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Anders Tegnell defends Sweden's virus approach (startribune.com)
152 points by whydoyoucare on June 4, 2020 | hide | past | favorite | 512 comments



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.


I believe Tegnell is brilliant, but that is where my accolades stop.

Scientists (which Tegnell is, effectively) are not meant to be politicians, and them getting into political matters is an excellent way to corrupt science. Although Sweden is not a place where one would look to think of corruption, there are still serious ethical issues with this. This is also a form of experimentation in COVID-19 that is among the riskiest and most dangerous in the world.

Early on in the COVID-19 pandemic, the significant differences in death rates in developed countries for COVID-19 were attributed mostly to whether COVID-19 severely penetrated care homes, mostly designed for the elderly. We know that Sweden did not have proper PPE protection in these care homes to protect their most vulnerable, and it still does not. Sure, the death rates worldwide have been going down, at least in developed countries, because, perhaps we have become smarter at treating it, despite having no effective treatment for it.

Still, it is not prudent to expose people needlessly to a virus that we know is deadly--and we know little about. A lot of these deaths could have been prevented, with relatively little pain, although it takes a lot of sacrifice.

One of the countries I am sovereign to, Croatia, (the other being the USA) has not had any COVID-19 cases for 3 days in a row [1]. You know, a former war-torn Yugoslav country that is up and rising and just became part of the EU in 2013. This kind of stuff is not rocket science. Even war-torn, economically suffering countries can be successful at these sorts of endeavors. It just requires brave political leaders (along with a strong emphasis on public health--which a lot of ex-Yugoslav countries actually have) who can deal with crises (which Croatia has legitimately dealt with before).

[1] https://koronavirus.hr/en


> This is also a form of experimentation

People are quick to forget that the Swedish strategy was everyone's strategy in February. It was (most) other countries that changed strategy from "we must prevent healthcare from being overwhelmed" into "we must eradicate the outbreak at all cost".

It was different to stay on the first strategy, but just because other countries changed doesn't make the first strategy any more an "experiment".


Because countries in Asia did manage to arrest the outbreak, so that was the standard from then on once we knew it was possible.


Their success is, I think, highly correlated to their mass testing campaigns. South Korea had drive-through testing facilities up within 48 hours of the outbreak, so they knew exactly how the virus spread and who to quarantine or not.

Add to this an existing culture of using face masks and gloves in public (i.e. supplies of those things were already in place), and you've got a very different scenario compared to most of Europe for example.


Masks seem significantly more important than tests.

Hard to make the argument that testing is of primary importance considering Japan did almost none and still didn't see a significant outbreak.


> Add to this an existing culture of using face masks and gloves in public (i.e. supplies of those things were already in place), and you've got a very different scenario compared to most of Europe for example.

This is a big one. Around these parts wearing a mask means people assume you're sick or immunocompromised.


Japan, South Korea managed the outbreak by testing/tracing and no lockdowns. Exactly.

Obviously Sweden couldn’t scale to the same testing as e.g South Korea, but few countries could. Perhaps one lesson would be that if you can’t scale testing then locking down until you can would be good?


Japan definitely did not do test and trace.

Japan did 90%+ mask coverage.


why could they not scale testing?


> It was (most) other countries that changed strategy from “we must prevent healthcare from being overwhelmed” into “we must eradicate the outbreak at all cost”.

I was surprised to learn that the aggressive approach has become more the rule than the exception. This is great for the world but sad for my country.

Here in the US we are still taking the weaker “we must prevent healthcare from being overwhelmed” strategy. Having (mostly) succeeded at that (so far) we’re already looking to ease the lockdowns.

I tabbed through the statistics [1] and confirmed that much of the world is indeed on the path of “we must eradicate the outbreak at all cost”. Whereas in America the total cases are still climbing linearly (new cases roughly constant) in many other countries the total cases have decelerated (new cases decreasing or even approaching zero).

[1]: https://www.statnews.com/2020/03/26/covid-19-tracker/


Confirmed case numbers is a pretty weak trend metric since it depends more on how many you test than how many are ill. Many countries have their outbreaks shrinking but their testing capacity growing, meaning they might find the same number of cases (or even more) every day, despite there actually being fewer and fewer suck people.

Hospitalizations and deaths are much better metrics.

Sweden probably finds about the same or more infected people every day now, than at their peak of deaths/hospitalizations (which lags the peak of infections!) in the last week of April, for example.


Thank you. Judging by deaths the crisis in the US has eased gradually since end of April.


> People are quick to forget that the Swedish strategy was everyone's strategy in February.

Simply not true. Taiwan (with a population 2.5 times that of Sweden) adopted a strict containment and suppression policy as soon as they detected the epidemic risk, which was at the end of December 2019. And of course China had moved to containment and suppression by then too.


You align rate and methods in spreading testing among population to be the same and produce same numbers among countries - this is not true. There are alot of things about this virus and way it impacts populations are not certain except some relatively weak correlations like more D3 and more Selenium in diets might leads less deaths. Deriving explicit conclusions from highly irregular dataset between various groupings is about as dishonest and corrupt as one can be, this is what politicians do. Please don't do that.


> with relatively little pain

have you been paying attention to what's going on? I would not describe it as "relatively little pain"...


I would, perhaps because I've paid attention to the news showing army trucks racing around the city with people in biohazard gear and military units setting up emergency hospitals with capacity for thousands of beds and, in case of Madrid, commandeering an ice rink to serve as emergency morgue.

Staying at home for a couple of weeks is easy least in comparison. All it takes is a dash of political leadership.

So yeah, op is right on the money.


Not a direct counterargument to anything you wrote, but I just wanted to mention that a lot of people seem to fixate on a makeshift ice rink morgue in Spain, as if it's the only one. I'd bet there are ice rink morgues in many countries that have a high death toll. For example, here is an ice rink that was being used as a morgue in Maryland.[1] I doubt it's the only example in the US.

https://www.wbal.com/article/449453/124/state-opens-temporar...


I don't see Madrid's ice rink as a problem, but as a solution to the problem.

It's far better to store piles of dead bodies on ice than leaving them piling up on morgues or crematoriums, as it was shown in Brazil or Mexico.

The only thing that ice rink morgues represent is the extent of the death wave, and how a nation has to cope with the sudden increase in mortality.


A couple of weeks would have delayed explosive outbreaks. To prevent them would require more than the 2+ months we've already invested.


There is no country where lockdowns have lasted for only a couple of weeks.


Where I live, Vietnam, the lockdown was 14 days, after which a handful of high risk regions had it extended for another 7 days.

I'd call 3 weeks "only a couple of weeks".


What's your definition of lockdown?

Here in Norway we haven't had one, if by that you mean being forbidden to leave our houses except for essential purposes.

We have been free to travel, to meet people, to go to bars, restaurants, cafés. My grown children have not had a single day off work.

The only people forbidden from leaving home are those who have tested positive for COVID-19.

Of course a lot of shops, bars, cafés, etc. have closed but that was for a combination of lack of customers and a desire to protect their staff together with, in some case,an inability or unwillingness to comply with distancing rules.

Schools were closed but that was a bit of an overreaction on the part of the government and against the advice of the Norwegian Institute of Public Health, https://www.fhi.no/en/ and they have been open again now for several weeks.

Here a page in English summarizing the rules: https://www.fhi.no/en/op/novel-coronavirus-facts-advice/fact...


NZ shutdown for six weeks (depending on how you count of course) and is reopening now, we have had no new cases at all for 12 days.

Effective leadership early on is effective.


So what happens as soon as people want to start visiting NZ? Seems like you will forever have to be scared of corona entering your country again, it must be a huge blow long-term to the tourism sector? Not trying to be snarky, genuinely trying to understad the plan.


The plan is basically that the tourism sector takes a beating and nobody is allowed to come to NZ without a 2 week quarantine. Possibly for years.

Under the theory that NZ citizens can’t go anywhere else, supposedly if all the people who would have gone overseas instead travel internally then it should recover up to 60%. If Australia can get thier shit together then it’s apparently 95%.

I guess it’s just a question of priorities. Most of the NZ population is feeling pretty good about life being normal and are willing to pitch the tourism sector into the fire to that end.


NZ tourism spending (excluding international airfares) was ~60% domestic before COVID19. (Yes I know it sounds high, but that's the number.) Shifting outbound tourism to domestic will boost domestic considerably higher than that even without Australia.


There are plenty of questions like that awaiting NZ. Almost 10% of our workforce is (was) in tourism.

But hopefully we have bought time to make measured decisions, and now we do have options, including skulking away until there's a vaccine available.


oh, absolutely.

Im fascinated to see how it plays out myself.

The plan for the next couple of months at least seems to be to require a 2-3 week quarantine for people coming into the country, which is definitely going to cause continued harm to the tourism sector.

I think the hope from the govt right now is that a vaccine becomes an option sooner rather than later...there is no guarantee of that even being possible of course, but its looking more hopeful as the data comes in.

OTOH within the country itself, as of right now, we are one of the least-shutdown economies in the world and have lost only 21 people to covid, which is a pretty solid place to be.

The longer we can keep covid out, the better the virus is understood and the more effective the treatments that are available, even without a vaccine.

It seems likely to be true that eventually we will need to shrug and let the virus have its way with our people, with or without a vaccine, but everyone with vulnerable dependents is grateful to have had more time with them, and already the treatment outcomes for covid have improved from 6 weeks ago.

Lives sacrificed by opening up too soon (or never closing) would be lost forever, while the economy is driven by people, and people are endlessly resilient, so the economy will recover.

Was it worth it for the lives saved? Clearly opinions are going to vary, but Im comfortable with the choices our govt has made so far.


I think we'll be admitting international students soon, with testing and at least a 14-day quarantine.

We are already admitting film crews for certain TV and film productions, with a 14-day quarantine.

If we can sustain being COVID-free, that makes NZ pretty attractive for those activities.

I don't think we'll be admitting tourists unconditionally until we have vaccinated most of our population. But our tourism sector will probably limp along OK with outbound tourism switching to domestic. Also we will hopefully be opening a "travel bubble" with other countries that have beaten COVID19, probably Australia first.


There are countries such as Portugal where timely social distancing measures were enough to curtail infections without any major impact.

Political leadership matters.


What?

We had 1.5 months of partly lockdown. We were blocked from leaving our cities of residence except for work for two weekends. We closed pretty much everything until a few weeks ago.

And with all that, we had almost 1/2 the deaths of Sweden. Not 5% or 10%, but close to half (3800 vs 1450).

And we 'reopened' the country and right now have more cases per day (yesterday 350) as at the beginning when gov. decided to shut down everything. (State of emergency was declared on 18 of March where our cases were around 200 per day)


> We had 1.5 months of partly lockdown.

No, we did not.

Portugal's state of emergency consisted of imposing the duty of home confinement only to risk cohorts, comprised of sick and actively monitored patients. Everyone else was only subjected to "social duty to home confinement" and was obligated to wear protective masks on public transportation, customer service, and services open to the public.

> We closed pretty much everything until a few weeks ago.

That assertion is somewhere between disingenuous and confused. There was a healthy general attitude towards the civic duty of home confinement, but it was primary self-imposed restrictions. The Portuguese government ceased to impose general confinement restrictions after they revised the first declaration of state of emergency, which were downgraded to mandatory facemasks in public transportation and public services.


What the fuck?

The state of Emergency (we had 3) lasted 6 weeks and during this time, bars, restaurants, car stands and a bunch of other stores were closed. They closed lojas do cidadao (?still many aren't open) and essential services were by appointment only.

Not by the owners but by the government: https://www.jornaldenegocios.pt/economia/coronavirus/detalhe...

'Que estabelecimentos encerram obrigatoriamente? Todos os estabelecimentos que não prestem serviços essenciais ou forneçam bens de primeira necessidade são obrigados a fechar portas. O diploma do Governo é exaustivo na lista que inclui: todos os locais de atividades de lazer e diversão, como bares, discotecas, zoos ou parques de diversões; locais de atividades culturais, como auditórios, cinemas, teatros, bibliotecas, galerias ou praças de touros; locais de atividades desportivas, como campos de futebol, courts de ténis, ringues de patinagem ou ginásios e academias; termas, casinos, salões de jogos, bares, esplanadas e restauração em geral.'

Layoff (furlough for other countries) was used to around one million people. 10% of the population and about 25% of the active population, and you are telling me that people just decided to stay at home and gov didn't ordered anything?

Basically, if it didn't sell food or medicine, chances it was closed, and not by choice. There were 117 people arrested and 311 stores/businesses where police/asa forcibly closed them: https://www.cmjornal.pt/portugal/detalhe/estado-de-emergenci...

Please, I don't know where the fuck you lived during the State of Emergency, but saying it was just 'social duty to home confinement' is a joke to what really happened here. The economic and social damage done was huge.


> we 'reopened' the country and right now have more cases per day (yesterday 350) as at the beginning

That's probably the bigger problem for your country than the absolute number of deaths: the "reopening" happened too early compared to some countries of equivalent size where the cases per day became lower before the "reopening."

Even after the "reopening" the war is not won.

Also, looking at the graphs of daily cases and comparing it with some other European countries, the measures were obviously less effective than in these other countries. Given that 10 million of people are involved, it's much more nuanced than "we had X for Y days."

Edit: To answer: "I don't know how we got the good press": deaths per million: Portugal: 142, Switzerland: 222, Sweden: 450, Spain: 580. It's easy to see that's how Portugal looks obviously better, statically. What I point to with "probably the bigger problem" (that it's not over) is that e.g. new daily cases in Switzerland are now 19, v.s. Portugal's 350.


I'm not defending my country at all. I don't know how we got the good press of being the 'miracle' country in international news where other countries did much better but are seemingly ignored.

I'll also edit ;):

Austria(75.73), Slovenia(52.72) Estonia(52.24) Lithuania(25.4) Croatia(25.19)

So it doesn't seem so good, but for some reason, we are called a miracle: https://bylinetimes.com/2020/04/27/the-coronavirus-crisis-th...

(first result in google, there are more)


I got the information, that you did very well, compared to your desastrous neighbour spain and given that spain was your neighbour.


We did ok, not a miracle. As mentioned, we had about half the deaths of Sweden, which is touted as the worst possible thing they could have done, and have triple or more than other countries (listed above).

Seems either people had very low expectations of Portugal, or are just using the Portugal is almost the same as Spain idea and expected the same results (even though we were affected later, if we were first, we would probably see something similar)


Why exactly shouldn’t scientists be politicians? It’s not like most of the people who are politicians have a formal education in political science. In an ideal world the ministers should come from exactly the background they are tasked with. This seems to fit in Sweden. I don’t know why you believe an economist or lawyer would make better decisions here.


I definitely think scientists should be politicians. Angela Merkel has a doctorate in quantum chemistry, and she is one of the most successful and respected politicians of our time.

But I do think it is dangerous to try to play the two roles at the same time. Science demands an honesty that few politicians can afford, which the current discussion about Anders Tegnell so well demonstrates.


> Science demands an honesty that few politicians can afford, which the current discussion about Anders Tegnell so well demonstrates.

This varies across cultures though. Scandinavian countries have a bit of a different approach to many thing, the most recent example I stumbled across was Danish zoos honestly and explicitly saying that they can't keep all the animals, that they will kill some, and that they will feed them to e.g. the lions. They even make it a public thing where somebody will chop up the animal and explain stuff.

Those things generate outcries - in other countries. We're very used to hide "how the meat is made" from the general population, but that's not necessarily the same in all countries. I find it very refreshing for politicians to not have "a public and a private opinion", and I wish it was more common.


Of course they can be politicians. But a politician is elected and sits on a mandate from the people, and this comes with a clear accountability. A scientist that is not a politician is a scientist. It is a big discussion in Sweden, who really is in charge and who is ultimately responsible for the failures.


Science, technology and politics have always been interlinked. If you look at history, it's how things have always been.


> This is also a form of experimentation in COVID-19 that is among the riskiest and most dangerous in the world.

Sweden has a long and revolting involvement of medical experimentation and eugenics on its own citizens, such as unconsented sterilisations, or feeding mental health patients diets designed to induce tooth decay so they could study the teeth rotting in the victims (I will not describe those so afflicted as patients).

In this context, the decision of a prominent Swedish scientist to "go it alone" and experiment on the population who have entrusted themselves to his care is unsurprising as well as tragic.

(And an actual brilliant scientist learns from their results and modifies their hypothesis. He seems to have done very little of either.)


For English readers, the Wikipedia page for the Vipeholm experiments is a good summary:

https://en.wikipedia.org/wiki/Vipeholm_experiments


Those experiments seem like a huge net positive for the world. Only a hundred people getting cavities rather than a million sounds pretty good.


Preying on the defenseless is not a net good.

In case you haven't noticed, billions still get cavities.


Human experiments often have a net positive, but that doesn't mean they're not highly unethical.


I’m not sure why you’re getting downvoted, every thing you wrote is verifiably true and documented fact, except perhaps the “go it alone” comment which is uncharitable at best but if you rephrase it to indict the public health agency instead I would tend to agree with the characterization.

As a Swede I‘m appalled at their handling of the matter, particularly when it comes to protecting the elderly. (Which is to say they didn’t.)


Stop spreading such stupid fantasies... Tegnell isn't some crazy scientist that experiments on the swedish population. All of the decision made by the government agency (FHM) has been made by the agency, not by the individual Anders Tegnell.

Saying that Tegnell "goes at it alone" is completely misinformed and comparing the situation to eugenics research is just going to show everyone how little you know about this situation. Stop wasting everyones time...


Ehm, going back to that time to compare what is happening today? You do realize that this is Hitler times right? How was black people treated in USA at this time? Can we please stay out of this type of discussion and instead keep to civilized matters?

For example the argument that the high death in Sweden would not have been any different had we shut down completely because most deaths happened at old age care where the same people travel around the whole city thanks to state trying to cut down on costs. Tegnell did say that they expected the old age care to take steps to limit this travel when they set up the guidelines but this never happened in Stockholm apparently. I know that in my home-town they compartmentalized the care a lot after the outbreak, every person only sees the same two to three faces and the personell groups don't meet any more. And the death rate is no different to last years average in our state.

We do not experiment on people without asking for permission in Sweden. We do expect people to treat us with some respect.


Contrary to popular belief (and to dismay of some users downvoting my comment for merely putting the historical facts straight), it's not just "Hitler times".

Eugenics went on for considerably longer. Eg. compulsory sterilization, sterilization without consent, persisted well until 1970s.

It was similar with lobotomy (carried out until mid- or late 1960s, I think).

See https://www.umu.se/en/news/swedish-big-brother-behind-loboto... for an interesting take on the Swedish case:

> Sweden was more accepting than the US in its attitude toward lobotomy in the 1940s and 1950s. A possible explanation for this may be the strength of paternalism in Sweden, that is, a greater tendency to make decisions on behalf of the patient in Swedish medical culture than in its American counterpart. This is according to Kenneth Ögren from Umeå University in Sweden.

Whether a legitimate parallel can be drawn with their approach regarding the pandemics, is another matter I'm not really commenting on here.


>Ehm, going back to that time to compare what is happening today? You do realize that this is Hitler times right? How was black people treated in USA at this time?

This may not be the best comparison to make if you want to argue that everything is fine now.


The evidence shows that the virus has no effect on the death rate of the under 45s and very little effect on those under retirement age. [1]

Those over retirement age by definition can choose where to go during the day.

Quite a lot of this argument boils down to political philosophy: Personal Choice vs Nanny Knows Best.

[1] https://www.cebm.net/covid-19/covid-19-mortality-over-time-o...


> Those over retirement age by definition can choose where to go during the day.

You somehow left out the fact that people can't see where the virus is or who carries it. Thus if you are, say, in a retirement home operated and visited freely by those you claim that have nothing to worry about then what chance do they have to avoid being exposed to the virus?

And all it takes is one exposure to get the virus to spread like wildfire within the retirement home. That's been observed in Italy and Spain.

The problem is even more serious if elderly live with family.

Additionally, you also left out the fact that your reference shows signifixant excess deaths in the cohort 46-64yo representing an increase of about 18% wrt the baseline.


I didn't leave anything out. Read it again. But it is interesting how your reply is full of problems that are easily solved without inconveniencing the majority of society (the majority being under the age of 42).

Similarly the denominator game won't save you because I can do maths. Do the numbers again with the population total in that age range.

Then compare that to the chance of dying on the operating table if you opt to have surgery.

Then remember I'm in that age range and have assessed the risk.

Now tell me again why you think you have the right to tell me what I can and can't do?


> But it is interesting how your reply is full of problems that are easily solved without inconveniencing the majority of society

I'd love to hear some of them.

> Now tell me again why you think you have the right to tell me what I can and can't do?

Same reason it's Ok to tell you can't drive drunk.


> I didn't leave anything out. Read it again. But it is interesting how your reply is full of problems that are easily solved without inconveniencing the majority of society (the majority being under the age of 42).

Care to tell us about these easy solutions?


>Quite a lot of this argument boils down to political philosophy: Personal Choice vs Nanny Knows Best.

Framing the argument in this way is the source of the problem every time this comes up.

Solutions don't adhere to philosophies. Some situations call us to work together, and sometimes the best way to work together is for everybody to cede a little control and defer to somebody doing the coordination.

That's all there is too it. We should agree to let everyone live their lives without unnecessary limits, but we should also agree that when collective action is needed, we are also prepared to accept that and to make it work.


> Those over retirement age by definition can choose where to go during the day.

Unless they are not able to. Or require basic resources. Or require medical attention they can't get at home. Or...

It's not a great generalisation.


It's a very good generalisation. I talk about the majority you talk about exceptions and attempt to extrapolate them.

Have you asked them whether they want to spend the few years and months they have left caged? If you did you may be surprised by the answer.


Looking exclusively at death rates is silly. There are many diseases which otherwise don't kill but make life terrible for those affected and result in huge costs to healthcare systems.

This virus doesn't just kill or leave people unscathed, it also leaves people with long term damage or knocks them out for a couple of weeks. Sitting in bed for weeks is not appealing at all to most people.


> This virus doesn't just kill or leave people unscathed, it also leaves people with long term damage

That is merely a possibility and if it's actually the case, it happens rarely.

> Sitting in bed for weeks is not appealing at all to most people.

It beats social distancing for months.


Which e.g. EU country is currently tracking the long-term sequelae of COVID? Where is this information available?

So far we've only seen individual reports about lung damage (including potentially life long) in e.g. divers (including for non-stationary disease courses!), reports about kidney damage, mid-term loss of smell, etc.

We're going to get a clear picture in years, so it's irresponsible to say it happens rarely.

The people for which social distancing is a major problem will also have a huge issue with becoming bedridden for weeks on end. Think single-income earners, single parents, etc. Even for a couple with kids this could be a nightmare with one partner taking care of the kids and their sick significant other. Remember that the sick person has to isolate too!


Yes, individual reports. Nothing frequent enough to care about.


If France and Sweden were the same population, here's a chart of confirmed cases (7 day average) and total deaths.

https://i.imgur.com/oiybcsx.png

Sweden will easily pass France in the next few days, yet new infections are now 500% greater than those of France.

Again, please keep in mind this is a per capita chart.


Sweden's approach is clearly one focused on long-term results. If Covid sees a resurgence in the fall or as nations return to relative normalcy, we can expect the infection and death counts to be multi-modal in most nations, while Sweden's might be a bell curve.

For this reason alone, we are unlikely to know the effectiveness of Sweden's herd immunity for months if not years.


It would take years with current infection rates in Sweden to get herd immunity. If the plan is to reduce pension costs it seems to work.


> If the plan is to reduce pension costs it seems to work.

We don't know. Covid19 leaves some people with long-term, perhaps permanent damage. You might lose working-age tax-paying people from workforce, having to pay them disability allowance, and this might offset part or all of your savings in pensions.


Taking years is generally the case with long term strategies.


You're assuming current understandings of herd immunity and epidemiology are correct, which by empirical observation they aren't.

The epidemic is already over in Sweden:

https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#De...

(more up to date graph: https://lockdownsceptics.org/wp-content/uploads/2020/06/IMG_...)

Yet a much lower level of infected population than conventionally understood has been reached. The models that assume the virus will continue to grow until 60%-70% have been infected are therefore wrong, reality itself is proving that.

There are now a whole lot of theories being explored as to why this is.

[edit: someone complained about the original graph link not matching worldometers. It's worldometers that's wrong so I replaced it with a Wikipedia link, which sources its data direct from Swedish health authorities. I left the lockdownsceptics link because it's a bit fresher]


I don’t know where “lockdown sceptics” got their data from but for me the current numbers look like a constant infection rate and only slightly reduced death rate that is also not falling: https://www.worldometers.info/coronavirus/country/sweden/


But Sweden isn't trying to stop the infection with herd immunity.


I'm not sure of how much of the "long-term results" was historical revisionism, but I can understand some of it.

Sweden (or any other country to be honest) is nowhere near herd immunity, which kicks in at 60% (though some studies seem to have pointed to a lower number around 45%/47% something like that, anyway), Stockholm I think is around 10%, maybe 15%

And even when you reach 60%, there's still an infection inertia

I think it's fine for Sweden to have tried their approach, at these times, there are no real right or wrong answers, and Sweden's population probably is a little more sensible than most other countries.


> Sweden's approach is clearly one focused on long-term results. If Covid sees a resurgence in the fall or as nations return to relative normalcy, we can expect the infection and death counts to be multi-modal in most nations, while Sweden's might be a bell curve.

Other than geometric tidiness I see no point in your comment.

In fact, it ignores the denial of service impact that an epidemic has on a national health service, and plays down how it advocates for a population culling.

Perhaps it's time to relearn the basic principles and merits of "flattening the curve", not to mention the benefits of gaining some time until a vaccine is developed.


Sweden’s hospitals hasn’t been besieged in the way seen in Italy, though, so I’m not sure that is true either. https://www.svt.se/datajournalistik/corona-i-intensivvarden/


There were a few articles that went by that indicated that they were being pretty cold-blooded in terms of triaging older people away from ICUs and ventilators. This isn't totally unreasonable, but it is weird from a "try to save everyone" perspective and does raise some awkward questions about their rather premature victory lap - "our ICUs aren't overloaded therefore we're OK".


The picture here is unclear. Public news interviewed several dozen doctors across hospitals in Stockholm. Some of them had the impression that they were preemptively turning patients away from intensive care units, but a substantial fraction of doctors also said that these are patients that wouldn’t have been put there under normal circumstances either. I think the truth is somewhere inbetween, but it’s clear that there hasn’t been the deluge of severe cases observed out of southern Europe.


Ventilators are extremely intensive treatment.i It's forced breathing. If you're old and frail, it will kill you.


Good points, but we still do not know how the second wave will look like in the countries that had quarantine (or in Sweden). We should revisit in a year. And there are other factors -- I personally know people whose cancer treatments were pushed out "because COVID" (for 1 and 2 months so far and counting). It is hard to quantify such things as there is no significant statistics, but lockdowns contribute to deaths, too.


> It is hard to quantify such things as there is no significant statistics, but lockdowns contribute to deaths, too.

There are systematic statistics on overall excess deaths which will include people whose deaths are a short term response to lockdown, so we can pretty conclusively say that lockdowns reduced short term excess deaths. They don't account for future excess deaths due to situations like cancelled operations you mentioned or different responses to a second wave, but they don't account for future deaths of COVID survivors where cardiac and lung damage caused by the disease is a comorbidity either.


Some of those cancer treatments would have been stopped whether there was a lockdown or not. Chemo becomes much riskier when Covid is working its way through the hospital.


on the other hand many places recorded record low injuries and fatalities from car crashes due to quarantine. i wonder how it balances out in the end.


When comparing policies, you have to factor in the costs though.

As a more straightforward example, it's simpler to compare countries with closed pandemics - say Iceland or New Zealand. Iceland has much higher deaths per capita, but they didn't lock down nearly as hard (groups limited to 10, schools open for kids below age 10, etc.). If you do the math, Iceland lost about 120 extra years of life, or something like ~3 hours per person. Is depriving everyone of additional liberties for a month worth increasing life expectancy by 3 hours?

The case for France vs. Sweden is a bit more complex, since Sweden, even though it isn't locked down, will be "unsafe" for large numbers of people longer. The raw math and projection models suggests Sweden will lose an extra 1-2 days of life per person, but more analysis is needed to really understand benefits and costs.


> If you do the math, Iceland lost about 120 extra years of life

The problem with "extra years of life" metrics is that they artificially play down the death wave on older segments of the population, as if those dying from covid19 who happen to be older than 40yo should not matter to society.

The consequences of this nonsensical pick of statistics indicators is that a death wave of thousands of people per day that happens to hit harder on the > 40yo segment is watered down with "all this just to gain 3 hours of life" nonsense, as if all the coffins were only piling up because instead of being delivered on scheduled they needed to be delivered 3 hours earlier.


So someone with 1 day left in their life is equal to someone with 70 years?

It does seem to me that a more just system would consider "time lost" as a metric since surely it can't be binary.


> So someone with 1 day left in their life is equal to someone with 70 years?

You're the one trying to quantify the value of life.

To me, my parents and grandparents are more important than your 1yo son/daughter, so YMMV.

Still, you're missing the whole point. The point is that it makes absolutely no sense to downplay an epidemic just because it hits hardest on those suffering from pre-existing medical conditions or being over 40. The coffins piling up on makeshift morgues make it quite obvious that the real effect of the death wave is not anticipating death by a couple of hours, and it matters nothing if those doing the dying are sick, old, or disabled.


So are you saying it's entirely binary? It's either terrible and should be avoided at all costs, or it's no-one dying?

You are bringing out facts such as "coffins are piling up" etc, this fact could be true if in one morgue in two places in the world there were coffins piling up. Maybe these morgues can only handle 5 deaths at once and now there's 5 more for each?

You need to quantify things to understand how bad they are. Otherwise these statements are meaningless.

You are essentially quantifying - any statement you do you is actually quantifying. For instance if you bring out the argument about coffins piling you seem to be considering potentially 10 deaths (which could cause coffins piling) to be the same as the whole world population dying.


> So are you saying it's entirely binary?

I'm stating the exact opposite: that crudely abusing statistics to pretend that people over 40 don't count for nothing because they will die in a few years is abhorrent, and downplays the real impact of the whole covid death wave.


Wow, you’d sacrifice a 1yo to save your grandparents? I find that genuinely shocking.


That is not what was being said - they said that they personally value the lives of their own parents more than the life of someone else's child; this in the context of someone trying to argue that the life of a 1 year old is inherently more valuable than the life of a 60 year old because the 1 year old can expect 79 more years of life, while the 60 year old can only expect 20 more.

And otherwise, assume there is a fire and you are in the middle of a corridor. On one end there is your mother, on the other there is some 1 year old you don't know in any way. Which would you rush to save first? I know I would rush to save my mother before the 1 year old.


So the implication is that we should calculate the emotional pain value instead of expected years left and act based on that? So if for example the 1 year old in question has no parents because they died due to an accident and no other relatives it means no-one will really mourn this death so we would choose this death over a popular 80 year old person?


> So the implication is that we should calculate the emotional pain

Wrong, the implications is that it makes absolutely no sense to state that society should just let old people die simply because you're so self-centered that you even fail to register the devastating effect of an epidemic just because you believe it doesn't affect you personally.


I think the argument is more akin to not sacrificing anybody, and trying to save everyone.


But in real world that is not possible. There's somewhere a line you have to draw. How many man-hours would you be willing to spend to save someone who would die in a week anyway?

According to that logic you should have all 7+ billion people working that whole week to keep this person alive.

Would the man-hours spent saving that person have to be exactly the same as saving someone who has further life expectancy of 70 years?


That's not really the choice here. The choice is we squelch the virus and my dad and his grand children get to see each other again. Vs you not being inconvenienced.


I couldn't reply for the other comment, maybe because it's too nested, but I'm replying to:

> You're pretending that the economic dislocations are do to measures to combate the virus instead of the virus killing people. Countries that acted swiftly and forcefully are returning to normal right now. While countries that are handling the way you want are seeing no end to this. Meaning you are 180 degrees wrong, your way kills people from the virus. You way kills people via extended economic dislocation.

1. I haven't made a choice on what is the best option.

2. There's no "my way", all I'm saying that these aspects should be considered and math should be ran and it is possible that another option could be better, a combination of some options etc. And in order to determine what is the best way should be using calculations.

3. It should also be discussed how to do these calculations. Should we consider death as a binary or should we consider "time left", "quality time left". How do we calculate loss of life, time, resources that stems from people unable to be productive etc, because certainly there are consequences to that.

4. I'm trying to prove that this should not be binary and there should be a line drawn somewhere considering all the pros and cons from the both sides, assigning weights to those and trying to predict what is best option from that.

These discussions should still be held even if it's not about coronavirus, but other similar decisions as well.


Since you are trying to make things personal... I'm personally not inconvenienced, I love WFH and having a good reason not to meet people.

So once again is that choice also appropriate if 7+ bln people have to spend 3 months working in order to save your dad? Obviously a lot of other people die because if they have to work 3 months saving your father it means the doctors are not saving other people, we won't have food etc.

I'm trying to show that there must be a line drawn somewhere and it can't be binary.


You're pretending that the economic dislocations are do to measures to combate the virus instead of the virus killing people. Countries that acted swiftly and forcefully are returning to normal right now. While countries that are handling the way you want are seeing no end to this. Meaning you are 180 degrees wrong, your way kills people from the virus. You way kills people via extended economic dislocation.


> Is depriving everyone of additional liberties for a month worth increasing life expectancy by 3 hours?

This analysis is flawed, because it compares the entire cost to only parts of the gain. Economic depression because no-one dares to go outside of fear for their lives, has for instance negative value too.


I never thought of it this way. This is a really good observation in my opinion.

There's a lot of math and viewpoints that should be considered here. It does not seem to me that proponents of lockdowns are even doing any maths, it seems like they take it for guaranteed that lockdowns are the only choice.


No, they just treat human life as valuable and tend to err on the side of caution - reducing people to numbers is a slippery slope, because you can prove almost any point with statistics. Then you end up with [Star Trek-style dystopias](https://en.wikipedia.org/wiki/Half_a_Life_(Star_Trek:_The_Ne...) like euthanising everyone at the age of 60 - after all, society as a whole is better off if you do that...


But when you are calculating active cases and death rates you are also reducing people to a number, it's just binary in this case, 1 = death, 0 = no deaths.


Are you open to the possibility that those proponents actually have considered those viewpoints and come to a different conclusion than you for reasons other than being too stupid to understand math?


> Iceland has much higher deaths per capita

We can’t know this number conclusively until a few years from now. The pandemic is still ongoing and does not have a flat distribution of impact over time.

So all this analysis is based on a false premise.


1 death is a tragedy, thousands of deaths is statistics.

That "3 hours" mean that you're likely to loose one of the relatives or friends who are in high risk group. Suddenly a month of lockdown is worth to give your loved ones years or even decades.


> That "3 hours" mean that you're likely to loose one of the relatives or friends who are in high risk group

Not arguing one way or the other, but I most certainly would not call it likely. Germany had more deaths than Iceland per capita and none of my relatives or friends are or know anyone even infected, let alone dead.

In Germany, you’d need to know about 440 people to even know someone who has been confirmed infected, in Iceland still around 200. To know someone who died, you’d need to know 9,661 in Germany and 36,363 in Iceland.


I don't live in one of the US hotspots, yet I personally know a person who had COVID (and lived), and have multiple friends who have had relatives die from COVID.

I have a feeling as things open up, more people are going to have my experience.


Of course some people will know someone. I’m not arguing against the danger, or changes, or anything but that it’s "likely to know someone".


Anecdata vs statistics? Some people did die. Some do know them. If no people you know died, does it makes it a media hoax?


Yes, I used statistics. You said it’s likely. I gave numbers on how many people you’d need to know to, on average, know someone who died. Which, considering how high that number is, does not make it seem "likely"

Edit:

> does it makes it a media hoax

Honestly, you completely lost me there. Did you read some other comment and attributed it to me?

edit2: FWIW, I wear a mask when going to the store despite it being only required inside, one of maybe 5% of people who do that. And that’s in a city of 200k with 0 known active cases.


Sure its sucks for some people who die or know people who died but for most other people they won't even notice.


What's what I said up the thread. It's a tragedy for people directly involved even though averaged-out it becomes a cold statistics.

Personally I'd rather not gamble wether I'd end up on tragedy or statistics side.


Technically, life itself is a series of gamble, every choice has its risk and benefit.


> That "3 hours" mean that you're likely to loose one of the relatives or friends who are in high risk group. Suddenly a month of lockdown is worth to give your loved ones years or even decades.

Not even close. For example, no one I know has been directly hurt by the coronavirus. And neither has anyone they know, including my friend from Wuhan.

(Why "directly"? I do know someone who had a mental breakdown related to isolation.)


Most people know more people than the average HN commenter.

I suspect you don't know the fate of everyone known by everyone you know.


> I suspect you don't know the fate of everyone known by everyone you know.

Certain information is significantly more likely than average to be broadcast. Do I know what those people are doing? Do I have any idea who they are? No.

But I do know they haven't been hurt by the coronavirus.


If your personal experience doesn't match statistics, are statistics wrong?


I read something different from that same graph. Assuming the French lockdown does not get rid of the virus/sickness completely, the "cases" line shows the speed at which the virus burns through the population. Sweden will have gone through its population long before France has, and will France be able to keep functioning under strict lockdown for all those months? Or even years, at the present rate?

Assuming we'll all contract COVID-19 anyway, eventually, it makes little sense to adopt strong restrictive measures on personal liberty to slow the spread down to a crawl. Sure, you have to impose some restrictions in order not to overload hospitals and whatnot, but anything beyond that is just extending the suffering (both making living harder and ensuring it will go on for a longer duration), is it not?


Delaying the spread also buys time to develop therapies and vaccines.


exactly, we've also learned that not all lockdowns are equal. Super-spreader events seem to be the driving force behind this pandemic, using effective measures we can avoid and learn to deal with super-spreader events while also allowing society to continue at a more normal rate.


Yes, absolutely true and I'm glad you brought it up. I should have mentioned that in my comment too.


> Delaying the spread also buys time to develop therapies and vaccines.

I would also add that delaying the spread also contributes to making it progressively harder to get the disease to spread.


> and will France be able to keep functioning under strict lockdown for all those months?

France has already lifted many of their lockdown restrictions.

> Assuming we'll all contract COVID-19 anyway, eventually,

That's a big assumption, and not necessarily correct.

First, we won't all get it - herd immunity means infection rates max out at something like 60% to 90% of the population. I understand this maximum is to some extent a function of how fast your infection rates rise due to a sort of momentum effect.

Second, we may be able to suppress maximum infections indefinitely (or until we get a vaccine or treatment) with tracing, local lockdowns and so on. It's not clear if this is an effective long-term strategy, and is disputed by some epidemiologists, but seems to be the leading preferred strategy by most experts.

> it makes little sense to adopt strong restrictive measures on personal liberty to slow the spread down to a crawl

The problem is that you can't really adopt half measures. That's linear thinking, and it's an exponential curve. You either keep the reproduction rate above 1 or below 1. Above 1 you get an accelerating increase and eventually overwhelmed hospitals. Below 1 your infection rates start halving.

Luckily, the measures required for keeping R<1 don't seem to be too intolerable. Spain, Italy, France etc. have managed to squash their epidemics and are getting close to having something like normal society back.


Btw. The statistics to calculate herd immunity to 60-90% were extremely flawed. They used numbers that came right out of superspreader-events. The most likely thing for COVID-19 is, that it has R0 < 1. It will spread by using a series of superspreader-events and will disappear after a while. Check out Michael Levitt for some understanding of the mathematics of COVID-19... https://www.youtube.com/watch?v=8aHrx68IT7o


I'm not sure what you're trying to say here. If R0 was <1 then we would never have had an outbreak in the first place.

I don't believe Levitt's interpretation. I certainly hope it's true, but I don't think it is. He seems to believe containment measures have no effect, which is implausible to me.

He's just talking about the stats, without giving a biological hypothesis for why infections would top out - that seems to be coming in an upcoming video that hasn't been released yet.


With local superspreading-events you can get an outbreak without needing R0 > 1. There can be fire without the world burning down. Levitts math works extremely good - you can calculate the entire German death-curve perfectly. In fact there is no constant R - the model is completely different.

I'm also a bit sceptical about his conclusions. The effects of containment measures aren't really visible in the curve, but e.g. Sweden has a much worse exponent - increasing the chance for more outbreaks will also change the parameters for Levitts curves. I think Germanys curve got very slightly worse recently (shops opening - masks didn't compensate). But I'm not sure if masks did anything at all - there is no clear trend-break in the growth-rate of Germany. Also masks may just keep a local population infectious for a longer time - increasing the risk for visitors.

One biological hypothesis is that covid-19 spreads in local clusters - and has a hard time to move to other places. (e.g. it might need 20 minutes of close-contact talking) The growth-rate is shrinking exponentially (something that Levitt noticed, and can be seen everywhere)- each outbreak locally is trapped and doomed to fizzle, because it is competing with itself - it's just not mobile enough to move to another location before it burns out to maintain a constant R=1.


At this rate, Sweden will take years until they "have gone through its population".

"Assuming we'll all contract COVID-19 anyway, eventually" is not a reasonable assumption - it was the worst case scenario that the world has avoided and (as it seems) will continue to avoid. It's reasonable to expect that if we solve this issue through a vaccine in 2021, then by that time perhaps 10% of the world's population will have contracted COVID-19 and almost everyone else will not. And the expected difference between Sweden and France is going to be that by the time that we have a solution, one of them will have burned through more of their population for no good reason.


Epidemiologists have been saying that per-capita comparisons don't make sense, since if you start with 10 cases, and have an Rt of 2, you get 20 cases, no matter if your population is 1 or 100 million.


At 90 days some their first 100 cases, Sweden has half the cases of China. Does that mean they have been twice as effective at fighting the disease? Half as impacted?


Chinese statistics is unreliable. It makes sense to compare Western countries, but not Western countries to China.


OK Sweden has fewer confirmed cases (40k) than most if not all of Western Europe.


Sweden doesn't test nearly as much as other countries in Western Europes. Comparing deaths is already complicated, comparing "confirmed cases" is completely useless.


Compared to population?


And if you start with X cases, and have and Rt of 2, you get 2X cases, no matter if X is 10 or 1000.


Perhaps it didn't make sense in the beginning, when outbreaks are sparse, but now that it's spread everywhere and it's a matter of suppressing it, that changes things, doesn't it?

If you start with 10 cases and immediately take action like Taiwan, you have 7 dead. If you start with 10 cases and do nothing like Sweden, you have 4500 dead.


Sweden hasn't "done nothing", please don't make things up.


In some cases they did worse than nothing, like when advising people not to wear masks.


Sweden passed France in relative Total Deaths the very next day.

https://i.imgur.com/2iBcWi2.png


France just lifted its quarantine now it's doing exactly what Sweden is doing as every country in the world.

It couldnt feed its citizens without an economy.

Also note there's no exponential explosion in the rate of infection in Sweden or anywhere else that is opened its economy like the model for quarantine predicted to flatten the curve.

It's reached a steady-state in all of these places.


Interestingly (to me anyway ;-) ) I recall when I heard about the Japanese government's plans (where I live). They had a whole special about what the plan was, what the rationale was, how they thought it would go, etc, etc. I thought they were bonkers. "This is going to go down badly", I thought.

But, looking back on it, I'm pretty impressed with the results. Good foresight? Luck? Not really sure, but you can't really argue with results. As time goes on, you can see that it's a bit like surfing those huge 50 foot waves. If you can manage it, everything will be fine. If not, you are crushed. Fingers crossed.


Yes, it's a bit of a puzzle. From most accounts Japan had some of the loosest government restrictions in the world, with relatively little contact tracing or testing, and their outcomes so far has not been bad at all (fewer death than most Western countries, more than most Asian).

The reality is that nobody really knows why, and there's a long list of potential confounded explanations (https://anond.hatelabo.jp/20200518004632 in Japanese).

It's really shocking to me to see to see that in 2020 humanity is so technically advanced (space probes at the edge of the solar system, chips at 7nm), yet so ignorant (how much do face masks, school closures, or climate differences affect the virus spread?)

https://www.bloomberg.com/news/articles/2020-05-22/did-japan...


> how much do face masks, school closures, or climate differences affect the virus spread

Shows how hard this is to actually find out. We have an enormous set of natural experiments and still each result is giving rise to more questions than answers. Are smokers better off? Does malaria drug X really help? How much do masks help? Do kids spread it a lot? Why are men more affected? We have no clue. We probably never will either, for many of the questions!


The problem in some of the states is that when it was becoming clear this wasn’t anything near the apocalypse that was promised, they refused to adjust course and relax restrictions.

Changing course in the US is seen as weak and politicians hate to do it, even when it’s the right thing to do.

Also: US media is in a bad place. They have lost their sense of civic responsibility and are blatant fear mongers now. It’s lead to a lot of hysterics in the US.


The disease turned out to be the worst pandemic in 50 years, and is continuing to get worse. How is it a good idea to relax restrictions when you have cemeteries overwhelmed with the huge death toll?

Sure, it wasn't the apocalypse, and not one serious person claimed it to be. Everyone could see from the IFR that even with the highest estimates it wouldn't kill the human race or anything; but even with the lowest estimates, letting it run amok would kill millions of people.


> How is it a good idea to relax restrictions when you have cemeteries overwhelmed with the huge death toll?

Big restrictions severely harm the poorest people. Most people are poor. They also damage economy and civil rights. Governments spend like crazy to make up for the damage and few dubious interest groups benefit the most. And politicians enjoy their power trips and erode civil rights. That's a huge toll.

If cemeteries in your place can't keep up, maybe its exceptionally bad there, but this is not the general situation. Also, if somebody dies there, there is no societal need for his body to be put in those cemeteries.

Some relaxing of COVID-19 restrictions can make a lot of sense even if millions of people are going to die as a result. So far 4500 Swedes are dead due to COVID-19 [1]. In recent years, over 50 million people die each year [2]. I'd say the Swedish model is doing fine, except for the most vulnerable group of people - old or sick people. The state response should focus on how to help that group, not to shut down whole country.

Of course, the proper local action depends on the local situation, how bad the outbreak is there, cost/benefit analysis.

[1] https://thenewdaily.com.au/news/coronavirus/2020/06/04/swede...

[2] https://ourworldindata.org/births-and-deaths


Disease also tends to hurt the poor the most. Most things tend to hurt the poor the most.

And especially for poor people, being forced to work will mean a much higher chance of catching and spreading the disease, since poor people tend to work directly with other people, and companies rarely invest in protecting "interchangeable" workers.

I do agree that the proper measures may depend on the specifics of the situation. But I think that the spectrum in most of the world should have been between "close down schools and tourism" and "close down everything". "Recommend social distancing" or "hold massive rallies" are not good enough IF you care about human life.

And comparing the number of people who died in Sweden in 2 months to the number who die in the world every year is not very useful. More useful would be to see how many more people died in Sweden compared to normal - just from Covid19, they have ~2000 more deaths/month, compared to a baseline of ~7500 deaths/month in recent years. That is not an insignificant number however you think about it.


> Disease also tends to hurt the poor the most.

You're right for U.S, but not in Sweden or other social democracies where healthcare does not correlate with how much you have. Disease hurts the already sick and the elderly the most, but it does not care about your wallet.

> And especially for poor people, being forced to work will mean a much higher chance of catching and spreading the disease, since poor people tend to work directly with other people, and companies rarely invest in protecting "interchangeable" workers.

That's true, I do not advocate for forcing anybody to work.

> ...not good enough IF you care about human life.

I care, but with some reasonable proportionality. Saving everyone is not possible. Saving almost everyone by hard isolation rules is very expensive and unsustainable. Helping the vulnerable via smart specific restrictions is enough.

> And comparing the number of people who died in Sweden in 2 months to the number who die in the world every year is not very useful. More useful would be to see how many more people died in Sweden compared to normal - just from Covid19

You're right it wasn't a good comparison. I just meant "let's get some perspective".

> More useful would be to see how many more people died in Sweden compared to normal - just from Covid19, they have ~2000 more deaths/month, compared to a baseline of ~7500 deaths/month in recent years. That is not an insignificant number however you think about it.

We are not doing that comparison, because even with tighter restrictions deaths would be increased. We do not know how many people would have been saved if hard U.S. like restrictions were used. I think not many, because most of the deaths happenned in nursing homes where restrictions on public places would have not have much of an effect.

Another substantial fact is that Sweden has greater birth rate than death rate and was projected to increase its population in next years. Their COVID policy will be responsible for curbing that population growth, but no disaster is happenning.


First, it was not "promised" as an apocalypse (for an apocalypse, the death rate would have to be much higher) - the intention behind the restrictions was simply to not overwhelm the medical system, so that everyone that needs treatment should be able to get it. Second, the restrictions are the reason why the situation didn't turn out (even) worse than it did, but some people just fail to see that (or intentionally ignore it)...


> the intention behind the restrictions was simply to not overwhelm the medical system

This is my point. When the medical system wasn’t overwhelmed, the restrictions should have been eased, but weren’t in many places. The goal posts were moved dramatically.


The window between an overwhelmed health care system and a suppressed epidemic is extremely thin. We simply cannot dial in exactly the right reproduction number to get this over with in a reasonable time frame without overloading the available hospitals. Even the Swedish approach has caused massive economic damages, and even then they are still in the early stages of their epidemic.


Who exactly promised an apocalypse?

The early estimates for the IFR from February turned ouf to be quite accurate.


Everything I was seeing in February for IFR was wildly inflated based on undercounting of infections from lack of testing. I’m curious what you saw that turned out to be correct.


Scientists and the WHO estimated the IFR to be around 1% in February. Most models that estimate fatalities use that number as well.

That estimate has hardly changed.


1%?!

CDC current estimate is around 0.2% and that's certainly still too high, for various reasons.


Seems highly unlikely, excess mortality is nearly 0.3% of NYC. You would need 150% of NYC to be infected to get to 0.2%.

Many seroprevalence studies with prevalence >5% also show that the IFR is in the region of 1%.


https://reason.com/2020/05/24/the-cdcs-new-best-estimate-imp...

"The CDC's New 'Best Estimate' Implies a COVID-19 Infection Fatality Rate Below 0.3%"


What is the basis for this best estimate?


It states that in the article.


> Sweden might have taken a better or a worse approach than, say, France but it is clearly not catastrophic

The only countries worse off than Sweden are significantly poorer - besides Belgium, which seems to be the only country counting correctly (e.g. untested excess deaths in Covid proximity are included).

The most similar countries to Sweden, regarding political structure and wealth, are Denmark and Norway, which have 20% and less than 10% of Swedens death rate, respectively. I'd say it's safe to assume that at least 80% of Swedish deaths could have been avoided with a conventional approach.


Don't compare countries, compare cities/regions. The Stockholm area is hard hit but e.g. the Malmö area fared much better. This isn't because of a difference in strategt but because the initial outbreak was smaller and later, so they had time to take action sooner. When Stockholm realized the problems in elderly homes, many of them already had the disease.

> I'd say it's safe to assume that at least 80% of Swedish deaths could have been avoided with a conventional approach.

What do you build that assumption on? Comparison to other countries, thinking "they have 1/4 the deaths and strategy X so if Sweden had strategy X they would have 1/4 the deaths"?

Half of the deaths were in elderly homes, and they could perhaps have been avoided with a different approach. That's the big failure. Old people who don't have care in their homes or live in elderly homes (e.g. retired healthy people) have been in full "lockdown" just like in most other countries.


The cases per capita in Stockholm are about the same as in most other counties with more than a handful of inhabitants, there are so many cases in Stockholm because many people live there: https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden#Ad...

The same is true for Norway, with Oslo leading the list and also having the most inhabitants. So there is no difference here between the countries.


If Sweden has a significantly higher percentage of the population infected (as they claim) then it doesn’t make sense to compare death rates at this point, because it may be that these other countries will reach the same numbers (infection rate and death rate) later. This is a likely outcome because Sweden’s healthcare system has not been overwhelmed, so it’s not obvious that their policies will lead to excess deaths in the long run. The thing to compare is the final death toll (as well as economic damage), and we don’t know that yet.


Why do you think Norway will eventually approach the same number of infections as Sweden? Norway only has a few hundred active cases left, and is testing 2 times as much than Sweden. They are on their way to normal life in a few weeks. If new outbreaks occur, they are well prepared to isolate them.


Just got a snap from a friend of mine. First pub beer of the season yesterday. 15 days with no new cases in my hometown. City of 300,000, West Norway.

Testing capacity of >1000 per week locally. No way it can sneak up on us without a large external influx.

Tourism is dead, music festivals are off and the oil industry is in a shambles, but otherwise things are close to normal.

Plenty of routines to limit contagion, lots of care and social distancing, but life goes on with no disease for now.


> infection rate and death rate later.

The most successful countries have already managed to reduce their infection rate to almost zero.


You can still compare it to countries like Vietnam, that, at 10 times the population, with a direct border to China and being the first country in they world to have the virus spread outside China, has managed to keep the infection to only ~400 of their citizens, with no deaths at all.


This is a general observation: you shouldn’t judge pandemic policy over the short term.


Yes, ignore the bodies piling up in morgues. Rational people know that in ten years time it won't really matter.


In addition to Belgium (833 dead per million), United Kingdom (597), Spain (580) and Italy (556) have higher death rates than Sweden (446). France is close behind (432).

And we don't know exactly why Sweden are hit the way it is. The exact week (February 24th to Mars 1st) where the schools in Stockholm had a winter break was the worse possible time for getting the virus back from Italy and the Alps. E.g. Gothenburg which winter break was two weeks earlier wasn't nearly as badly hit. There are just too many variables to assign any clear causes and effects yet.


Norway and Denmark had the same factors you’re pointing to, with a large influx of cases from Italy and Switzerland.

But they shut down immediately to stop further spread. In Norway, things were spurred on even faster because a royal testing screwup in one of the biggest hospitals sent 30 people in quarantine. I think that event spooked everyone to take it seriously right away, along with some video conferences with doctors in Lombardy.

Textbook case of reducing the exponent of an exponential function early for massive benefits, if you ask me. That’s a very simple explanation. I don’t think the truth is more fancy than that. Even a week or two is an eternity when the doubling time is 3 days, everyone being unprepared and all.


Yes, but all these countries, as said, are significantly poorer than Sweden per capita (e.g. Spain has about 50% of GDP per capita than Sweden).

OTOH, Sweden has pretty similar politics and cultural values compared to Denmark and Norway, which means people would react similar to measures like lockdowns etc. Additionally, health care professionals have a similar social standing (as opposed to Spain, where healthcare workers are often poor, which significantly worsened Spains problems).

I fully agree that we cannot have a complete understanding of the situation until everything is over, BTW! But Norway and Sweden are similar enough that a factor 10 difference in outcome cannot be ignored.


Also, why compare Sweden to France, and not Greece or Bulgaria? Sure, the French and the Spanish and Italians and the UK all had disastrous outbreaks as well, but as Eastern Europe and other places have shown, it didn't need to be that way.


> ... the French and the Spanish and Italians and the UK all had disastrous outbreaks as well, but as Eastern Europe and other places have shown, it didn't need to be that way.

The outbreak is likely most defined by how large the initial/seed outbreak is, which depends on how early it happened (how ready people was and how much they had changed behavior already).

Some cities and countries had lots of travel in Week 9 (Week of feb 24) because of holidays. This is e.g. All of Belgium, and the Stockholm region in Sweden.

In Sweden its striking how much better regions that had the holiday just one week later fared (e.g. Sweden's second and third largest cities).

Obviously an initial/seed outbreak of 5000 infected people in a city, compared to an initial outbreak of 50 people will be very different.

It's like commentators on this particular subject assume this diseases was distributed evenly across all countries and the outcomes after that depends on the mitigations applied...

It's also peculiar how some routes didn't incur a lot of spread but others did. E.g. compare the travel from the Italian alps to Scandinavia - tons of people infected. But packed high speed trains between Lombardy and Rome left several times per day during the time when lots were infected but no lockdowns were in place, yet Rome managed with a lot less disease. No one can really explain that yet. Is it something about how the virus spreads that makes planes worse than trains? Is it something about the particular population in Rome having had a Coronavirus cold last season that Lombardy didn't? Who knows.


Sweden botched the initial response.

People coming from Italy (for instance) were not asked to quarantine or even informed that it might be a good idea to self quarantine for two weeks.

Nothing. This initial non-response might alone explain the Stockholm outbreak.

Edit:

someone could have greeted arriving travellers at the airport with a pamphlet. This would have made a huge difference without having to adjust actual policy. Etc, etc. There could have been so many things done which were not done.


They were informed, but the information was "if you show symptoms you should stay home", not "since you are returning from italy you should stay home". This was based on info from Italian authorities that ski resorts were not big hotspots like other places in the region.


It was a cheap thing to do out of caution. But I guess, it's not in the culture to "over"-react. Sometimes it's good, sometimes it comes back to bite you.


I think the disease took a back door from the travellers (who got the information and probably were pretty careful) to taxi drivers and other people who met even the most sick travellers, then from taxi drivers to other occupations common in those suburbs including elderly care. So unfortunately I think among the first to be infected where the families of taxi drivers, who often work in elderly homes or in home care. This was very early even before the elderly homes were completely locked down.


> The outbreak is likely most defined by how large the initial/seed outbreak is, which depends on how early it happened (how ready people was and how much they had changed behavior already).

But that was absolutely a part of government response. In Romania, isolation of travelers from Italy and China began on February 21st, before any confirmed cases. Travel and meeting restrictions started when we hit 10 total cases. The lockdown measures increased significantly when we hit 100 total cases. This was in the same time that France was holding general elections with a few thousand cases.


> isolation of travelers from Italy and China began on February 21st, before any confirmed cases.

I think that was the case everywhere. What didn't work was that it wasn't just Italy (Wuhan was almost no travellers compared to Northern italy that had many thousands in that worst week alone).

Part of the problem was that a) While the travellers were told to isolate, especially if they had symptoms, you had Taxi drivers that took people from the airport who were already sick, caught the disease. It then exploded in the areas where taxi drivers live (where people live in very crowded apartments and often don't speak good swedish etc) and b) that it apparently came from many more places e.g. the US, Spain, France etc already at that time.

In hindsight, there should have been clear messaging that anyone returning from italy and several other locations should isolate, regardless of whether they had symptoms, and that they shouldn't take taxis or public transport when returning from the airport.

That's easier said than done though - if you do that you risk having thousands of sick people carrying skis, sitting at the airport not sure how to get home. That doesn't help either. So in hindsight, authorities should have arranged transports for these people too. But now as you can see it's becoming a pretty complex operation.


Denmark has had 100 deaths per million and neighboring Swedish region Scania has had 139 deaths per million (1.4 million population). The death rate of just the regions of Zealand and Copenhagen is 170 per million (2.6 million population). The same strategy has been in place in Stockholm and Scania, so why is the death rate not higher everywhere in Sweden?

Maybe leaving schools, stores and restaurants open is not what's behind the high number of deaths in predominantly Stockholm, but something else, like how the elder care homes are managed. It doesn't seem fair to point to Sweden's high death numbers when Stockholm is a big outlier that skews the average. In most other parts of Sweden the people are doing fine, without lockdown.


which seems to be the only country counting correctly (e.g. untested excess deaths in Covid proximity are included).

That's not a correct way to count and is one of the reasons why comparing "COVID deaths" between countries is meaningless.

It's not valid because:

1. It assumes COVID is the default cause of death even though it's known to be a very mild disease for virtually everyone (0.2% IFR and estimates keep falling, not 100%).

2. It assumes lockdowns don't kill anyone, but that's known to not be true for all kinds of reasons.

The problem with this kind of reasoning is it looks motivated. It's what leads to fiascos like the New York Times publishing a list of 1000 COVID deaths and the 5th person on the list turned out to be a homicide victim. It's how you get reports of a 19 year old dying of COVID and then it turns out he had leukemia. It's how you end up with COVID death counts going down by large amounts in various parts of the world, as we're seeing now, because cases get re-evaluated and discovered to be incorrectly attributed.

And all that ignores the problem of severe co-morbidities in the elderly, who often are claimed to have died of COVID even when they had major pre-existing problems and were about to die anyway.

These things destroy public confidence in disease statistics. The message that COVID death counts don't mean anything hasn't really got out yet but in time it will.


You can compare the nordic countries here -> https://www.vg.no/spesial/2020/corona/norden/


The death rates can be off by an order of magnitude. Or not. We have no clue. This is the only thing “safe to assume” about this pandemic.


How is 4.500 dead, beeing worldwide #1 in deaths pr capita 2 weeks running, allround #7 in deaths and climbing, not qualify as catastrophic?

And this nonsense of how Sweden will be better of in a second wave.. why? Because people are already dead?? They are not even done with the first wave, they are litterally #1 in deaths pr capita.


Depends on how you measure deaths from Covid-19, for one.

There have been a multitude of reports from other countries on how they fail to account for all deaths, let alone all deaths from the disease, for instance.

The death toll is severe though, no two ways about it, but therea are also a lot of factors to weigh in, such as:

- What could have been done instead? There are several countries with radically different measures that still face high numbers of reported deaths

- Would more severe restrictions have mitigated the most damaging vectors? A lot of the deaths come from elderly homes, for instance, and further lockdowns wouldn't naturally have prevented that (as much as, say, more personnel in elderly care)

- What will the secondary effects be? The effects of Covid-19 go beyond the deaths from the disease itself. How many will die from the economical impact of lesser, or more severe restrictions? For instance.

These are all difficult considerations and near-impossible to answer.


"There have been a multitude of reports from other countries on how they fail to account for all deaths, let alone all deaths from the disease, for instance."

Look here[1] to see that Sweden is the only Nordic country with under-estimated deaths for this period.

Living in Sweden I must say I'm really tired of constantly hearing that other countries are just "cheating" by under-estimating their covid death-rates. The whole thing is seen as some type of bizarre competition.

When the supposed herd-immunity rate was re-calculated by the Swedish-resident statistician Tom Britton to possibly be around 40%[2] the news was widely discussed as though Swedes had won some sort of 'race' - one of my colleagues actually punched the air and said "I knew we'd be first!" (the actual rate of antibodies is around 7-10% in the worst-affected Stockholm area)

[1] https://www.nytimes.com/interactive/2020/04/21/world/coronav...

[2] https://www.expressen.se/nyheter/coronaviruset/hoppfulla-teo...


> The whole thing is seen as some type of bizarre competition.

Yes, it's somewhat ugly, but I feel that some confirmation bias is unavoidable. At this point, pretty much everybody has experienced substantial downsides of the epidemic (either restricted public life, or increased deaths around them), so it seems only natural to look for data implying that it was all worth it.


The Swedes are actually poor at counting deaths, as they lag in their reporting, and often report 0 deaths in the weekend and hollidays. According to NYT Sweden has an excess of deaths totally of about 30%, about the same as France, but climbing. And no its not difficult to compare to say Denmark or Norway.


> The Swedes are actually poor at counting deaths, as they lag in their reporting, and often report 0 deaths in the weekend and hollidays.

That doesn't make them poor at counting death, so long as those deaths do eventually get counted. Everyone knows there are lags in reporting and counting, and everyone should take those lags into account when using the data.

Compare that to Spain, which has recently changed their count method and ended up with a confusing and misleading set of data. https://twitter.com/jburnmurdoch/status/1268450736398098433?...


It’s because it takes time to coordinate the collection of deaths from nursing hones and so forth. A large number of countries are not even collecting these statistics, so I think it’s unfair to say that Sweden is poor at it. According to the latest report, 79% of excess deaths were accounted for in official statistics.

https://www.folkhalsomyndigheten.se/globalassets/statistik-u...


> And this nonsense of how Sweden will be better of in a second wave.. why?

The assumption then is that the difference between 1% immunity, 10% immunity or 20% immunity is massive when it comes to how strict any tracing regime, temporary lockdowns and so on need to be during the next outbreak. If that's the case remains to be seen. But if it is, then that's the answer to the "why?".


To be honest every single death in Sweden is probably counted so the stats are rocksolid. Other countries might have a lower quality of stats (unaccounted death, paperless/undocumented people, missdiagnosed, etc)..


They may be counted eventually, but as of writing, the numbers are lagging, with delays from various areas in Sweden.

There is no evidence that the quality of data from Sweden, should be better then anywhere else. Sweden actually has a testing problem, so by design, missdiagnosed could be higher in Sweden. There are very very vey few undocumented people in Scandinavia.


I keep seeing people saying things along the lines of "but the official statistics massively (under/over) estimate the true count" depending on which particular point they want to make.


Wait a year for 75% of people having spent 3 weeks on mechanical ventilation in other countries to die from complications, and only then will we be able to really evaluate deaths and costs...


The initial projections (ones that guided the responses of other countries like the UK) predicted that Sweden would have 40,000 dead by a month ago without a strict lockdown. That would have been catastrophic.


>> How is 4.500 dead, beeing worldwide #1 in deaths pr capita 2 weeks running, allround #7 in deaths and climbing, not qualify as catastrophic?

Looking at graphs of excess deaths compared to previous years the graph for Sweden is pretty much identical to most Europen mainlaind countries. It spikes at the same time, and it goes down at about the same rate at the same moment, which is when the governments of some countries went into lockdown, while Sweden just advised social distancing etc. But the effect was pretty much the same as e.g. here in the Netherlands, Belgium, parts of Germany, France, Switzerland, etc.

I get this feeling some people really want to rake Sweden over the coals because their policy is supposedly 'killing more people', but the numbers only show this when you compare against direct neighbors, and not at all when you compare to EU mainland countries. Coincidentally, Sweden was one of the first countries that had its first confirmed cases, way before other countries, and way before everyone realised this was going to get bad. So it's very likely that the high number of early infections that went undetected lead to a later spike similar to countries in mainland EU, and, as a result of that, similar statistics in terms of excess deaths. Other nordic countries may have dodged the bullet simply by virtue of a having a little more time before the exponential increase in infections started to get out of hand.

Also (and this seems to be an unpopular opinion around here), maybe we should accept the fact that a certain number of deaths/capita will be inevitable, even for those countries like Norway/Denmark etc, at least in their more densely populated areas. Countries like Netherlands and Sweden had a big spike where many people died in a short time, the vast majority being old (80+ year old) people and people with one or more comorbidities. In the past three weeks, the excess deaths here have been negative compared to other years, and if you look at the area under the graph for total excess deaths for this year so far, it's not that much higher than for the 2018 flu season, which was a much lower spike but it lasted for much longer. It's very likely that over the next months, barring a vaccine, excess deaths in countries that have very few corona fatalities so far will go up and linger higher for a long time.

There was a study posted here recently that showed a very high correlation between the chance of dying from corona now and the 'normal' (ie: before-corona) chance of dying in the next year, through different age groups, health risk factors and some other variables. I think it's fair to say we have to wait for at least one or two years before we can draw any conclusions at all about which countries handled this right and which didn't, or if it even mattered at all. One data point that indicates that maybe there wasn't really a way to prevent all these deaths, is that when you compare countries where the number of hospitalized corona patients spiked similarly before any measures were taken, it seems there is next to no difference in the progression of infections and deaths between countries with ultra-strict lockdown measures and countries that were a little less strict. Things like face masks, closing schools or banning outside activities appear to have had no effect whatsoever.


Its neighbours have managed death rates of nearly one TENTH of Sweden. The difference in timing of the outbreaks was one or two weeks. That certainly should not account for a factor of ten difference.

And yes, some number of deaths is inevitable. That does not mean that every life saved isn't still a life saved. There is not a set quota of deaths that will inevitably happen, and you can choose to have them happen sooner rather than later. Any extra deaths will mostly be on top of the number of unpreventable deaths.


> Its neighbours have managed death rates of nearly one TENTH of Sweden. The difference in timing of the outbreaks was one or two weeks. That certainly should not account for a factor of ten difference.

How can you be so certain of that, considering the dynamics of the infection rate are exponential. If you look at the curve for the Netherlands it went from 'nothing serious, its just 1 or 2 hospitalizations a day' to full-blown 'within 10 days all hospitals will be overloaded'-panic literally within one week. Add one 'super-spreader' event into the mix like the soccer match in north Italy and you create a huge spike that is only seen two weeks later when its already too late.

The exact same thing happened in all of the countries that had the longest lead time between 'nothing to see here' and 'this is really bad we have to do something', the shapes of the excess deaths graphs for these countries are all the same, lock-down or no lock-down. Which makes sense because these were the result of not doing anything for weeks because no-one was taking this seriously yet. I think you cannot just point to the numbers now and conclude the policy in Sweden is to blame for their high numbers of deaths. Especially not considering countries have been opening up for ~3 weeks now, moving more towards the model Sweden has had since day one, and so far no effect on infections or hospitalizations have been observed.


> Especially not considering countries have been opening up for ~3 weeks now, moving more towards the model Sweden has had since day one, and so far no effect on infections or hospitalizations have been observed.

This did not happen automatically. This happens because those countries first got infections under control, and put systems in place to keep them under control.


> 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.

Sadly, the discourse affects the results. When everybody believes a lockdown will work, it does. When about half the population isn't sure about it, it just wastes money.

It would be great to have some countries go all-in in one strategy and others all-in in another, and compare results later -- but when people talk, you end up with lots of countries effectively doing something in the middle, without the advantages of either extreme but essentially all of the costs.


I have been following the situation in Sweden closely.

As far as I can see, calling Tegnell a scientist is incorrect. He may have a Ph.D but does decisively not behave scientifically. Instead he should should be called a bureaucrat, which much better describes his behavior.

The catastrophe that is swedish covid-19 strategy, probably started as something like this: http://www.openias.org/swedens-covid19-strategy

They believed Covid-19 was much more infectious and much fewer people were seriously affected, than we now believe.

This was understandable at the time, since it's known that early on in an epidemic only serious cases are noted, and so infectiousness is underestimated and mortality usually overestimated. However, towards march it became definitely clear for most everybody else that covid-19 was fairly serious for many people and the Chinese mortality numbers were not vastly exaggerated.

Because of his belief in an exaggerated infectiousness, Tegnell believed herd immunity would be reached fairly fast. Most of april Tegnell spent on justifying his faulty assumptions, believing herd immunity was to be had in Stockholm in may. To justify this, they used highly dubious modelling and wishful thinking: https://twitter.com/AdamJKucharski/status/125408476749626163...

Sweden currently is now sitting in a horrible quagmire. The infection is still uncontrolled and mortality, though below its peak, is still significant. Testing infrastructure has still not been built out, and is still not done on all symptomatic cases. Likely because the infection was seen as having a similar severity to flu, and therefore it was presumed better to just stay home for a few days, than to go and get tested.

Tegnell can not admit having been wrong, because of bureaucratic honor. The population which are, like in all other countries, generally not very scientifically literate or interested, have not quite fully grasped the situation. But judging by the latest polls of confidence in the government, many are starting to suspect something is not quite right.

I fully support a very open debate, and believe all opinions have a right to be heard. But the Swedish situation should not be confused with science. It saddens me to say, that only very few countries have been more passive, bureaucratic and unscientific handling this crisis. And that seems to have cost quite many lives and much suffering for swedes.


I have followed the news in Sweden quite closely. I have never heard Anders Tegnell or anyone else från FHM say that they believe any significant herd immunity is close or anything they are trying to achieve.

This is a strawman!


While it is correct that they have never explicitly mentioned herd immunity, it is at least somewhat implied. Quite a few claims were made with regards to what percentage of the population in Stockholm have already had the disease, at one point Johan Giesecke even claimed 50% when mass serology testing becomes available.[0] Although we haven't really heard from him much lately. A study by the Swedish health organization was retracted recently as well, they were too optimistic about their immunity claims and it was based on a flawed study.[1] They have since put out a correct version. The most recent numbers say Stockholm is at about 7,3%.[2] This article is actually a pretty good representation of how they have been communicating. Something similar to flock immunity is implied while not actually being flock immunity.

[0] https://www.youtube.com/watch?v=bfN2JWifLCY [1] https://www.svt.se/nyheter/inrikes/folkhalsomyndigheten-drar... [2] https://www.aftonbladet.se/nyheter/a/3Jyxmq/flockimmunitet-i...


Neither of the text links you posted support what you say, rather the opposite. Do either Tom Britton or Johan Giesecke speak for FHM? I didn’t care to watch the 35 minute YouTube video to figure out what it says.

A lot of people have been talking about herd immunity, but FHM has been quite clear from the start that they don’t think herd immunity will make Corona go away.


  A lot of people have been talking about herd immunity, but    
  FHM has been quite clear from the start that they don’t 
  think herd immunity will make Corona go away. 

You are quite simply wrong.

Here is an interview with Anders Tegnell from 16. march:

https://www.aftonbladet.se/nyheter/a/6j7vaO/anders-tegnell-h...

Flockimmunitet skulle därmed även kunna bli aktuellt i Sverige.

– Vi har varit lite försiktiga med att använda det ordet för det andas ju lite att man har gett upp och det är ju inte alls det som det är frågan om, säger Anders Tegnell.

– Men grundtanken börjar nog bli mer och mer relevant ju mer vi ser av det här viruset, att det är dit vi behöver komma. Vi kommer inte att få kontroll på det på något annat sätt.

Translation:

Herd immunity could therefore also be relevant for Sweden

- We have been a little careful using that word [herd immunity], as it sounds a little like we have given up, and that's not true at all, says Tegnell.

- But the basic idea becomes more and more relevant the more we see of this virus. We need to reach herd immunity. We are not going to be able to control this virus in any other way.


Tom Britton's research is used to base the policy of the Swedish health organization on, but he doesn't speak for them. In Johan Giesecke's case it's more difficult since he charges them for some of his interviews, so I lean more towards yes. You don't have to watch the entire video, you can just read the summary below the video.

In Sweden the policy is to mostly let people do what they want (at least when compared to other countries), unless they're in a risk group then they should take some additional measures. You expose people that don't have a big risk of getting seriously ill to a disease, they become immune and the risk group can reduce their additional measures. I would say that's pretty similar to herd immunity even without it being explicitly called that. Right now I think that's an acceptable strategy[0], when this started there maybe were too many unknowns to go down this route?

[0] There are some unstated assumptions here such as how long people would be immune against it, how many people have serious complications afterwards but don't die and so on, so it's definitely debatable.


My understanding is that the objective is to suppress the spread enough so that the healthcare system doesn’t get overwhelmed while at the same time not have harder restrictions than that people can live with them for a long time, many months and most likely a couple of years. The virus ain’t going anywhere, at least until we have a vaccine. Considering it’s a relative to some viruses that causes common colds, it’s not a given there will be any vaccines.


The 7.3% was taken at the end of April. It's likely well above that now.


That's correct yes. End of April beginning of May and to my knowledge these are the most recent numbers available, but feel free to correct me. What would you consider well above if you were to put a number or an interval on it?




This is simply not true.

Both Johan Giesecke (a consultant for Folkhälsomyndigheten, which is Tegnell's workplace) and Anders Tegnell has repeatedly been saying, that modelling suggests, herd immunity will occur in may.

Along with many others, who are working at the Karolinska Institute, that are closely cooperating with Folkhälsomyndigheten, like the the professors Jan Albert, Anders Björkman and Tom Britton.

Here is Johan Giesecke saying it in english: https://www.youtube.com/watch?v=kOxITQQ8F3w


Are any of the people in the video speaking for FHM? A lot of experts have said different things, and some of them have at one point or the other been paid by FHM. That doesn’t mean they speak for, or represents, FHM.


This is Johan Giesecke, a former state epidemiologist (Tegnell is the current state epidemiologist), who has been working closely with Tegnell on the epidemic.

He apparently billed Folkhälsomyndigheten (FHM) for some of his interviews, as he thought himself speaking for FHM.

FHM refused to pay after a journalist inquired into it. They said that interviews was not part of Giesecke's responsibilities. He answered that he had discussed the interviews and what he was going to say, with people in FHM, and therefore considered them part of his consultancy contract.

Here is Tegnell saying there will be herd immunity in may, in swedish: https://www.nrk.no/urix/tegnell_-_-det-kan-bli-flokkimmunite...

The situation is a mess, and it feels as though many people are trying to muddle the waters, by spreading confusion.


Big spike in confirmed cases for Sweden yesterday:

https://i.imgur.com/Wca1VeY.png

I'm not sure what changed.


As mentioned it's most likely more tests, especially in Västra Götaland where almost half of the new cases came from yesterday. The hospital metrics such as patients in the hospital and patients in intensive care are slowly going down, in that region as well. You can see that in the first graph here. https://www.vgregion.se/covid-19-corona/statistik-covid-19-i...


Probably just more people getting tested, finally.

I wouldn't worry too much about it.


He said, “We still believe our strategy is good”. That’s a far cry from “he is not sure”.


I don't think you can compare strategies in Sweden and France. Scandinavia, Japan, etc. are known to be places where people are civic-minded, responsible adults, where wallets left on benches make their way back to their owners with the money still inside. You can count on Swedish or Japanese people to do the responsible, advised, thing without a police officer standing behind them with a nightstick. That's not true of other countries and that's why those other countries have had to take heavy-handed approaches and still found little success in them.


I'd take that "little success" any day.

From another comment below:

Sweden vs Czech Republic (both 10M):

New cases (7 day average): https://i.imgur.com/fciq4Ra.png

Total deaths: https://i.imgur.com/do9Zbvn.png


Despite press coverage to the contrary, compliance of the U.K. public has been higher, and higher than modelled.

Can’t reveal my source but one region of England had over 80% complete compliance with government guidelines. That was as of a month ago.


> Can’t reveal my source

That's an odd thing to say. What is the reason?


I don't want to get someone fired.


Might be a public authority backchanneling private data to a hedge fund who is trading on it.


Tegnell has been wrong about almost everything. Hard to see for me why that level of incompetence deserves respect. But he seems to have a lot of charisma so many people mistake that for brilliance. In one Swedish podcast, he was described with the analogy of a “manipulating boyfriend”. Quite fitting.


Source confirming your statement, please, that Tegnell has been "wrong about almost everything". Because that is false and this is not Reddit.

In my opinion he _lacks_ charisma. He's just a scientist. Which is good.


Sweden has one of the highest death rates in the EU. So they were wrong about their strategy.

They are also basing their strategy on the belief that getting the disease grants immunity, which, according to WHO, there is currently no evidence of.

Perhaps saying that they were "wrong about almost everything" is an exaggeration, but they were certainly wrong about a few very important things.


>Sweden has one of the highest death rates in the EU. So they were wrong about their strategy.

There strategy is focused on the long-term. Obviously allowing a higher infection rate is going to lead to more deaths initially, but their argument is that eventually everybody everywhere else will be infected (it will keep coming back), in which case the death toll over the long run is the same.

>They are also basing their strategy on the belief that getting the disease grants immunity, which, according to WHO, there is currently no evidence of.

There's no direct evidence of but it's still incredibly unlikely it's not the case, given what we know of how all similar viruses behave.


> Sweden has one of the highest death rates in the EU. So they were wrong about their strategy.

Of course not having full lockdowns will give a higher Covid death rate (at least initially) than lockdowns.

If you measure that data point and use it to determine "success" then you are saying that a strategy known to be a failure was chosen, and it failed...

> the belief that getting the disease grants immunity, which, according to WHO, there is currently no evidence of.

That was a poor wording from the WHO. The reality is that scientists were always so sure that clearing an infection gives some (at least short term) immunity that it was never in question. It still isn't in question. Any policy can easily take that into consideration. What was (and still is) questioned is how long this immunity works, and how strong the immunity is for those with no or very mild symptoms. Luckily, signs are saying that even that looks positive.


I was specifically referring to Tegnell. I seriously am under the impression that he got almost everything wrong. I personally don't see anything he got right as an expert epidemiologist shaping the country's policy.

Tegnell seriously believed it would be possible to have the virus spread through Sweden's healthy population, having them build up herd immunity, while not infecting those in risk groups, and ending up with a very low number of fatalities while keeping everything else running.

This man has zero ability for system's thinking and intelligent forecasting. I'm not sure if this is something one would need as a epidemiologist working with virus research. But one surely needs it if one is the leading figure shaping a country's complex response to a new virus.

Thanks for the addition regarding immunity, I forgot that one. Will take myself the freedom to add this to the list.


Tegnell predicted that though, actually he thought it would be much higher, between 8k and 20k. The numbers we are seeing now are much better than he initially thought.

> Uppskattningen att mellan 8 000 och 20 000 svenskar kan komma att dö av coronaviruset är inte helt orimlig.

https://www.expressen.se/nyheter/tegnell-om-dodstalen-har-sa...


No, that said someone else, he just commented on it and basically said it could become true. It wasn't his own prediction.

A few days later, in an interview he said that the country's elevated death toll "really came as a surprise to us." https://www.businessinsider.com/coronavirus-sweden-lockdown-...


He has been wrong, partly wrong or ignorant about:

- Foreseeing the possibility of local transmission in Europe during the early stages despite first cases popping up in Italy (when many informed, interested lay people understood that this will happen with high probability).

- Not recommended any measures to prevent thousands of travelers returning form Italy, Austria and the US from spreading the virus in Sweden in early March.

- Claimed that there won't be any risk for widespread spread in Sweden.

- Over and over again made claims that "the peak of transmission has been reached" once it started in Sweden during March/April - every time incorrect.

- Underestimated the fatality rate (by being overly optimistic and by a assuming that most infected with the virus won't show any symptoms - a totally baseless assumption).

- (Ironically) denied the existence/significance of asymptomatic/presymptomatic transmission (he's still not admitting that it plays a significant role).

- Not foreseen that asymptomatic/asymptomatic transmission will, through workers, bring the virus into elderly care.

- Made multiple, way too optimistic claims about when Stockholm might have reached herd immunity (May, June) - in reality, it's far far away.

- Making assumptions about effective, lasting immunity without the existence of any actual evidence for it (thanks tsimionescu for the addition).

- Ignored/denied the potential of wide-spread usage of masks to reduce transmission (instead, only focusing on its disadvantages "False security", "people not using them correctly")

- Claimed that children don't spread the virus in significant ways (as far as I know, there is no consensus about that).

This is just an excerpt. I'm an armchair epidemiologist (however one who has monitored this situation closely since February), so I am not stating that I got everything from the list above perfectly right. But I am informed enough to understand that he has been mostly wrong, ignorant, or unwilling to take in new information. Which makes me wonder: Why outsource everything to an "expert organization" when they perform so incompetently.

I have no time now to present you with sources for each of the things from this list. You can either do that yourself, conveniently assume that I'm making all this up (which I don't), or present me with anything he did/claimed which actually turned out to be correct. It's harder to find that, than to find things he was wrong about.

Personally I also think he lacks Charisma. But judging from how large parts of the Swedish population at least until recently loved him, some even got themselves tattoos, he clearly seem to have something which captivates the broad masses.


> - Ignored/denied the potential of wide-spread usage of masks to reduce transmission (instead, only focusing on its disadvantages)

This one personally I couldn't and still can't understand. People saw since at least late April - early May that there was a strong correlation between the use of masks and the number of new cases going down (most visible for me in countries like Czechia, Slovakia, Austria, maybe there were others, too), by that point there was almost no downside asking everyone to wear a mask (at least indoors), so, again, I can't understand why some informed people were against it.


An in addition to that, in his Hardtalk interview, at the end he said "In Sweden we don't wear masks, we stay at home if we feel sick", so implicitly he is completely sure that there is no asymptomatic transmission of COVID-19 and that all residents in Sweden stay at home if they feel sick (and I would guess... also allergic people that might sneeze).


(Edit: I agree with some of these, just not all - I come across as dismissive below just because I responded to only those I disagree with...)

> Claimed that there won't be any risk for widespread spread in Sweden.

This is incorrect. That was a momentary assessment "right now we don't see that risk". That obviously never meant "We can't see that this will ever happen".

> Over and over again made claims that "the peak of transmission has been reached" once it started in Sweden during March/April - every time incorrect.

When was the first time this happened? I think what people found weird was that cases and deaths kept going up afterwards. But that doesn't mean the peak of transmission hasn't happened. The peak of hospitalizations/deaths etc was Apr 24 or thereabout, that means peak of transmission was a couple of weeks before that. When did he first say it?

> (Ironically) denied the existence/significance of asymptomatic/presymptomatic transmission (he's still not admitting that it plays a significant role).

He's arguing that there is still no clear evidence it is. I'm going to give him a pass on that. You might argue that one should act as though it might be because we don't know so better safe than sorry - and I'd agree with that too.

> Made multiple, way too optimistic claims about when Stockholm might have reached herd immunity (May, June) - in reality, it's far far away.

I also found these confusing. But perhaps he looks at different numbers such as the bend in various curves rather than serological numbers (in that case he's very bad att communicating clearly what he means). I'm still optimistic that actual immunity can be much higher than serological tests show, because people turn out to have innate immunity /immunity that isn't IgG/IgA. But yes - he shouldn't be so optimistic in public I think.

> - Claimed that children don't spread the virus in significant ways (as far as I know, there is no consensus about that).

Again, if you look at it as "Don't take any action based on anything that isn't scientifically clear" rather than "Assume worst case and act accordingly". What's becoming clear is that the FHM is extremely afraid of the consequences of mitigations (lockdowns, school closing) on public health. Example: if you count a semester lost at school as 6 months life lost - then you can start to make the numbers add up. I don't know exactly how they value things - but I trust they know what they are doing. Essentially I think that the FHM assign a high value to parameters such as personal freedom, domestic abuse, mental health, future healthcare budget... and a rather low value, to the value of a year of life for people 75 and over. This sounds ethically cynical (especially in e.g. a Catholic worldview). To me it's absolutely natural to set up these equations and balance deaths vs. other things (Not just "the economy" but "public health" in general, including the wellbeing of school children etc).


"When was the first time this happened? " March 5th " Det finns anledning att tro att ökningen av antalet svenska fall har nått sin kulmen, säger Folkhälsomyndighetens statsepidemiolog Anders Tegnell till DN. " https://omni.se/tegnell-om-virusfallen-jag-tror-att-det-vars... So on March 5, he believed that Sweden had reached the peak of infections. As if Wuhan, Italy - and at that point a bunch of other countries that were seeing rapid early infection - never happened. To me, just astonishing.

"You might argue that one should act as though it might be because we don't know so better safe than sorry - and I'd agree with that too." Indeed. I remember taking a flight on March 1 and being on high alert and pretty nervous, because already at that point, I had been reading in non-Swedish media about indications regarding asymptomatic transmission, and I was assuming that local transmission in Europe already was ongoing in various countries. While I didn't catch the virus, in hindsight, it clearly was a correct assumption. I early on internalized that instead of relying on advice from Tegnell and his health agency, I had to rely on my own understanding/sense-making, information consumption, on foreign experts and common sense.

"I don't know exactly how they value things - but I trust they know what they are doing. " For me, it's the opposite: Absolutely zero trust. And I had not even an opinion about him and his agency before Corona (I didn't even know of him). So this is not the result of a long-standing mistrust of Swedish authorities. This is the first time I am so strongly feeling a total lack of trust.


Wow yeas Mar 5th was probably around a month before it actually peaked, at least. Now, I don't know what data that statement was based on, it's possible that the days leading up to that really showed it - but in that case I don't think they were clear enough in saying a few days later that "nope, no it's not going down it's clearly still up".

I don't doubt that they are professionals but they are lousy communicators that somehow believe that sounding positive doesn't make them sound incompetent eventually. Sounding pessimistic and then positively surprised would be equally bad (scientifically) but would have much better optics!


3 days later Tegnell (March 8) said he had been "a bit too optimistic" (something he stated a couple of more times since then) and that the increase "might go on for a few more days".

"Därför verkar peaken dra ut ytterligare något eller några dygn mer än jag trodde, säger han och tror att kulmen kommer att nås i början på nästa vecka." https://omni.se/anders-tegnell-om-kulmen-jag-var-lite-for-op...

Personally I don't buy this being mostly a communication issue. I see this as an actual inability in intelligent, complex, system's thinking. In his brain, there is no large "simulation" of a global pandemic. There is a very small perspective, focusing only on Sweden, and only on the here and now, and the evidence that already has been produced. With this, one is doomed to be always behind, to ignore a lot of valuable knowledge, always being "too optimistic", and accumulating fatalities along the way. Obviously, his team doesn't seem to have contributed with a lot more either (or they have been ignored by him, who knows how the internal dynamics are)

He might be a scientist. But there are good scientists. And there are bad ones. Right?


This is a good argument and it somewhat changed my mind.

But I would add that if you take a risky decision in a scenario where the potential downside is mountains of corpses on the streets (or a Lombardy scenario), and then it turns out not to happen, you might have not made the objectively right decision. In hindsight, you got lucky, so it was OK; but maybe confronted with the same situation again you should choose differently. (I guess Tegnell would argue that he had reasons to be confident that Sweden wouldn't become Italy, and that it wasn't just a matter of blind guessing.)


> instead of trying to exorcise dissent and label opponents, admit to uncertainties in their policies.

I get the impression social media is killing off this sort of approach (or maybe it's some other cultural driver). There seems to be a clear trend toward monoculture for everything.


Just an obvious question to ask: have we human-being ever gain immunity to common flu? Then how could those Hurd-immunity advocates be so sure it would ever work?


Influenza reproduces differently from SARS-CoV-2. I think the term is "recombinant virus" [0], making it mutate much more, it's like a regularly shape-shifting virus.

From what I've read about SARS-CoV-2 it doesn't reproduce that way, it mutates relatively slowly in the usual random minor errors fashion.

Because of the slow mutation rate of SARS-CoV-2, we're able to easily trace its spread across the globe by comparing genomes of collected samples. [1]

This of course also bodes well for vaccination efforts, as well as developing robust herd immunity.

[0] https://en.wikipedia.org/wiki/Recombinant_virus#Natural_reco...

[1] https://www.nationalgeographic.com/science/2020/03/how-coron...


We always get immunity to each flu, or we'd all be dead.

So we will get herd immunity to COVID-19, or all be dead. And that hasn't happened in the last million years.

There is no vaccine yet, so the only sure thing is herd immunity. The US is especially vulnerable because we have so many patients in so many locations - testing and tracing isn't going to work in the US. The horse left the barn on that one.


And herd immunity is not going to work very well with a virus if it's been engineered to overcome that.

"The SARS-CoV-2 spike is significantly different from any other Sars that we have studied"

https://www.cambridge.org/core/services/aop-cambridge-core/c...


Yes, we do have herd immunity to the common flu. It's why, for most people with healthy immune systems, the flu is a real annoyance, but nothing more. For those with compromised immune systems, such as AIDs patients, the old, and the very young, the flu can be a disaster. But, once a young child gets the flu a few times, they develop herd immunity so that subsequent infections are less severe.

Once in a while a flu virus learns to trigger the immune system of those with immunity to flu viruses, and then flu pandemics happen, but that is a rare occurence relatively speaking.


> But, once a young child gets the flu a few times, they develop herd immunity

herd immunity is a property of the herd and not any single person, though.


yea, the fact that most children get the flu is a counter example to herd immunity. Full scale herd immunity would protect vulnerable members of societies (who don't have immunity) of contracting the disease in the first place.


You could be immune but be a carrier?


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.


4500 out of 10 million ? 0.045% not bad considering Sweden doesn't do lock down. I wish more country adapt Sweden approach.


It’s not like there are no interventions at all in Sweden. I haven’t been at the office since early March. People are restricted in traveling and crowds over 50 people are forbidden etc.


And perhaps most significantly of all, people with the disease in outbreak areas aren't travelling to Sweden in large numbers like they were to the UK before it was forced into aborting the 'Swedish strategy'. The other side of that coin is that Sweden isn't forecasting better economic performance this year than the countries which had bailouts.


They haven't stopped dying, though: Yesterday, Sweden had 74 deaths. Norway, meanwhile, hasn't had a single death in 9 days.


> Yesterday, Sweden had 74 deaths.

That's a pretty noisy value since sunday reported zero. Because there is no weekend reporting, a 7 day average is better. That average is around 45.


Actually on the 3rd of June there was 1 death attributed to COVID-19. This is very likely to increase as we get more confirmations and backfills the data. The other 73 deaths reported are confirmed cases for other days.


Yes, the data is very noisy, and yes, much of it is backfill, but elementary queuing theory suggests that if deaths by reporting date keep oscillating around the same level, deaths by occurrence date will eventually converge to that level as well.


Depends on how much more they have, if their hospital is not overwhelmed, its acceptable.

>Norway, meanwhile, hasn't had a single death in 9 days

But Norway has lockdown ? of course its a trade off


> But Norway has lockdown ?

No it doesn't. We have prohibitions on large gatherings but private individuals may come and go as they please, visit each other's houses, etc.


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-deat...


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.


So does Sweden. The public health agency also reports weekly on excess deaths. About 80% of excess deaths are captured in the official COVID-19 statistics.


Yup. All discussions should also include excess deaths.


The thing is, at least in Norway, less people than normal have died since COVID-19... So there is no excess.


Then they would report negative excess deaths. That's important information.


This is the only source I've found to easily compare those https://euromomo.eu/graphs-and-maps


I’ve been wondering if you take population density into account where that would put the figures as UK has much higher population density than Sweden


I can't imagine the Belgians being that much more inefficient than the Dutch. I always felt because of the lack of testing in The Netherlands the numbers are probably a bit higher. Until the 1st of June testing was extremely limited even for people that had all of the symptoms.


Sweden has also been very good at counting deaths, there was a New York Times report that compared excess deaths and Sweden was the only region where reported COVID-19 deaths actually outnumbered excess deaths


The "negative excess" was due to reporting lags, repeating the NYT analysis with up-to-date data for that period there are actually "unexplained" deaths. But it actually seems they make a better job at counting than some other European countries (maybe not as good as Belgium, I don't know).


Yeah being nice is all well and good but the results more or less speak for themselves. I hope they at least got some echo economic benefit out of it. It surprised me to see a country where politicians don't make this call. More surprising to see that the result turned out like this.


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.


This.

Sweden's path has been conventional. The attention is coming from nations that executed extreme and even revolutionary policies of universal home arrest, "shutting" an entire nation like a coffee shop, and sending a 30%+ of the workers onto unemployment.

This ultimately comes back to the so-called "Trolley problem,"[1] which some posters in this thread have brilliantly acknowledged. Would we throw the whole world out of work, or imprison them, or bankrupt them, to save 1 life? If not, what is the limit or deciding principle?

[1] https://en.wikipedia.org/wiki/Trolley_problem


> This.

You say "this", and then proceed to state the exact fallacy the OP made as a truthful observation.

> Sweden's path has been conventional.

Yes. Sweden's path has been conventional. Italy's path has been conventional as well.

There is this whole wave of misapprehension and misunderstanding on HN, especially when it comes to the pandemic: "My opinion is backed by facts, therefor all other opinions must be political and I do not need to think about them because my opinion is correct", which is a form of circular reasoning.

> This ultimately comes back to

This ultimately comes back people whose day-job entails shoveling data with computers and being (or at least feeling) smarter than average, and as such feel at least somewhat qualified as a statistician/epidemiologist.

One of the few things that is clear is that the spread and the course of the disease has an enormous amount of unknown confounding factors.

This means that any approach within general ethical boundaries is valid: from making future prediction based on the most advanced epidemiological data to date, to a system-wide shutdown of "doing the things that are very likely to worsen the situation".

None of the scientific advisors to the various democratic governments are complete idiots, and even none of the elected government officials involved are out to willfully wreak havoc on their populations.

Find out what works. Find out what doesn't work and why it doesn't work even though it seems to work elsewhere.

Sweden's approach is valid. Italy's approach is valid. The chances of any one person getting it exactly right the first time are negligible, so there is no point in cheering for what one believed to be the "winning team".

To spell it out for you: you are not right. You are, at best, less wrong. And to paraphrase the OP, "it is about their own opinions, trying to prematurely pat themselves on the back for believing the right thing."


Find out what works. Find out what doesn't work and why it doesn't work even though it seems to work elsewhere.

Absolutely. The trouble is that there is no consensus on what "working" means. Is it minimising short term deaths? Well, then it is easy to see what worked and what didn't, but is that the correct metric? Perhaps, it is minimising impact on society? Well, it is less easy to see, but there is enough information to make some reasoned statements. However, you will probably come up with a different answer than you had for the previous question. And are we talking about short term or long term impact? Perhaps the goal is to minimise long term deaths and suffering? I don't think that we can begin to claim to have enough information to make any definite statements on that (though, of course, I have my opinions).


Italy's path has been conventional as well.

Conventional in what sense? They did hard lockdown which I believe has never been tried before, outside of Mexico, once, for a few days. This type of long term shutdown is entirely new.

None of the scientific advisors to the various democratic governments are complete idiots

Given their behaviour a lot of people have concluded otherwise.

Sweden's approach is valid. Italy's approach is valid.

Nobody is arguing about validity, which is undefined here and thus meaningless anyway, but cost and proportionality.

The stated justification for lockdowns was to avoid overflowing hospitals. Sweden avoided this despite taking far less harsh measures than Italy. This automatically makes Sweden's approach better than Italy's (or "more valid" if you like).

In Belarus they locked down less than Sweden, and still didn't see hospital overflow. Presumably that means Belarus is even less wrong than Sweden!


Italy’s starting point was that they were in the midst of getting overwhelmed (and were already over capacity in some regions) when they executed their shutdown.

Sweden had a better starting point and more time and room to maneuver.


> revolutionary policies of universal home arrest

Quarantine is an age-old method of disease prevention. There is nothing revolutionary about it.

https://en.wikipedia.org/wiki/Quarantine#History


Quarantine for the sick is an age-old method. Lockdowns of entire populations for extended periods is a massive experiment, and the closest analogy we have is the wholesale internment of Japanese Americans in WWII, based on the idea that some of them might pose a danger.


In 1918 they did the exact same thing, they shut stuff down : https://www.nationalgeographic.com/history/2020/03/how-citie...


> Weekly deaths per 100,000 from 1918 pandemic above the expected rate.

The 1918 with worst cities 400+ Weekly deaths per 100.000 people are not comparable with the following numbers of COVID-19. Note that covid numbers not weekly but total.

> The Johns Hopkins University looked into the number deaths per 100,000 of the population in the top-10 countries worst affected by COVID-19. Belgium had over 57,000 cases on May 25 but it had the highest number of deaths per 100,000 of its inhabitants at 81.53. By comparison, badly-hit Spain and Italy had 57.43 and 55.64 deaths per 100,000 people respectively. The U.S. has surpassed 1.5 million cases and its deaths per 100,000 inhabitants stood at 30.02 on May 25.

https://www.google.com/amp/s/www.statista.com/chart/amp/2117...


The 1918 flu was awful, however Covid is nothing to sneeze at: https://www.youtube.com/watch?v=UPCkVrdZVjM

Keep in mind that the graph from that video looks the way it does despite almost the entire world taking measures to prevent the spread of Covid ;-)


Quarantine is only for the healthy.

The sick are isolated.

https://en.wikipedia.org/wiki/Quarantine

And quarantines have been used since the earliest times. In Boccacio's Decamerone the protagonists escape to the countryside.


> The quarantine against chol era has been lifted in the Black Sea port of Odessa, Pravda re ported today, but Soviet travel organizations said they were still limiting travel to the city.

From the New York Times archive, 1970 [1]. The Soviet government quarantined Odessa in 1970 during the cholera outbreak in a rather cruel way - information about the outbreak was suppressed but since it was a popular vacation spot, people kept coming only to be trapped there [2]. It's hard to find much information on the event due to the iron curtain but I've heard several personal accounts and the similarities are striking.

[1] https://www.nytimes.com/1970/09/21/archives/cholera-quaranti...

[2] https://lareviewofbooks.org/article/chorela-quarantine-odess... - My apologies for a long form article but search for "quarantine" deeper into it.


There is nothing 'extreme' or 'revolutionary' about adopting strong containment (quarantine) measures during a pandemic. That has been established human practice for millennia. What is extreme is not doing so.

And your mention of the trolley problem is bogus. Early containment measures would have saved lives and the economy. There was no dilemma there.


It's like the trolley problem, but Sweden pulled the lever that sends the trolley over lots of people rather than just a few.

I think you used the right ethical analysis tool, but I think you got the ethical analysis wrong.


Sweden’s position is that the trolley in this set of choices is eventually going to roll over roughly the same number of people no matter which lever is pulled. The timing varies in different scenarios, not the total numbers.

It just appears that the numbers are worse for them because the scenario hasn’t fully played out yet in all countries, and they chose the lever that has them taking their hits early. Comparisons with other countries aren’t appropriate, they would say, until all trolleys have stopped rolling.

And they are choosing their strategy deliberately, because they think there are various benefits (including epidemiological ones) of this path.

>rather than just a few

No. It looks like just a few. But that’s a false conclusion, taken only because we are still in the early stages. Other countries will catch up to their numbers.


> Other countries will catch up to their numbers.

The fatality rate seems to be declining globally, in part due to improved treatment. Even if that was the only objection to your claim, it would be a serious objection. In addition to that, we're also rapidly learning lessons about how to protect vulnerable patients in care homes (part of the "learning" here is just manufacturing enough PPE to do the job). Many of the elderly patients who died in Sweden's first wave might have been saved if they'd delayed the infections enough to apply what we've learned.


By this logic any great loss can be rationalized as the prelude to some even greater win.

At the moment the best we have are the current numbers. By that measure, Sweden looks terrible.

Comparisons between counties of similar population are quite informative: https://i.imgur.com/do9Zbvn.png


I think that's not quite correct. Sweden didn't pull any lever at all. They advised their citizens but left them individually free to choose their own path, or pull their own lever. I would argue that's a different ethical choice than what most other countries made.


> Sweden didn't pull any lever at all

Your analysis of their passivity does not acknowledge the assumptions underlying an individualist strategy. The lever Sweden pulled was permitting the atomization of a collective public health problem.


>The lever Sweden pulled was permitting the atomization of a collective public health problem.

Did that happen? I didn't hear that their health system broke under the load.

To the contrary, everyone else atomized their economies and still had the virus go through their populations.

Per-capita Sweden did about the same as France, and better than Italy, UK, and Spain.


> over lots of people rather than just a few.

This is too soon to say

- We don't know whether different actions would have produced a very different outcome (I don't beleive a Norwegain strategy would have yielded significantly better outcome, for example).

- More importantly it's too soon to say given we don't have the effects of public health on other mitigations which come much later (e.g. GDP for healthcare spending etc). We also aren't even nearly through the pandemic. More outbreaks are likely, and we don't know how much effect the places with 10%, 20% or 30% immunity will have compared to places with places that have a much lower immunity.


There is no wrong answer in the trolley problem, ethics are subjective.


>Sweden's path has been conventional. The attention is coming from nations that executed extreme and even revolutionary policies of universal home arrest, "shutting" an entire nation like a coffee shop, and sending a 30%+ of the workers onto unemployment.

As opposed to abusing the situation to rebalance a ponzi scheme pension system? After all, most of the people dying have stopped contributing taxes, so nothing of value was lost. Right?

Another thing to note is that most countries didn't just cause a huge number of people to lose their jobs with no plan, only US did that (because it's a 3rd world country). Normal people use the QE money to keep everyone safe and healthy until the danger passes. Which it does, if you take proper measures and close down travel from red zones.

Viruses don't become benign just because people aren't in the mood to deal with them anymore.


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.


> 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.


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/

Currently, it seems the disease is being suppressed in Sweden. I have no idea what Folkhälsomyndigheten or Anders Tegnell thinks about that.


Of course it’s being suppressed. R has been below 1 since what, mid-April? (Deaths and hospitalizations peaked on apr 24).


I agree a bit, I'm not certain exactly what their game is either. The one thing that feels consistent is the priority to endurance, to push for actions that are sustainable in the long run.

Of course, in the long run we are all dead anyway, so I'm not certain what's best!


Well, Sweden's 4:10000 death rate is alarming. In only a few months. And their confident approach (doing very little) in the face of scant information was bold. With lives at stake, its natural to be alarmed/scandalized at their lack of effort to control a pandemic.


A pandemic cannot be controlled, only mitigated. That's what one part of the definition of epidemic vs. pandemic.

What's alarming is that there isn't sympathy or discussion of the way lockdowns are putting lives at stake, when control of the virus is an illusion.

It's natural to be alarmed at overly authoritarian responses, the justifications of which are diminishing as we get more information.

Sweden, as far as I understand, is doing very little authoritarian intervention, but are providing thre public information so they can make their own choices with respect to risks they want to take.


But several countries have basically eliminated the virus. SARS-COV-2 spreads in clusters. Tracing these clusters, testing people, and isolating patients seems to work.

Neighboring Denmark is down to ~30 cases a day. Is it impossible to believe that with border control and testing they’ll basically have it eliminated on their territory?

Countries which have basically eliminated it: Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China

Also the Canadian provinces of new brunswick, nova scotia, newfoundland, PEI, Saskatchewan, Manitoba

I’m sure I’m forgetting some. What do the countries in that list have in common? Yes some are islands but not all. Yes some are small but not all.

For the most part, they took action early, and used contact tracing, testing, isolation, and border control systems.

According to this article the small, poor country of Belize has outdone the province of Quebec, where I live. Belize developed a software based contact tracing system. Quebec still does it by fax. It is not a surprise which jurisdiction has better results.

What’s your theory for how the systems built in these countries will inevitably fail? The virus is contagious but it isn’t magical. It has to spread from person to person. If you test people, isolate the infected, trace their contacts, the virus has nowhere to go.

Most of the west is still not isolating the infected, instead sending them home to their families, and in many cases free to leave home if they decide to break quarantine.

https://www.vancourier.com/living/government-of-belize-credi...


The only virus ever to be eliminated globally is smallpox, and it took a vaccine to do so.

Unless Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China plan on never reopening to the World, the virus will spread again. It's already been proven you can go from 1 case to full pandemic in 4 months.


> It's already been proven you can go from 1 case to full pandemic in 4 months.

When nobody was testing, and nobody was expecting it. Testing and tracing infrastructure will only get better, not worse. You won’t see cases in Hong Kong suddenly go from zero to thousands.

> Unless Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China plan on never reopening to the World, the virus will spread again.

I suspect they'll reopen with mandatory testing and isolation of travelers. Many of those countries already have varying versions of this.

This will go until a vaccine exists. Then once a vaccine exists you’ll need proof of vaccination to enter.

Tourism is nice for economies, but not being in lockdown and not paying the costs of an outbreak is even better.

Why exactly will it be impossible for those countries to use this system for 1-2 years until a vaccine is ready? The alternative on offer in countries with outbreaks is hardly compelling.

Perhaps we’ll discover a treatment in between that will make this unnecessary, but barring that the world may divide into cold zones and hot zones.


Indeed. NZ & Aus exchange about 20% of each other's tourism in a regular year. Sometime in July we should see open borders across the ditch, saving a good number of jobs in travel and tourism sectors. Job subsidies have been timed to maximize this 'bounce back' economy as well.

China, Singapore, and Qatar seem to have less-lethal strains if their recent numbers are to be believed. Perhaps in lieu of an early vaccine we might see weaker asymptomatic strains as providing a safer path to herd immunity. Someone here from these countries might be able to explain their low death rates in more detail.


Good point about tourism amongst clean zones. There will also be less domestic money that leaks out to foreign tourism: much will be spent domestically instead. Tourism is mostly a wash.

The bigger loss will likely be from whatever business/scientific travel is truly necessary. If that gets harder you may see some long run economic harm.

As for China, not obvious they have a lower fatality rate? Their official stats show a 5% CFR.

Singapore and Qatar have their cases amongst the mostly young migrant workers, which should have a much lower fatality rate due to age. I’m skeptical that any countries have a much less lethal strain. Unless we see nursing homes with widespread infections but few deaths.

https://www.bloomberg.com/news/articles/2020-05-05/as-virus-...


Wuhan recently tested all 9 million residents and found only 300 currently positive cases, which are not included in official figures since they are all asymptomatic. If they had tested the residents for antibodies instead then we would have a much better understanding of mortality vs immunity. So it seems like a wasted effort other than forcing residents out of their homes to stand in long queues. CFR depends on knowing the percentage of all cases, not just those showing up in distress at hospitals, as i suspect their official figures actually indicated.


Yeah I don't expect their IFR is 5%. But, some antibody result in places like New York and Spain suggest an IFR in the 1% range.

Sinapore and Qatar are clear cases of a lower IFR, but not obvious to me that China is. Every place has undiscovered cases, the question is how many.


Of course there's discussion. All over.

And the point of lockdown was, time. Time to understand what to do next. Now that's happening.

The concern is all the idealism and absolutism thrown about, instead of measured intelligent discussion, IMO.


> With lives at stake,

I think we must remember that "lives at stake" aren't just Covid infected. People will die in 10 years from budget cuts coming from things we do now. This isn't about counting bodies in the spring of 2020 (only).


That's pure speculation and not very informative to the debate. Basically you're saying, "In a decade the government will spend less money on a number of unspecified things and those cuts are going to kill people in some unspecified way".

You could just as easy make a number of different equally speculative arguments, such as:

"This will force drastic cuts in spending, including military budgets, leading to fewer deaths from war".

"This will kill a lot of the elderly and chronically ill, drastically reducing government costs for things like healthcare, socially security and pensions, freeing up money for other things".

"This will leads to more people moving to suburbs, increasing carbon emissions."

"This will lead to more people working remotely, decreasing carbon emissions."

What this pandemic has taught us so far is that we're really bad at predicting the future. In the meantime, we should try to minimize the death toll in the here and now.


> What this pandemic has taught us so far is that we're really bad at predicting the future. In the meantime, we should try to minimize the death toll in the here and now.

While I agree that it’s hard and speculative, I don’t agree with this. We have to minimize total suffering and lives lost and in the long term even if it means using very difficult predictions.


I certainly don't like the death rate either. Unfortunately lots of countries are in the same ballpark, 3-4/10000, but with wildly varying stragies. "Only a few months" happens to be the same timeframe for almost everyone else, so not sure why that is relevant. We aren't "doing very little", lots of restrictions on behaviour and travel, but certainly less strict than many other places. "Effort" isn't a good proxy for effective in these circumstances.

I think there is at least two things going on: - The long-run approach being taken makes it seem like nothing is going on, since there isn't much action. Slow and steady easily registers and stillness. - Tons of misreporting, in all directions. I get newsclips from friends in the UK that are just out wrongwrongwrong, and they are wrong in different ways and directions!

With this being said, I hope that Sweden's approach is in't the best! Why? Well, that would mean that large parts of the rest of the world is doing something better (if we simplify it into "lockdown" vs "limited restrictions"). That would cost us here in Sweden 1000's of unnecessary death, but perhaps spare millions in the rest of the world.


With only 4:10000, its not worth being alarmed. I like their approach.


That rate is in line with the US and most European countries. The US lost 40 million jobs and spent $4 trillion dollars to achieve the same outcome as Sweden.

And now the US is reopening and attempting a similar approach to Sweden. You can’t shut the world down for months and months waiting for a vaccine.


You compare two of the worst approaches in the world and present a false fallacy of "shut down the world" when in fact the countries with stricter quarantine/tracing/tracking approaches had far better outcomes:

Germany, and Japan, and Korea, and Taiwan lost far fewer jobs, killed far fewer people per capita and nearly eradicated the pandemic while it is still rampant in the US and Sweden.


Japan is an interesting one. They did next to nothing.

Life is almost back to what it was before atm. How did Tokyo not have a massive outbreak is an absolute mystery. But it did not.

Was it that 99% of people when told to started wearing masks and people do not hug or shake hands? We have no idea, no tracing, very small amount of testing, no house arrests of any kind.


They didn’t do “next to nothing.” They used a cluster-based approach through their public health center network, that was put in place to combat TB in the 30s. Turns out, that was pretty effective at combatting COVID.

> In 1935, with funding from the Rockefeller Foundation, Japan opened its first public health centre (PHC) in Tokyo. The country then put in place a programme that led to the building of another 187 nationwide. They survived the war and the occupation. But the thing of note is that before and after the war, their priority, says Taniguchi, was always to “stay watchful all the time” for the emergence of TB cases. If one was found, they were tasked with rushing to the patient's residence, checking for clusters and sterilising the house Seventy-five years on, 469 PHCs are in operation across the country, with each manned, on average, by 64 medical professionals, including one to two licensed doctors. They still locate clusters, track links and conduct tests. It is this “accumulated wealth of expertise, rarely found elsewhere” that has made the difference. Japan has not had to rely on mass testing strategies because it’s health care history had already left a cluster-crushing strategy embedded in its system

https://moneyweek.com/economy/global-economy/601264/cluster-...


> They didn’t do “next to nothing.” They used a cluster-based approach through their public health center network, that was put in place to combat TB in the 30s. Turns out, that was pretty effective at combatting COVID.

Also, IIRC, their culture is naturally more socially distanced than western ones (e.g. mask wearing was already common in some situations, bowing instead of hand shaking, etc.).


Mask wearing, yes. I’m not sure about the other parts. Unmarried people live with their parents well into adulthood. There are less children, so maybe that’s a factor. But most stores, restaurants, and other venues in Japan would seem cramped and overcapacity by Western standards.


America's rate was kept under control ever since the lockdown. As planned.


By definition a pandemic is not eradicated if it is still rampant.

Without a vaccine, Germany, Japan, Korea, Taiwan, and anyone else are still at the same risk they were five months ago.


not really: in five months we (humans) have gathered ideas on how to treat the disease; we've ramped up the production of masks, ventilators, tests, an so on; we've educated the population on how to be safer; we've set up special paths to manage infected people in hospitals so we can avoid contamination; we've increased IC beds; we've learned how to identify the disease earlier rather than just consider it a flu; and many other things.

Everyone is still at risk but the risk today is lower than 5 months ago.


Worst approaches? In what way? Certainly not in outcome. Just in your mind?


It is a doubling or tripling of other places. 5% of all deaths due to a single infection.

The US lockdown had concrete effect, limiting cases to what the hospitals could manage. Further, we understand more now (1000's of studies and papers published in a few months).

To compare blindly ignoring the disease and crossing fingers (Sweden's approach) vs wait-measure-respond, I know which way I prefer.


Doubling or tripling? Belgium 8.2, UK 5.8, Spain 5.8, Italy 5.5, France 4.4, Netherlands 3.5, Ireland 3.3, US 3.3.

The US lockdown may not have had any impact. Mobility trends are disconnected from government orders. The people more likely stemmed the tide in the US more than any government action.

Sweden is just marginally worse off against Covid overall than the US. And they didn’t have to spend $4 trillion or lose 40 million jobs to achieve that.


> Sweden is just marginally worse off against Covid overall than the US. And they didn’t have to spend $4 trillion or lose 40 million jobs to achieve that.

Sweden took less drastic action than the US. Sweden did take some action early, encouraging social distancing, increased hand hygiene etc. Then again, in Sweden you can take sick leave with full pay. More people will stay home if they feel sick.

Parts of the US took more drastic actions, but very, very late (during a pandemic where number of cases double every 4-5 days, one week is late, several weeks is very late). Shutting down borders to foreigners doesn't cut it when the virus is already spreading in the communities.

While they ended up in almost the same place, you really cannot compare them. The Swedish circumstances are so different from those of the US, that you cannot expect the Swedish same strategy to work the same way in the US.

And before you claim that the Swedish strategy is a success, consider how Sweden compares to its Nordic neighbors, where you can compare the circumstances.

Per 1,000,000 inhabitants:

    Sweden  4042 cases, 450 deaths
    Denmark 2040 cases, 101 deaths
    Finland 1247 cases,  58 deaths
    Norway  1567 cases,  44 deaths


But yet Norway's prime minister thinks they overreacted with their lockdown:

>Leaders in some European countries have suggested enforcing tough lockdown measures early in the COVID-19 outbreak may not have been entirely necessary.

>Norway’s prime minister Erna Solberg said during a television interview last week with state broadcaster NRK that its approach had been over cautious.

>“I probably took many of the decisions out of fear. Worst case scenarios became controlling,” Ms Solberg explained.

>She assured viewers that strict restrictions were imposed based on the international state of the disease at the time, but said that on reflection perhaps they were misguided.

[0] https://au.news.yahoo.com/coronavirus-norway-pm-regrets-not-...


Why are we cherry-picking Nordic neighbours? Because they happen to back one of several competing narratives? We can find plenty of other countries that have implemented stringent lockdowns and have similar or higher cases and deaths per capita.

That's the beautiful thing about these almost meaningless cross-country comparisons - the data is so low-quality and heterogenous that you can pick a pair of countries and validate pretty much every hypothesis with it.


The comparisons aren't meaningless, cause they are very similar. People who want to defend Sweden don't like how terrible Sweden looks. Because of idealogical reasons around locking down a lot of people want Sweden's strategy to work, and they torture themselves into weak arguments to justify killing a lot more people. If you can't compare them for some reason, then you basically can't do any comparisons because you ruled out their nearest neighbors.


That is exactly right - you can't do any cross-country comparisons, because the data simply is not comparable across countries. It can be used to a limited degree for tracking the epidemic within a country over time, and even that's got plenty of caveats. But cross-country comparison is a non-starter. Here's an incomplete list of giant confounders:

- for cases: how widespread was the testing? How quickly did it ramp up (e.g. how many tests per 1M in relation to 1000th case)?

- for deaths: what counts as a COVID death? Is death with COVID = death from COVID?

- how soon after the onset of the epidemic in the particular country were lockdown measures enacted? How long did they last? How stringent were they in reality vs on paper?


Well I think you can compare, but with caveat you have to compare amount of testing, and various other situations. I only see people who say "you can't compare" to be those who want to minimize their own problems. It's endemic to the US where multiple states have been caught reducing the numbers, firing the people who organize them and prohibiting them from talking about it.


So wait, if they are reducing the numbers, we'll then turn around and use them for comparison?

There are many countries who figured out how to play this numbers game. Russia, for example, faithfully reports any and all cases of COVID and simultaneously employs every trick in the book to minimize the number of deaths. They have already and will continue to win propaganda points from people who then use these meaningless death numbers to compare to another country's far more accurate death numbers and proceed to draw garbage conclusions from garbage data.


Again, as someone else up thread pointed out, you’re just comparing various notches on the “bad response” scale. Your calculus doesn’t work if you compare Sweden to Taiwan or the US to South Korea, even with adjustments to population.

If your argument is that “it doesn’t make that much of a difference choosing between doing nothing and pursuing a bungled, haphazard response,” then sure, a lot would probably agree with you. But these are not the only choices any of these countries had.

The economic damage is part and parcel of the overall mismanagement, which is why Taiwan and South Korea are doing better with both handling the pandemic and the state of their economies.


I specifically said Europe. You all are the ones who continue to move the goalposts.

In context of the European response Sweden is doing just fine. Japan and Korea have a different culture around surveillance than people in America or Europe. What worked in those two countries isn't relevant because Europeans and Americans reject that kind of surveillance.

Sweden has done about as well as any other western country in regard to the coronavirus and they did it without ruining their economy.

Sometimes I think people here on HN are just hoping the economy will tank.


I honestly hope the economy gets back to normal, I just think you need to have a rational and thorough response, like South Korea and Taiwan in order to do that. Otherwise, you’re talking about the possibility of regionally endemic disease with sporadic flare-ups that’s constantly throwing things off course.

You also can’t really shift goal posts comparing Taiwan to Sweden because we’re talking about a global pandemic that originated in China. It honestly doesn’t matter who’s doing best in Europe if people are better off in SE Asia, both in terms of economic damage and that caused by disease. Hand-waiving at “cultural differences” seems mostly an excuse because there is as much difference in culture between the high-performing countries in Asia as there is between the low-performing ones in Europe.


If "doing just fine" is code for "5-10 times worse than their nearest neighbours" (in terms of deaths per capita), sure.


You're cherry picking data points. JP Morgan amongst others have studied all the data and found no correlation or even declines in infection rates before and after lockdowns:

https://dailycaller.com/2020/05/20/jp-morgan-infection-rates...

Sweden is about middle of the pack. Most of that is because of the virus getting into care homes, which a lockdown can't prevent anyway given the staff have to come and go, and blocking the elderly from all visits forever is deeply inhumane. Given their age many of them would rather catch the virus than live longer but always be alone, and have said so.

So far it appears lockdowns didn't affect the virus much at all. However, they are definitely killing people if you look at the changes in suicide rates, the backlogs for cancer treatment that have built up and so on.

The problem with believing that Taiwan and South Korea are doing better for fundamental reasons is that it may simply be random. Japan did very little or nothing, probably due to trying to avoid the Olympics getting cancelled, and had similarly good results. The differences in testing levels and definitions between countries alone make comparisons based on reported infection and death rates meaningless.


"JP Morgan amongst others have studied all the data and found no correlation or even declines in infection rates before and after lockdowns"

This claim doesn't pass the sniff test, doesn't match a clear signal that anyone can see on graphs of data from Wuhan, NYC and Italy as well as other US states, and doesn't comport with our basic understanding of how infectious disease spreads. The fact that it's featured in a political website that uses the words "research... allegedly found" in its first sentence is just the cherry on top.


Our basic understanding of how infectious diseases spread is completely wrong, otherwise epidemiological models would correctly predict disease and they don't.

I don't really know how to answer your other objections. Their analysis looked at more countries than your list, your "sniff test" isn't a substitute for actual analysis, and the fact that a wide range of news websites summarised the results is to be expected (the actual report appears to have been sent to clients rather than posted on the web).

Here's a different source for you:

https://www.dailymail.co.uk/news/article-8347635/Lockdowns-f...


I can't even find the actual study itself, and the results Google produces are just a laundry-list of right-wing newspapers with an anti-lockdown agenda. With all that said, the summary of the research appears to be "in the immediate aftermath of a lockdown, when the lockdown hasn't even been fully relaxed yet in many jurisdictions, infection rates are lower than before the lockdown." This isn't exactly big news. (Also, the study is out of date: rates are now spiking in a number of states that have moved out of lockdown.)


I can’t really parse this “article,” which appears to be from a right-wing opinion site, mostly linking tweets from a CNBC anchor.

Taiwan and South Korea being random seems a spurious claim. Taiwan’s Vice President is an epidemiologist invested with a great deal of executive authority in dealing with public health crises and has guided the country’s response from the outset. South Korea was trending in a quite bad direction with the church outbreaks and quashed them through massive interventions in testing and mobile hospital capacity. And neither country has mass-scale lockdowns like the west (because they didn’t need them).


Taiwan and South Korea also had first hand experience with SARS, and were much better prepared for COVID. Mask wearing was already a thing there, they had supplies, and they had contact tracing in place and ready to go. They did a good job with this.

Other countries can invest in the same readiness. It's always a decision of limited resources and many opportunity costs (poverty, infrastructure, climate, security, etc).

Different countries with different experiences and difference cultures will make different decisions. That's ok, that's how it should work. Can't have it any other way in a democracy, right?


> Different countries with different experiences and difference cultures will make different decisions. That's ok, that's how it should work. Can't have it any other way in a democracy, right?

Sure, but both South Korea and Taiwan are wealthy liberal democracies. I know this isn’t your intention, but a lot of commentators seem to appeal to some kind of Western exceptionalism, completely refusing the examples of SE Asia democracies as a valid measure of comparison. To me, that seems like insanity, because again, they’re also wealthy liberal democracies and have had the best-in-class responses thus far.


A vaccine which might never come. Or which may come in a year or more. Or which has side effects.


Just the beginning of it. There are antibody treatments, new knowledge about ventilators vs oxygen, triage and testing advances. All because we took the time for that.


Here are the deaths per 1M for few countries around Sweden's death number. Even ignoring Italy which was affected first, all other countries deaths per million are within 2% of each other. What is alarming about Sweden's numbers?

* UK 585

* Spain 580

* Italy 556

* Sweden 450

* France 445

* Netherlands 350

* USA 330


Here are the deaths per 1M for few countries around Sweden's death number.

Why that restriction? Let's expand your list a bit more, shall we:

* Portugal 142

* Germany 103

* Denmark 100

* Austria 75

* Finland 58

* Norway 44

* Czechia 30

* Poland 29

* Greece 17

The contrast between Sweden and its nearest neighbors Denmark, Finland, Norway is kind of glaring...


A chart to help visualize some of those countries...

https://i.imgur.com/WrYORJL.png


You are 100% correct about the world looking at Sweden through a lens to validate their own opinions (and enacted strategies) about how best to deal with the virus.

I've watched over the last few months as people in the US flip flopped:

Center-left folks who cite Sweden as an economic model but trashed the way they handled the virus due to their support of lockdowns.

Center-right folks who normally claim Sweden is nothing like the US and therefore we can't emulate their economic policies, but then point to them as a model for reopening.

Similarly, every single mention of antibody tests on here results in a similar collection of highly-intelligent people not recognizing their own drive to validate their preconceived beliefs.


We're more susceptible to god complex because we're highly skilled at one thing already. We also don't want to admit to ourselves that we're living through a confusing time that we can't make sense of in them moment.


I have lived in Sweden, and see why people living there would believe that Sweden’s policy is normal. But it’s not. It’s not only killing Sweden’s population but also recklessly endangers the rest of the EU. I really hope borders stay closed towards Sweden


I can only speak for the parts of Sweden where I live and socialise, but I know of no-one who things our policy is "normal", whatever that means. It is some kind of myth that we are ignoring the risks and pretends like nothing is happening. Lots of restrictions, just not as strict as it could have been.

That part about recklessly endangering Europe (!) is hyperbole, UK, Spain and Italy has more deaths capita but apparently the EU can handle them, so...

* Source for death per capita is https://www.worldometers.info/coronavirus/#countries. I've heard something about them not being fully reliable, but the death statistics should be comparatively easy to aggregate, so I'll use that number unless obviously wrong.


Hyperbole or not, Sweden is going to have to live with being excluded from a lot of EU & international travel relaxations.


I would suppose the world's obsession would be seeing a lot of people dying and thinking in a perhaps mistaken way "that seems unnecessary" and then being upset enough by this idea to not think as highly of the Swedish government as it might otherwise wish people to think of it.

A lot of course being in the eye of the beholder.

I think that seems a less cynical and perhaps simpler explanation for why people would be obsessed with Sweden.


Let me try to rephrase it in a less cynical manner, best as I can.

It seems to me that Sweden's strategy is attracting more attention (in form of primarily criticism) than f.x. Belgium's, despite the latters deathrate being ~2x that of Sweden's. To me that indicates that the issue is the strategy in itself, and not the magnitude of the failure of it. Other countries have failed worse (although thankfully the vast majority of countries are currently doing better than Sweden, hopefully forever). Why would people care about 4000 dead in a small country far away, when many don't give a damn when 4000 people die from starvation or malnurishment?

Because it says something about _your_ country and _your_ strategy.

For me that is the simplest and not at all cynical interpretation of this. I will admit this is speculation, but I don't think I claimed certainty.

PS. I'm _guessing_ our Achilles tendon is certain organisational deficiancies in the care of the elderly. How it's done and at what stages of life one is moved between different kinds of care. Even if I'm right (big if) I fear that the outfall from this might be "me caveman gruk, weak restrictions bad for COVID19, dum-dum-donut", or the equivalent opposit. That would be sad. PS.

PSS. Belgium seems to be the most "liberal" country in terms of including suspected COVID19-related deaths in the official statistics, but those are the numbers at our disposal. DSS.


Maybe but I think in the case of media attention on the strategy - I'm sure you're aware of the saying that man bites dog is news and dog bites man isn't. Sweden is trying a notably different strategy than most everyone else - that makes it newsworthy.

Then there is another saying - if it bleeds it leads. Sweden has a high percentage of deaths in comparison to a lot of other countries. Two uncommon things make interesting news in the media's calculation - now what story to construct about these uncommon things. The story is pretty obvious given the parameters.


but other countries are having worse results due to mismanagement by their authorities, and yet are not at the center of the public discourse.

I am inclined to agree with grandparent's comment: there is a lot of "we did better then them!" at play in the media.


Countries have various institutions and organisations tracking and reporting on the virus within their borders. Then there's the press and the locals publishing info on various channels.

One doesn't need to set foot in Sweden to form an opinion about how things are going.


You are right. I meant to point out that for some significant proportion of people, Sweden are in these circumstances not a country, but a tool to prove their point. And unless one is careful, which some people are, one will reach whatever conclusions one is looking for simply due to lack of resolution. From far away enough you can come up with the details yourself...


I agree with this.

It scares me that there are people (even in this thread?!) who say Tegnell is some wicked scientist experimenting on the swedish population.

Feels like some people read a buzzfeed article on viruses and suddenly they are an expert that somehow figured out the things that the government agency for national health did not. "No, my extremely limited knowledge about virology tells me that I am right and the only logical conclusion is that Tegnell is a wicked scientist". For gods sake... Grow a brain, will you?


Heh, I don't think Europeans get to get their tails up given that they are the world kings and queens of criticizing everybody else in the world.


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.


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?


> 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).


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.)


That's only assuming we never get a vaccine or an effective treatment. If we do, then the number of people to die before that point matters a lot, because we would get a sharp decline after.


In addition to your points, another reason for "flattening the curve" is to give time for hospitals and health care systems to prepare for a spike in cases, so that every patient who needs critical care can receive it. For countries like Italy that were hit at the start of the pandemic, this was a serious problem.

Where I live, in Victoria, Australia, the state government has used the lockdown time to plan for and deliver a huge increase of ICU beds [1]. Thankfully, it looks like these beds may not even be necessary, but initial modelling suggested a peak of 10,000 active cases with only 500 IUC beds available.

[1] https://www.theage.com.au/national/victoria/thousands-of-bed...


Precisely. I've simulated this numerically and shown that the curve of [deaths]-vs-[duration of widespread economic crisis] is concave, like an inverted parabola that's been truncated by eventually getting a vaccine (or effective treatment).

Perhaps counterintuitively, the points on the strategy curve that have both lowest death counts and shortest widespread economic crisis are the same. I've published these simulations here: "Surprising COVID-19 Strategy: Reduce Economic Damage and Deaths Simultaneously" https://www.youtube.com/watch?v=NuNrkG188HA


The Swedish assumption (not officially, but what I take away from communication is what they assume)

- No effective treatment or vaccine will arrive within a year.

- Measures that completely eradicate the virus aren't sustainable for the time it takes to do so or until a vaccine arrives (e.g. lockdowns),

- Without at least some immunity, "Test, Trace, Isolate" is not a viable strategy for dense regions.

- Without at least some immunity, a second wave is unavoidable, and risks being worse than the first, if it arrives early next season. It's better to have a small immunity in the low risk population now, than let risk high risk groups later.

- Even a small level of immunity has a large effectiveness in limiting spread, i.e. 10% or 20% immunity in a region can make a big difference, so if that can be achieved in the low risk population that is a good thing.

- Asymtomatic spread, presymptomatic spread, and spread from children are all possible but not significant (That is: if symptomatic spread is controlled, that is enough).

Some of these assumptions have been challeneged, some were not at all controverrsial to begin with but have changed over the last months.


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.


> surprisingly easy to stop the spread, but the death rates are higher.

Are they? The current IFR estimates (general, not counting age divided groups) range between 0.2 and 0.9%. That might still include a significant number of individuals, but it's not very high (of course by age groups, this changes).

I still wonder whether the high death rates in some countries, including my own, were not due to the virus itself being very deadly, but because it found "niches" of vulnerable people (hospitals, nursing care homes). I don't think anyone has yet studied these dynamics in depth.


Early random sampling in Sweden indicated a IFR around 0.2%, but the more recent antibody test points to 1.1%, putting the expected final death toll up an order of magnitude


Death rate is smaller than it was initially thought to be afaik. Under 1%.


Why compare with Portugal? Why not compare with some other country with similar deathrate as Sweden but completely different choices? Maybe because you assertion about "very bad choices" then wouldn't hold any water.

It might still be true, but the actual support for it seems to just be cherry-picking.


If you believe that feel free to provide an example, so we can discuss it. Your post is just FUD at the moment.


Rereading my own post some hours later I don't like the tone of it, so I'll willingly appologise for that. This might warrant a FUD-claim (I had to look up FUD to start with).

The point I was trying to make, which I don't at all think is based on fear, uncertainly and/or doubt, is that any two countries will differ on so many variables that one can almost freely pick what correlation one thinks is the important one. To do something akin to that and the go "shame on you" feels wrong.


Honestly, I wouldn't trust the numbers reported by the Portugal, in particular the reported number of daily COVID-19 deaths, I feel the numbers are being misreported.

I have been closely following the progress of the situation in the country and the leadership is very messy and very clueless about the entire situation, both from the government and from the portuguese health agency in particular.



You don't know what's causing the deaths. Maybe it's lockdown/fear: we know that fewer people are seeking medical treatment for non covid related issues, fewer organ transplants are happening, fewer cancer screenings occuring, etc.


The excess mortality rates definitely lie, unless you believe that the coronavirus is bringing dead people back to life in Finland.


-10% means that the death rate is 10% less than normal. 90 people dead instead of 100. Not that 10 people are no longer dead.


Unfortunately we have a 'mini-outbreak' in the greater Lisbon area right now with 90% of new cases - previously this had been masked in the overall numbers by success in the North of the country, which was hit first, and hard (something similar happened with US data, NY's better numbers hid a growing problem elsewhere).

Data for each county in Portugal is available here: https://github.com/dssg-pt/covid19pt-data/blob/master/data_c... - graphing this data shows that Lisbon and its surrounding councils have been putting on new cases at a steady rate (linear for now!), albeit low numbers in the grand scheme of things. I don't know what the Portuguese government is going to do about that, or how effective their action may be. I live nearby, so I am particularly concerned.


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.


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.


It failed in terms of their own goals.

The actual spread of the virus is a fraction of what Tegnell predicted. They were predicting close to 60% by the end of May. It was in the low teens with about a week to go in May in Stockholm.

Their primary goal was to protect the vulnerable ie the elderly. But Tegnell did not believe in the existence of asymptomatic carriers (well after other countries had locked down because of them) so care workers who were infected but not showing symptoms were in constant contact with the elderly since his guidance required them to avoid going in to work only if they showed symptoms.

Both of these were the primary stated goals. Neither were achieved.


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.


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.


And the politicians should have put in that severe, very expensive effort. But that would have required them to be fast, which is not a very Swedish thing. Everything is extremely decentralised and in many cases privatized.

Either the state (highest level) should have forced an intervention, or all actors should have acted responsibly. But there is too much inertia. The elderly care is so poorly managed, it was not only a disaster waiting to happen, it actually was a slow burning dumpster fire even before Covid19.

So many wasted opportunities.


How would they do that? I think it's safe to assume right away that the companies aren't going to act responsibly, because, well, they haven't for years. So that leaves the state, and what should they do?

Not like they can push a button and invent more caretakers, fix internal routines, etc, across an entire country.

I'd love it if they could, but in general, there is going to be inertia when trying to affect change in a system that has been degrading for years, with actors actively working against those changes (in this case, companies putting profit over welfare).

It's so very, very easy to say "the state should have done something, fast", but it gets very difficult when you're trying to specify which parts of the state should have done what, to which actors and on which level.


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).


I mean, way more people died per capita than their geographic/cultural neighbors. That seems like a pretty clear failure.


So far. The more "successful" countries will catch up when their populations get tired of being locked down and the second wave comes.


Norway is right next door, and did a lockdown, but has opened up and will open up more shortly.

It will be very interesting to see how things go in Norway compared to Sweden in the next weeks and months.


Germany has been slowly opening up for a month or so and this hasn't happened: https://www.worldometers.info/coronavirus/country/germany/


Yet.


Your argument has been repeated a number of times through this thread and it's bogus. Sweden's policy is already a failure because its economy has been affected to much the same level as other similar countries while experiencing a much higher death rate. And other countries are now opening up again to each other, while Sweden has become a pariah.


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.


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.


Economies are already re-opening to each other and Sweden is being excluded. So no, Sweden has already failed.


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-7... [2] https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-over...


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-coronavi...


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.


They weren't under any effective quarantine. That was the big problem. I think that the biggest problem in Sweden has been that FHM (the public health agency) went out and said very clearly that the elderly were very vulnerable and needed protection. FHM thought that would be enough action from them. Unfortunately the care givers didn't take that seriously enough, so a lot of temporary workers came and went in the nursing homes without proper routines or equipment.


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.


Care takers have been forced to work with symptoms, and there's even one known case where a woman went to work at her care home after testing positive for covid-19 and staying quiet about it.

This would not have changed with a different strategy.


The actual execution of how elderly care is run, is very sloppy too. Lots of people come and go and didn't even use any PPE because there wasn't any.

Also not washing hands, and using PPE incorrectly, and so on.


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.


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.


You do not even have to close borders long-term to be a success story. Croatia (an EU country) shares both land and maritime borders with Italy, and a lot of Italians have property in Croatia that they go to on the weekend. So far, there have been 103 deaths and 2,246 cases, with a population of 1.4 million.

Croatia has not had a single case of COVID-19 for 3 days in a row [1], and has been allowing citizens of several European countries, including ones like Germany, come there [2], since mid-May.

This stuff is not rocket science, and while Croatia will not completely eradicate COVID-19, which is unfortunate, it still is impressive.

[1] https://koronavirus.hr/en [2] https://koronavirus.hr/frequently-asked-questions-and-answer...


Please do not post the same remarks verbatim and the same links multiple times in a discussion, it is not good netiquette.


While it's admirable, Croatia has 2 / 3 times less density of population than Italy. Lombardy alone has twice the population of the whole Croatia and 6 times it's density of population. It's hard to make comparisons


The comparison is not between Croatia and Italy, but between Croatia and Sweden. In the case of Sweden, it has approximately 1/3 of the population density of Croatia.

The fact that Sweden does not have a coronavirus hotspot as a neighbour further indicates that the Croatian outcomes have been much better.


Sweden has a low population density yes, but that's irrelevant - most is unpopulated land, which doesn't have an effect. If you count Greenland when measuring the population density of Denmark, it's super low, but that would be ridiculous.

More relevant measures would be things like urbanization, where Sweden is number 23 in the world and Croatia number 104 (by https://en.wikipedia.org/wiki/Urbanization_by_country). Or, perhaps, the population density of the most dense areas (5,200/km2 for Stockholm, 4,055/km2 for Zagreb). These are just examples of possible metrics, of course there are many more which might be more relevant, but population density of the entire country has no relevance at all.


"it has approximately 1/3 of the population density of Croatia"

Not really. Sweden has a low population density (23/km²) because most of the country has no one living there. The Stockholm region, where the spread of the virus has been the highest, has a population density of 5200/km².

(Numbers from wikipedia)


NZ also needs migrant workers for agriculture, and guess what, we don't have them, and yep, it's causing issues.


So what if New Zealand is an island? How many people are walking to Sweden?


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.


You can close roads and bridges. You can punish people who try to cross in secret.

There may be reasons why you would choose not to close the borders, but it's a choice.


NZ does rely on quite a few seasonal workers from overseas. Some are currently stuck here: https://www.stuff.co.nz/national/300025484/seasonal-workers-...

That article says 14,000 workers/year from just the Pacific. Not sure of the total, and it's probably not large by European standards.

Our borders have been very effectively closed the last few weeks though. The fact that 56 Avatar film crew people have just been let in (on a chartered flight, after testing negative, and now spending 14 days in quarantine) has been quite contentious: https://www.stuff.co.nz/dominion-post/news/wellington/121681...


In southern Sweden, people are still daily commuting to/from work in Denmark over the bridge and ferry connections


That's actually a fair point. Why does the islandness matter?


Right, and smaller island countries like Iceland were able to go for border-line eradiction without a full lock down.


Do we have a good understanding of what the economic impact was in New Zealand? I can't find any unemployment numbers - they haven't released anything since March, before the pandemic took hold. But Sweden's unemployment rate of 7.9% and rising (from the article) is still much lower than the current US numbers - around 20% [1].

[1] https://www.cnn.com/2020/06/03/economy/may-jobs-report-previ...


The NZ Treasury forecast (made 3 weeks ago) was that unemployment would hit 9.8% by September. I can't find any numbers for the current rate though.

https://www.rnz.co.nz/news/political/416633/budget-2020-50bn...


Almost half of retail tenants have not paid their May rent:

https://www.stuff.co.nz/business/121704549/almost-half-of-re...



How quickly people are unemployed varies. In the US you might be able to fire someone on the day, but in Sweden or Germany it might take 1-6 months from that you give notice until you can stop paying them and they are officially unemployed.


New Zealand is not comparable to any other country really - the geographical location, isolation, culture and way of living etc makes it ideal case for a lockdown based approach.

It is not feasible to lock down Brazil or Mexico - more people would die because of the lockdown.

As for the Swedish approach - the rest of the world hates it primarly because long term it might just prove that the lockdowns were both ineffectual and unnecessary perhaps even more damaging.


Countries quite different to NZ achieved (near) elimination with a lockdown approach. Vietnam, for example. Other countries have been successful without a lockdown, e.g. South Korea. There's more than one way to beat this virus. New Zealand even made some big mistakes to this day --- not encouraging mask wearing, not testing people in quarantine --- and still pulled it off. Beating COVID19 is not easy but it's not crazy hard and you don't have to be an island fortress. Seems to me there's a lot of special pleading going on to rationalize failures of leadership and execution.

OTOH I agree that lockdowns in many countries have been very poorly done. In particular, a lot of countries have used lockdowns as a delaying tactic with no clear strategy for eliminating the virus or avoiding endless cycles of infection and lockdown --- certainly no clearly communicated strategy. In those cases, indeed a relaxed lockdown with more infection might be better in the long term.


> the rest of the world hates it primarly because long term it might just prove that the lockdowns were both ineffectual and unnecessary perhaps even more damaging.

This is already what it's looking like when comparing across states in the US.


What I do not see anyone talking about is the economic and social effects of having closed borders for 1.5+ years (until the population is sufficiently vaccinated).

NZ's tourism industry is a large chunk of their GDP and will be reduced significantly until borders are open again. Re-opening borders after elimination is political suicide as all you need is one person to start the whole thing again.


NZ tourist spending was 60% domestic pre-COVID. A lot of outbound tourism also happens that will be going domestic now. We also expect to have a "travel bubble" with Australia and possibly other countries where COVID is effectively eliminated --- Australia was 50% of international visitors pre-COVID.

Other affected industries are international students and TV/film production. We will be admitting people for those with at least a 14-day quarantine and testing. That's not much fun but if you're a student or a media producer NZ looks like a particularly good destination at this time.

All assuming we can keep COVID down, of course, which we shouldn't take for granted.

Yeah, our economy's going to hurt, but countries wracked by ongoing COVID and various levels of lockdown for the forseeable future will suffer worse.


I thought the borders would reopen once we exit alert level 1? They're not planning to drop out of level 1 for 1.5 years? I hadn't heard this.


I don't think there's any information on how long level 1 would last. I am just wondering what the strategy on borders would be if you are going for elimination.

Surely once you have opened the borders it is only a matter of time for a new case to be imported (if you look at NSW right now, we've had a week of no local transmission but near-daily new cases for returned travellers, who are luckily in forced quarantine).

You could force-quarantine everyone for 14 days but I would not call that an 'open' border and it wouldn't do much to help the tourism industry.


> near-daily new cases for returned travellers, who are luckily in forced quarantine

How do you do that though? People arrive at the airport and take a taxi or train to a hotel? Thst's how a lot of the early spread started in Sweden: tourists returned from skiing in the italian alps in the last week of February, and infected taxi drivers.


I am not quite sure how the transport works here (Australia) but it's most definitely not a random taxi.

The hotels are paid for and organised by the government and are guarded to ensure no one goes in/leaves, so I assume the transport to the hotels is also tightly monitored and the safety of drivers is ensured.

I believe China has similar procedures.

Before the hotels we had self-quarantine and that actually caused an Uber driver to become infected when he drove a cruise ship passenger home.


Once the number of cases falls below a certain level it becomes feasible to test every visitor, contact-trace every infection, and only quarantine the people who need it.

This is a strategy that has worked well to fight other communicable diseases for which there is no vaccine.


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.


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%.


The 7% figure is also for the Stockholm area


> 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.


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.


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.


«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.


> the people at risk are mostly people at the end of their life

The estimates I have seen suggest that the people dying lose, on average, 10 years of their life. That's not exactly insignificant.


10 years is the average life expectancy of a person that is between 75 and 80 years old in North America.

So on average everyone dying at that age loses 10 years of life.

75 to 80 years old is also the mean age of death from covid.

Im going to go out on a limb and say that it is likely that people on average that die from covid do not lose 10 years of life.

This does not make it less of a tragedy for the individuals involved.


The study in question does adjust for long-term health conditions: https://wellcomeopenresearch.org/articles/5-75


Thank you. That was interesting.

I am skeptical about the methodology and the results of the paper.

It does not make sense to me, and it looks like the authors knowingly chose to increase the YLL with the choice of their data sets and how they analyzed the correlation between covid deaths and comorbidities.

I’m happy to admit that I might just not fully understand it.


> 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.


> There is no convincing evidence that Sweden’s approach has led to a materially worse outcome

Four thousand people would like to have a word with you, but can't, because they are dead.


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

Total deaths: https://i.imgur.com/do9Zbvn.png


Masks can do wonders


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.


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.


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/wh...


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.


> 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...


  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.


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/...

[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])


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.


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.


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.


It is worth noting that the "self-imposed" lockdown and social distancing is due to the recommendations (and in some aspects regulations) made by FHM (the Swedish department of health where Tegnell works).

I've seen this sentiment elsewhere that "Swedes have taken it in their own hands", no we are _listening_ to our experts on what to do (in many cases, people seem to have a harder time now that there is some sun out..).


Countries where people don't listen to the experts and think for themselves have done much better:

https://i.imgur.com/do9Zbvn.png


> Those scientists in Denmark, Germany, Switzerland, Finland, Norway, France, Spain, Italy are as good as Tegnell is.

I can't speak well of the Italian expert panel. On the day of the "reopening" (not a reopening, but I digress), May 4th, they quoted a non-public report saying that the worst case scenario (out of 92) would bring 150,000 Italians needing ICU care by June 4th. AFAICR, no other scenarios were made known.

The report was then leaked (or made known somehow). It had no author information, and contained a lot of old and inaccurate models, and totally arbitrary and unjustified statements. In short, it was utterly wrong.

A critique of the report (in Italian):

https://www.scienzainrete.it/articolo/fase-2-e-alcune-questi...

(second half, the first part is about some questionable policy decisions from a legal standpoint)

Some Italian experts also say that physical distancing and masks are useless (supporting an indefinite lockdown). The government itself said that masks were not effective until very recently.

There is also a lot of confusion (for the lay person) because many contradictory statements are often said.


> 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.

That 40,000 number is "people who died, after testing positive, with a test administered by a Public Health or NHS laboratory"

The actual number (excess mortality) is closer to 60,000.


Giesecke has no official position. He's an attention-seeking troll.


He is, however, the former state epidemiologist, Anders Tegnells former boss, and - as was recently reported in the big dailies in Sweden - is currently working as a paid consultant informing the Swedish strategy. Quite the influential troll...


Giesecke had Tegnell's job (State Epidemiologist) 15 years ago. He claims to have recruited both Tegnell and Tegnell's boss Johan Carlson to folkhälsomyndigheten. (FHM)

He has furthermore been a paid consultant for FHM for many months now. So he is not just anybody.


Deaths in Sweden are at their highest level since 1993:

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.


First of all, while the 1993 flu pandemic in Sweden was a severe one, the total number of deaths linked to the flu in 1993 is 566, according to the Swedish Central Statistics Bureau.

Second, there was also a massive (and local) financial crisis in Sweden during 1992 and 1993, resulting in mass unemployment. The federal interest rate peaked at ~500% in 1992. While influenza deaths are always tragic, the financial crisis is what most people will remember from those years.

Also, the population was roughly 15% smaller in 1993 compared to 2019, not 25%. No matter how you measure it, COVID-19 has proven to be far deadlier over the span of a few months.


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.


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.


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...


> 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".


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.


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.”


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-behin...


Actually, both articles are based on the same quotes – just very different interpretations and headlines.


This is the situation in a nutshell. Would be comical if the topic was different.


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.



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?


This is what authorities like the FHM (the public health authority does every day). You use tools like counting QALY, for example.


But how do you equate or make commensurable those different measures? How many job losses equal a lost life year?


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.


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/PIIS2215-0...


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.


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.


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.


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.


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.


Also the way countries report deaths may be different.


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


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.


Tegnell has been openly discussing mistakes they made for at least a month:

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.


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.


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.


I assume you've never looked at a Swedish newspaper then, they've all been full of criticisms and discussions since the start.


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...

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?


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.


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

The very existence of this programme was a secret until the early 2000s, and to this day continues to be a taboo in Sweden.


> 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.


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-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/statsepidemiolog...

[2] https://www.nytimes.com/interactive/2020/04/21/world/coronav...


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.


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.


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/


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.




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