6 ms·

As a Swede that did not agree with the strategy at the time (it was hugely risky), given what we know now, I'm starting to think it was the right decisions (for

As a Swede that did not agree with the strategy at the time (it was hugely risky), given what we know now, I'm starting to think it was the right decisions (for the wrong reasons). The reason the economy is in trouble has more to do with that the rest of the word shut down, it being a highly export dependent economy. Sweden did not shut down, practically nobody wears a mask (still), social distancing is minimal (crammed subways, buses and beaches), schools have remained open, yet there has not been a single death in the worst hit area of Stockholm for the past 5 days. Again, I think given the uncertainty and lack of evidence in March, not shutting down was an extremely stupid risk, and Tegnell and crew have shown to been wrong at practically every turn, but at this point you have to look at the evidence and reassess. It would seem Stockholm has reached the point of significant herd immunity, which is probably true for other hard hit areas like NYC. Less hit areas will probably have second waves, and unless a vaccine is here soon, my guess is most of the world will go through the same thing eventually.

kanox 6y ago
> I'm starting to think it was the right decision Sweden is #6 by deaths/population according to this page: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ This would indicate that the swedish response is among the worst. Several countries with comparable health systems have a death rate which is many times lower, for example Germany. This saved many thousands of lives. What am I missing?
- marcusverus 6y ago
  If the pandemic is expected to continue for many months, isn't it a bit premature to talk about current death rates as a metric for success? Given Sweden's 'herd immunity' plan, higher death rates at the beginning would seem to be a given. They didn't flatten their curve. But as they approach something like herd immunity, the number of possible carriers should plummet permanently (assuming immunity is a thing with COVID), and infections and deaths would permanently decline. Nations which have held down infection numbers with shutdowns have, of course, flattened their curves. But they may well suffer from second/third waves which will hike up their total numbers.
  - kingkawn 6y ago
    Herd immunity cannot be considered the plan given that herd immunity has not been proven to be possible
    - noodlenotes 6y ago
      Indefinite lockdowns, vaccines haven't been "proven possible" either. At some point you have to make a plan with the best information you have. The fact that spread in New York has slowed down compared to other states that weren't initially hit hard implies that there's some immunity effect going on.
    - tripletao 6y ago
      Herd immunity is certainly possible--we could hold a parade, and spray it with cultured virus. Obviously no one is doing that, because no one actually wants natural herd immunity. Sweden just thinks the cost to control the epidemic to the point that it doesn't end in that way is unacceptably high. If a treatment is discovered next month that cuts the IFR by a factor of ten, then Sweden was wrong. If no safe and effective vaccine is ever developed and treatment never improves, then Sweden was right. Reality will fall somewhere between those two unlikely extremes, and we don't know where. Fewer infected is always good news[1], in Sweden or anywhere else--it means fewer dead now, more infections pushed until later when treatment will probably be better, etc. It's weird to see low infection rates twisted around as if they were bad, "evidence that herd immunity may not be possible". This is particularly true when the prevalence is compared to herd immunity from a model assuming a well-mixed, homogeneous population, which we know overestimates the herd immunity threshold (though not by how much, since estimates of the heterogeneity of the coronavirus are even more uncertain than those of R0). Finally, herd immunity is a gradual process. Even in a crude homogeneous SIR model, you may approach it asymptotically but never get there. This is good--the only case where a disease "burns itself out" abruptly is when there's big overshoot, which implies many avoidable deaths. Perhaps that kind of overshoot could be desirable in a population of young people, if the small excess mortality in the young people were more than offset by their decreased ability to spread it later; but that's a narrow needle to thread. For the avoidance of doubt, I believe Sweden did a bad job protecting elder care facilities (though many places that locked down did too), and I disagree with their position on masks. Their response otherwise seems reasonable to me, not obviously better than stricter approaches but also not obviously worse. 1. Unless you know the death count and you're looking for the denominator for your IFR, since more infected then means lower IFR. That was true early in the epidemic, before the first high-quality serosurveys, but not anymore.
- martindbp 6y ago
  Simple: it's not over yet, but it might be for some hard hit areas of Sweden. We'll see. Then there is another question whether it was worth it to shut down the world economy over a 0.05% death rate, or a few years worth of flu at once. I'd say probably no. We didn't know this back in Feb/March, which is why I was very much for a quarantine then, but not now. I don't think the powers that be would have done a complete shutdown if they'd known what they know now.
  - tomjakubowski 6y ago
    > it might be for some hard hit areas of Sweden The long-term success of Sweden's approach appears to hinge on this question. What evidence is there which supports that their hardest hit locales have achieved herd immunity?
    - wk_end 6y ago
      Numbers and projections show things slowing down in Sweden [1]. The obvious explanation for this would be that herd immunity is kicking in, isn't it? [1] https://covid19.healthdata.org/sweden https://covid19.healthdata.org/sweden
    - martindbp 6y ago
      My own observeration from Stockholm is: beaches crowded during heatwave, public transit is crowded as usual. Lots of movement of people, travel within Sweden etc. Practically nobody is wearing a mask. People are still generally careful, washing hands, keeping the distance in lines etc, but I don't think this can explain the cases going down. In March-April, I think people were the most careful, when hundreds were dying every day. Since then people have gradually become more relaxed, but the numbers keep going down. Of course, it could be that these rather small measures have pushed r0 a bit under 1 ever since March. But there have also been reports that for each person tested with antibodies, two more are actually immune, which would put the immunity at maybe 30% two weeks ago. At least it's in the right ball-park, as some have proposed that herd immunity could be reached at much lower percentages than previously thought.
- drewg123 6y ago
  The same data source also shows that Sweden's per-capita death rates are lower than Spain and Italy, which had full scale lockdowns.
  - watwut 6y ago
    They had lockdowns after country systems were completely overwhelmed. Up to inability to handle dead people in some places. Their situations was strong argument for other countries to lock down much sooner.
    - SpicyLemonZest 6y ago
      The question is whether locking down sooner actually solves the problem. As Melbourne heads into another 6 weeks of lockdown, I'm growing skeptical.
- deleted 6y ago
  [deleted]
throw-away_42 6y ago
Sweden's total per-capita death rate is 50% higher than the Netherlands, 500% higher than Germany and Denmark, and 900+% higher than Finland, Norway, and Poland. All those deaths have not made you safer--your daily per-capita death rate is still several times that of those countries. Source: https://ourworldindata.org/coronavirus-data https://ourworldindata.org/coronavirus-data
- martindbp 6y ago
  The current death rate, 10-15 people a day, is insignificant compared to other causes of death. It is not reasonable to talk about percentage differences when we're talking 15 vs 3 deaths a day.
  - alltakendamned 6y ago
    Do note that there's easily a 15-day delay when it comes to Sweden reporting somewhat correct number of deaths, so let's not focus on the "current" death rate too much. And I expect the reporting delay to actually be worse right now as we're in the middle of vacation time. Source: https://adamaltmejd.se/covid/ https://adamaltmejd.se/covid/
    - catalogia 6y ago
      > Do note that there's easily a 15-day delay when it comes to Sweden reporting somewhat correct number of deaths, 15 days ago Sweden was experiencing about 20 covid deaths per day. https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#Deaths_per_day https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#De...
  - SomeoneFromCA 6y ago
    Really? 4500 hundred extra death a year is not insignifcant.
    - martindbp 6y ago
      90000 people die in Sweden every year. Shutting down the economy for a 5% increase is not reasonable.
drummer 6y ago
Sweden did the right thing. Covid-19 is not worse than the flu. Norway recently also admitted the lockdown there was not neccesary according to the data they have now. In March they thought differently.
- martindbp 6y ago
  It is definitely many times worse than the flu, but probably not 10 and definitely not 100 times.
  - text70 6y ago
    It's ten times worse. https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/i/influenza-in-sweden/?pub=63511 https://www.folkhalsomyndigheten.se/publicerat-material/publ...
  - addled 6y ago
    https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm For US data, I like how this table compares deaths from covid, flu, and pneumonia against the total deaths for all causes each week. I especially like that they show the ratio of current deaths vs the average of the 3 years prior for the same week. The downside is how the data is slowly updated as each state trickles in data, so the most recent 4-8 weeks look lower now than if you check back later. Still if you look back to April, flu deaths each week were in the hundreds, while covid deaths 9-15k. Saying it is 10x or more worse, doesn't seem unreasonable to me. What really grabbed me is that the total US deaths in April from all causes was +40% compared to prior 3 year average.
    - drummer 6y ago
      Unfortunately covid deaths are highly unreliable as there is lots of evidence worldwide that people dying with covid are also counted with those dying of covid. Also lots of cases of dead people being counted while not being tested or positively tested for covid.
contemporary343 6y ago
Not really: I would much rather get the coronavirus today than three months ago. And would much rather get it 6 months or a year from now than today. Survival rates are measurably improving due to both improved procedures (proning) and better protocols on steroid use, as well as emerging therapies like remdesivir and monoclonal antibodies (in addition to convalescent plasma). Not to mention that many vaccines are barreling into phase 3 trials soon. I suspect history will not be kind to Sweden's approach.
h3ll0k4ll3 6y ago
Dont fall for the numbers game. The numbers in Sweden are reported on with an expected delay of 7 - 10 days for some deaths. The other game is the break-point in time 1400 - each day when public health agency ( state run ) report their numbers. They reported no new dead in Stockholm and then later on tuesday afternoon Smittskydd Stockholm ( regionally run ) reported 7 new deaths in Stockholm since monday...

kanox 6y ago

> I'm starting to think it was the right decision Sweden is #6 by deaths/population according to this page: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ This would indicate that the swedish response is among the worst. Several countries with comparable health systems have a death rate which is many times lower, for example Germany. This saved many thousands of lives. What am I missing?

marcusverus 6y ago
If the pandemic is expected to continue for many months, isn't it a bit premature to talk about current death rates as a metric for success? Given Sweden's 'herd immunity' plan, higher death rates at the beginning would seem to be a given. They didn't flatten their curve. But as they approach something like herd immunity, the number of possible carriers should plummet permanently (assuming immunity is a thing with COVID), and infections and deaths would permanently decline. Nations which have held down infection numbers with shutdowns have, of course, flattened their curves. But they may well suffer from second/third waves which will hike up their total numbers.
- kingkawn 6y ago
  Herd immunity cannot be considered the plan given that herd immunity has not been proven to be possible
  - noodlenotes 6y ago
    Indefinite lockdowns, vaccines haven't been "proven possible" either. At some point you have to make a plan with the best information you have. The fact that spread in New York has slowed down compared to other states that weren't initially hit hard implies that there's some immunity effect going on.
  - tripletao 6y ago
    Herd immunity is certainly possible--we could hold a parade, and spray it with cultured virus. Obviously no one is doing that, because no one actually wants natural herd immunity. Sweden just thinks the cost to control the epidemic to the point that it doesn't end in that way is unacceptably high. If a treatment is discovered next month that cuts the IFR by a factor of ten, then Sweden was wrong. If no safe and effective vaccine is ever developed and treatment never improves, then Sweden was right. Reality will fall somewhere between those two unlikely extremes, and we don't know where. Fewer infected is always good news[1], in Sweden or anywhere else--it means fewer dead now, more infections pushed until later when treatment will probably be better, etc. It's weird to see low infection rates twisted around as if they were bad, "evidence that herd immunity may not be possible". This is particularly true when the prevalence is compared to herd immunity from a model assuming a well-mixed, homogeneous population, which we know overestimates the herd immunity threshold (though not by how much, since estimates of the heterogeneity of the coronavirus are even more uncertain than those of R0). Finally, herd immunity is a gradual process. Even in a crude homogeneous SIR model, you may approach it asymptotically but never get there. This is good--the only case where a disease "burns itself out" abruptly is when there's big overshoot, which implies many avoidable deaths. Perhaps that kind of overshoot could be desirable in a population of young people, if the small excess mortality in the young people were more than offset by their decreased ability to spread it later; but that's a narrow needle to thread. For the avoidance of doubt, I believe Sweden did a bad job protecting elder care facilities (though many places that locked down did too), and I disagree with their position on masks. Their response otherwise seems reasonable to me, not obviously better than stricter approaches but also not obviously worse. 1. Unless you know the death count and you're looking for the denominator for your IFR, since more infected then means lower IFR. That was true early in the epidemic, before the first high-quality serosurveys, but not anymore.
martindbp 6y ago
Simple: it's not over yet, but it might be for some hard hit areas of Sweden. We'll see. Then there is another question whether it was worth it to shut down the world economy over a 0.05% death rate, or a few years worth of flu at once. I'd say probably no. We didn't know this back in Feb/March, which is why I was very much for a quarantine then, but not now. I don't think the powers that be would have done a complete shutdown if they'd known what they know now.
- tomjakubowski 6y ago
  > it might be for some hard hit areas of Sweden The long-term success of Sweden's approach appears to hinge on this question. What evidence is there which supports that their hardest hit locales have achieved herd immunity?
  - wk_end 6y ago
    Numbers and projections show things slowing down in Sweden [1]. The obvious explanation for this would be that herd immunity is kicking in, isn't it? [1] https://covid19.healthdata.org/sweden https://covid19.healthdata.org/sweden
  - martindbp 6y ago
    My own observeration from Stockholm is: beaches crowded during heatwave, public transit is crowded as usual. Lots of movement of people, travel within Sweden etc. Practically nobody is wearing a mask. People are still generally careful, washing hands, keeping the distance in lines etc, but I don't think this can explain the cases going down. In March-April, I think people were the most careful, when hundreds were dying every day. Since then people have gradually become more relaxed, but the numbers keep going down. Of course, it could be that these rather small measures have pushed r0 a bit under 1 ever since March. But there have also been reports that for each person tested with antibodies, two more are actually immune, which would put the immunity at maybe 30% two weeks ago. At least it's in the right ball-park, as some have proposed that herd immunity could be reached at much lower percentages than previously thought.
drewg123 6y ago
The same data source also shows that Sweden's per-capita death rates are lower than Spain and Italy, which had full scale lockdowns.
- watwut 6y ago
  They had lockdowns after country systems were completely overwhelmed. Up to inability to handle dead people in some places. Their situations was strong argument for other countries to lock down much sooner.
  - SpicyLemonZest 6y ago
    The question is whether locking down sooner actually solves the problem. As Melbourne heads into another 6 weeks of lockdown, I'm growing skeptical.
deleted 6y ago
[deleted]

throw-away_42 6y ago

Sweden's total per-capita death rate is 50% higher than the Netherlands, 500% higher than Germany and Denmark, and 900+% higher than Finland, Norway, and Poland. All those deaths have not made you safer--your daily per-capita death rate is still several times that of those countries. Source: https://ourworldindata.org/coronavirus-data https://ourworldindata.org/coronavirus-data

martindbp 6y ago
The current death rate, 10-15 people a day, is insignificant compared to other causes of death. It is not reasonable to talk about percentage differences when we're talking 15 vs 3 deaths a day.
- alltakendamned 6y ago
  Do note that there's easily a 15-day delay when it comes to Sweden reporting somewhat correct number of deaths, so let's not focus on the "current" death rate too much. And I expect the reporting delay to actually be worse right now as we're in the middle of vacation time. Source: https://adamaltmejd.se/covid/ https://adamaltmejd.se/covid/
  - catalogia 6y ago
    > Do note that there's easily a 15-day delay when it comes to Sweden reporting somewhat correct number of deaths, 15 days ago Sweden was experiencing about 20 covid deaths per day. https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#Deaths_per_day https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#De...
- SomeoneFromCA 6y ago
  Really? 4500 hundred extra death a year is not insignifcant.
  - martindbp 6y ago
    90000 people die in Sweden every year. Shutting down the economy for a 5% increase is not reasonable.

drummer 6y ago

Sweden did the right thing. Covid-19 is not worse than the flu. Norway recently also admitted the lockdown there was not neccesary according to the data they have now. In March they thought differently.

martindbp 6y ago
It is definitely many times worse than the flu, but probably not 10 and definitely not 100 times.
- text70 6y ago
  It's ten times worse. https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/i/influenza-in-sweden/?pub=63511 https://www.folkhalsomyndigheten.se/publicerat-material/publ...
- addled 6y ago
  https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm For US data, I like how this table compares deaths from covid, flu, and pneumonia against the total deaths for all causes each week. I especially like that they show the ratio of current deaths vs the average of the 3 years prior for the same week. The downside is how the data is slowly updated as each state trickles in data, so the most recent 4-8 weeks look lower now than if you check back later. Still if you look back to April, flu deaths each week were in the hundreds, while covid deaths 9-15k. Saying it is 10x or more worse, doesn't seem unreasonable to me. What really grabbed me is that the total US deaths in April from all causes was +40% compared to prior 3 year average.
  - drummer 6y ago
    Unfortunately covid deaths are highly unreliable as there is lots of evidence worldwide that people dying with covid are also counted with those dying of covid. Also lots of cases of dead people being counted while not being tested or positively tested for covid.

contemporary343 6y ago

Not really: I would much rather get the coronavirus today than three months ago. And would much rather get it 6 months or a year from now than today. Survival rates are measurably improving due to both improved procedures (proning) and better protocols on steroid use, as well as emerging therapies like remdesivir and monoclonal antibodies (in addition to convalescent plasma). Not to mention that many vaccines are barreling into phase 3 trials soon. I suspect history will not be kind to Sweden's approach.

h3ll0k4ll3 6y ago

Dont fall for the numbers game. The numbers in Sweden are reported on with an expected delay of 7 - 10 days for some deaths. The other game is the break-point in time 1400 - each day when public health agency ( state run ) report their numbers. They reported no new dead in Stockholm and then later on tuesday afternoon Smittskydd Stockholm ( regionally run ) reported 7 new deaths in Stockholm since monday...