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Comment by makomk | Hacker News Reader

I'd say that the fact that Sweden still had the same level of restrictions as they previously had is proof that their approach is working exactly as intended - the people behind it have long said that the goal isn't to push for herd immunity, but to impose measures that are sustainable in the long term rather than a short-term lockdown. Especially since many of the countries that have locked down and then opened up are seeing a resurgence of the disease, and their definition of opening up is sometimes as strict or stricter than Sweden's rules (for example, the UK bans gatherings of over 30 people and restricts restaurants and bars to table service only, amongst many other restrictions).

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>Especially since many of the countries that have locked down and then opened up are seeing a resurgence of the disease

Isnt that the expected result? Did anyone think something else would happen? The original communication everyone was fed was "hospitals arent ready, close down to flatten the curve to buy time." They asked for a delay, not spread prevention. Spread prevention being, stay locked down forever until everybody gets its slowly.

Sweden made a contrarian bet: that hospitals won't be flooded, and a few less ambitious measures that people will tolerate for a longer time is better than a large list of freedom destroying measures that can only lead to riots if imposed for too long (depending on the countries, you had things like lockdown at home, with only shopping on some days depending on the last digit of your social security, or only going out for 1 hour per day with printed, signed and dated papers to present to the police, etc)

It worked better than for Serbia, where people were recently rioting for being locked down again for a whole weekend.

I also think the bet depended on Sweden's culture of social responsibility.

Doing something similar in the US would never work. We don't have a culture of social responsibility. It's why draconian measures were required. Recommendations don't work and laws/ordnances only work to an extent. In essence, the US has such a self-centered culture that the only option to combat a pandemic like this is draconian lockdown that borders on infringing on individual rights.

  Conquer with Inaction

  Do not control the people with laws, 
  Nor violence nor espionage, 
  But conquer them with inaction. 
  For: 
  The more morals and taboos there are, 
  The more cruelty afflicts people; 
  The more guns and knives there are, 
  The more factions divide people; 
  The more arts and skills there are, 
  The more change obsoletes people; 
  The more laws and taxes there are, 
  The more theft corrupts people. 
  Yet take no action, and the people nurture eachother; 
  Make no laws, and the people deal fairly with eachother;
  Own no interest, and the people cooperate with eachother;
  Express no desire, and the people harmonize with eachother.
                -- Lao Tse, "Tao Te Ching"

I didn't realize there were guns in the 4th century BC.

A 6th century BCE philosopher had an opinion on guns?

It's also important to note that Lao Tse was trying to make sense of the collapse of his entire way of life during the Warring States period. He was trying to find an answer as to how the governments of the day failed so badly and descended into such chaos.

While it is true that community spirit can thrive under pressure, we should not be seeking to attain community spirit at the cost of overall quality of life. We should not allow COVID-19 to run rampant so that people learn the usefulness of masks. This falls into the same trap that Lao Tse fell into, thinking that the perceived causative opposite will result in the opposite outcome. If this were true, then the Sudan and Somalia would be the happiest places on Earth.

> We don't have a culture of social responsibility. It's why draconian measures were required.

Sounds backwards to me. I'd bet a logical approach like Sweden's would have been much better tolerated and observed, especially in the long term. The current "new plan of the week" here in California is for the birds.

Not to mention that a significant portion of US deaths were a direct cause of NY forcing sick into nursing homes.

Colorado went a couple months recommending but not requiring face masks. The governor finally enacted a mandate because people weren't abiding by it.

And? I know many folks have been convinced that cloth-mask wearing is the primary factor in reducing transmission. But, deep down I think we all know that it's not that important compared to other things.

Also, folks do comply voluntarily when they see local stats and people around them getting sick. Yes, scolding when statistically no one in a rural state has it is not surprisingly effective in the short term.

What other things?

Any of the dozens of other guidelines that should be followed, minus the cloth mask. One not often mentioned but touched on here is getting outdoors in the sunshine.

Locally I often see folks hiking alone in the sun wearing cloth masks and it is clear they don't understand when they are actually useful or not. Anti folks don't appear to either.

> but deep down we all know...

From 18 July Wall Street Journal:

Face Masks Really Do Matter. The Scientific Evidence Is Growing.

New research suggests that face coverings help reduce the transmission of droplets, though some masks are more protective than others.[1]

Face masks are emerging as one of the most powerful weapons to fight the novel coronavirus, with growing evidence that facial coverings help prevent transmission—even if an infected wearer is in close contact with others.

Robert Redfield, director of the Centers for Disease Control and Prevention, said he believes the pandemic could be brought under control over the next four to eight weeks if “we could get everybody to wear a mask right now.” His comments, made Tuesday with the Journal of the American Medical Association, followed an editorial[2] he and others wrote there emphasizing “ample evidence” of asymptomatic spread and highlighting new studies showing how masks help reduce transmission.

%< snip %<

Researchers say the benefits of widespread mask use were recently seen in a Missouri hair salon, where two stylists directly served 139 clients in May before testing positive for Covid-19. According to a recent report[3] published by the CDC, both wore either a double-layered cotton or surgical mask, and nearly all clients who were interviewed reported wearing masks the entire time.

After contact tracing and two weeks of follow-up, no Covid-19 symptoms were identified among the 139 clients or their secondary contacts, the report found. Of the 67 who were willing to be tested, all were negative for Covid-19.

%< snip %<

Wearing a mask is “one of the most urgent things we can do to get our country under control,” said Melanie Ott, director of the Gladstone Institute of Virology. “We’re all waiting for the vaccine, we’re waiting for therapeutics, and we’re not there.”

“We have masks, we have social distancing, and we have testing,” she continued. “But there’s not much more in the toolbox here.”

1. https://www.wsj.com/articles/face-masks-really-do-matter-the...

2. https://jamanetwork.com/journals/jama/fullarticle/2768532

3. https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e2.htm

> (...) is better than a large list of freedom destroying measures that can only lead to riots if imposed for too long

Do you have any example of such a civilization-destroying reaction to basic public health measures?

I mean, Spain was locked down for a long time, and they did had armed forces personnel patrolling the streets, and Spain didn't descended into chaos although they still remember quite well what's it like to live in a dictatorship.

If you need the army patrolling the streets to enforce the rules, I think that riots are not too far away.

I also learned in this thread they happened in other countries like Serbia.

I would expect them to happen in more european countries if there is indeed a second wave, and they do not have the foresight to deploy soldiers in the streets.

And that the country was happy with a much higher death rate. Sweden has less than half the population of Australia and they have had 5,667 deaths and Australia has had 128.

Oz is probably the sparsest country in the world.

With the majority of the population living in cities on the coast. Sydney? Melbourne? Big, dense cities. We're not all out living in the bush shouting cooee at each other.

If you measure average population density across the entire country, sure, but the vast majority of the country is practically uninhabited.

Sydney and Melbourne are much like any other large city in the world and, at around five million people each, combined they represent ~40% of the country's population.

The early success Australia saw in dealing with this pandemic had nothing to do with sparse population.

> And that the country was happy with a much higher death rate. Sweden has less than half the population of Australia and they have had 5,667 deaths and Australia has had 128.

When Australia went into the first lockdown they had essentially no community transmission.

It is unclear that the lockdowns had any impact at all.

Now that there is significant community transmission in Melbourne we can see if the second lockdown is effective.

I've seen different messaging spread around. With Australia, for example, I've heard people say they did a great job "squashing the virus", so I think there's definitely surprise from some people that cases are surging again.

For example, I found an article called "Coronavirus: Are Australia's numbers at risk of escalating?"[0] (to me, the headline itself seems a strange question to ask, since the answer is obviously 'yes').

From the article:

"Australia has reported just over 7,400 cases, far fewer than many nations. It has seen 102 deaths - the last was a month ago.

Since May, the country has entered a phased exit from lockdown restrictions as the curve flattened.

But in the last week there's been a rise in cases in Victoria, mostly in the state capital Melbourne.

Concern has crept back into public conversation: Is this a small setback, or could it be something more sustained?"

To me there seems to be a widespread misunderstanding, perhaps perpetuated by the media, that locking down the country would stop the spread of the virus entirely.

[0]: https://www.bbc.com/news/world-australia-53132585

Well, we didn't exactly lock it down properly ... In Melbourne the poorly trained security guards responsible for quarantining returning passengers in a hotel were having sex with the passengers.

It was also mentioned by the Victorian Premier yesterday that roughly 90% of people who felt sick were still out and about in the community and that roughly 50% of people who got tested for Covid were still active in the community before they got their results. Some of this would have been because they couldn't afford to miss work etc, but it's still disappointing.

Yes, but that changed very quickly to "lockdowns reduce total deaths" once it became clear that the predictions of hospital overload were wrong.

Now you have places like New Zealand that appear to be trying to keep themselves COVID-free forever, without any clearly articulated path out of the restrictions.

You do realize New Zealand at the moment is almost restriction free outside of external travel? At this point they have fewer restrictions than any major country in the world including Sweden.

Throttling all external travel is a severe and major restriction, especially for a country that derives significant revenue from tourism. It's not some minor thing that can be blown off. Travel to/from NZ will be minimal for as long as that continues, and they have no way out.

The UK is a bad example, cause they have been doing worse than Sweden in every regard. There are plenty of countries in Europe which have much more relaxed limits now, for example Germany, Switzerland or the Czech Republic. Probably the other Nordic countries too (I'm not entirely sure about the latest there though).

According to:

https://covid19.healthdata.org/sweden

Germany is currently socially distancing at a similar rate as Sweden.

They previously had stricter social distancing and have far fewer per-capita infections and deaths, but the model says they’ll hit a nasty second wave in mid October.

Time will tell whether Sweden’s bet pays off in the long term.

Our (Germany) rates are actually somewhat surprising to me. We seem to generally have done very well when compared to other (European) countries of similar density.

> but the model says they’ll hit a nasty second wave in mid October.

I am wary of modeling "that far" in time, because while vaccines may take a little more to get ready, there are plenty of trials starting or going on for pharmacological treatments, which may give readouts as early as September.

While perhaps they won't be able to avoid infections, they might change clinical management significantly, in particular monoclonal antibodies.

How in the world will “time tell”?

Sweden has a worse death rate than its comparable neighbors, it’s economy has been hit as much if not more, and it has no greater “herd immunity” than the rest.

And the neighbors are opening up in a way Sweden cannot.

Essentially, Sweden did go into lockdown, and the difference from its neighbors were at the very margins. The economy was affected linearly by the additional activity at the margin, in other words, not by much, but on the other hand the virus growth was impacted exponentially, causing a significantly higher infection and death rate.

And this is Sweden, a country with a highly educated population, extremely good social and health systems, that was far better equipped to implement voluntary measures than the vast majority of the world.

5 times as many deaths as their neighbors, with as much, if not greater economic hit than their neighbors, and an economic hut that is continuing unlike their neighbors who are now much closer to normality.

If this is exactly how it’s supposed to be working I shudder to think what the bad case scenarios would have been.

Short term economic damage is a) hard to measure and b) meaningless

Sweden’s betting on long term recovery in light of second/third/etc waves. As much as it detracts from the catastrophic fear and loathing narrative, it has sound economic and epidemiological foundations.

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