Which epidemiologist do you believe?
unherd.com
unherd.com
I'm watching friends and family knocked back by this virus for weeks, and now pushing into months (36 days and 42 days since first symptoms for 2 people I know), and research in the US and China points to the increase in long term health risks in the 20 to 50 year olds that recover from this. I know people that just walk away from this with no impact, but if we only focus on death we are likely missing the bigger picture.
The thing is, I also don't think you can get away from the way that those pushing for lower-end estimates aren't arguing from pure, selfless virology. They're arguing from a "this is uncertain, so should we really risk our economy to avoid potential lives lost?" position. I can see that if you could translate the lost money directly to other lives lost. But you can't. The various state could just support people for the period of the lockdown - all the advanced nations besides the Dysfunctional US are essentially doing this. So if you phrase things in terms of just paying lives for money, I would disagree with the article, that is evil. People who actively enable that are evil. Sweden's policy looks to be baring bitter fruit and I wouldn't forgive Dr. Giesecke any blame for that if it matures. I could be wrong and I'm OK risking money on that, it's a better choice imo.
It seems to me more of "I dont want this to be true whether for both practical or for ideological reasons, therefore it can not be true".
Isn't that just hiding the truth though? After all, what is the state, where does it get the funds? Whether you take my money today or tomorrow, you've still taken my money. I don't see any reason to believe that there will be a magical no-tax funding of government any time soon.
There's no question that a lot of questions remained unanswered, but one question that has a concrete answer is that this is nothing like the flu.
a) People running out of money is only the surface level problem. Money is an abstraction over value. We can and should mess with the abstraction, but we can't do anything about the underlying value in the economy going up in smoke. "Bullshit jobs" notwithstanding, the things people do at work all day do actually have a role in our collective standard of living. There is a reason we can do modern medicine while the third world can't, and we could lose it.
b) Social life seems frivolous in the small, but in the large it is not. Years without human contact will seriously fuck you up. Not only are individuals in distress, but friendships, relationships, families, communities, and society itself are all in rapid decay. Screen time can only slow that down a little.
Becoming a world of 7 billion hermits for as long as it takes carries real risks and real costs, too.
On the one hand we don't know how dangerous the virus actually is. If you look around you can find very serious scientists calculating the risks both as very low and very high. There are a number of various complicating factors (like comorbidity, or lockdown measures) to take into consideration.
On the other hand we have some idea that lockdown is going to be really bad. We are likely to face a huge economic crisis, except a lot of the outlets for negative emotion have been cut off. That is going to have a very real death toll as well. But again, we don't know how bad this is going to be. Will it cause wars? Perhaps. Will it cause suicides? Definitely.
I am personally fairly surprised that the Giesecke view isn't more popular around the world. Having a bit more scepticism about the virus before one decides to also sacrifice a lot of people's livelihoods seems prudent to me.
Assuming an optimistic "vaccine" scenario of 1 year of lockdown, universal vaccine, then immediate bounce-back, and extrapolating the debt figures, that's 50% GDP new debt; and in reality, I expect that the longer the lockdown, the more expensive it is. I can well imagine the casualties of such a scenario to be worse than the pessimistic Coronavirus numbers. Public health funding collapsing, God knows what about schools, social spending etc., and yes, perhaps even societal collapse.
I'd love to be proved wrong, but the UK government at least doesn't see it as necessary to even share its thinking of the financial consequences of lockdown, or even acknowledge that there is a trade-off.
Until a region effectively eradicates the disease (elimination, vaccination or haphazard herd immunity) there is no option of returning to normality.
Ie. What may be the outcomes of not locking down by any measure, and is this response in any way realistically viable? The deeper reflections are missing from public discourse.
The problem is that scenario analysis cannot really be open to the public, and is also highly complex where "small" variables may turn out to have high impacts.
Giesecke has claimed less than two weeks ago that at least 600k people in Stockholm (pop 950k) have had it. We did viral and antibody tests that came up with 11%(and had to be retracted because it was based on blood donors and included all donors who had recovered and were specifically asked to donate plasma with antibodies, so 11% is above max) and 2.5% respectively.
This claim and Gieseckes claim that deaths are <0.1% were was then the basis of a study published to show the Swedish policy was right, which had to be retracted because it put the population of Sweden to be >3*45million.
Gieseckes claims and articles starting to disappear/overwritten on same URLs made me back up 4000 news articles yesterday. I think we are close to one of our famous overnight 180 degree public opinion turns from the media starting to question any claims at all.
A large anti body study was supposed to be released yesterday, and I'm waiting to see what it says. We seem to be very far off the herd immunity Gieseckes strategy is based on.
1. He's aiming for herd immunity, using the people who are the less likely to have severe cases to protect the most vulnerable
2. He believes the death toll will really not be that high to justify the actions that we are taking to prevent the virus from spreading
3. He does not care about the deaths, and the faster they die, the faster we can go back to normal
Of course I don't think he believes in number 3, which is quite horrible in my opinion.
Regarding 2, the numbers emerging of the population that has actually contracted the virus seem to be much smaller than what Giesecke was assuming. So it would seem correct to assume that the death toll is going to be much higher than he was anticipating based on a wrong hypothesis.
To me it only leaves number 1 as a potentially valid approach that does not rely on quarantine.
The most credible connection to FHM this strategy has is that a former employee wrote a mail explaining the reasoning of not closing the schools to a friend who is a politician working on local school issues, the friend then (with permission) shared the text further on FB.
> Den tidigare statsepidemiologen Annika Linde hade inte tänkt ge sig in i diskussionen om Folkhälsomyndighetens strategi för att bekämpa det nya coronaviruset. > > – Jag halkade in på ett bananskal, säger hon. > > Bananskalet var en fråga den 12 mars från en lokal skolpolitiker som ville ha hjälp att förklara varför det är rätt av Sverige att inte stänga skolorna. > > Varför säger inte Folkhälsomyndigheten bara att flockimmunitet är planen, undrar folk i sociala medier upprört efter Lindes inlägg. Andra tycker att planen låter rimlig. > > – Sedan förnekade Folkhälsomyndigheten att det var tänkt så, säger Annika Linde. > [...] > > Den tidigare statsepidemiologen Annika Linde tänker inte så mycket på att hennes budskap om den svenska strategin tog sig hela vägen till Vita huset, säger hon. Däremot tänker hon fortfarande att flockimmunitet är målet för Sverige, i väntan på ett vaccin. Men hon försöker låta bli att kommentera sina efterträdares arbete. > > – Det finns något som kallas ”lösa kanoner på däck”. De skjuter lite hit och dit och kan träffa skeppet och sänka det helt och hållet och sedan inte ha något ansvarstagande. Så jag nöjer mig numera med att svara på enstaka frågor, som nu från dig om att jag inte höll tyst där i början. https://www.dn.se/nyheter/sverigebilden-under-coronakrisen/
Also be aware that there are false positives, especially significant with these antibody tests, so with the low numbers of positives it's extremely important to evaluate if the claimed values are more than noise artifacts of the tests themselves. It is also important to be aware of the scenarios for which the use of the apparent test results is not reasonable.
Moreover, here's what happened in the UK a few weeks ago:
https://www.theguardian.com/world/2020/apr/09/uk-government-...
"None of 3.5m home tests ordered have so far been accurate enough to detect coronavirus immunity"
UK got 3.5 million(!) unusable antibody tests.
https://www.bmj.com/content/369/bmj.m1449
"John Newton, Public Health England’s director of health improvement, said:"
"A number of companies were offering us these quick antibody tests, and we were hoping that they’d be fit for purpose, but when they got to test, they all worked but were just not good enough to rely on.
“The judgment was made [that] it’s worth taking the time to develop a better antibody test before rolling it out, and that is what the current plan is.”"
"Newton told the committee that the tests trialled so far had lacked sufficient sensitivity to identify people who had been infected. “We set a clear target for tests to achieve, and none of them frankly were close.”"
The article quotes Gieseke as saying "The real death toll, he suggested, will be in the region of a severe influenza season — maybe double that at most".
Sweden's official death toll was 2270 yesterday (2020-04-28). The three worst influenza seasons in Sweden since 1969 killed 807, 674 and 652 people[1]. So we've already passed his "at most" claim. The only way I can see that working out is if he feels that none of the influenza seasons in the past 50 years count as "severe".
[1]: numbers taken from the Swedish wikipedia entry on influenza. I didn't bother to check wikipedia's source. An average Swedish influenza season kills about 200.
Or that he doesn't think deaths in past influenza seasons were all attributed to influenza but rather just "normal" deaths.
The excess all-cause deaths will be the figure to look at, but it will take quite a while before those numbers are reliable.
Of course it's also very hard to distinguish between people dying with covid19 and dying because of it. And we've never even made a serious effort to track the cause of death of the elderly.
Meaning we don't know how many people die each year from the flu, and we don't know how many people are dying of covid19. When you add it all up, it will be very difficult to learn the right lessons from this pandemic.
When cancer patients die because their cancer treatment was cancelled they die of a cancer related cause, and that's how their death will be recorded, and that's how their death will be reported.
> And we've never even made a serious effort to track the cause of death of the elderly.
It's hard to understand your "we" here. Which country doesn't try to track cause of death for elderly people?
> Meaning we don't know how many people die each year from the flu,
But we can count the deaths the same way. We can look at deaths of people confirmed to have the disease, we can look at death certificates, we can look at excess mortality combined with community surveillance. The errors for all three are going to be similar for flu and covid-19.
When person in an elderly care facility dies we don't do a forensic investigation. We just shrug and say "I guess it was their time". So we don't have an accurate mortality baseline to do any comparison against. And that's assuming we are accurately distinguishing between those who died of covid19 and those who died with covid19, which we don't.
I'm not suggesting that people who draw conclusions from incomplete data are idiots, I'm pointing out that the data we have is completely insufficient to make an accurate assessment of covid19 mortality.
This ("we just shrug and say "I guess it was their time"") is untrue. It's okay that you don't know, but you should stop spreading this misinformation.
The accuracy of death certificates. Implications for health statistics. https://www.ncbi.nlm.nih.gov/pubmed/1871957
> Significant discrepancies between the two documents were observed in 50% of patients. In 25%, the immediate cause of death was incorrectly stated on the certificate, having been assigned to a different organ system in the majority of those cases. In 33%, there was disagreement on major disease other than the immediate cause of death.
Anecdotally, elderly people I've lost had completely wrong death certificates. When common sense, anecdotal evidence, and a cursory review of the scientific literature point in the same direction I'm going to assume that's the way it is.
Also, try to be kinder in the way you communicate.
We know that death rates with the disease vary a lot due to attribution.
We really can't get a good comparison as influenza isn't usually attributed as the main cause of death but coronavirus is.
We can only look at all cause mortality rates which is quite the lagging indicator.
https://www.euromomo.eu/graphs-and-maps/
The best we have.
What makes you say this?
https://www.spectator.co.uk/article/The-evidence-on-Covid-19...
But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.
Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.
1) Death certificates rely on doctors using their best knowledge and experience to say what the patient died of, and what the patient died with. Flu and other respiratory illness is mentioned on many death certificates. See 5.4 here: https://assets.publishing.service.gov.uk/government/uploads/...
2) A notifiable illness has no meaning for death certificates.
3) We don't routinely test for flu. That's why all cause mortality is the preferred statistic for flu deaths, and also for covid-19 deaths.
You're not arguing with the Spectator, they're just acting as a publisher. You're arguing with in his words, "a recently-retired Professor of Pathology and NHS consultant pathologist". So you're claiming a professional British pathologist doesn't understand how British death certificates work, and you know better. Bold move.
Especially so because you seem to actually be agreeing with what he wrote, which is weird. For instance your claim (3) exactly matches his claim that:
"the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections."
You say flu appears on many death certificates. Yes and he never argued otherwise. He said despite that it's sometimes mentioned it's actually under-reported because testing isn't really done much for it - as you agreed with!
That leaves the question of notifiability. The rules say that COVID-19 must be mentioned on a death certificate if testing was done at all, even if negative (which is new to me, I wonder what that does to the widely cited stat of "number of certificates that mention COVID"). But the point is that relative to flu, testing deaths for COVID is enormous, practically blanket at this point. If you test a lot and you insist that every case is reported to central government it will cause a flood of reports to arrive on the desks of decision makers, who will then feel it's much worse than flu. But it's not, it's just a reporting artifact.
Source: https://www.socialstyrelsen.se/globalassets/sharepoint-dokum...
In any case, boosting the number to 685 still isn't enough so that covid is "double at most", and boosting it to 1100 isn't enough either.
My point is more that statistics is hard. You tried to debunk someones "dodgy" statistics with your own numbers that can be twisted to be even more off than the person you tried dismiss. I'm afraid nobody and everybody will be right after this is over. People will always find statistics to prove their points and that they where right and the other people where wrong.
> [1]: numbers taken from the Swedish wikipedia entry on influenza. I didn't bother to check wikipedia's source. An average Swedish influenza season kills about 200.
Sorry, but you can't just throw around numbers without explaining exactly what they mean or where they come from. The numbers you're quoting is most likely deaths that has been diagnozed as influenza. To get the full picture you need to look at excess mortality (which is reported by EuroMOMO[1]) and possibly adjust the numbers to pick out the influenza-related excess (FluMOMO[2] is the model most countries use).
If you look at the 2016/2017 season in Sweden [3, figure 17, page 46] you will see that the excess mortality as reported by FluMOMO goes way beyond ~600 for a season. In the peak season we see that it was ~300 per week. There are of course uncertainties in these numbers (which is why you won't see any official "x number of people died of influenza" figures), but it was probably closer to thousands than hundreds in 2016/2017.
[1]: https://www.euromomo.eu/ [2]: https://www.euromomo.eu/how-it-works/flumomo [3]: https://www.folkhalsomyndigheten.se/publicerat-material/publ...
In the interview, Gieseke says influenza kills 1000 to 2000 people per year in Sweden, it's part of the exchange starting at 24:16. He doesn't explain exactly what those numbers mean or where they come from.
A minute or two later, he guards his 'double' comment by saying it's not going to be 10x.
One interpretation of the exchange is that he's predicting 2000-4000 deaths in Sweden, and definitely not 20000.
Stockholm has 2.34 million inhabitants. (Stockholm in this context is always stockholm area, not the city). That makes a 600k estimate much less outlandish although still optimistic (25%). Self-selecting hospital workers showed 20% in yesterdays publication, which seems like it should be an upper bound for the general population.
It's also important to remember that when people make the claim that "X had it" they also simultaneously estimate that perhaps X/2 would show up as positive in serological tests (because the rate of infection and delay of antibodies would create a lag) so a person claiming 20% having been infected isn't contradicted by a serological result of 10% positive.
I agree, counting only Stockholm city isn't reasonable. But I've found the 'Metropolitan Stockholm' number is seldom used as well, but looking at the definitions it should be more common.
What is more commonly used is the number for the Stockholm urban area (I'll link the Swedish wiki article since it contains a lot more data, https://sv.wikipedia.org/wiki/Stockholm_(tätort) ).
It's interesting to compare the metropolitan areas. In Stockholm is stretches so far that it includes areas that feed to (and somewhat off) some of the other large cities (mostly Uppsala I guess), but in Skåne the metropolitan area only covers a few municipalities although commuting by car is more commonplace and there seems to be a lot more commuting by train from Helsingborg and Kristianstad to Malmö (it's also extremely handy by train) than from Uppsala to Stockolm (no hard numbers, but I commuted Uppsala -> Stockholm for five years and Helsingborg -> Malmö for a while).
So it does make more sense to use the 'Greater' areas for all the major cities.
The county (region, or formerly "län") is the area responsible for healthcare so it's natural that this area is used for all things healthcare related.
We have studied corona viruses before so we have information about mutations and immunity. We have also been watching covid-19 for these for 4 months.
So this is 100% untrue - "Currently we don't have any evidence that either assumption is true"
"for very little benefit." - We are talking millions of millions of lives, so I'm not sure why you'd say this. The lockdowns are killing millions, a lot of them are the very poor.
We need to plan for the fact it might mutate or we are not seeing immunity stick. But that's different to throwing out Giesecke approach because we don't know something with certainty.
I don't know who came up with the idea that the goal would be heard immunity. Arguably, a "lockdown until vaccine" strategy is more clearly focused on (artificially) reaching herd immunity.
This particular error on my part I regarding the reasons for the lockdown I attribute to Tomas Pueyo and his hammer-and-dance amateur epidemiology blog.
So soft lockdown in maybe a year or more, deaths will be in the 0,5% vicinity, more in some countries, less in some. Hard lockdown in the same timespan as above. Less deaths but will you have any society to return to? If you do hard lockdown for a while and then lighten up you're in situation 1 basically or forced to lock down soon again. Number three is very attractive. Had we all been prepared and had plans for this like South Korea and being island nations with easily shut borders like NZ it would have been simpler. But most countries were not and are not any of that.
For 2, it’s unlikely to mutate to the point of not being recognized within a relevant timeframe. We can track how fast it’s mutating reliably, and it’s not dangerously quick. The good news is if we have immunity, it should last for several years if considering only what we can see about the mutations. Follow the NextStrain project and Trevor Bedford on Twitter for a smarter analysis than I can provide here.
Every person who merely delays getting COVID-19 until better treatment is available is a win. Even if it succeeds by other metrics, the Swedish approach will fail (has already failed) by this one.
As I understand it, that is what most countries do and achieve with various success. And as soon as there is any respite in the load of the hospitals, people are already pushing for a easing of restrictions in place.
But with all that, Giesecke's approach is more like getting the whole thing over with quickly, which would have brutal effect on the health care system, to say the least. IE, once this is done, all the doctors and nurses in the emergency care system are going to quit.
The point of lockdowns wasn't to stay locked until total control. That simply will not happen in the US, at this point. (And I'm not sure it's feasible anywhere other than South Korea, now.)
The point was to give everybody time to react and get ready. It's been almost 45 days since the lockdowns started--healthcare workers should have all the gowns, wipes, masks, etc. that they need, by now.
The fact that they don't is an indictment of most of the governments of most of the countries.
In my opinion, we stay locked down until healthcare workers have what they need even if a gigantic wave hits. If enough healthcare workers die, we're all in deep shit even after Covid-19 reaches herd immunity.
Want to unlock things? Start smacking some idiot leaders around about giving equipment to healthcare workers.
When I see healthcare workers saying "Please, stop, we have all the equipment we need and then some," then I'll believe we can come out of a lockdown.
Most countries are seeing death rates beginning to decrease after weeks of lockdown.
There were four new cases today. One confirmed by test and three presumptive cases which according to the experts probably have it. Plus there are hundreds of people in isolation/quarantine who are still sick. I wouldn't declare "elimination" just yet.
Even if new cases dwindled down to zero, that doesn't imply elimination either. There might be many asymptomatic people who are not spreading it currently because of the lockdown, but who will start spreading it once they start interacting with people outside of their bubble.
https://www.rnz.co.nz/news/national/415278/covid-19-new-zeal...
Do you think that's practical? This virus has a hospitalisation rate of somewhere between 10% and 20% and an ICU rate of 4-10%, and people who are hospitalised need to be in there for 2-4 weeks. If a 'gigantic wave' is even 10% of your population (which realistically it would far exceed, given how contagious the virus is) you need 10-20 free hospital beds per 1000 population of which 4-10 are ICU beds.
The United States has 800k hospital beds of which ~100k are ICU beds, for a population of 330 million (source: https://www.aha.org/statistics/fast-facts-us-hospitals) That's 2.4 hospital beds per 1000 population, of which 0.3 are ICU beds.
You're gonna need at least 10x as many additional beds as you currently have. At least. And that's for only 10% of your population getting sick.
Edit: To be clear, I'm not saying that lockdowns are pointless. I'm saying that they need to be longer and more thorough to get to the point where the virus is entirely eliminated, or they need to remain at current levels indefinitely until an effective vaccine or other treatment is available.
Part of the reason there is even a debate is because we don't know this for sure.
The few studies where a large population was tested and shown to be widely infected but largely asymptomatic seem to fall into one of two camps: They used immunological tests (which are now under serious suspicion don't seem reliable) or they tested a newly infected population after the first cases were found (before the majority of infections had time to manifest symptoms.) They've also been reported misleadingly (eg. the aircraft carrier case where it was reported "80% of the crew were infected but asymptomatic" when actually 80% of the crew who tested positive were asymptomatic.)
The number of hospital and ICU beds are being increased rapidly. Medical students are now allowed to work with patients until the crisis passes ( thus increasing the healthcare capacity).
After carefuly observation the plan is to slowly reduce the stringent lock down measures and increase the infection rate, while keeping the medical staff sane.
We will get the next update in the first week of may, whether the first step of "easing" worked as intended.
What we are going to see is a new normal, even if we find a working vaccination soon.
It isn't quite so bad. Lockdowns are a continuum of measures, and you can modulate them over time. We're having to do such strict lockdowns because we were so slow in responding. Once the R is below 1 you can release measures to keep it at that threshold and modulate it over time to match your health care capacity. Merkel seems particularly well informed about this, having even explained what the curve of healthcare capacity versus R looks like for Germany.
This was a good discussion on this at the beginning of the lockdowns:
https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
The problem is that even if we just fill the current beds we have, we STILL don't have enough equipment for the healthcare workers.
This is a major problem.
Especially so since we can substitute therapies. For example, apparently high-flow ventilation is just as good as invasive ventilation--and maybe better. The problem is that it aerosolizes the virus, so your workers need a lot more equipment.
If you don't have enough equipment for the healthcare workers, things fall apart long before you reach available system capacity.
I defy you to find a specific "point" of lock down. I more or less support it but I'd still claim there's not been a proactive strategy in the US even if occasionally the US uses rhetoric. So for that reason, there's no specific "point". Maybe authorities will reach sufficient clarity that they can articulate and stick to a point but not now.
But otherwise, yeah, the entire situation is a mess, an indictment of all the state involved, etc.
Cool. Any resources to read up on that? To my knowledge only a few countries have very few cases. But eliminated completely? Wow. I'd like to dive into this topic.
Unless they believe that's sustainable for 18 months, their whole strategy of eradication wouldn't be feasible, so one would have to assume this is the plan.
Asked whether New Zealand had eliminated COVID-19, Ardern replied: "currently."
[1] https://www.npr.org/sections/coronavirus-live-updates/2020/0...
Wait are we saying that Giesecke is arguing for an (even) more relaxed approach than is currently happening?
I assumed he was arguing for the status quo in Sweden, because hospitals are effectively at capacity now, and have been stable there for a while. A significant increase in new infections would be pretty bad so I don't think he's arguing for "business as usual".
If I understand him correctly then what he's saying is that it's not good to minimize the number of infected, but rather one should only ensure hospitals aren't overwhelmed. A good outcome is if hospitals are never overwhelmed and a significant portion (enough to make a difference) have immunity. A poor outcome would be one where either people die from lack of available care or one where the outbreak is contained through means that aren't sustainable until a vaccine is available.
Obviously if there are long term effects on the health care system from the situation where hospitals are not overwhelmed but just overworked so they quit or are burned out (e.g. many countries won't be able to give healthcare workers summer holiday this year) then that needs to be taken into account as well of course.
Meanwhile in other countries perhaps some authorities are working from shorter term ethical guidelines.
Using different views and optimizing for different goals isn't necessarily wrong. There is no "right" here. Everyone realizes that thousands will die in the coming years from things we can afford to treat today, but that we won't be able to afford if we have 15% unemployment. Whether that's part of the equation or not varies between countries and experts. In many places these decisions aren't even left to relevant expert authorities but rather to politicians who have an additional set of concerns (such as popularity) to deal with.
Note: Johan Giesecke is no longer working as State Epidemologist but his views are rather consistent with those of the current authority and the current State Epidemologist Dr Tegnell, so his views are probably shaped in this framework.
EDIT: should have added politics as another differentiator
Korea "should" be comparable to western countries if it wasn't for politics. But they have 100x fewer deaths. They're not trying to reach herd immunity, it's a political choice.
Agreed and I amended my comment accordingly - and thanks for pointing out my oversight!
https://mg.co.za/article/2020-04-08-is-lockdown-wrong-for-af...
> it’s like a tsunami sweeping across Europe.” The real death toll, he suggested, will be in the region of a severe influenza season
>UK fatality rate of Covid-19 is likely to be 0.8-0.9%,
That right there is the thing. I think there are a lot of questions that fall into this catagory. People want them to be questions of science but they are fundamentally political questions. You can use science - in ways that are fair or unfair - but at heart science can't answer them.
Instead put a Figure of Merit against the idea.
I 30% buy off that covid-19 is a nasty virus that one Does Not Want, and that precautions are in order to protect those with compromised immune systems (my wife).
I 70% think that a variety of leaders on all levels and parties are not "letting a crisis go to waste" here, and purging the backlog of items that they don't care to discuss in detail.
Deaths are almost an order of magnitude higher in Sweden v the rest of Scandinavia: https://ourworldindata.org/grapher/covid-daily-deaths-trajec...
I'll let you know which one it isn't: the first one.
How is Sweden in any better position to minimise total (lifetime) C19 deaths? Or all-cause deaths this year?
One strategy is ensuring you have some protection from immunity in the population (e.g. 20%) when the first wave is over, so that together with other measures (testing, contact tracing, quarantines) you have a chance to control the virus until a vaccine is found in say 18 months, while also allowing the economy to function. That is to say: flatten the curve but not too much. You want some percentage of immunity too.
The effects on deaths from the economy will take years to manifest. What quality of cancer care can be offered in a country in 5 or 10 years can definitely depend on how this situation is managed now.
https://calmatters.org/health/2020/04/debunking-bakersfield-...
"So if you look at California—these numbers are from yesterday—we have 33,865 COVID cases, out of a total of 280,900 total tested. That’s 12% of Californians were positive for COVID. So we don’t, the initial—as you guys know, the initial models were woefully inaccurate. They predicted millions of cases of death—not of prevalence or incidence—but death. That is not materializing. What is materializing is, in the state of California is 12% positives. You have a 0.03 chance of dying from COVID in the state of California."
Even a child can figure out why this is not even wrong.
[1] https://www.aier.org/article/open-up-society-now-say-dr-dan-...