immunity and one that will lead to herd immunity, at best is purely semantic.
  - alkonaut 6y ago
    > That sort of communication leads to confusion, as the difference between a strategy that aims for herd immunity and one that will lead to herd immunity, at best is purely semantic. I think it's a bit more than semantic at least. "use mitigations that are as effective as possible while still being sustainable in the long term". So long as healthcare isn't overwhelmed and R is kept under 1, these mitigations aren't leading to herd immunity because the outbreak is going to disappear before that, most likely. If you accept an R on or over 1 then you are using a strategy that will lead to herd immunity.
    - zosima 6y ago
      Again I think we are getting into semantics, where there's no reason to not be clear. If you make R < 1 you are in fact suppressing the disease. However slowly. If you are keeping R around 1 or above, you are mitigating. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172840/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172840/ Currently, it seems the disease is being suppressed in Sweden. I have no idea what Folkhälsomyndigheten or Anders Tegnell thinks about that.
bobthemover 6y ago
There is no convincing evidence that Sweden’s approach has led to a materially worse outcome, and in fact if you look at the overall health of the country considerable evidence that outcomes will be much better in the long term. Every country will have to adopt the Swedish approach eventually or find themselves caught in an endless cycle of lockdowns. It seems to me that the experiment is countries trying to eradicate the virus through lockdown as opposed to just slowing it down, with no evidence that this is working or could ever work. NoW that the virus is better understood and we know that the people at risk are mostly people at the end of their life the continued tyrannical lock down Of the general population in many countries is a failure of leadership, not a success. The large number of hysterical articles condemning the Swedish approach reflects the fact that people don’t want to admit that they made a mistake and want to desperately justify doing something really stupid.
- marvin 6y ago
  «Adopting the Swedish approach» after three months of expanding test capacity, ensuring PPE availability, instituting WFH routines where possible, adopting slightly-inconvenient disinfecting routines and having everyone know to keep distance and report cold symptoms, is not following the Swedish approach. It is something completely different. The R number will be lower at this later stage than they were in an early-hit country with no preparation. The biggest mistake Tegnell did for Sweden, was wasting the first month of the epidemic out of hubris. This laid the groundwork for the persistent epidemic they have today, which stands in obvious contrast to their neighboring countries — most of which now have a daily life similar to Sweden, except with the epidemic under control. 10x per capita difference in deaths as compared to Norway, 5x to Denmark. Similar for other markers. Initial conditions similar, except for different response from leadership.
- roca 6y ago
  > It seems to me that the experiment is countries trying to eradicate the virus through lockdown as opposed to just slowing it down, with no evidence that this is working or could ever work. It seems to be working in Vietnam, New Zealand, Hong Kong, Taiwan, South Korea, Australia, and others ... even China probably. Those countries have achieved local elimination or very close to it and are reopening (or never locked down) and have not yet had to (re)turn to wholesale lockdown. So "Every country will have to adopt the Swedish approach eventually or find themselves caught in an endless cycle of lockdowns" is, at best, not proven.
adthomsen 6y ago
I believe it's way too early to make conclusions about which approach would have been the best from a scientific/public health perspective. The reason I think Sweden's approach is wrong is that other countries are much more hesitant to work with them now. An example being Denmark opening the borders to Norway and Germany but not Sweden.
curation 6y ago
The book Necropolitics by A. Mbembe makes these conversations more productive. I am part of many groups abandoning the constraints of the assumptions that act as thresholds throughout each back and forth on this page.
wycy 6y ago
My takeaway from the NYT article[0] was that Sweden's approach to coronavirus hasn't left them totally overwhelmed primarily because Swedes willingly self-lockdowned and distanced almost as much as people under government-mandated lockdowns. So while some like to point to them and say "see, we could've stayed totally open," the reality is that they did lockdown but it came as a decentralized decision rather than a centralized order. Because they did effectively lockdown, their economy is expected to be impacted similarly to the rest of Europe[1]. Is my interpretation incorrect? [0] https://www.nytimes.com/interactive/2020/05/15/world/europe/sweden-coronavirus-deaths.html https://www.nytimes.com/interactive/2020/05/15/world/europe/... [1] "Preliminary evidence shows Sweden has suffered similar economic effects as its neighbors: The Swedish Central Bank projects the country’s G.D.P. will contract by 7 to 10 percent this year, an estimate on par with the rest of Europe. (The European Commission projects the E.U. economy will contract by 7.5 percent.)" (Ref [0])
deleted 6y ago
[deleted]

152 points by whydoyoucare 6y ago

whydoyoucare 6y ago

BBC, WaPo and NPR have conflicting titles, but I found this to be better worded and balanced article.

vesinisa 6y ago
Tegnell has previously categorically denied any mistakes were made, but is now saying a stricter approach should have been taken in hindsight. In Swedish political culture, it seems to be a big thing if even a hint of a mistake is admitted by an authority figure. Directly criticizing public policies is almost a taboo for ordinary civilians.
- hedora 6y ago
  Tegnell has been openly discussing mistakes they made for at least a month: https://www.businessinsider.com/coronavirus-sweden-lockdown-chief-says-high-death-toll-was-surprise-2020-5?op=1 https://www.businessinsider.com/coronavirus-sweden-lockdown-... Today’s article is consistent with the statements he made last month. As others have pointed out, we won’t know if the approach was successful until after we see post-reopening trends.
  - vesinisa 6y ago
    Note that back then he only acknowledged that there has been more deaths than they thought. But he did not back then think having adopted a different strategy would have necessarily saved any lives, because many of the deaths were in elderly homes. In yesterday's press meeting, he admitted that given what they know now Sweden would have actually adopted a different strategy. It was at perceived as the first actual admission that the adopted policy was in fact too open. Given that the policy mistake might have at this point lead to thousands of preventable deaths, he understandably treads very carefully.
- zlorch 6y ago
  > Directly criticizing public policies is almost a taboo for ordinary civilians. This could possibly be the worst lie I've heard this week. And I've listened to Trump.
  - jojje2k 6y ago
    That struck me as an odd statement as well. If anything, the amount of criticism used by grass root movements on social media is bordering being an issue. A self-fueling fire.
  - null_object 6y ago
    There have now been several articles documenting the attacks that have been the consequence of questioning Tegnell's decisions in public. This is one example (in Swedish) https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-er-for-att-tysta-coronadebatten https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-er-f... But in DN (behind a paywall) there have been other articles where those that questioned Sweden's policy have even been personally threatened. Tegnell has been wrong about pretty much everything - from saying that the pandemic had reached its "peak" in Sweden when we had 137 cases[1] to being consistently wrong about how far we've supposedly come with 'herd immunity' - which was supposed to be around 50% by the beginning of June, but which has shown itself to be only around 7-10% in the worst-affected areas in Stockholm. There is also a lot of finger-pointing in articles and comments by Swedes, accusing other Nordic countries of purposely under-estimating their covid figures - whereas the actual statistics[2] show that Sweden itself is the only Nordic country with massively under-estimated deaths. [1] https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiologen-toppen-kan-vara-nadd-nu https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiolog... [2] https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
    - jojje2k 6y ago
      Regarding [1], it sounds more like Aftonbladet is either misquoting him, quoting out of context or The title claims he said we had reached the peak, giving the impression of peak infections across the whole population, but the contents only covers a specific group of people who had returned from their vacations in Italy. I'm not saying he didn't mean or say peak total infections in the interview. I'm just saying that particular article is all over the place. Edit: On the contrary, according to the article he said we could very well be hit by a new wave from new arrivals.
- samsari 6y ago
  I assume you've never looked at a Swedish newspaper then, they've all been full of criticisms and discussions since the start.
  - vesinisa 6y ago
    As a fellow Nordic citizen our media monitors the situation in Sweden very closely. One point that has been raised is the "consensus culture" of Swedish political discourse where no one seems brave enough to openly question the chosen policies. Even the hermit opposition party Sweden Democrats toed the government's line loyally. In lieu of domestic alternate voices, we have other Nordic health officials questioning the Swedish strategy instead: https://www.thelocal.no/20200520/interview-my-belief-is-that-we-wont-have-a-big-second-wave https://www.thelocal.no/20200520/interview-my-belief-is-that... Is Tegnell really the only credible epidemiologist in Sweden? Given that pretty much all of Europe has adopted a different strategy, that does not seem plausible. But is there anyone in the Swedish public sphere actually challenging Tegnell's ideas?
    - mongol 6y ago
      Yes there have been quite many. But the sad thing is that they have been shouted down because their rethorical skills were not that good. So the discussion turned dishonest, not interpreting their viewpoints with the best intent.
      - vesinisa 6y ago
        Exactly. Life and death of thouands of people should not be decided based on someone's charisma alone. Even if something is done in the name of a scientific experiment - like Tegnell's unique policy - it is outregeously unethical if this causes avoidable mass death to innocent civilians. Sadly Sweden is no stranger to application of questionable and unethical scientific experiments to the masses. The country had an extensive Nazi-inspired eugenics programme from 1930s all the way up to the late 1970s: https://www.theguardian.com/world/1999/mar/06/stephenbates https://www.theguardian.com/world/1999/mar/06/stephenbates The very existence of this programme was a secret until the early 2000s, and to this day continues to be a taboo in Sweden.
- lostmyoldone 6y ago
  There is a strong culture of reaching for consensus, and to (in most cases) follow rules and recommendations, but it's nothing even close to a taboo to criticize public figures. We generally criticize everything, and everyone, but there are very few screaming matches. What is scalding criticism in Swedish eyes might not always register as such unless you are aware of the culture. It's (probably) to some extent down to how written Swedish works in concert with our predominantly protestant culture. Swedish is reasonably good for factual discourse, and quite awesome for writing a dramatic epic with words that soar. Hitting the space in between, without sounding ridiculous, is rather hard. Most love songs and poems written in modern day Swedish are very indirect because of this, as they would risk sounding ridiculous otherwise. Life is rarely epic on the scale of the sagas. This also makes public discourse sometimes seem a bit odd, because as the last thing you want to do is to make yourself and your criticism sound inane. Scalding criticism might look more like a slight disagreement if you read it in a newspaper and considered the words at face value.
KarlKemp 6y ago
Every other report highlights his admission that he would do things differently knowing what he knows now. And that angle to the story actually makes it a story, while "we still believe what we previously believed" really isn't something that, by itself, would warrant an article. But sure, this outlier is "better worded" and "balanced". Oh, and note the URL of this article: www.startribune.com/scientist-admits-sweden-could-have-battled-virus-better/570980492/

rfrey 6y ago

Seems to me that we won't really know if the Swedish approach was a disaster or not until economies are reopened, second waves happen or don't, etc. The game isn't over.

alkonaut 6y ago
Indeed. The strategy if it works perfectly was never going to have fewer deaths than a lockdown strategy after 3 months. That much should be obvious. The criticism early on was "Oh my god look at these simulations you'll have 25k ICU beds needed and you have only 1k", 50k will die before july! When that didn't happen, somehow now the message is that 4k dead and emergency hospital capacity never even used is a complete failure - because Norway has fewer deaths? I think if anything we should be happy that most of Europe managed to actually contain this disease and people weren't left to die without ventilators as the early alarms said. Whether 500 or 5000 die in a country is a big difference, but remember we were fearing tens of thousands in every countruy.
oska 6y ago
Economies are already re-opening to each other and Sweden is being excluded. So no, Sweden has already failed.

viburnum 6y ago

It’s still too soon to tell but it seems like the economic impact of a thorough lockdown (New Zealand) isn’t much greater than most people staying home voluntarily (Sweden). The difference seems worth it to control the pandemic. Two weeks from now it looks like New Zealand (with zero cases left) with have fewer restrictions than Sweden.

Mediterraneo10 6y ago
New Zealand is an island. It knew that it could pursue the full eradication option because it had few cases and could fully close its borders. European countries with their large numbers of infected and more porous borders (economy requiring movement of migrant workers for agriculture, etc.) never pursued full eradication, only curve-flattening.
- viburnum 6y ago
  So what if New Zealand is an island? How many people are walking to Sweden?
  - renewiltord 6y ago
    That's actually a fair point. Why does the islandness matter?
  - Mediterraneo10 6y ago
    Few people might be walking on foot to Sweden (though in Tornio/Haparanda, some do walk over the border), but Sweden has land borders with two countries and a bridge to a third. Traffic has continued to move over those border crossings during the time of the pandemic. In fact, there has been a steady flow of traffic over most European border crossings along major motorways, though that traffic has consisted of only drivers and passengers who could show they are moving around for work purposes etc. The only common way into New Zealand is a flight or an occasional ship. NZ has no immediately neighboring countries that it runs freight trucks to and from day in and day out, and it doesn't need to move large numbers of agricultural workers around internationally. Therefore, for New Zealand traffic is obviously going to be smaller and easier to control than European countries.

ptero 6y ago

The guy is a scientist and his answers have to be viewed from that angle. A politician goes for spin and tries to project confidence; "I am not sure this is the right approach" from a politician usually means "hell, no!". Tegnell's answer means just that -- he is not sure. Which is a normal way for a scientist to feel as there are always uncertainties and when we choose an action we are often not sure for a while if that action is optimal or not. I personally feel a lot of respect to Tegnell. Sweden might have taken a better or a worse approach than, say, France but it is clearly not catastrophic: there are no mountains of corpses on the streets there are a number of countries with lockdowns and worse per capita death rates; second wave, if appears, will likely go much easier on Sweden, etc. I think other countries should take a page out of Tegnell's book and instead of trying to exorcise dissent and label opponents, admit to uncertainties in their policies. This will not make their argument weaker; it might still mean that lockdowns are a better option. But it would also open policies for discussion and debate. Good policies will still win. But then they win by merits, not because of trying to silence any opposition. My 2c.

KarlKemp 6y ago
Sweden has the highest per-capita rate of deaths from COVID. In Sweden, 4,500 people have died. In neighbouring Norway, 237 people died. Even adjusted for population, Sweden has 10x the deaths. I'm a scientist as well and my math skills say their strategy sucks.
- prepend 6y ago
  Finland also only has 300 deaths. Sweden is not the highest in Europe, per capita, it’s fifth [0]. So it’s pretty bad out of 31 countries but better than Belgium. [0] https://www.statista.com/statistics/1111779/coronavirus-death-rate-europe-by-country/ https://www.statista.com/statistics/1111779/coronavirus-deat...
  - timwaagh 6y ago
    Lies greater lies and statistics... Belgium counts people who die in nursing homes as covid 19 deaths. They say Belgiums figure would be twice as small if they counted the way others did. Removing that anomaly the only countries higher are Spain, Italy and UK. The first two were hit very hard very early and the last had similar issues as Sweden, reacting very late.

geoffreymcgill 6y ago

Making a comparison of Sweden (10,094,432 population) vs Czech Republic (10,707,502 population) seems to reveal a very different story. New cases (7 day average): https://i.imgur.com/fciq4Ra.png https://i.imgur.com/fciq4Ra.png Total deaths: https://i.imgur.com/do9Zbvn.png https://i.imgur.com/do9Zbvn.png

pedrosorio 6y ago
Masks can do wonders
- alkonaut 6y ago
  If there is a clear sign of the mask requirement being introduced in graphs from various countries (e.g. these graphs) I can't see it... I think there is a lot of "I believe X would give outcome Y and I see outcome Y therefore X must work". This mistake is called Affirming the Consequent. Without clear signs of causation we can't know.
  - heracles 6y ago
    Thank you. There's sooooo much "I think like this therefore I will find two variables out of 10000 and link them" going around. The easy with which one could argue the exact opposite using some two other variables seems to go unnoticed by the original makes of the claim, whatever it was.

thawaway1837 6y ago

Sweden’s strategy failed on its own terms. There is absolutely no arguing that. Their first goal was to protect the vulnerable, and they failed miserably at that. Fundamentally because Tegnell resisted the fact that asymptomatic carriers existed. One could argue, like some Iraq war proponents do, that the idea was ok for Sweden, but the failure was in execution. But one can not argue that it wasn’t a significant failure.

jmauritz 6y ago
We're barely 3 months into this and your calling it a failure? could it be done better: yes, it is failure? no. "no arguing", "can not argue" Yes, you very much can, and we'll see in a few years what the "correct" choice was.
- dpau 6y ago
  the comment was referring to failure in execution, not necessarily failure in choosing the correct approach. it's hard to argue that sweden shouldn't have been more careful with its elderly and vulnerable, even if going for herd immunity.
  - svrtknst 6y ago
    It's fairly impossible to say "Sweden should hav ebeen more careful with its elderly" - The measures put in place by Sweden were designed with that in mind. That's why elderly care facilities were the first, if not only ones, to face quarantine. However, when you have years of poor management of elderly care, and elderly care companies that refuse to heed the recommendations, there's not much "Sweden" can do in the moment wihtout severe effort.
    - addicted 6y ago
      Right, and it had nothing to do with Tegnell’s resistance to the idea of asymptomatic carriers and hence his guidance that care workers were free to go into work as long as they didn’t show symptoms. Edit: Also, your comment basically justifies the lockdowns in every other country. Tegnell’s whole argument was that the enlightened Swedes didn’t need a mandatory lockdown because they would simply do the right thing without the government telling them. And there is some truth to that in a society that is wealthy, well educated, and highly trusting of its government. Despite that, it’s citizenry failed to achieve what Tegnell said they would. How in the world would you expect other countries’ citizens to voluntarily do what the government was recommending when Sweden couldn’t? His criticism of lockdowns in other countries was completely unwarranted based on his own reasoning for why Sweden didn’t need a lockdown (which also, as you point out, turned out to be wrong).

scott_meyer 6y ago

Just watch this chart for a couple years: https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&deathsMetric=true&totalFreq=true&aligned=true&perCapita=true&smoothing=0&country=USA~SWE https://ourworldindata.org/coronavirus-data-explorer?zoomToS...

somewhereoutth 6y ago

Sweden made some very bad choices and a lot of people died unnecessarily. Compare with Portugal, same population, right next to Spain, lower GDP, a fraction of the deaths. There is no excuse, no 'second wave', no economic payoff, no wait and see. Scientists are trained to make judgments based on experimentation and evidence. In a fast moving novel pandemic situation, where there is no time to carry out experiments, where evidence is confused and hard to corroborate, their utility is much reduced. That is why politicians exist, to make these hard decisions. It is unfair to pillory scientists such as Tegnell, as it is the politicians who abdicated responsibility in the face of this crisis that should rightfully face condemnation. Except of course, there was evidence, from China, Taiwan, South Korea and elsewhere. It was clear what needed to be done, and how to do it. Shame on Sweden, and other places, for not heeding that guidance.

dependenttypes 6y ago
I was under the impression that quarantine was an option only to "flatten the curve" (and make it easier for the hospitals to treat people) and that the same amount of people would die regardless (from the virus), is this wrong?
- quelltext 6y ago
  > that the same amount of people would die regardless Maybe "be infected", not "die"? Otherwise there's little reason to flatten the curve (meant to allow for better treatment).
- kqr 6y ago
  This is one of the assumptions underlying the Swedish approach, yes. The knob you can fiddle is how soon people die: with relaxed response, people who would have died a few months or a year from now might die of the pandemic tomorrow. (But of course, strict countermeasures also have their long-term costs, which are harder to quantify in terms of lives, although that's definitely a component of it.)
- kalleboo 6y ago
  It was, yes, under the early assumption that the virus spread rapidly but had a relatively low death rate. It turns out it's the opposite - it's surprisingly easy to stop the spread, but the death rates are higher. So countries that locked down under the plan that they were just flattening the curve still managed to nearly eradicate the virus despite that not being the original strategy.

contemporary343 6y ago

Scientists are human and prone to as many cognitive biases as anyone. As one myself, I see here an effort to contort oneself and one’s model/framework to somehow explain the data. When the data seems fairly clear that this has been a failure for Sweden. That being said, I think our failures here in the US have been vast and worse.

ReticentVole 6y ago

Deaths in Sweden are at their highest level since 1993: https://www.reuters.com/article/us-health-coronavirus-sweden-toll/coronavirus-pushes-swedish-deaths-to-highest-since-1993-in-april-idUSKBN22U1S4 https://www.reuters.com/article/us-health-coronavirus-sweden... What happened in 1993? A Flu Pandemic... That no one has ever heard about, that seemed to have no lasting impact, and occurred when the population was younger and 25% smaller (thus having a proportionally much greater impact). Without the media panic, COVID-19 would have come and gone as a unusually deadly flu wave, nothing more.

chrisco255 6y ago
Yeah, agreed. The whole point of shutdowns was to prevent hospitals from being overrun, and with the exception of the few states in the U.S. that compromised their nursing home population by sending sick patients back there, the vast majority of hospitals experienced lower-than-average patient count for the past 3 months.
WildParser 6y ago
In the Gompertz-Model (that worked perfectly for China) Sweden is converging to R~0,8 - with a total death-count <6000. Germany is going to R~0,7 / <9000. Given the explosive dynamics of COVID-19 that soon converges to R<1 going for herd immunity was most likely a bad choice. For Germany cutting the flu in half worked - while the bad math of the epidemiologists-community seems to last forever...
- alkonaut 6y ago
  > going for herd immunity was most likely a bad choice. I think this has been repeated a lot. No one is "going for herd immunity". Every country including sweden has two goals: having as few as possible infected and preventing healthcare from being overwhelmed. If partial or full immunity makes the virus go away that's a fortunate side effect of slow burn, not the "goal".
hansbo 6y ago
Perhaps, but seeing as Sweden has had quite large changes in behavior (most people who can work from home, do; people are much better at washing their hands; the subways of Stockholm are significantly less crowded, going from being crowded while standing up, to always being sparse even during rush hour), it's not hard to consider the death rate being much higher than in 1993 without the media panic.

ggrrhh_ta 6y ago

Other countries in Europe also have lead epidemiologists and scientists (or technical bodies) making the recommendations that then get turned into policy. Those scientists in Denmark, Germany, Switzerland, Finland, Norway, France, Spain, Italy are as good as Tegnell is. Also, the medical approach to people getting sick with COVID-19 has significantly improved over the first month (e.g., early hospitalisation instead of sending a sick person to isolate themselves at home, weeding out drugs that did not work from those that worked, introduction of drugs to control trombosis and secondary damage from the virus, better approaches to when and how use ventilators, etc.). That means that a number of the deaths that have occurred within the Swedish policy could have been avoided by delaying the infection. More importantly, Sweden's approach has not even achieved a significant level of immunity, as Swedes have been self-imposing social distancing and even a 'lockdown' (working from home). In an interview in "unherd", Giesecke estimated that the deaths in UK without lockdown would be in the 12,000 (when they where 13,000), then corrected himself to 24,000 (they are almost 40,000 now), and then said they will not be 10x 12,000. On freedom. The lockdown for reasons of public health is a limitation of our freedom that has been accepted (except in Sweden) by their citizens in their respective contracts as a society (constitutions, laws, etc.). So, per se, it's a limitation akin to not driving over a certain speed in certain roads. Moreover, many people (and students) have reported that the lockdown has been "liberating" - and for others have been depressing (it never rains to everyone's liking) On ending the lockdown. Tegnell and Giesecke repeat and repeat and repeat that countries imposed a lockdown without a strategy out. Well that's just dire false. When the lockdown was being discussed, the press was already pointing that issue and several strategies were being considered (press from March already discusses the measure by measure approach). But, whereas other countries are looking conservatively with the evidence (that could be flawed because it is small and incomplete) that they already have, Sweden is relying in an evidence that will only be apparent in the future (if the events turn out to be advantageous for that approach). If each country had been given an "ant population" with some infected individuals and their epidemiologists needed to manage the epidemic long term while a cure for the ant's illness is found, maybe, the Sweden's approach would have made more sense... At least, most people wouldn't have had much feelings for those ants that could have lived a couple of days longer.

DanBC 6y ago

hyperpallium 6y ago

Sweden's economy, which relies heavily on exports, is expected to shrink 7% in 2020 [neighbours] dropping mutual border controls but would keep Sweden out Sometimes it's better to go with the crowd, even if you're right.

dr_dshiv 6y ago

How would one rationally model and determine a multifactor policy on covid lockdown, balancing for health, economy, and overall wellbeing? Is it even possible to balance those, if it means making x lost life years equal to y many bankruptcies or z lost jobs, etc?

alkonaut 6y ago
This is what authorities like the FHM (the public health authority does every day). You use tools like counting QALY, for example.
- dr_dshiv 6y ago
  But how do you equate or make commensurable those different measures? How many job losses equal a lost life year?
  - alkonaut 6y ago
    That’s the difficult part, but that’s the job of the public health authority. Same thing with missed semesters of a school. How many add up to an 80 year old dying? And so on and so forth. I don’t envy those that have to do this arithmetic, but it can’t be avoided.
    - dr_dshiv 6y ago
      I don't see how it is arithmetic nor the job of a public health authority. It's a philosophical, ethical and political issue. There are bounding conditions, like research showing that job loss increases rates of suicide. [1] But we still argue about whether it is fair to treat the life of a 12 year old as more valuable than the life of a 92 year old. So it isn't just arithmetic. [1] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30141-3/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

nounaut 6y ago

90% of all covid-19 deaths in Sweden have been people over the age of 70 [1] which is the only group of the population which have been quarantined. So it's arguable what difference a nation wide quarantine would have made. Of those over 70, half of the deaths were in care homes and another 26% had home care [2]. Many of the workers in care homes have reported that their companies/bosses won't allow them to stay home when they're showing symptoms and some have been forced to work without protective equipment. There have "only" been 42 deaths under the age of 50 [2]. [1] https://www.svd.se/90-procent-av-alla-doda-i-covid-19-over-70-ar https://www.svd.se/90-procent-av-alla-doda-i-covid-19-over-7... [2] https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-over-70-ar-med-coronasmitta-bodde-pa-sarskilda-boenden https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-over...

ptx 6y ago
Those numbers are a month old. There have now been 64 deaths[1] under the age of 50. In the age group between 50 and 70, which you didn't directly mention, 455 people have died. [1] https://www.svt.se/datajournalistik/har-sprider-sig-coronaviruset/ https://www.svt.se/datajournalistik/har-sprider-sig-coronavi...
- nounaut 6y ago
  Doesn't change the fact that the high death toll have been among the part of the population that were in fact in quarantine and would most likely have been the same had Sweden chosen a more common tactic.
  - addicted 6y ago
    They were in “quarantine”. Tegnell didn’t believe in the existence of asymptomatic carriers so younger care workers were allowed to visit them freely as long as they didn’t show symptoms. He made a huge mistake but is simply unwilling to admit it.
    - nounaut 6y ago

buboard 6y ago

I think epidemiologists shoot themselves in the foot as a profession when they started talking about herd immunity, which is the one situation we are trying to to avoid in infections, and really the entire reason their profession exists. We could reach herd immunities without them but the toll is dramatic and untenable. Politicians mistook the term to mean some kind of solution and made it a buzzword, but it really is the worst solution. Swedens situation is not the worst in the world, but they really did not win much with their "strategy" either. Talk of "reaching herd immunity in a few months" was irresponsible and heavily fatalistic. As a country with a big public sector they could easily have followed a slightly more conservative approach. An "initial freeze, then plan accordingly" would be a more rational way to go. It was also irrational to assume that their economy can "rebound faster" when most of the rest world is shut down. Epidemiology did not wear its best suit in this pandemic, and will lose a lot of respect in the eyes of many[1]. Scientists have a duty to inform people when their results are being misused or misinterpreted 1. https://marginalrevolution.com/marginalrevolution/2020/04/what-does-this-economist-think-of-epidemiology.html https://marginalrevolution.com/marginalrevolution/2020/04/wh...

acd 6y ago

I am happy we let our expert government agency in this matter make the decision and not the politicians. There will be an autumn. Countries which let politicians shutdown early have numbers that look good now, but there is autumn and there is shutdown stamina. If you shutdown early there is little herd immunity in the autumn. There is also psychological effects of keeping people in total isolation for too long. In prison isolation is a punishment which I do not wish upon anyone. Then has to see that its also a group decision from the health authorities in Sweden where there is consensus on the direction board on how to act. Its not a one person decision.

glangdale 6y ago
But you didn't achieve herd immunity, and you're going to be in the same place as everyone else (except with more dead). There might be a marginal advantage but antibody studies show Sweden is nowhere near even the more generous estimates of what herd immunity might require. Everything about the Swedish approach is a failure, and the amazing thing is that not only was the approach bizarre, but the Swedes have a very low testing rate relative to the number of cases - which seems like a weird move (innovate both in approach and in terms of "not knowing what's going on"). Positively 3rd world cases:deaths ratio - it's just embarrassing.

raverbashing 6y ago

More important seems to be his previous statement (which is also quoted in the article): > Tegnell's statement to reporters came after more contrite comments earlier in the day to Swedish radio in which he said “I think there is potential for improvement in what we have done in Sweden, quite clearly.” > Asked if the country’s high death toll has made him reconsider his unique approach to the pandemic, Tegnell told Swedish radio “yes, absolutely.”

butler14 6y ago

Tegnell was wrong. He predicted that the virus was circulating many times more widely than people thought (20-25%) -- and posited much of his strategy on that. In reality that appears to be closer to 7%. He was also particularly wrong in attacking other countries - and the underlying Imperial College study that influenced them - for locking down in the way they did. 18.1m people came in and out of the UK between January and March in the UK -- nearly twice the entire population of Sweden. What was optimal for Sweden would never have been optimal for others.

notahacker 6y ago
> 18.1m people came in and out of the UK between January and March in the UK -- nearly twice the entire population of Sweden. What was optimal for Sweden would never have been optimal for others. Yep. This is critical. The UK originally wanted to follow the Swedish strategy, but it was a disastrous failure that left us with the highest per capita excess death rates in the world, only brought under control by lockdown. Sweden was somewhat more isolated hence the initial growth of the disease was slower, and was considerably more isolated over everybody else's lockdown period.
sbt 6y ago
The 20-25% immunity was for the Stockholm area, not for the country as a whole. In reality they were off by something like 5%.
- butler14 6y ago
  The 7% figure is also for the Stockholm area

confuseshrink 6y ago

I find it very surprising that someone would rely on unvalidated mathematical models for this, that goes for the Imperial College people as well as Sweden. Are they even able to fit the parameters in retrospect? Anyone with a background in mathematical modelling should be extremely cautious of applying models in situations where there are serious ramifications to getting the wrong answer. Hubris.

alkonaut 6y ago
> serious ramifications to getting the wrong answer. I think "locking millions of people inside" is one of the most serious ramifications you can imagine too. It's like we lost all grip of what suffering and cost is so long as we save lives. I'm not saying we should value lives highly but we sure didn't value them this highly last year and we probably won't next year...

misja111 6y ago

To me it seems that there is only one fundamental assumption that determines how to handle the pandemic: do you believe that we can have a lockdown until a vaccin is on the market, or do you think the vaccin will take too long. If you believe the first, then yes a lockdown like in Denmark or Norway is the best choice. If you believe it will take too long, then what matters is to minimise economical damage by containing the virus just enough making sure that the health system is not overwhelmed and to protect the most vulnerable groups. This is what Sweden chose and what most countries believed in as well in February. Sweden's health system was never overwhelmed, so the higher death rate in Sweden must be due to the higher infection rate in combination with the fact that they could have protected their elderly people better. But if the vaccin takes too long then neighbour countries will catch up.

hkai 6y ago

It's mind blowing how the media spinned his defense, with headlines like "Sweden admits they were wrong and should have locked down", whereas he said exactly the opposite. He said: we should have had more labs, locked down retirement homes, but we shouldn't have asked students to stay home.

nickbauman 6y ago

There's a deep problem of all these comparisons of economies with public health policies: Markets and money are vehicles for making agreements. They are all about negotiation. They are imminently and manifold fungible. They are contrivances. A deadly virus is not. Let's also not forget for every death from C19 there are a handful-dozen people who survive to lifelong health problems from the episode. That has a cost, too.

hajderr 6y ago

Also the way countries report deaths may be different.

yogthos 6y ago

That same guy who now admitted that his strategy to fight Covid-19 resulted in too many deaths, after persuading his country to avoid a strict lockdown. https://www.bloomberg.com/news/articles/2020-06-03/man-behind-sweden-s-virus-strategy-says-he-got-some-things-wrong https://www.bloomberg.com/news/articles/2020-06-03/man-behin...

andreasley 6y ago
Actually, both articles are based on the same quotes – just very different interpretations and headlines.
- heracles 6y ago
  This is the situation in a nutshell. Would be comical if the topic was different.

nickthemagicman 6y ago

The irony of demonizing Sweden...is that as we speak...every single other country in the world is starting to do what Sweden is doing and opening its economy with basic social distancing. The model of exponential infections used to justify quarantine and flattening the curve has not happened any of the places opening up. Coronavirus appears to reach a steady-state in the rate of infections in populations, just like numerous other infectious diseases. The people in my town are absolutely terrified. Unemployment has skyrocketed poverty riots. This is a sad failure of leadership and science. Sweden and Tegnell appear to have been right.

eveningcoffee 6y ago

I think that Sweden mistake has been to not react to the realities and keep the line and cover their mistakes by propaganda. This and complete failure to increase testing capacity and find even essential PPE. For example people who took the swab samples whore nothing more than a visor.

DeonPenny 6y ago

I'm glad he came out against that Bloomberg article it was a obvious misquote. You could tell. not only did they not attached the audio. He literally has interviews about a week or 2 before talking about how well it was going. Regardless about how you feel about Sweden's strategy Bloomberg's obvious manipulation is garbage.

heracles 6y ago

The amount of misinformation (or the very least, confused statements) in this thread is high for being HN. Soo many people know much about Sweden without ever setting their foot here. Interesting that. The world's apparent obsession with the Swedish strategy isn't about Sweden at all. It is about their own strategies, trying to prematurely pat themselves on the back for doing the right thing, whatever that was. There's myriads of variables that differ between Any two countries.

zosima 6y ago
A large part of this confusion has been caused by Tegnell and folkhälsomyndigheten (FHM). Tegnell and folkhälsomyndigheten (FHM) have clarified their strategy as: Keep the number of infected people down at any one time to not overwhelm the health system. Groups at risk for severe disease should quarantine themselves. But they have also repeatedly indicated that they don't want to stop the spread of infection completely. And that they are not running a strategy aiming at herd immunity, though when most people have been infected there will be herd immunity. That sort of communication leads to confusion, as the difference between a strategy that aims for herd immunity and one that will lead to herd immunity, at best is purely semantic.
- alkonaut 6y ago
  > That sort of communication leads to confusion, as the difference between a strategy that aims for herd immunity and one that will lead to herd immunity, at best is purely semantic. I think it's a bit more than semantic at least. "use mitigations that are as effective as possible while still being sustainable in the long term". So long as healthcare isn't overwhelmed and R is kept under 1, these mitigations aren't leading to herd immunity because the outbreak is going to disappear before that, most likely. If you accept an R on or over 1 then you are using a strategy that will lead to herd immunity.
  - zosima 6y ago
    Again I think we are getting into semantics, where there's no reason to not be clear. If you make R < 1 you are in fact suppressing the disease. However slowly. If you are keeping R around 1 or above, you are mitigating. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172840/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172840/ Currently, it seems the disease is being suppressed in Sweden. I have no idea what Folkhälsomyndigheten or Anders Tegnell thinks about that.

bobthemover 6y ago

There is no convincing evidence that Sweden’s approach has led to a materially worse outcome, and in fact if you look at the overall health of the country considerable evidence that outcomes will be much better in the long term. Every country will have to adopt the Swedish approach eventually or find themselves caught in an endless cycle of lockdowns. It seems to me that the experiment is countries trying to eradicate the virus through lockdown as opposed to just slowing it down, with no evidence that this is working or could ever work. NoW that the virus is better understood and we know that the people at risk are mostly people at the end of their life the continued tyrannical lock down Of the general population in many countries is a failure of leadership, not a success. The large number of hysterical articles condemning the Swedish approach reflects the fact that people don’t want to admit that they made a mistake and want to desperately justify doing something really stupid.

marvin 6y ago
«Adopting the Swedish approach» after three months of expanding test capacity, ensuring PPE availability, instituting WFH routines where possible, adopting slightly-inconvenient disinfecting routines and having everyone know to keep distance and report cold symptoms, is not following the Swedish approach. It is something completely different. The R number will be lower at this later stage than they were in an early-hit country with no preparation. The biggest mistake Tegnell did for Sweden, was wasting the first month of the epidemic out of hubris. This laid the groundwork for the persistent epidemic they have today, which stands in obvious contrast to their neighboring countries — most of which now have a daily life similar to Sweden, except with the epidemic under control. 10x per capita difference in deaths as compared to Norway, 5x to Denmark. Similar for other markers. Initial conditions similar, except for different response from leadership.
roca 6y ago
> It seems to me that the experiment is countries trying to eradicate the virus through lockdown as opposed to just slowing it down, with no evidence that this is working or could ever work. It seems to be working in Vietnam, New Zealand, Hong Kong, Taiwan, South Korea, Australia, and others ... even China probably. Those countries have achieved local elimination or very close to it and are reopening (or never locked down) and have not yet had to (re)turn to wholesale lockdown. So "Every country will have to adopt the Swedish approach eventually or find themselves caught in an endless cycle of lockdowns" is, at best, not proven.

adthomsen 6y ago

I believe it's way too early to make conclusions about which approach would have been the best from a scientific/public health perspective. The reason I think Sweden's approach is wrong is that other countries are much more hesitant to work with them now. An example being Denmark opening the borders to Norway and Germany but not Sweden.

curation 6y ago

The book Necropolitics by A. Mbembe makes these conversations more productive. I am part of many groups abandoning the constraints of the assumptions that act as thresholds throughout each back and forth on this page.

wycy 6y ago

My takeaway from the NYT article[0] was that Sweden's approach to coronavirus hasn't left them totally overwhelmed primarily because Swedes willingly self-lockdowned and distanced almost as much as people under government-mandated lockdowns. So while some like to point to them and say "see, we could've stayed totally open," the reality is that they did lockdown but it came as a decentralized decision rather than a centralized order. Because they did effectively lockdown, their economy is expected to be impacted similarly to the rest of Europe[1]. Is my interpretation incorrect? [0] https://www.nytimes.com/interactive/2020/05/15/world/europe/sweden-coronavirus-deaths.html https://www.nytimes.com/interactive/2020/05/15/world/europe/... [1] "Preliminary evidence shows Sweden has suffered similar economic effects as its neighbors: The Swedish Central Bank projects the country’s G.D.P. will contract by 7 to 10 percent this year, an estimate on par with the rest of Europe. (The European Commission projects the E.U. economy will contract by 7.5 percent.)" (Ref [0])

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