I remember people praising Sweden's strategy for one important reason: they can do it indefinitely, while more stringent lock-down measures will fail because people will get tired of them and ignore the measures. It made perfect sense. By all indications, Sweden should have enjoyed a flat and sustainable level of infections. While this level may have been higher than neighbouring countries, the fact that it would have remained constant while other countries' would have surged as governments loosened restrictions and people stopped paying attention to them meant that Sweden's was the winning strategy for a pandemic that would be with us for several years.
Why did this not pan out? Why is Sweden seeing a second wave as well? Why did the number of infections soar, while it should theoretically have remained constant?
This doesn't answer your question, but it's worth pointing out that what "worked" for Sweden wouldn't necessarily work or flatten the curve elsewhere.
Sweden has a healthy population, tons of spare healthcare capacity, inexpensive healthcare, a high propensity to social distance, an outdoorsy culture, low socioeconomic disparity, and very few people living in multi-generational households. The US, sadly, has none of that.
Also, Sweden did have a few restrictions in place. They shut down high schools and universities, and strongly encouraged WFH if possible. Arguably, most of red state US had even looser restrictions than that.
HN's perspective on lockdowns might be skewed by the fact that most of us here live in places that actually did have a good faith reasonable response to COVID, but it didn't really work in the absence of a coordinated nationwide response.
>HN's perspective on lockdowns might be skewed by the fact that most of us here live in places that actually did have a good faith reasonable response to COVID, but it didn't really work in the absence of a coordinated nationwide response.
...care to expand on this hypothesis? I've heard variations on a theme around this. I live in an area which seems to have close to 100% mask compliance for the last several months as near as I can tell, and we still have cases increasing. I guess I'm having a hard time believing that it is visitors from Texas (or where ever) coming in and spreading coronavirus. What it seems to indicate to me, is that public shopping, etc. isn't a driver behind the spread.
Exponential growth can get out of hand very quickly. It doesn't take too many people to mess up, break rules, or get unlucky for this virus to erupt.
Also, way more people are indoors in November in Sweden than August. Many people travel to remote cabins in the summer - August in Stockholm is about as deserted as San Francisco during Burning Man. They're mostly back by September, bringing more people in proximity. I'm in Seattle and Washington is locking down again, as colder temps have brought the long predicted fall spike.
If those in power knew a Fall spike would likely occur, would it have made sense to encourage healthy people to seroconvert during the summer, when the flu is less prevalent? Instead, this was purposefully stretched into the flu season.
I don't understand why "fear and lockdowns" are equated here. Lockdowns aren't an agenda on their own - it's because of the virus, which exists whether you do a lockdown or not. I guess people believe that the virus is nothing to be scared of, and so then they believe that people fearmonger to whip up support for a lockdown, but this belief makes zero sense to me - why would anyone be in favor of a lockdown if the virus isn't dangerous?
it seems politically safer to do "something", than to do "nothing". if the lockdowns stop the virus you're a hero, if they dont, you're still a hero for thinking of the children... if instead you do nothing, and things get better, you're just seen as lucky, if things get worse, you get to take the blame.
That depends which pox. For chicken pox (varicella) before we had an effective vaccine almost everyone got infected at some point. The effects were more severe for older people so it was safer to catch it as a youth.
It was predicted because the change in weather causes more people to be indoors, and poor indoor air circulation is a big contributing factor for spreading. Same with the onset of the hot weather and A/C in the US South in May, around the time cases started increasing there.
Also, catching Covid sucks for a lot of people, even if they survive. Encouraging people to catch it during summer seems pretty irresponsible.
Seroconversion was avoided because it's potentially deadly. And while you're waiting for a vaccine to get ready, it kind of makes sense to spread things out.
Who benefits from fear? I'd guess weapons companies.
Who benefits from lockdowns? No idea. Pro gamers?
I can't really decide if you're posting here to stir up a reaction or if you are strongly convinced that seroconversion is a good idea. But just for the sake of discussion, you should consider that the chance of side effects is high enough that many people would actively resist seroconversion. So my guess would be that people who consider that to be a great idea are a 5% minority. That's why governments will likely not do it.
Japan did it. Japan learned from the docking of the Princess cruise there and the results from each passenger. Those results were quite interesting.
And death rates by age group are revealing. The young without co-morbidities have great prospects.
September Tokyo study said,
"Boston Children’s Hospital and Beth Israel Deaconess Medical School, Boston, say their study suggests that seroprevalence for SARS-CoV-2 rose to almost 50% ..."
That study uses seroconversion in the meaning that a previous infection becomes measurable.
But when people suggest active seroconversion they usually mean that you start infecting otherwise healthy individuals deliberately to increase herd immunity.
So while both groups use the same word, they mean quite different things.
With even healthy people dying or having long term if not life long health impacts, was it really "incompetent" to prevent people from taking those risks?
Your sentence makes very little sense to me because the seroconversion has a high chance of causing life-altering side effects. I'd say it would be irresponsible to suggest that to the general public.
There's a counterfactual logic flaw there though. How do you know ahead of time that a healthy person would recover nicely? There are plenty of counterexamples. If you respond in a utilitarian manner, well then you have to compare it with other utilitarian approaches.
Nobody benefits from fear and lockdowns, that's why the conspiracy theories around them are so fucking stupid.
We did not encourage healthy people to seroconvert during the summer because achieving the necessary numbers of infected would have caused millions of deaths. This was the UK's original plan and they backed off when they actually ran the numbers and saw how many fatalities it would require.
As a person who lives in Sweden, here is my best guess. While we did not have mandated lockdowns, there was relatively effective, voluntary limitation of indoor social gatherings throughout the summer, which limited the spread of covid19. Sure, businesses mostly stayed open, but Swedes tend to try to avoid each other to begin with. Asking some Swedes to stand 2m apart in a store would be asking them to stand closer together than they would prefer.
Swedes spend a lot of time outdoors, especially in the summer. (Not suggesting more than elsewhere; most places seemed to have better numbers in the summer.) Now that the weather is turning less pleasant, more people spend more time indoors. Therefore, transmission is rising again.
> Sweden should have enjoyed a flat and sustainable level of infections.
So I think therefore that this didn't really happen, which means now we get our second wave. In some places, such as the nearby town of a few thousand, we are actually only starting to get a first wave as we never really had a first wave yet.
Still almost no mask wearing, though. Not sure when or if masks will happen here, although I have seen packs of them at the market now.
Again, I am no expert and I have not looked at actual transmission numbers throughout the summer etc. This is just my best guess.
Edit: What I mean is, I don't think most regions of Sweden had sustained levels of transmission during the summer, in case that wasn't clear.
What makes you think the number of infections should remain constant? Studies suggest up to 20% of Covid cases are asymptomatic - those people wouldn't know to follow any guidance/regulations on isolation.
The basic R0 is believed to be around 5.7, so even with precautions such as social distancing, masks, and hand washing (which won't be followed flawlessly), it's still trying to mitigate something outstandingly infectious. You need to bring the R0 to 1.0 for the number of cases to only increase at a constant rate, as for anything above 1 every 10 cases will lead to more than 10 new cases, which compounds as it spreads.
> Why is Sweden seeing a second wave as well? Why did the number of infections soar, while it should theoretically have remained constant?
I think we can now conclude that covid19 behaves seasonally, just like other respiratory viruses.
But nobody knows exactly why. There are many theories, but none universally accepted: Summertime higher vitamin D levels from sunlight, maybe this gives better immune defense. Sunlight disinfects surfaces. Colder air is dry, respiratory droplets stay afloat longer and spread better in dry air. People's mucous membranes stay healthier in more humid air, maybe they are more susceptible for virus attacks in dry air. Maybe the patterns of how much people meet each other indoors is different in cold weather.
> Why did this not pan out? Why is Sweden seeing a second wave as well? Why did the number of infections soar, while it should theoretically have remained constant?
I have no idea whether this is actually the case in Sweden or not, but it seems like one possibility could be that people/businesses were originally taking additional measures beyond what was legally required but then stopped.
The previous strategy was to "flatten the curve" and nothing else. There was no vaccine or very effective treatment and this could go on for a very long time. The previous strategy was optimal for that problem.
Now that multiple vaccines are around the corner, minimizing infections can most definitely save lives. Would they have done better if they had been stricter? Yes. But there was no way to know this back then.
Imagine that there was no vaccine and the pandemic became an endemic that nobody could escape... and the only viable option was herd immunity. Had that happened, the Swedish strategy would have put them ahead of most. They would have taken a smaller hit to the economy while not losing that many more lives in a given period (do note that, in that case, the period would have been much longer and most of those who died last year had pre-existing conditions and something else would have most likely killed them within the next few years anyway).
The focus on rate of infection, as if that should be minimized, is misplaced. It would be reasonable to protect the vulnerable and focus on allowing healthy people to seroconvert to move the overall population to herd immunity.
You seem to be fixated on intentional seroconversion as an effective strategy we somehow "missed", but the experts (i.e. epidemiologists) seem to be pretty consistent that this is a poor strategy. Why are you convinced otherwise?
The null hypothesis is that the differences in death rates between countries are mostly a matter of luck and timing rather than caused by pandemic control measures (or lack thereof). Only a few countries have successfully contained the virus: mainly New Zealand, Vietnam, and possibly Taiwan, China, and Australia. For other countries which still have widespread community transmission we may see the per capita death rates gradually converge (after adjusting for population demographics).
To be clear I'm not claiming that all pandemic control measures are ineffective. We just don't have strong scientific evidence that they are effective at the national level over long periods. Sometimes things just happen randomly. Is it possible that Sweden just flipped the coin to heads a bunch of times in al row and now it finally came up tails?
I should have included South Korea in my list. But for those other developing countries we don't have enough data to conclude whether their containment efforts have been successful or not. They generally haven't done a lot of widespread random population testing. And their population demographics would lead to low per capita death rates even absent any pandemic control measures.
I don't know what is this strong focus on Sweden, they are just 10 million people with a small population density spread all over the Scandinavian peninsula. There were some herd immunity fans discussing on the Turkish TV about Sweden and how their model can be applied to Istanbul but they forget that Sweden has only 2/3 of the total population of just one city of Turkey. Apples with oranges. Like in programming, some people don't get the scaling right.
Population densities are irrelevant at national scales. Most of Sweden is uninhabited wilderness, whereas most Swedes live in urban areas just like every other comparable country. Population densities only start to matter when comparing smaller regions.
Monumental incompetency/groupthink at our small CDC-equivalency (Folkhälsomyndigheten) during the spring. Disaster was narrowly avoided by heroic work by healthcare workers/hospitals. A lot of people died though. Death per capita levels are similar to US levels, not to rest-of-Nordics levels (e.g. Norway/Denmark/Finland). This isn't acceptable.
Herd immunity was the obvious plan all along although it was publicly denied. Recent "leaked" emails have revealed the truth.
The same people responsible for the above are still in charge. It will be a long winter.
It is useful to look at death rates by age group. Sweden initially made the same mistake as Cuomo in New York by putting known infected people in nursing homes that housed compromised older people. That caused it to spread into and kill a known vulnerable age group.
I mean, sure, for a very long time Sweden had insanely high per death per capita stats. By now, though, the US has passed Sweden in deaths per capita. It's about the same, e.g. horrible, though.
Yes my point was Sweden's original policy was so bad it lead the world in deaths per capita, while it's neighbors had a small fraction of their infections / deaths and no noticeable difference in economic performance due to their lockdowns (Sweden had -9% GDP in Q2 the rest of the nordic bloc -9.8% averaged).
Their policy was and continues to be an abject failure.
The overarching goal has never been herd immunity. Sweden has always, and is continuing to pursue, sustainable social distancing and curve flattening. They have never significantly changed that course.
> However, email exchanges obtained by Swedish journalists under freedom of information laws show Tegnell discussing herd immunity as an objective in mid-March, days after the World Health Organization declared Covid-19 a pandemic.
That discussion was in an email conversation with, among others, Finland, where they stated that they've had the same thoughts about herd immunity. All countries have discussed herd immunity at some point.
However, herd immunity was never the goal, as you can read from the email exchanges in the original source the article links to. It was merely a discussion about a possible side effect of the actual goals, which was to prevent a collapse of the Swedish healthcare system, and to prevent side effects that lockdowns have (because they're not a silver bullet either).
Now, if they were successful is another question. I'm a Swede and I do not agree with our strategy.
This is getting down-voted but it is something of a myth that Sweden ever had herd immunity as an officially adopted policy. Yes it was discussed at high levels but it is not true to say this was the strategy adopted and implemented by the government.
This is not a defense of the strategy they did follow, which appears to have failed badly.
> Sweden's authorities never said achieving herd immunity was their goal, but they did argue that by keeping more of society open, Swedes would be more likely to develop a resistance to Covid-19.
> Speaking to Times radio on Sunday, Torbjörn Sohlström said that Sweden’s maverick no-lockdown coronavirus response did not seek to boost the number of infections and reach a critical mass of infected to stop the virus from spreading.
etc.
(It might help to consider what a "herd immunity" strategy would actually look like, vs the extremely light touch they actually took.)
Final edit: this was a good look at the handling from a NZ journalist talking to a Swedish researcher from Lund University who looked at the international media coverage. Worth a listen if you want to understand how the "Sweden herd immunity" meme spread https://www.rnz.co.nz/programmes/the-detail/story/2018769007... _and_ how that's hiding some of the negative aspects of the Swedish approach you might not have heard about.
It's a feature present in all anglosaxon jurisdiction: nothing can be discussed in terms other than their political implications. Discussing the validity of the herd immunity argument is equivalent to considering a sort of genocide, and cannot be an honest and sincere discussion of a scientific theory. Fortunately Swedish gov didn't see much merit in the argument, as there isn't.
It's good to know some jurisdictions haven't lost the ability to discuss things on scientific merits just yet.
Trivium: Rus itself seems to have been the Finnish name for Sweden, meaning "land of rowing" (as in boats), carried by Swedes to Kiev in the 9th century.
For a country-wide strategy I think you need to do a bit better than digging discussions out of a guy's email. If herd immunity was the plan, then when was Tegnell going to let us co-conspirators in on it?
Ok this is interesting. Any discussion of Sweden on here and certain other sites seemed to get a bit politicised - I think because its become a Dem/Rep battle topic in the USA.
But up to a few weeks ago, it seemed that Sweden's policy of not introducing any measures that weren't long-term sustainable had worked kindof ok. It certainly hadn't been a complete disaster. People will point out that Sweden did worse than its immediate neighbours who locked down more. But Sweden also did better than places like the UK and USA who locked down more. There are probably many factors to that (e.g. Sweden has a high proportion of people who live on their own etc).
But the Sweden data (until a few weeks ago) did point to the idea that some sort of herd immunity might be achievable, perhaps due to latent T-cell immunity from other coronaviruses. Not conclusively, but it was an interesting data point to discuss if anyone was able to keep an open mind about it.
(Side note : and here's the important point for people involved in the Dem/Rep battle over Sweden - if Sweden was having success with their covid policy, that success could only have been understood in the context of Sweden’s highly developed welfare state and social system: universal healthcare, paid sick leave, paid leave to care for sick kids, subsidized daycare & pre/after-school care. The USA barely has any of those things.)
Anyway if you read the linked article, there's a graph halfway down showing a massive second wave in Sweden, much bigger than the first, and so now they are having to lock down more.
But hopefully its all moot now anyway becasue we have multiple vaccine candidates on the way.
edit: yes of course vaccine distribution is going to take some time
What is the difference in testing for covid at the beginning compared to now? I seems that no one takes into account that the world wide deaths are down as infections spike, and that the two week latency doesn't seem to be a factor.
WW deaths are down because IIRC in many places that had a first wave, hospital operations are now more familiar with what to do during COVID and so it's not spiraled wildly out of control as quickly. It could still happen as this wave continues.
> But hopefully its all moot now anyway becasue we have multiple vaccine candidates on the way.
Actual delivery of vaccines to the general public is probably still a minimum of 6 months away, even assuming we have enough vaccine doses to cover the general public. We are in the middle of accelerating case counts right now, and we don't have the luxury of waiting that long.
That makes me nervous as well. I'd like a Covid vaccine, but I'd like to see a few tens of millions of people take it first. Especially since I (small town, WFH, kids in virtual school) have a much less risky situation wrt Covid.
Consider Sweden to be like Minnesota, Italy to be like Florida, UK to be like New York, and Belgium to be like ... well, I don't know Belgium well. These places have very different climate, population, connections to other countries/states, economies, density, etc.
We regularly compare states on all sorts of measures including test scores, income levels, murder rates, etc. despite all these differences. Right now, Sweden is ranked 20th in the world in deaths per million for Covid and dropping.
Population sizes, density, climate variations, cultural aspects, etc. Not to mention, Sweden is vast compared to any of those places - for 10 million people, it should not have had as many cases or deaths.
How come absolutely EVERY time these discussions start and such links are posted, I check who owns the respective website and it's ALWAYS a "libertarian and economic think-tank" or a "Republican think-tank" or a "freedom think-tank"?
I think it's worth considering that the absolute number of covid deaths in Sweden per day at the moment is around 15. I get the value of per capita rates, but do you think the numbers are as meaningful when they're that low?
while they have an uptick in cases, deaths are steady.
Edit: What this chart makes pretty clear, who dies from covid 19. Sweden has < 100 people who were not older than 50 who died, while elderly got completely wrecked.
Despite their best efforts and intentions, it’s becoming increasingly clear that the public health officials have little idea how to combat the spread of coronavirus. Today’s WSJ article had public health contact tracers unable to determine the source of 50-70% of new infections.
Obviously strict isolation works. Wearing masks And avoiding large enclosed gatherings are common sense and almost certainly help. But beyond that, there isn’t any evidence based plan. There is guessing and post-hoc just-so stories. The idea that the public is to blame and if we had only “followed the science” we’d have it beat by now is weirdly moralizing nonsense.
Why did this not pan out? Why is Sweden seeing a second wave as well? Why did the number of infections soar, while it should theoretically have remained constant?