Swedish expert: why lockdowns are the wrong policy
unherd.com
unherd.com
It also has one of the lowest testing rates in the Western world at 0.7%, compared to around 2% in Spain, Italy and Germany.
Year from now we will see the total number of deaths from different strategies and the thing is settled by then.
It appears people are forgetting or retroactively changing the justifications already. The lockdowns were meant to reduce deaths by ensuring everyone who got infected could get healthcare. In Sweden that is the case despite having been much less severe than other countries. Thus, their approach is de facto more successful than elsewhere.
Comparing to their direct neighbours is thus irrelevant, because a total reduction in deaths was never the goal (it cannot be, because there's no vaccine). But if you want an explanation for why Sweden may differ, for whatever reason it appears the virus hits non-whites much harder. This is being observed in the USA and Sweden reports that non-whites from e.g. Iraq, Somalia etc are disproportionately affected. Why that would be so is unclear, but a higher death rate than Norway is likely to be at least partly due to the much higher rate of immigration Sweden has allowed than its neighbours.
And yet very sick patients are already being placed in field hospitals with no running water, laying too close, poor air circulation and on old ventilators which have received criticism from the doctors there.
There is still available intensive care space at ordinary hospitals and it looks like the number of people needing intensive care has stabilized [1]. The latest numbers are 1072 total intensive care units (not counting field hospitals) and 528 people treated for covid-19 in intensive care [2].
[0] https://www.aftonbladet.se/nyheter/a/MRrGxK/patientstopp-pa-...
[1] https://portal.icuregswe.org/siri/report/corona.covid-daglig...
[2] https://www.socialstyrelsen.se/coronavirus-covid-19/socialst...
We've seen hints that blood type, climate, average social distance, average obesity, average age, etc. But nothing definitive yet.
The costs to the economy from these lockdowns are trivial compared to the cost of a runaway and persistent viral hotspot like New York or Seattle, even if we pretend (as some folks here seem to insist we do) that the loss of life is not worth discussing.
What works in a given area population is great; but until you have some idea what your local R factors and hospitalization rates are, you really should play it safe.
On the other hand, as a Swede I feel that we ARE playing it pretty safe. Some of the measures other countries are taking seems extreme to me.
You can find isolated reports of sub-optimal care in any hospital system in the world, at any time. Especially now when so many people are incentivised to paint Sweden in the most negative light possible.
Just a couple of weeks ago world leaders were fighting over every ventilator that existed. Now the biggest problem is that someone, somewhere was given an old one? When many doctors are already starting to argue that forced ventilation is the wrong therapy and switching to simple CPAP anyway? That is not a sign of a system in crisis.
People in Sweden are not scared compared to what they are in the UK for example. It's the rest of the world that is scared for the Swedes.
A no-lockdown policy may be reasonable for Sweden, Norway or Finland, while being completely unfeasible elsewhere.
I'm from Rome, Italy, and Stockholm is farther away from it than Cairo in Egypt
It's not uninteresting who's in the lead now. But it's the goal line standings that matter.
A significant portion of the population won’t stand for it, and given the current make up of the Supreme Court any mandatory citizen tracking, or job based discrimination based on mandatory testing will not pass muster. Nor will forced vaccinations. We can’t get people to vaccinate against measles and whooping cough, which spread faster and kill more people (including children).
Civil liberty practically ensures that in most places tracking and vaccination will have to be optional.
Whether we like it or not we are heading toward a herd immunity strategy.
If this were killing 30% of the general population, like smallpox could, people would fall in line. But I can’t see it happening for something as comparatively mild as COVID-19.
Having worked as a US Census Enumerator, I can confirm this. A surprising number of Americans will call the cops or put a dog on you to avoid being asked how many bathrooms they have.
You can say this is foolish, but policy makers have to deal with what is, not what should be.
One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many other countries have in one form or another. Unfortunately, I expect this to happen because the shortcomings of the current system are going to be painfully exposed and result in a lot of people dying unnecessarily in the US and in the coronavirus problem taking longer to deal with than it will in most developed nations.
I also think there is a small but non-zero chance of much of the world blocking travel for people who have recently been in the US until they get their house in order. Under normal circumstances, this might sound preposterous, but clearly these are not normal circumstances. The virus doesn't care about American exceptionalism, and if the anti-science agenda that starts right at the top of the US federal government today continues, nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress even if it means a big economic cost due to isolating the US that would never be seriously considered without the public health threat.
Furthermore, the heavily impacted areas are all already Democrat strongholds. Densely populated urban centers.
The only country where socialized medicine appears to be outperforming is Germany.
Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed.
All these points have good refutations, I’m just illustrating that I think this virus will divide us further, not bring us together.
I am highly educated, top tier private university, etc., I have the profile of someone who would support mandatory testing and contact tracking, but I do not as a matter of civil liberty.
As a fellow believer in civil liberties, I understand where you are coming from here, and I am extremely wary of governments using this situation to claim "emergency" powers that they may be reluctant to give up afterwards.
But as a believer in science, I'm not sure hundreds of thousands of lives lost in the near future in my country alone is a price worth paying for my concerns about what might happen to make lives worse later.
The brutal reality is that the virus doesn't care. Fools posing in close proximity to each other with assault rifles but no protection against the virus are simply more likely to get themselves and their friends and families killed. Students who went on Spring Break and then spread the virus all across the country are more likely to get themselves and their friends and families killed. People who listen to politicians like Donald Trump and Mike Pence instead of epidemiologists are more likely... well, you get the picture.
Right wingers will point to Italy, Spain, and the UK as failures of socialized medicine. They will point out that the healthcare systems in Democrat cities failed.
I'm curious to know in what way(s) the systems in these countries are seen to have failed by those outside. With hindsight they would probably all have instituted lockdown measures sooner, but as they say, hindsight is 20/20.
I am personally not afraid of it, I wear a mask out of courtesy and not wanting to spread it if I happen to be one of the silent carriers.
I've best seen it described by a mathametician as follows (wish I could find the link) - COVID-19 has comparable mortality to the flu, but you are 300 times more likely to contract it.
For something with such a low mortality rate I do not support mandatory contact tracking or testing. I certainly would if the number starts sharply going in the other direction.
I can't say for sure what will be pointed out specifically about socialized medicine in the UK, France, and Italy, but our numbers for the United States outside of NYC appear to be much better than those countries and I suspect that is where the right wing will come out and say our private system outperformed the public systems (i.e., cherry picking the countries with the highest mortalities for comparison with the US).
They will point out that Italy had to triage beds and favored treating younger patients with higher chances of survival, allowing some older patients to die. It was the rational thing to do, but also unimaginable here in the US where you would be sued to high heaven.
Can't you imagine the situation in Italy turned into a campaign add in Florida? "The Democrats want a health care system that lets seniors die" or some such with some pictures of overwhelmed Italian hospitals and a sad looking old man not being treated, but coughing and wheezing.
I never said these were good arguments, I just know that they will say it, I've been following politics for a very long time.
The only crises that bring both parties together are ones that hit everyone. Technically a virus hits everyone (does not discriminate as you say), but in fact it does discriminate. It spreads faster where population is denser and where there is mass transit.
So just like everything in the US, this crisis is divided between urban and fly over. The urban people are literally worried for their lives, and the fly over people are worried about their jobs. This is a super broad generalization, but I am trying to make the point that the virus is not affecting all people the same way and it happens to be right down party lines.
Most of the US seems to be a bit behind Europe in where it is on the curve, so it also seems premature to compare statistics.
Until we know when and how different places have implemented lockdown conditions, track-and-trace programmes and other responses, possibly in several stages over an extended period, and how successful each place has been at limiting total excess deaths caused by the virus and at avoiding unwanted side effects from those responses, it will be difficult to draw any reliable conclusions.
That seems to be a big part of the problem we face: the data we have so far is still well short of what we'd like to know in order to accurately assess the threat and decide on a proportionate response. Consequently, everyone is basing policy largely on educated guesswork and hoping to avoid any catastrophic escalation happening too fast to react, with some increasing awareness that the more severe responses will probably have serious consequences of their own if maintained for more than a very short period and we don't necessarily fully understand those either.
Of course it will be tenuous and disingenuous for any political ad to make statements about the success or failure of containment strategies. I was only pointing out what we will be said, and what people will believe, not what was rational. Irrationality is not a roadblock in politics, lol.
As a Brit, I am very sceptical of that. In the UK this crisis is painfully exposing the deep structural flaws of the NHS. The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. One reason - it's actually refused and ignored testing capacity in the private sector.
e.g. here's a firm saying they could run lots of tests but the government hasn't returned their calls
https://www.telegraph.co.uk/news/2020/04/15/british-company-...
Here's another analysis that mentions private sector companies being baffled by lack of swabs being sent to them:
https://reaction.life/why-is-the-uk-so-slow-at-increasing-te...
Places like Germany have an apparently much lower death rate because they're testing far more aggressively. Why is that possible, well, because there's no ideological problem with involving the private sector in healthcare like there is in Britain. It's really hard to fail more severely than the UK has done. It's uniquely terrible at handling this crisis, and that's the fault of its unique healthcare system. Nobody rational in America will look at this performance and say, yep, that's what we need.
nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress
So far the data says the epidemic is basically following the same path everywhere, regardless of what governments do. There appears to be no correlation between how governments reacted and outcomes, so no, nowhere is going to be blocking travel to the US because of coronavirus.
As for "follow the science", that phrase is being used mostly to mean "listen to epidemiologists". But their models are all being disproven in real time, over and over again. Nobody is going to have any respect that so-called science when this is over. It simply is incapable of making accurate predictions. It's no more a science than economics is.
It has never been the case that the NHS was the only provider of healthcare facilities in the UK or that it did everything "in house". We have biotech firms and medical equipment providers and direct clinical healthcare services in our private sector, too, and the NHS works with many of them routinely. Some of the big questions seem to be about why the government and NHS aren't making use of the capabilities those organisations might be able to provide in this particular situation.
I'm not sure the data we have so far does support your claim that everywhere is on the same path regardless of government response. Indeed, your own example of Germany suggests otherwise. There are also the (relative) success stories in Asia where they appear to have managed to avoid imposing the heavy restrictions we've seen in Europe without letting the virus get out of control. The widespread use of testing and the willingness to engage in population-scale track-and-trace programmes seem to be recurring themes in the places with better outcomes so far.
It looks like the thinking from governments in the UK and other locked down European nations is rapidly evolving to these heavy lockdowns being unsustainable for more than a few weeks, but possibly being a useful bridge to a time when we can adopt a track-and-trace strategy with a manageable number of cases. This brings us back to the same questions yet again about testing and engagement by the UK leadership with other facilities that might be available.
> The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity.
The NHS had capacity. The DH&SC decided that testing wasn't worthwhile. (I disagree with them, but they were saying that covid-19 is so contagious and testing doesn't affect the treatment someone gets so there's no point testing them, and when they made that decision we didn't have reliable antibody testing).
> One reason - it's actually refused and ignored testing capacity in the private sector.
That's not a decision for "the NHS" to make.
Testing the population for Covid-19 would be Public Health England, not the NHS. PHE has a central arm, but is mostly split out to local authorities.
But PHE can't make that decision if the minister has said not to test.
> because its 100% centralised and government run healthcare system
That's not at all how the NHS works in England. It's mostly not centralised. Most commissioning is done locally by Clinical Commissioning Groups. They buy services from NHS providers who, again, are mostly local organisations. There's some central commissioning, but that tends to be very specialised services. ("inpatient mental health treatment for deaf adults", for example.)
But if you want to play civil servant lawyer and argue "any failing part of the British healthcare system isn't really the NHS", go for it. From the international perspective nobody cares. Public Health England is the Department of Health is the NHS is the government. How the government divides up responsibility between variously branded bureaucracies doesn't alter the overall outcomes, nor the reasons for them. The UK centralised all CV testing in a bureaucracy that was quickly overwhelmed, didn't scale up, didn't involve the private sector and didn't react quickly to need. Privately run healthcare systems managed all these things.
Newsnight have a good point when they say the Lansley reforms caused problems.
I'm not even close to an anti-vaxxer, and a lot of that is because existing vaccines have been around for a long time and we know a lot about their safety. The US government forcing vaccines that were rushed to market scares me. This is the government that did the Tuskegee experiment.
This is not even closed to comparable. So far off that I begin to suspect everything else you said.
The Tuskegee experiments were a limited horrible experiment undertaken by the US government fully aware of the fact that they were performing horrific experiments on the people in the study specifically to see how bad things would get.
The vaccines being rushed through trial are sourced from multiple labs in multiple countries with the hope they will help the entire population. The primarily role the US government plays is to ease the rules and to provide some funding. They are not pushing a particular vaccine, type of vaccine, the trial groups, or any of the other details.
1. "The actual fatality rate of Covid-19 is the region of 0.1%"
2. "At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available"
The second is less trivially wrong, but there's a lot of evidence against it: tests from Wuhan[0], Denmark[1], the Netherlands[2] all show very low infection rates, around 3-4%.
[0]: https://www.wsj.com/articles/wuhan-starts-testing-to-determi...
[1]: https://nyheder.tv2.dk/samfund/2020-04-17-stor-screening-vis...
[2]: https://nltimes.nl/2020/04/16/3-dutch-blood-donors-covid-19-...
I guess that means if New York's lock down didn't reduce that 70% of the population getting infected, with a population of 20M or so they can expect around 2M deaths.
March 31st deaths from Covid-19 in Sweden: 180
April 17th deaths from Covid-19 in Sweden: 1400
It has been > 7x deaths just within April.
The quoted figure would be for a situation with hospitals in perfect operational state.
So the Sweden reasoning is: we will stay within normal capacity even at peak, and everything will be ok.
If infection rate is actually slow, that may work, but it's not obvious this is true.
But you don't need to reach the level of people being denied treatment to be at an "overwhelming" level, where the hospitals are not operating at peak efficiency.
There have been many reports of hospitals not having masks, gowns and so on, or lacking ventilators or few people able to use them which need to be overworked. Many hospital workers have been infected, and hospitals had to switch to longer shifts.
It's just not business as usual.
The correct figures (as of April 18, 2020) is:
New York State: 14,636 deaths / 19.45M population = 0.0752%
New York City: 8,893 deaths / 8.3M population = 0.1071%
https://chicagocitywire.com/stories/530092711-roseland-hospi...
1. When we put in these lockdown measures, we basically had very little science behind the disease. Not locking down and hoping things generalize from very small sample sized studies coming out of Italy (which did enter lockdown at that point) is not prudent policy.
2. The only clean room evidence we have even now is the US Naval carrier that was exposed to COVID. It turned out that amongst those infected, 30% of the sailors were just asymptomatic. Previous modeling assumptions that US policy is driven off of were using 15-20% are asymptomatic. Okay, fine our initial assumptions were off a little, but not orders of magnitude off.
3. The other problem with the Swedish approach is that you can't simply isolate old people in isolation from younger people - healthcare workers, nursing home workers etc. are all fairly young and can be asymptomatic COVID carriers.
4. Even if the mortality for younger folks is ~0.1% the toll that COVID is taking on the lungs of even recovered patients is pretty brutal (anecdotal evidence, needs more study). Especially, if you're an athlete or want 100% lung capacity for the rest of your life, it's a bit iffy at this point if you'll actually get it. It also looks like it's hitting multiple organs and not just lungs, again we don't have much science here at this point.
5. I was hoping we could do antibody testing as a way to judge who can safely go out, but I was watching a Bill Gates interview yesterday and it looks like the testing is not good enough yet to make that call - it still has too high a false positive rate, people with antibodies still can get reinfected if their viral load the first time was enough to only trigger a mild infection.
That's to my mind the most consequential misestimation of the test characteristics, but Balaji Srinivasan details more:
https://medium.com/@balajis/peer-review-of-covid-19-antibody...
From Reddit:
South Korea: 802 imported cases, 17 from China, 389 from Europe, 306 from Americas. Taiwan: evacuated 975 from Wuhan so far, only 1 tested positive. 728 evacuated from Wuhan since March 10th, 0 positives. Singapore: ~80% of 800 cases imported, 24 from China. Ontario (Province of Canada): 968 imported cases, US 318, UK 101, Mexico 49, Spain 46, Germany 34... China 5. HK 1 - HK has 200x less population than China.
It was clear Wuhan was hit by something incredibly deadly that had only barely started inching its way through the population.
South Korea is one of the most comprehensively tested nations on the planet and their death rate right now is 2%.
People are still desperately clinging onto a narrative that this thing is way less deadly than it appears and twisting and distorting all sorts of stats to get them there but it just plain is vanishingly unlikely to be true.
This virus started with Westerners assuming that they were somehow exceptionally different from Asians and did not need to learn from their experience and it will end with Westerners assuming that they are exceptionally different from Asians and do not need to learn from their experiences.
many of these would explain why SoKo, Japan and Sweden fare well without lockdown
2. Most thinkers I know and follow widely believe this to be the case as well, it also passes the common sense test.
(OK, 3.4% of reported cases, my point is they have thrown out death rates as well, all of them can be considered fantasy because we have zero clue what the denominator is)
https://www.who.int/dg/speeches/detail/who-director-general-...
> Globally, about 3.4% of reported COVID-19 cases have died.
They said that 3.4% of REPORTED cases had died, which was true at that point.
> Most thinkers I know and follow widely believe this to be the case as well, it also passes the common sense test.
0.015% of the Swedish population has died so far from the coronavirus. On the other hand ~0.15% of NYC has already died from the coronavirus. If the majority of the Swedish population is already infected, why is the death rate only 1/10th that of NYC? How does that pass the "common sense test"?
I hope that doesn't translate to "people in the same Facebook groups like me", i.e. the typical echo chamber effect.
It's amazing how there can be a hundred experts plus hard figures, studies, whatnot, which then get strictly ignored by those "just the flu" folks, which forward the same handful of interviews with some doctor or virologist on WhatsApp or Facebook claiming we're overreacting, it's just a slightly more aggressive kind of flu, mass panic, coming up with excuses why Wuhan, Italy and NY don't quite fit what they're saying, but no convincing counter argument yet.
Sure it would be the more convenient truth, or you just feel woke, but there are more and more places on this planet that simply show this is not true.
there are more and more places on this planet that simply show this is not true.
But there are far more places that seem to show it is true. So whose data do you believe? At some point it boils down to the same way people make decisions in every other area of politics.
When this thing started in China, it was initially assumed to be just that, then when evidence showed up it wouldn't be, there was the initial cover-up phase. Everybody involved at that point was pretty much doctors and other experts which aren't exactly the random dork that just panics, as well as government officials who's last desire is to have that go public. Yet they reached the point where they couldn't deny it anymore and started taking drastic measures.
No good explanation for this I've come across so far.
Then Europe, Italy first. Again the government and the people ignored this as much as possible. It's the China flu, it can't affect normal humans like us. Milan had the famous "let's keep going" campaign. There was absolutely no sort of panic, besides maybe the panic buying of toilet paper etc. People only really started to change when their hospitals got overloaded and you could actually see the effects of this in everyday life.
Yet those claiming this is just the flu like to change it around and say there was panic first which somehow lead to overcrowded hospitals. Even that part isn't very clear, given that testing was ramped up slowly, initially you couldn't just get the test if you didn't have any contact with an infected person, or were in China recently. Even if you were tested positive you were sent home if your symptoms were only mild. So even assuming there was some sort of panic, hospitals wouldn't suddenly have accepted people with mild symptoms (just like with the flu every year before). So how did the hospitals get so full?
Then I've heard a German virologist say that Italian hospitals have terrible hygiene, and people with covid19 who would have otherwise survived then got other infections in the hospital and died of those, so just died with covid19 but not of. Why didn't that happen the years before with regular flu patients? Again it's not like the hospitals accepted people with mild symptoms because they thought it would be funny to fill up the hospital beds. Also I guess by the same logic HIV is no biggie since you only die with it.
https://swprs.org/a-swiss-doctor-on-covid-19/
It's concise, dense and to the point.
Besides, the planet doesn't care about our little problems: https://www.youtube.com/watch?v=uHgJKrmbYfg
Same with the stock market, predictions about the house market, the weather, political events, and so on.
Overconfidence is the rule, not the exception.
I'm certain of it.
EDIT: As a recent example, consider the lies we were told by the administration about the effectiveness of surgical masks in preventing spread. While this lie was told in service of keeping the supply prioritized for health care workers, it caused vulnerable people to not wear them and discouraged people from wearing home made masks that might help prevent asymptomatic spread. We have only overcome this lie through public discussion and eventual acknowledgement by the CDC.
if your system is not overloaded or kills almost only the people who would die anyway soon
I feel pity for Spain, their economy was F up prior this virus, can't imagine what it's gonna be after virus
I don't see why this must be true. R before the lockdown in northern CA and WA (heavy voluntary measures but people "working") was ~1.45. [source: https://www.medrxiv.org/content/10.1101/2020.04.12.20062943v...]. SoCal was higher at R=2.1, possibly due to less voluntary restrictions.
Add on a functional testing and contact tracing (built up during the lockdown) and you should be at r < 1.
Sigh.
So right now they actually are locking down sufficiently to shrink the number of cases.
Well I can tell you the answer to that, because in Australia I watched it unfold in real time. We have an aggressive tracking and tracking regime. Our most populous state published the figures on it - lettings us know new cases, overseas infections and local infections (which was the real number that mattered). Overseas infections dominated, and we got most of them from the USA. Extraordinarily, we watched as the doubling period of people infected in the USA dipped below 2 days, while at the time the USA was saying it was a flu that would blow over in summer. In the end it became too much. The USA become too dangerous for us, and because were weren't prepared to single out the USA like we singled out China for bans, we shut down the border completely.
During the peak of that period, the "untested" number in those tracking and tracing figures grew exponentially. In case it isn't obvious that means it's failing: the virus has overwhelmed the resources of the nation-state. But it turned out they were mostly foreign infections being imported, and so after 14 days when that ended new infections plummeted, and we caught up.
Now we are down to 50 new cases a day and are opening up the economy again.
What it takes to overwhelm you depends on how much work tracking and tracing each infection requires. In Australia, it's all manual. In South Korea the co-opted the banks, mobile networks and other sources of data, built a system in under 60 days to tie it all together (as an I professional, colour me impressed). So they are _much_ more efficient at it than we are. Nonetheless it's not strictly true they didn't have lock downs. They didn't ever have a country wide lock down, but they did lock down regions for a few weeks when tracking and tracing was looking like it might be overwhelmed. Such small lock downs are very cheap compared to what everyone else is going through of course. I suspect it's even cheaper than the "let it burn" approach of Sweden.
In Australia we now have it under control. Since we are an island I think they are pretty confident if we can eliminate it internally, we have it beat. The only thing that would have to remain in place is the mandatory 14 day quarantine for international travellers, and even that could be reduced to a few days with good early detection tests. But eliminating it internally is going to be very difficult with a 30% asymptomatic rate even with our current tracking and tracing effort, as many local infections are of the "we have no idea how they got it" variety. In fact I think they've decided it isn't possible, since they are now rolling out bluetrace. They recon if 40% of the population takes it up, we can eradicate the thing.
Also, there are still a lot of unknowns about this virus.
* It has been reported to cause long term organ damage. How common is that? How severe is it?
* It has killed lots of people who are not frail.
* We don’t have a good idea of how widespread it is, so we don’t know what the true death rate is. The Santa Clara serological study suggested that 48k residents have been infected. Santa Clara currently only has 73 deaths, which gives a death rate of .15%. We only had access to this serological data yesterday, so how would we have made decisions using it last month? And even if the death rate is low, that’s the death rate with a health care system that’s not at capacity thanks to social distancing and lockdown measures.
* We don’t know how effective a policy of “protect the old and frail” would be because it’s never been tried.
* etc etc
All of these unknowns together should give you pause. It’s tiring to hear people confidently promoting their unfounded opinions on the virus grounded in nothing more than a know-it-all attitude and a generous helping of Dunning-Kruger.
Stats for week ending April 10th aren't out yet, however they are alluded to in https://assets.publishing.service.gov.uk/government/uploads/... at being over 20k deaths, twice the number.
(The week 15 report predicted 5k excess deaths for week ending apr3, more concrete figures had it at 6k. Week 16 predicts about 12k excess deaths for w/e april 10.
60% extra deaths isn't "slightly above background level"
If covid is burning itself out then that's great, we'd be looking at a total 100k excess deaths, or 20% above background level for the year.
However there is no evidence that we're anywhere near 20% of the country having had it, let alone 70%.
Those dying in week ending april 10th will likely have contracted covid before lockdown
w/e | reported covid deaths | actual excess deaths
w/e mar 27 | 842 | 1.5k
w/e apr 3 | 3294 | 6k
w/e apr 10 | 5562 | 10-15k
w/e apr 17 | 5589 |
Tobacco kills an average 2k per week in the UK, covid is killing 5 times as many, and that's with all the controls.
Cars kill an average 30 per week
Cases didn’t peak in NY until April so we may see some increase after this month.
I realize the U.K. locked down later than many countries, but there must be other factors driving mortality as there are other countries that did not lock down and aren’t being ravaged quite the same.
What is it? Level of care in the NHS? Higher prevalence of secondary conditions like diabetes? Hygiene? Crowding?
We're slightly ahead of New York state in covid breakout too (about 4-5 days at the occurrence of both 10th and 100th death)
I suspect that the excess numbers are undiagnosed covid cases - especially those dying in care homes.
In w/e 3rd april compared with the week before
Place | Excess Deaths | Excess covid deaths
Home | 1079 | 105
Care Home | 1280 | 175
Hospital | 2779 | 2609
Where are the stats for deaths in New York? UK (Or rather England and Wales, but that's 90% of the population of the UK) are at https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
We are at about 8800 COVID deaths for all of NYC (this includes the city boroughs) so out of a total population of about 8.5 million. We will have a more accurate population after this year’s census.
Public transit appears to be a big spreader with outbreaks tracking closely to subway stops. Unfortunately we keep it going because it is essential some people couldn’t get food without subway access. This is also probably why suburban America has a far lower number of cases, outside of nursing homes.
Even in states like NJ all the counties in trouble have rail lines to and from NYC and are densely populated.
In the UK all deaths must be registered with the date of death. Normally we expect X deaths per week, we're seeing far more excess deaths than covid deaths in homes and care homes.
Two possibilities
1) Non covid deaths are happening at home rather than hospital because people aren't being taken to hospital. I'm sure this is happening in some cases (people being frightened of going to hospital when they have tell-tale signs of strokes etc), but if it was happening a lot then non-covid deaths in hospitals would be down. They aren't.
2) Much more likely, people are dying at home/care home frmo covid but it's not being reported on the death certificate because they haven't been tested for covid.
https://www1.nyc.gov/site/doh/data/data-sets/vital-statistic...
I do not think Covid deaths are being under-counted in NYC they recently changed to a very liberal policy for labeling Covid-related deaths. No test is required and all deaths not clearly from another cause are now being counted as Covid. This has conspiracy theorists crying foul, but it’s probably prudent.
You piqued my curiosity and this change in death classification added 3500 deaths to the count on top of the 8800 confirmed/tested mortalities that Google publishes, and so far NYC is on track to double their monthly deaths from all causes for the month of April :-(
Same at home.
W/e 3rd april had no change in death rates for people upto the age of 45
45-50 was 34% higher
50-65 about 40% higher
65-85 about 50% higher
Then drops back down over 85
Based on life expectency from https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... at each given age, about 60,000 excess years were removed week ending april 3rd. That's likely twice as much the next week.
for all these stats we need to wait years and by then nobody will be interested anymore because people will be dealing with ruined economy from hysterical response
"At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available"
"The results will eventually be similar for all countries"
"Covid-19 is a “mild disease” and similar to the flu, and it was the novelty of the disease that scared people."
> "At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available"
It's just pure speculation at the moment. You don't take life or death decision based on such optimistic speculation. This is just irresponsible.
Not more or less irresponsible than large-scale lockdowns. Don't kid yourself and think the lockdowns were evidence-driven and accounted for knock-on effects. They were desperation moves.
Lockdowns were not irrational, just the fruit on not having enough masks ans test ready on time for selective quarantine.
https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter...
Projected deaths for COVID-19 are 70K through July.
"In recent years, flu-related deaths have ranged from about 12,000 to — in the worst year — 56,000, according to the CDC."
This is not to mention that these estimates include non flu deaths to compensate for the fact that not every dead person gets tested for the flu and even those that are, often wouldn't be documented as flu deaths. For example, if COVID-19 was merely a minor outbreak, COVID-19 deaths would be counted towards flu deaths, as the cause of the death would be viral pneumonia and viral pneumonia is statistically likely to be caused by the flu.
The reverse isn't close to true - we're for the most part only attributing deaths to COVID-19 when it's either a confirmed case or otherwise overwhelmingly likely to be caused by it. It's a certainty that COVID-19 will end up killing more people in the month of April than the flu kills most years.
So the contagiousness of the disease actually reduces the mortality rate quite a lot, more so than uncounted deaths in the numerator.
Secondly if you do the same thing for the flu, put confirmed flu deaths over confirmed flu cases (tested) the mortality for flu is 4%. This would be the apples to apples comparison.
They're already doing antibody testing in other countries and the numbers are much lower than 50%.
In Santa Clara county, California, the estimate is only 2.49% to 4.16%
https://www.google.com/amp/s/amp.cnn.com/cnn/2020/04/17/heal...
https://chicagocitywire.com/stories/530092711-roseland-hospi...
Santa Clara was testing from the general population.
https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-mo...
This was shown in the difference in death rates in Wuhan vs other cities in China. ...as well as northern Italy vs other provinces in Italy.
The chart you linked to bears that out. As itself says, it's excluding estimated delays from the last 7 days, so the last really solid numbers are up to April 10th. Everything before that is increasing exponentially. Even if we assume the backlog has stopped increasing (blue bars getting bigger), which is what the grey estimates are based upon, then Sweden is still getting another 70 or so deaths per day, which means the per-capita death rate is going up by 7/million every day.
Are those the things you agree with most or are those things you disagree with?
How is it working out with that. Last I heard old people in Sweden don’t go to the ICU but is left to die and they have a large spread in care homes for elderly. And as if their economy is in a vacuum they think they won’t be struggling with the same recession as the rest of us
This is not to sound cold or callus. I’ll be old one day (but am also not going to expect extraordinary resources to live a few extra months). These are necessary discussions in a finite world.
Severe infection and death rates are still quite high among people that are not especially old or frail; and then it sort of depends a lot of whether 'frail' is an apt description of the people that are more susceptible.
I would like to see data supporting this. Because at the moment, things are pretty bleak.
I think everyone would like better data but one point I can follow is that scared people are bad consumers. I can’t find the exact story but I recall some research on Denver vs Philadelphia where the hard lockdown came out ahead later and the psychology of dealing with the disease contributed to this.
For example, bar and restaurant traffic would probably be down quite a lot regardless of lockdowns.
For reopening, a potential downside of doing it too early is that the spread rapidly spirals out of control again, with greater death and real panic ensuing.