As for Sweden, there's a lot of variety in human behavior and a lot we don't understand about the virus, and there are many possible explanations for the lack of major spread in any particular area. Sweden has continued to post a steady low level of cases over the last two months, not a continuing bell-curve decline, suggesting the virus is still consistently finding new hosts, just at a low and steady pace.
[0] https://www.reuters.com/article/us-health-coronavirus-spain-...
[1] https://www.theguardian.com/world/2020/may/21/just-7-per-cen...
[2] https://medicalxpress.com/news/2020-09-doctors-hard-hit-madr...
That's a different experience than Madrid, where the virus hit much earlier. By the end of April, daily case counts were 1/5th of their peak in Madrid.
I'm not aware of a more recent study.
Lockdown also seems to increase the threshold for herd immunity and increase deaths, by dramatically changing the demographics of who is infected. Without lockdown, the youngest and most mobile people are likely to be infected - with minimal/zero deaths since COVID mortality is incredibly age dependent.
Under lockdown, those people are at home and intermingling with family. The only 'social' activity is shopping for food, leading to an unnatural mingling of old and young.
I live in Ukraine which has masks and little else against COVID. In shopping centers particularly in the evenings there are essentially zero old people - they fear for their lives, as they should.
The most effective policy we could have adopted was 6AM-10AM public transport and shopping for the aged only, and everyone else from then on. Segregate the elderly population into the mornings and let the masses in in the afternoon. This might have required shifting school and work to later hours in the day for three months, which seems a minor inconvenience.
Literally everything in your post is as poorly considered. It's important not to spread misinformation.
In addition to immunity based on T cells, the HIT depends on how individuals are networked. The original 60-70% estimates were based on 100% of people being vulnerable and also a random distribution of individuals interacting. In reality a small fraction of the population will have many interactions and once they become immune those transmission vectors away and the average R number drops. So based on the latest research plus observations of the worst hit places, 20-25% seems plausible.
https://ec.europa.eu/eurostat/documents/3433488/5579620/KS-S...
Looking at this data for the US, it could be a factor for COVID mortality being higher in minorities:
https://www.pewsocialtrends.org/2010/03/18/the-return-of-the...
The numbers you cite are explained by old people living in retirement facilities or coliving arrangements, but that doesn't imply cohabitation with young people. Under these circumstances, special precautions can and must be taken.
Here's daily deaths in Spain:
https://i.imgur.com/G84d20p.png
All numbers about total reported cases from the spring are going to be way, way off. There simply wasn't enough testing.
Deaths do not lie, which is why we should focus on those numbers. And by those numbers, this is in no way a repeat of Spring for Spain.
The daily number of cases in Spain appears to still be on the rise, and the death curve is usually 3-4 weeks lagging the cases. So deaths is likely still on the rise.
All that said, it may not reach the same proportions as the spring. But it is too early to wave it off either.
Sweden didn't lock down because they wanted to achieve herd immunity quickly, while still taking measures to protect the most vulnerable. Spain locked down, actively attempting to minimize the spread of the virus.
How is the failure of Spain to achieve herd immunity (while actively attempting to achieve the opposite) a counterpoint to the Swedish example?
This is a popular myth. There are no such statements (no not even from internal communication and similar). It was never a “strategy”
https://www.newsweek.com/sweden-herd-immunity-mastermind-who...
The outbreak in Spain isn't as severe as you might think, there's a lot more positive tests, yet a lot less illness.
Herd immunity just means that R=1 without precautions. I would agree that Spain hasn't quite achieved herd immunity, but spread right now isn't anything like earlier this year.
One could speculate that because Spain went into such a strict lockdown, herd immunity could not be achieved, or that herd immunity was achieved, it just didn't last because COVID immunity doesn't last.
That being said, in one hard-hit area of Stockholm, seroprevalence was 19% (https://www.folkhalsomyndigheten.se/publicerat-material/publ...). Stockholm as a whole has about 11% seroprevalence in their most recent numbers, but again, I believe antibodies are starting to fade now (https://www.folkhalsomyndigheten.se/publicerat-material/publ...).
Just to give two possible alternative reasons:
- outdoor life over the summer, leading to higher vitamin D levels;
- older people are more likely to still be living in their summer cottages.
Have you noticed that the death rate is possibly creeping upwards again? It’s simply too early to say.
When I arrived back in Stockholm (from the countryside) three weeks ago, the town was very empty: our family was alone eating lunch in a central Italian restaurant on a Sunday. Now the streets are full again, but covid takes 3-4 weeks to take hold again.
Not that I expect to see the levels of sickness from April again. But there’s a long winter still ahead of us.
Sweden has managed to address some of its other issues related to spread & fatalities. Notable among these are nursing homes, which had been a key source of spread. Once proper precautions were taken, they have stopped being as much of an issue.
That said, Sweden isn't out of the woods: The current trends are flat at best, and perhaps have a slight upward cast to them for new infections over the past few weeks.
Because so many different people visit those? Nursing homes have been key source of death, but not of spread.
Key source of spread are e.g. Prostitutes. Prostitution is (used to be) legal in e.g. Germany (afaik, in Sweden they intent to curb Prostitution by fining the client), but has been (temporarily) banned during the epidemic. That, of course, doesn't stop the custom, just moves it underground where the health of the providers cannot be monitored. Alleviating the financial problems of the providers might help curb the custom (as has been attempted in Germany afaik), as well as scaring the clients (as the state and media are doing their darnedest of).
Besides, I gave that as one single example that helps explain Sweden's infection trends. I wasn't trying to comprehensively enumerate the many steps Sweden has taken to address COVID-19 without strict shutdown. I gave an existence proof of the possibility that your claim of herd immunity isn't the only possible explanation.
This is especially true given that other countries have not all had experiences in keeping with herd immunity.
The fact is that we still know too little about this puzzle. But every time a new piece comes out, everyone rushed to jam that piece into their own pre-conceived ideas.
My what? What else did you read into my text which I didn't write?
Yes, you can have temp workers that work in 5 facilities in a week, especially when staff starts falling ill and even more temp staff is nedded. The staff situation in Swedish elderly care was already a mess, and the pandemic just exposed some of the flaws.
In Perú we are (sadly) keeping track of the pandemic by comparing the daily death count from previous years with the one for this years. You can safely assume: - there is no contact tracing - adherence to mask usage is good - social interactions are generally avoided with the usual folks that don't pay attention and an increase in those interactions every week.
These are the "death curves" of every region:
This is what happens when your government does not do anything and pretty much every one gets infected and your healthcare system collapses. You get a high spike in daily deaths and then a sharp drop (Lima is a special case for many reasons - size and geography).
Heard Immunity in every region (except Lima - yet). Seroprevalence studies are on their way...
Covid could be "lightly seasonal", so-to-say, though by far too infectious to be as seasonal as influenza. This is speculation, of course, unless it's backed up with studies.
By the way, maybe I'm mistaken about this, but it seems to me that any increase of the number of immunized people will statistically decrease the R-value even long before herd-immunity is reached. Together with the measures and heightened awareness this might also explain the data.
> What explanation is there other than the herd immunity thresholds being wrong?
Let's start with sources on those first items before we get to an explanation.
My general understanding is that Sweden recommended certain things but never technically enforced anything, so I'm not sure what "compliance" means.
Huh? That was not the point in contention. You said "the only conclusion is that the herd immunity numbers must be wrong" but have shown no evidence whatsoever to back that up.
https://ourworldindata.org/coronavirus/country/sweden?countr...
The age-stratified IFR is magnitudes different between people under 40 and people above 70. You can still achieve herd immunity without infecting the vulnerable.
We have become better at treating patients with time as well, we now know that putting people on ventilators is a phenomenally bad idea, oxygen, steroids, and blood thinners is the way to go.
Also, the death rate in the US is higher than in Sweden, so how are those lockdowns working out for you?
https://www.nytimes.com/interactive/2020/05/05/us/coronaviru...
If we take that into account then California actually has more deaths per capita than Sweden, and people are still dying in California so it will only get worse. So I agree their strategy was not all that good.
Is Sweden comparable to the US? The population is more like a US state. Let's take Oregon as an example. About half the population of Sweden, and less than 10% of the covid deaths. We're not exactly locked down, either.
Massachusetts, Connecticut, and Rhode Island all have a total covid-19 death rate that's more than 2x that of Sweden.
Currently, the average daily cases is 5x higher in Rhode Island than in Sweden, 3x higher in Connecticut than in Sweden, and 2x higher in Massachusetts than in Sweden. The current daily covid-19 death rate in both Massachusetts and Rhode Island is higher than in Sweden.
great, but what's the point? That Sweden is doing better than about a third of the United States?
The original point being made is that it's apples to oranges to compare the U.S. as a country to another country that it dwarfs in every population metric if you're looking at how to shape public policy.
In other words : There doesn't seem to be a one-size-fits-all solution for nation-wide policy making regarding a pandemic that fits every culture in the world.
I don't think that this surprises anyone.
https://www.telegraph.co.uk/travel/destinations/europe/swede...
If masks are truly effective enough to alone cause the dramatic change we're seeing, then the initial advice that they weren't necessary was utterly disastrous.
There has been earlier WHO studies that suggests improper use of masks may be detrimental, but it might just as well be confounding effects of something else.