> Yet without implementing any major controls,
Weasel word "major". Everyone who can work from home has done so since April. I'm basically isolated at home all day. The difference is that it's voluntary because the government thinks we are adults. Turns out we are!
> with significantly less social distancing among the population,
Than what? And citation needed. I have cut down my physical interactions by crazy amounts and this is extremely common.
> without significant mask usage,
This is true.
> the outbreak seems to have slowed substantially.
The most vulnerable have died already if that's what you mean.
Now there IS a good argument for Swedens approach being good for Sweden and that is that we have had lower than average total mortality a while now. Meaning probably that the deaths we saw were dominated by people who had their lives cut short by 6 months or less.
"X dead" is an obvious crap number if you think about it for 1 second. The actual interesting number is how many years have the disease cut from people's lives. Seems like not a lot actually. We took a huge gamble on this entire thing though.
Or, a country of lonely conformists.
Over half of households in Sweden (52 % of all households) were one person households in 2017, the highest in the EU by a considerable margin (Eurostat data.)
Also, Swedes have extreme levels of social conformity, more comparable to Japan than even its Scandinavian neighbours.
Not a good environment for a virus.
Now it is 80% for a year, you need a doctor's note after three weeks. This used to be one week but to limit the strain of the health services it was increased. If the company want one earlier they need to pay a private doctor to do it.
You also get 80% of your income if your children younger than 12 get sick and you need to stay home to take care of them.
Due to corona any respiratory illness is included in this, and it is a crime to go out in society if you have confirmed or serious suspicion of infection. (Infectious disease law)
So, what you are saying, is that compared to say, the US, Sweden has been subjected to a truly draconic lockdown.
Edit: I'm not sure I understand the karmic sentiment. In the US, closing movie theatres and requiring patrons to wear masks was controversial.
Being criminally charged for going outside would be considered tyranny - so it's a little odd to hear that Sweden is given as example of a less-locked down country.
Exactly. Coronavirus truthers point to Sweden only as an example of a country that avoided a catastrophe despite not instituting a lockdown, then change the subject when you talk about what Swedes actually did do that they are also not going to do.
It fits under the standard argument "We don't need to do [X] when [Y] would work just as well. We're also not going to do [Y]."
The politicisation of this issue was totally catastrophic. There was right-wing and left-wing science, no-one could accept that some things are unclear, and anyone who opposed the "correct science" was a conspiracy theorist nutjob.
I am glad that some places took another path though. I thought masks would be effective, where I am you are legally obliged to wear masks inside, and our rate of infection is higher than it was a few months ago...I was wrong. The UK won't learn from this (we would have locked down irregardless, I have had people tell me earnestly that they won't stop socialising, irregardless of other people's health...btw, these are not right-wing/freedom people...this was a lefty software developer who likes going to the pub...as a society, we deserve to suffer), other places hopefully will.
My perception is that it wasn't a gamble for Sweden either, the guy in charge seems to have had experience with infectious diseases at the WTO..tbf, a lot of our people had experience in this area too (and specifically with coronaviruses/influenza)...maybe in terms of public/international opinion but...the UK took that path, it didn't work.
Feel sorry for you lot, you got the worst of both worlds through what appears to be confused leadership.
e.g.: the Swedish bus stop meme shows that social distancing has been the standard for years before COVID-19.
I think it’s something else. Probably the working from home has a large impact.
Well, yes, people wake up eventually, when their friends are dying. That said, new cases per capita in Sweden are still an order of magnitude higher than in Finland and Norway. Denmark caught up last month, but that may be because they are so much more urbanized there.
See graphs: https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
Why is this a relevant metric at all?? UK (where I am) has more confirmed cases than in March, yet comparatively negligible death rate. So the raw new cases metric is obviously completely useless and uninformative, there's clearly something else going on (better management of disease, more medical resources, less extremely vulnerable people, more testing, ...)
Looking at some countries that offer more detailed data, you can sometimes see the cases double, while hospitalizations and deaths grow at a much lower rate (if at all).
Compare for example the UK:
- This chart for the daily new cases shows a dramatic second wave that even exceeds the first one: https://www.worldometers.info/coronavirus/country/uk/
- This chart for the positive rate on the other hand shows a modest increase to ~3% over the past few weeks, far below the 30% in April: https://ourworldindata.org/coronavirus-testing#the-positive-...
- And if you look at the number of tests you'll see it has more than tripled since April, hence the increase in "cases": https://ourworldindata.org/coronavirus-testing#how-many-test...
But there is no reason to care whether infection is prevented or not, unless infection carries some sort of cost. That metric has no value on its own.
To get a good estimate we'd have to randomly test the population, instead of measuring people with symptoms. Since a lot of people are asymptomatic or don't get a test since they don't feel too sick. Picking people at random would give us a good overview of active cases.
In March in Germany they were reporting a doubling of cases on TV every day, but they failed to mention that they had administered almost twice the tests as well. So basically the number we were measuring was the number of tests we could administer, which was naturally rising as testing capacities expanded, not the number of Corona cases.
Deaths just seem way more reliable a measure.
However, the metric that is actually at least attempting to measure the underlying reality of interest, here, is not deaths, but cases, that's my only point. But I totally concede that in some cases deaths may be the less bad metric for cases, than confirmed cases.
0.9% end of April
0.3% end of May
Zero of the tested were infected end of August
End of September is being published next week
https://www.folkhalsomyndigheten.se/nyheter-och-press/nyhets...
It is that there is range of consequences from absolutely nothing to death through "sick for months" and through "maybe lifelong consequences but we dont know yet".
Even if 10 % of patients end up with permanently reduced lung function it's a lot because the disease is so infectious, given the right conditions, and it isn't going anywhere soon, at least not this winter.
Here's an overview: https://www.nature.com/articles/d41586-020-02598-6
We don't know enough about long-term problems affecting those who caught it, although one glance at Boris Johnson should get anyone worried.
Convalescence is protracted, and there are reports of lung damage and cardiomyopathies in a good number of recovered patients. We don't know yet for certain about neurological problems, but there are indications that covid might cause demyelinating disease, and until that's settled I'm not going to find out.
He always looked disheveled. Has it gotten worse?
Agreed on he longterm effects, I don't think we know all of the longterm impacts yet and as such I'd prefer to avoid it until a safe vaccine is available.
Isn't this primarily because it's mostly the younger demographic that was getting covid over the summer?
We are freaking lucky that COVID’s death rate is by the lower end of all the estimates. If the actual rate was closer to what Italy was seeing, or even a smaller fraction of thst, Sweden would have had far more dead.
And the death rate is down because we understand the virus better and so are able to take actions that do not involve locking down to control it. And also it wasn’t a massive emergency at this time with massive shortages of PPE etc.
If you think that was luck, then you didn't understand the difference between CFR and IFR.
The Case Fatality Rate (CFR) is the fraction of reported cases that result in death. This is easier to measure. And if you're sick enough to become a reported case, it is the best back of the envelope estimate of how likely you are to die.
The Infection Fatality Rate (IFR) is the fraction of infected people that will die. For estimating how many will wind up dead if you hit herd immunity, that is the relevant figure. It is also harder to produce.
Early on we were seeing CFRs in the 5-10% range. That is the figure that you remember
But the first estimates of the IFR was an analysis of the Diamond Princess. It estimated an IFR of around 0.5%. In late March, Fauci reported that it was about 1%. Both estimates had significant error bars. The figures that Neil Ferguson used in his model was in the same range. All of this happened while we saw CFRs in the 5-10% range.
And therefore there should have been no surprise from the beginning that the CDC estimate of the IFR for the Spring would come out where it did, 0.65%.
Anyone who claimed to know what the fatality rate was back then is full of it. Even in places that had gotten the spread of the virus under control, there were still significant numbers of unresolved cases. And it will likely be another year or two before we have a good idea what IFR is, as COVID has demonstrated differing levels of severity in different populations, and adequate health care capacity has show to have a large impact, which large portions of the world do not have access to.
0.5% was therefore the best available early estimate, with a large error bar.
Where are you seeing the CDC say that please?
0-19 years: 0.00003
20-49 years: 0.0002
50-69 years: 0.005
70+ years: 0.054
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
That's the bulk of the deaths. Add in the other age groups and, if you do the numbers correctly, you should get close to my figure. (With a small difference because you're quoting updated numbers and I'm quoting figures that are a few months old.)
> The parameters in the scenarios:
> Are estimates intended to support public health preparedness and planning.
> Are not predictions of the expected effects of COVID-19.
But it's still an interesting data point.
The Atlantic [1] has an interesting article on the role of super-spreaders. It possibly suggests a particular contact tracing approach but it also suggests that, especially early on, there was probably a great deal of randomness in how events unfolded in a particular place. I can't speak to the medicine but it has certainly seemed as if a lot of outcomes have been pretty random. (With some exceptions like nursing home deaths that were just bad policies.)
[1] https://www.theatlantic.com/health/archive/2020/09/k-overloo...
Look how things have changed since even early March. I was at my last in-person tech event at the beginning of March, a few hundred people, and lots of care was being given to not shaking hands and wiping down surfaces but there wasn't so much as a thought of distancing or mask wearing (and who knows how important those things will turn out to be either).
I got a feeling that picking the low hanging fruit in time (i.e. concerts, clubs, packed public transport) is enough to not get a big spike at all. Otherwise most European countries should explode since social distancing is no way taken as serious anymore.
I don't think so. This problem is not monolithic. Response is just one factor but not the only, structural factors are other.
An example on structural factors is the population size. Biggest countries will have a higher absolute mortality (more deaths) than smaller ones for example. Just because they had a bigger pool of people vulnerable.
Small ones, on the other hand, could end having a much higher relative mortality.
Is unclear at this point who types of factors have more weight here, but all the hot spots in the first part of the first wave share several common denominators. All except one, and they are structural ones.
A cursory look suggests most of them actually have been exploding in new cases since mid-july/early-august
But you'd need to study how much correlation on this dimension there is in general worldwide to conclude it's a major factor.
Are you saying that social distancing wasn't mandated by the government or that people didn't choose to do it all? Because there is an obvious potential explanation that once people started dying, Swedes chose to social distance on their own without being told to do so.
Per the IMHE's COVID page [1], mobility has been depressed, around -30%-35% at peak, and that does line up with the peak of deaths, so there's some merit to your argument there.
What doesn't really line up is that mobility quickly rose again, up to around -25% and then -15% from base line, without a corresponding increase in cases, deaths, or hospitalizations. It dipped again, and then went back up, and is now hovering closer to -10%.
There's also been virtually no mask usage throughout the entire pandemic.
Compare this to the US [2], which fell to -50% at peak, and has never risen above -20% this entire time.
If I go to that mobility stat and plug in a bunch of other countries they almost all look the same and Sweden is no outlier. That is also true for the lack of increasing deaths which is nowhere to be seen compared to the first wave.
So either everyone is doing what Sweden does or Sweden is doing what everyone else does, depending on your perspective I suppose.
I gave one very big counter example: the US is social distancing at a rate roughly double that of Sweden and is getting worse results. It's also had multiple waves of deaths.
Canada isn't getting worse results, but is also roughly socially distancing twice as much as the Swedes.
The UK went down even further, down to -70% mobility.
Leaving the Anglosphere (what I'm most familiar with, sorry), Germany is now closer to Sweden, but was also below ~50% mobility. France was down to -84%!
And the Scandinavian countries: both Denmark and Norway was down to around -60%, and Finland was at around -50%.
All of these countries also rebounded from their social distancing "peak" much more slowly than Sweden.
At least among Western countries, I think a fair characterization is that while Swedes may have socially distanced on their own, based on mobility data, they did so less and for a shorter time.
Maybe not mandatory, but Sweden had/has voluntary controls in place. People there seem to actually listen to their government and try to do the right thing. The US could be in a similar situation, but we all know how that has gone.
https://www.newscientist.com/article/2251615-is-swedens-coro...
While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people.
“Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.
This appears to be true, in Sweden at least. The measures did work nearly as well in getting people to change their behaviour. Adam Sheridan at the University of Copenhagen in Denmark, for instance, has used data from a bank to compare spending patterns up to April in Sweden and Denmark. Denmark introduced a compulsory lockdown on 11 March, one of the first in Europe.
Perhaps, but Finland and Norway only took about 50 days to reach steady state on deaths per capita while it took about 120 days for Sweden.
The current data suggests that Sweden did not do better than Finland or Norway unless one of those two countries has a sudden spike that Sweden does not have. Anybody crowing "Sweden did better" needs to present some evidence that Finland and Norway are going to get some spike in the future that Sweden will not--and currently Finland and Norway have about 150 days (and increasing) of evidence to the contrary.
And if Sweden has another outbreak? You'll revisit those arguments? Really it seems like everything you're saying is predicated on the idea that Sweden hast his "beaten" in a way that just doesn't seem rational. What's the argument that they won't see a phase 2 just like everyone else has, or will?
(Obviously someone is going to chime in with "herd immunity", but that's simply wrong: other nations and regions with similar initial outbreak sizes saw second outbreaks.)
Everywhere except Sweden implemented legally mandated strategies -- often with police and military enforcement - that were designed to limit virus spread, including places that had just-as-bad-or-worse death outcomes such as NYC, Italy, Spain, Switzerland and France.
Really, almost nothing can be said for certain, and it's definitely possible for Sweden to experience a second wave soon, but it won't if this virus' dynamics is similar to other viruses - which, by all studies, it very much is.
[0] https://sebastianrushworth.com/2020/09/28/herd-immunity-with...
Again, that seems like you're just trying to argue by fiat. There's NO EVIDENCE that Sweden has reached herd immunity. It's initial outbreak was less severe than Spain or France, both of which are now well into a very large phase 2 outbreak. What's the argument that this is impossible in Sweden that doesn't rest on arguing that it hasn't happened yet?
What's the argument that Sweden will experience one, given that there is no reason to believe a phase change in Sweden (or a change in circumstances, like measures in other places cause), other than that other countries experienced ones? It goes both ways.
That everyone else has? Again, the only way for you to make your argument work is to argue that Sweden is somehow special in a deeply unique way. All I need to say is that they're probably just lucky.
All I need to say that is that they did something different to postulate that the result might be different (and so far, has). I acknowledge there is no proof either way, but you are just putting hands in your ears and saying "I can't hear you, my position is right by default so there". This argument is over as far as I am concerned.
Do you care to revisit your assurance that this couldn't happen and that the one outlier (no longer an outlier) of Swedish data might not have been the best reference for informing US policy?
(Edit: I love the near synchronous downvote in a week old thread. That's just... <chef's kiss>)
And that chance to significantly improve the medicine was helped, hopefully, by the "flatten the curve" policies intended to delay the spread of the disease regardless of whether the number of people getting it would end up the same.
So you can't directly compare both waves. A lot of things have changed between them.
Sweden had a light response to the pandemic, and it quickly found itself with a major outbreak, and a high rate of deaths. Yet without implementing any major controls, with significantly less social distancing among the population, without significant mask usage, the outbreak seems to have slowed substantially.
It's almost impossible to make these comparisons in real-time, without the benefit of hindsight. We won't know if this approach made sense until after the pandemic is over. But it's certainly an interesting data point.
One thing that is clear is that it's far too complex to look at a couple metrics, compare them against wildly different populations, and form a conclusion. Sweden had a higher unemployment rate than many of its peers before the pandemic. Exports are a staggering 47% of GDP in Sweden. Sweden made the same mistake as many other countries, putting COVID-positive patients in nursing homes.
But the longer the pandemic remains under control in Sweden, with comparatively little social distancing and mask usage, the more interesting it becomes, particularly as countries which implemented strong lockdowns see renewed outbreaks.