Vilified early over Covid-19 strategy, Sweden seems to have scourge controlled | Hacker News Reader

Vilified early over Covid-19 strategy, Sweden seems to have scourge controlled

straitstimes.com

150 pointsdoppp426 comments

I live in NZ, which has taken the opposite approach.

We locked down early and hard, and there was a definite hit to the economy (although not as bad as some had feared).

We eliminated Covid in the country. There was a tiny second wave which forced our largest city back into lockdown, but that has been lifted.

Aside from international travel, Covid now has basically zero impact on my day to day life. Because there is effectly 0 chance of communitry transmission at the moment, life has essentially returned to normal. Bars, restaurants, etc are open and buzzing.

All this and our case numbers are lower than almost any other countries death numbers.

There is no way I would rather live in Sweden.

The same thing has happened in China. A hard lockdown, a near-eradication of the virus, followed by a lifting of economic restrictions.

Why is someone being downvoted for saying factual information? Vietnam has also done so.

I'm guessing some people are skeptical about China's claims about having no more cases. It's hard to trust anything they say.

That or they are so hardcore crazy "My freedoms above all else" that they would rather 250k die than they be asked to stay in for a few weeks

Sure, but this isn't evidence based skepticism, it's just unfounded skepticism. In any case, Vietnam used the same tactics and arrived to the same result, so I don't understand why anything else would be expect for the same tactics being implemented in China.

It's evidence-based in the sense that China has long established itself as a society with a poor human rights and censorship record.

Clearly any announcements that suggest an outlier positive performance in this situation will be taken with a pinch of salt, regardless of whether they are true or not.

The issue is that hiding the millions of cases there would be if the virus was not eradicated given the end of all containment measures would be completely impossible.

Also, this isn't outlier-positive performance, it is the expectation given the measures that were taken. I don't see how the virus could spread with the strict measures that were imposed.

Both Vietnam and China have a track record of covering up disease outbreaks. They also both use homegrown tests for COVID-19. It is not unreasonable to discount their figures without independent verification.

I understand why you would think this might be the case - but please consider the logistical difficulties of such a vast conspiracy.

There's over a billion people in China, with an extensive diaspora that keeps in touch with family back home. The world is connected, and we aren't living in 1929 anymore (Where your entire extended family could have starved to death, and you wouldn't hear about it for a decade.)

What exactly do you think is happening there? They've lifted the lockdowns - and if the virus were still circulating through the community, it should have infected tens of millions of people by now. Do you think that millions of people are getting sick and dying, and their overseas relatives, who are frequently in touch with them, don't know about it?

They've tried to suppress COVID information, when only thousands of people were infected in January, and... Everybody still knew about it.

Do you think they are somehow orders of magnitude more successful at doing so in September, while secretly having millions and tens of millions of cases?

Or is the more plausible explanation that they probably don't have millions and tens of millions of cases?

Or, alternatively, do you think that they only have tens and hundreds of thousands of cases (Few enough to suppress information on), and somehow, despite the lockdowns being lifted, they aren't ballooning into millions?

My Chinese friends who live in multiple different cities are all telling me the pandemic is pretty much over where they are located. Businesses are basically back to normal. Even mask wearing is not as widespread as it used to be out in the open (still required in most indoor spaces). I guess they must all be CCP stooges and are lying to me.

People thinks the CCP is some omnipotent organization and can suppress any and all information. If that's the case, then how do we even know about the Uyghur detention camps?

Right.

So there are no more containment measures in China, not even masks are needed. However, the cases haven't spiked in the 2-3 months since the lockdowns had ended.

If China was covering up the disease and still had thousands of cases, then by now there would be millions of cases. However there aren't, I have friends and China and they don't know anyone who caught the virus in the last months. There haven't been secret lockdowns either because they would be easily noticeable.

As a consequence, we can come to the conclusion that the virus has essentially been eradicated in China, and while I don't know anyone in Vietnam I'd imagine it's the same.

It's been over 6 months. And being asked to is quite different than being bolted into your apartment complex: https://www.youtube.com/watch?v=ald2FIAGRvs

> It's been over 6 months.

For us. It's been over for them for a while.

For China? How long exactly, mate? You got CCP sanctioned stats on this? How reliable are they, by the way?

Because HN, in general, hates China with a passion. Please self-censor and refrain from saying anything positive about China in the future or you will be down-voted to oblivion.

Your idiotic down-votes are just proving my point. Keep them coming.

HN aka dipshits who think they're smarter than reddit users.

That can only ever work in a small island country like NZ or a country with totalitarian control over the populace (China)

It worked in China and Vietnam, neither of which are small or island countries.

As for your edit according to which this is only possible in large countries if they are totalitarian, the tactics China used are exactly the same that NZ has used, and are fully consititutional in the United States. Basically, telling people not to leave their homes for two weeks, using the Army to deliver food and supplies, and stopping travel between cities. These tactics have been implemented historically in the US in other epidemics and pandemics, so unless your claim is that the US is authoritarian, I don't follow.

China has totalitarian control over its populace which can simulate the level of control possible in a small island democracy. Vietnam I haven't studied.

It is fully constitutional in the US to stop travel and enforce quarantine in cities, and has been done before, and this was only ever needed in a select few cities in China.

Here in Canada I'm not allowed for the next 28 days to socialize with anyone outside of work. This is more restrictive than what was imposed on most cities in China.

You can't nail people's door shut in the US with them inside, which happened in Wuhan. You also can't unilaterally and swiftly implement extreme lockdown measures that would be required, only China can move that quickly with its one party dictatorship. So it's not a valid comparison being made here.

No, but you can legally stick a policeman outside and prevent them from leaving, which is functionally identical.

You can also legally take them into a complex and prevent them from leaving until they test negative, as has already been done for other infactions in the US.

The executive branch in the US also has the authority to rapidly execute such measures, and has done so historically.

It is functionally identical but completely theoretical and not achievable in practice. There's no way you can achieve that level of homogeneous control in a large democracy with states that have heterogeneous beliefs and political values, which is what you have when a democracy is sufficiently large.

If New York was isolated totally and completely self governed, you have a hope of achieving what NZ achieves.

Even a country as small as Australia is evidence of this thesis. They can get it under control in one state but a cluster pops up in another and it becomes a never ending game of whack a mole. If Australia was only Sydney, covid would be a distant memory. If Australia, population of 25 million, can't eliminate it, then trying to do so in a democracy with 300 million is a pipe dream.

You've moved from saying that NZ's policies couldn't be implemented in other countries because they wouldn't be effective to saying that NZ's policies couldn't be implemented in other countries because other countries refused to implement NZ's policies. The first is meaningful, the second is tautological.

Where in Canada is socializing banned?

In Québec as of midnight today it will be illegal to engage in any social activity outside of work, with the sole of two people living alone visiting one another in their residence, for a period of 28 days, in the regions marked as "zone rouge"

This includes outside gathering.

The end result is that I am not allowed to engage in any in person social activity for the next 28 days, at all. The only context in which I will be able to see people outside of my dwelling will be going to work (sadly/luckily I work remote), and getting groceries.

So basically, I'm banned from socializing for the next 28 days at minimum, and so are most people in Québec.

and yet Ireland, (island nation, similiar population) is way worse off.

I'd argue that it would work in any nation with an educated population where the leadership is listening to health experts and not undermining the containment effort or lying about the danger.

Did Ireland employ the same strategy as NZ? My claim isn't that being a small island nation is a sufficient condition.

Did a larger, non-island country without totalitarian control over their population unsuccessfully employ the same strategy as NZ? You can't have this both ways.

Yes. Australia copied NZ almost move for move (travel nearly completely banned - small handful of daily flights with quarantine, harsh lockdowns), and failed, primarily because Australia is too big.

They were able to eliminate covid in states of equivalent size as NZ, in effect achieving something just as impressive. But because the country is bigger, all it takes is a cluster in a single state to then propagate to others.

Australia is a pretty small country. In a country as big as the US it would be virtually impossible to eliminate without extreme levels of control over the population.

This is wrong, Australia did not have New Zealand's elimination strategy. It followed the same sort of strategy as most of Western Europe. Control the worst spike with a lockdown, and then relax once the worst is over.

One of the giveaways was in their briefings at the time. New Zealand was interested in every new case, because you don't get to elimination with some sort of high level statistical approach, you get there one case at a time. Australia was happy to cheer success if it had fewer cases this week than last week - but fewer isn't elimination.

New Zealand left Level 2 only after weeks with zero new cases. Because they understood that "it's just one case" plus "infectious disease" multiplied by time = unlimited cases. Meanwhile Australians decided they were done, after all it's only a few cases, what's the harm? Well this is the harm.

Except I can fly to Ireland from most of the EU for cheap (sometimes under 10 euros), with no passport and it's part of a very interconnected economy. Ireland also shares a land border with hr UK.

It seems entirely reasonable to disallow non-essential international travel during a global pandemic.

Maybe now, but that was not at all a sanctioned idea at the time, if we only listened to health experts as you suggest. [0][1][2]

[0] https://www.who.int/news-room/articles-detail/updated-who-re...

[1] https://www.statnews.com/2020/01/31/as-far-right-calls-for-c...

[2] https://euobserver.com/coronavirus/147576

> We eliminated Covid in the country

Verifiable untrue.

That's an odd way of spelling "factually correct"

https://theconversation.com/new-zealand-hits-zero-active-cor...

NZ eliminated Covid in the country. There were no active cases at one point.

The fact that another case came into the country does not change that fact.

Whoops you missed something

New Zealand Reports No New COVID Cases as Country Nears Elimination for Second Time

https://www.newsweek.com/new-zealand-reports-no-new-covid-ca...

And a third is coming. And a fourth. And a fifth.

At what point will you admit that it won't be eliminated?

I fail to see your point. We eliminated the virus in the country. There were no active cases of COVID, and we're on track to eliminate it again.

If your house has rats and you call an exterminator, you don't say you still have rats because other houses do and they might show up again.

Your idea of eliminated is "no positive cases for several weeks"

Mine is longer term.

> I fail to see your point

I know you do. I know you would.

My point is that you have not eliminated it. If it keeps coming back it's not eliminated is it?

> If it keeps coming back it's not eliminated is it?

Yes it is eliminated. If it's not eliminated, it can't come back.

If someone removes all the rats from the house, so that there aren't any, we say they have eliminated the rats.

If, later, someone brings a rat to the house, we say they have brought rats back to the house and now we need to eliminate them again.

Elimination is an action, the action of removal, and eliminated means the removal is now done. It means the thing is gone. It can still come back later.

New Zealand, for sure, has had probably the most effective response (helped by geography, for sure) among western nations.

That said: having it controlled now doesn't mean that it will stay controlled forever. As we're seeing right now in Spain, France and the US plains states, even very low steady state infection rates can still flare up. Then you spend a week watching people die, locking down, and watch rates go back down slowly. And then... realistically it probably happens a third time. Or a fourth.

Everyone needs to be taking this seriously. NZ isn't immune to the next outbreak, nor Sweden. But no: in areas with known-low and steady infection rates, a full lockdown isn't necessarily required.

Still: stay outside, stay masked, stay apart. Break those rules as little as possible.

I've seen people complain that talking about Sweden's approach is pointless because other countries that took the same approach couldn't expect the same results, but that's actually much more clear for New Zealand. For a start, just the inherent leakage of infections into the country through the quarantine hotel system, imports, etc - which causes a new imported cluster say every hundred days or less at New Zealand scale - means that a larger country would never reach the point where they eliminate Covid. Then there's the problem that other countries are just too well connected compared to an island nation a thousand miles from anywhere - if you tried the same thing in EU countries or the UK, you'd run into the problem that they rely on a constant stream of commercial trucking traffic across the border carrying important things like food, people live in different countries from their workplace, etc, all of which help spread the virus.

I dont think people catch the virus through contaminated surfaces. It s almost always airborne transmission

All those cross-border trucks have drivers, just like the ships importing stuff into New Zealand have crew. Unlike ships, the trucks don't just stop at the border and unload - they go on to destinations within the country, use trucking facilities along the route, etc. It's the people that're the main risk rather than the goods they carry. (Though when trying to eliminate the virus altogether even rare events can be a problem. There's some evidence that Covid may have spread to a NZ quarantine hotel worker via a contaminated surface and nearly escaped into the community. Obviously, the bigger the country the more likely rare events are to occur too.)

You seem to be making the common mistake of assuming that COVID is "over" in your country. COVID is endemic now - it's not going away. How long can you guys stay isolated from the rest of the world?

No, that's a really important point. Right now, the plan is to keep the borders closed until a vaccine is ready.

If that doesn't happen within a reasonable timeframe, then we definitely have to reassess our strategy.

But in the meantime, yes, COVID is effectively "over" within the country.

But it won't be "ready" for at least 6-9 more months, if it's ever "ready" at all. No vaccine exists for any other coronavirus. And when it's "ready" you won't know if it's safer than the virus itself, since there wasn't time to conduct large-scale, long-duration safety studies.

I mean, sure it's nice to be able to shut down borders for a year and a half, but you must see how this is not a realistic option for most other countries, including Sweden, so it's not really a valid comparison in the first place.

> this is not a realistic option for most other countries, including Sweden

It is also a question of how much economic cost a country is willing to incur. Trucks can swap trailers/tractors at borders so drivers never cross border. International Tourism can be completely shutdown. Borders of some countries could be closed by the army, incurring personal costs to anyone that normally would cross the border regularly.

Tourism in New Zealand contributed 6% of the country's GDP and supported 8% of New Zealand's workforce. Most of that was international so has dropped radically, and there are other economic costs to NZ on top of that. There are also the personal costs of families that are split between countries and people that can’t get to important life events like weddings or funerals etc.

NZ has decided that the economic costs are worth the gains of avoiding 2500 early deaths (expected 10yr decrease in lifetime for each) and x0000 long-term health problems. I don’t know if the gains are worth the costs, but I am pleased we have given ourselves time and avoided making a rash decision to incur those costs.

no offense but nz and other islands are extremely easy to control. as long as you close your border early and don’t allow it to take root in the first place, you don’t have to worry.

But you don't need to be an island to close your borders. Yes, some borders are porous and it would be ineffectual, but fundamentally, if a country commits to isolation, they will be isolated, island or not.

After decades of the single market, any EU country relies on at least a steady stream of freight trucks to keep its population fed, and fruit pickers have to be brought in seasonally from other countries, because otherwise all that produce will simply rot in the field, etc. Completely closing borders would simply not be feasible without years of preparation.

To that point, Hawaii currently has 1/7th the per capita mortality rate of the entire US.

Hawaii's mortality rate is nearly 1/3 the rate of Canada (which has done a solid job by comparison to the US) and 1/6 the rate of Sweden. Finland, which has one of the elite outcomes in the West, is how far you have to go to find a better outcome (Finland's mortality rate is only 2/3 that of Hawaii).

Yep, that is exactly what people like the OP fail to grasp.

Based on NZ's past actions I would bet they come out of total lockdown sometime in mid 2022 or about 2 years from now. If the people of NZ are fine living this way for the next 2 years while their economy and lively hoods crumble then that is their business.

No way in hell I would let that silently happen to me.

> Aside from international travel, Covid now has basically zero impact on my day to day life. Because there is effectly 0 chance of communitry transmission at the moment, life has essentially returned to normal. Bars, restaurants, etc are open and buzzing. All this and our case numbers are lower than almost any other countries death numbers.

Doesn't sound like "total lockdown" is what's happening there right now.

Yeah, it's not. That was the whole point. We did an "early and hard" lockdown so that we could be done with it. Which we largely are.

Yes, it sucks for the travel sector and it sucks for people who need to travel internationally (my family are in Ireland so it directly affects me).

But it sucks everywhere for everyone, and in both economic and health outcomes, we are way ahead of the curve.

> Based on NZ's past actions I would bet they come out of total lockdown sometime in mid 2022 or about 2 years from now.

Most of New Zealand is at "Alert Level 1" which means there aren't any restrictions or mandates, but since COVID-19 exists you're asked to please consider wearing masks on public transport, and try to keep your distance when possible.

For now (likely until next Wednesday) the city of Auckland is at "Alert Level 2" with a prohibition on large gatherings (more than 100 people in one place together) and a requirement to wear masks etc. as a result of an outbreak that happened there in August.

> no offense but nz and other islands are extremely easy to control. as long as you close your border early and don’t allow it to take root in the first place, you don’t have to worry.

I'm not sure there's actually much of a difference in ability to "close the border" between a island country like NZ and one with land borders like the US. The US probably has equal control over arrivals by air, and most land traffic comes via controlled border crossings.

The main difference is basically the greater amount of illegal immigration and other kinds of smuggling. I don't know what the ratio of legal international travel vs. illegal immigration is, but I'd strongly suspect there's orders of magnitude more of the former than the later (at least during normal times). IIRC, the rates of illegal immigration have also dropped significantly during the pandemic.

Sweden only borders Norway and Finland, which are both stable countries with amicable relationship with Sweden. Also most of the border is arctic forest with very few people.

It may be harder than NZ, but closing borders should be much easier for Sweden than Germany, Turkey, or Thailand. They all fared better than Sweden.

We're jealously watching from across the water in Melbourne :(

> Aside from international travel

Could you tell us how you feel about your fellow countrymen and women who work in travel and who's lives have been completely upended (sometimes permanently) by the affects of the lockdowns?

Or those such as myself who were forcibly separated from our partners overseas for 5 months? I had to fly to Dubai to reunite with my partner just so I could bring her back to NZ with me. I'm lucky to be able to do so; remote job, no kids, have savings. We have a Facebook group with 1,400 members in the same position who were and are suffering for months from the extreme border closure, many are married and have children.

No one is claiming it's a good situation. But given the alternative was 000's of deaths, that is just the unfortunate reality.

There's no good answer here, only a least bad alternative.

Somehow any comparison with NZ about ability to isolate seems rigged...

You don't have to be an isolated island to pull this off.

I live in Nova Scotia, Canada. We've bubbled with three surrounding provinces (~2.5 million people) and are in basically the same boat as NZ. We've had < 10 known cases since June IIRC, often with < 5. We're currently at two known cases.

We are NOT an island nation but have taken one hard line measure that has been effective: a 14 day quarantine when you come here from anywhere outside the four-province bubble

We also have a largely compliant population when it comes to social distancing and masking in public indoor places.

We also have the benefit of being a discretionary trip for most people who visit - there isn't a ton of travel in and out of the main cities compared with e.g. Toronto or Vancouver.

But life is pretty much back to normal. Restaurants + bars buzzing (at 50% capacity), retail open, no lockdown, etc.

People keep moving the goal posts on this.

Unless Sweden's health system implodes because the pandemic overwhelms it, their approach has obviously not been a total failure.

The rationale for the brute force lock-downs, AIUI, has always been to preserve the ability to treat patients. i.e. to not have all hospitals resembling the early scenes coming out of Lombardy Italy or Wuhan China.

Sweden didn't institute draconian lock-downs, and never lost the ability to treat patients, never devolved into the utter chaos many predicted.

We can't meaningfully compare other statistics like total deaths and economic impacts until the pandemic has run its course.

How is it goal post moving? They have one of the highest death per capita in the world from Coronavirus. It's roughly equal to Italy's. To say it hasn't been a total failure doesn't mean it's something to emulate.

>We can't meaningfully compare other statistics like total deaths and economic impacts until the pandemic has run its course.

We can. Otherwise you wouldn't do anything differently at any time.

He means the goal posts moved from "flattening the curve" to "save every last life". Maybe the goal shouldn't be to save every last life but to strike a better balance between living our lives freely and containing COVID to some extent.

They also have the highest unemployment rate among neighboring countries, so it doesn't seem like they continued living their lives freely, either.

In some places, like Sweden, many people have voluntarily adopted policies much more strict than required by law. In other places, like the US, many people have chosen to live lives much less strict than required by law. Government mandates alone don't make as good a basis for comparison as actual activity.

The unemployment rate has been higher in Sweden than in Denmark before Covid-19 though, and similar to Norway (which it is today as well). It doesn't seem to have moved very differently from the neighboring countries.

Useful statistics will hardly be available until the pandemic has come to a hold. It's too early to tell if e.g. Germany's approach of avoiding unemployment by massively increasing public debt is successful in the long run.

Deaths above median will tell the actual story. There are too many bad incentives on covid death reporting.

Please tell me the story of deaths above median. I'm dying to know.

In March/April many said Sweden was heading for disaster

Social distancing and masks only slow the spread, so unless these measures prevent healthcare system overload, they have only delayed and not prevented deaths. So yeah, since Sweden's healthcare system has not been overwhelmed, their approach has not been a failure.

The Swedish healthcare system was not overwhelmed in part because they only offered palliative to the elderly.

Sweden flattened the curve and did it without authoritarian lockdowns. So of course lockdown proponents are upset.

This desire to have the government force people and businesses to shut down is unnerving. Are people seriously this susceptible to authoritarianism when they are scared?

The goal is to flatten the curve. We did it. Sweden did it. Why are people so happy to dunk on Sweden because Sweden didn’t follow authoritarian ideas?

Your interpretation of the world is fascinating.

I find it fascinating that people are happy to dunk on Sweden for NOT imposing authoritarian rules on their citizens. Are we not free people?

We are. Free people that consent to laws in the interest of the public good. Ideally anyway.

In the US, most of rules have been propagated by fiat, not lawmaking.

>We are. Free people that consent to laws in the interest of the public good. Ideally anyway.

Not necessarily. Optimizing the for the public good is a social utilitarian argument[1]. Absolute utilitarian is incompatible with personal freedom and justice, so most people put limits on it.

Reasonable and moral people can differ on where this limit should be.

https://en.wikipedia.org/wiki/Utilitarianism

"Mission Accomplished" - The banner behind George W. Bush in 2003. There are still US troops in Iraq to this day, 17 years later.

This just seems like an extreme case of premature celebration. We have the winter ahead, and are still many many months from a widely available vaccine. Sweden's methodology has yet to be fully tested, and they also don't live in an isolated vacuum, immune from actions taken by their neighbors and the world. Let's wait until Spring 2021 before we start handing out trophies.

Perhaps, in the end, it will turn out that Sweden made an unwise choice from a medical perspective. As of today, the USA and UK have more deaths per million than Sweden.

Even in some unknown future where it is determined that Sweden took the "wrong" path, it will always be true that Sweden allowed the citizens the freedom to make their own decisions instead of imposing decisions on them through force of law.

I am sure the dead will value their freedom.

A common defense of authoritarianism. It's for your benefit, silly!

We know the risks of Covid. We know who the at-risk population is. Adults can make their own decisions. If you don't think free people deserve their freedom, we'll just have to agree to disagree.

These are generally the same people that call Trump a fascist/say democracy is dead.

Paternalism and authoritarianism is alive and well on the left too.

And it's generally worse cause they act like they have the certainty of science, academia, etc. to justify however they abuse power.

See how that played out in the Progressive era...eugenics, central planning, corporations...the list goes on.

The common question is where do your freedoms end and mine begin? Are you free to drive drunk and put others at risk? What about smoking in restaurants?

COVID appears to be fairly contagious, and spreadable by asymptomatic people. If you are out being 'free' while asymptomatic and giving X number of people COVID, you are infringing on their freedoms. It's not as simple as you wanting to be free to make your own choices, when your choices can impact someone else's freedom.

If you feel that you are in a risk pool where covid could be deadly to you, then you should stay home. That is a true statement whether there is a lockdown, or not.

Doesn't answer the drunk driving or smoking issue. "Your Freedoms" always have limits. Without a strong safety net and worker protection, some at risk people are being forced outside to survive. Sweden at least has a strong safety net, some would even consider it relatively socialist. That can't be said for everywhere.

Your right to swing your fist ends where my nose begins.

You can choose to, or to not, go outside or into a restaurant. If you feel that your life is at risk due to covid then you should choose to not. Whether or not I go into a restaurant is of no consequence to you.

A lot of people have sacrificed their life for freedom, especially in America. It’s literally one of our few uniting values

Maybe your goal was to "just" flatten the curve which, even if you don't overwhelm hospitals, still leaves a lot of people dead or with permanent damage. Others think the best strategy is (and some other countries' stated goal was) to push cases down to a number where containment strategies (tracing contacts and wiping out infection chains) work again. Some countries got too lax after the lockdown and let cases rise above tracing capabilities again, in other countries that still works.

But you’re pretending like all people are equally vulnerable to the virus. What if Sweden had not ducked up their nursing home response?

A lot of illnesses leave people dead or with serious damage. Why Lockdown for only COVID then?

Sweden's problem was not "ducking" up its nursing home response, this has been debunked over and over. The problem was wide-scale community spread, making spread to nursing homes inevitable. As a data point, Norway's nursing homes were actually hit harder proportional to the total number of deaths, but as a country they got away with 1/10 per capita deaths of Sweden thanks to limiting community spread.

Spreading to nursing home doesn't have to be inevitable. Swedish government has admitted they could have handled this a lot better. I think this time around they will not duck it up again, making the strategy look even better

>People keep moving the goal posts on this.

I think it's because the story is being politicized. People who want to reopen everything are saying it's a success. Whereas people who want to keep things closed are saying it's a failure.

My understanding is that Sweden did not attempt to treat elderly patients; it only provided palliative care. (https://www.wsj.com/articles/coronavirus-is-taking-a-high-to..., for example)

Then there's this, from back in May: https://www.medpagetoday.com/infectiousdisease/covid19/86256

I'm confused why stories about Sweden's success keep popping up here. The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries. Seems to me like the worst of both worlds.

I too call B.S. There is an ongoing concerted and heavily proactive campaign being orchestrated in the press about Sweden, at their own behest (I'm sure other foreign governments that like to meddle in elections). And it seems almost entirely to prevent comparing them to their more successful neighbors.

Exactly and why I've tuned out all media minus local weather and or emergency reports.

It's also sporting a GDP contraction that is... A little worse than some of its neighbors, a little better than others, but entirely in the same ballpark.

I really wonder what GDP really means in todays world when money is "free" and there are no limits on government spending. For example Denmark had less bankruptcies than previous years back in March and April.

Looking at government debt both Finland and Denmark loaned about double compared to Sweden, while having half the population, essentially 4x the loaning per inhabitant with similar results.

Sweden: https://tradingeconomics.com/sweden/government-debt

Denmark: https://tradingeconomics.com/denmark/government-debt

Finland: https://tradingeconomics.com/finland/government-debt

> I'm confused why stories about Sweden's success keep popping up here.

I'm not.

What was their relative unemployment rate before covid? It doesn't make sense to compare absolute rates - you should compare the change.

Because the outbreak slowed without any strong controls.

Sweden had a light response to the pandemic, and it quickly found itself with a major outbreak, and a high rate of deaths. Yet without implementing any major controls, with significantly less social distancing among the population, without significant mask usage, the outbreak seems to have slowed substantially.

It's almost impossible to make these comparisons in real-time, without the benefit of hindsight. We won't know if this approach made sense until after the pandemic is over. But it's certainly an interesting data point.

One thing that is clear is that it's far too complex to look at a couple metrics, compare them against wildly different populations, and form a conclusion. Sweden had a higher unemployment rate than many of its peers before the pandemic. Exports are a staggering 47% of GDP in Sweden. Sweden made the same mistake as many other countries, putting COVID-positive patients in nursing homes.

But the longer the pandemic remains under control in Sweden, with comparatively little social distancing and mask usage, the more interesting it becomes, particularly as countries which implemented strong lockdowns see renewed outbreaks.

The uncertainty was all the more reason to be more aggressive!

We are freaking lucky that COVID’s death rate is by the lower end of all the estimates. If the actual rate was closer to what Italy was seeing, or even a smaller fraction of thst, Sweden would have had far more dead.

And the death rate is down because we understand the virus better and so are able to take actions that do not involve locking down to control it. And also it wasn’t a massive emergency at this time with massive shortages of PPE etc.

I agree with you, I supported the lockdowns in the United States, and I think, for instance, the SF Bay Area did a good job.

But it's still an interesting data point.

If you think that was luck, then you didn't understand the difference between CFR and IFR.

The Case Fatality Rate (CFR) is the fraction of reported cases that result in death. This is easier to measure. And if you're sick enough to become a reported case, it is the best back of the envelope estimate of how likely you are to die.

The Infection Fatality Rate (IFR) is the fraction of infected people that will die. For estimating how many will wind up dead if you hit herd immunity, that is the relevant figure. It is also harder to produce.

Early on we were seeing CFRs in the 5-10% range. That is the figure that you remember

But the first estimates of the IFR was an analysis of the Diamond Princess. It estimated an IFR of around 0.5%. In late March, Fauci reported that it was about 1%. Both estimates had significant error bars. The figures that Neil Ferguson used in his model was in the same range. All of this happened while we saw CFRs in the 5-10% range.

And therefore there should have been no surprise from the beginning that the CDC estimate of the IFR for the Spring would come out where it did, 0.65%.

Part of the problem is that early on the US media actively misinformed people about this crucial point for partisan reasons, describing the naive CFR as the real WTO-confirmed fatality rate and lower figures as Trumpian lies created to downplay the severity of the disease.

> And therefore there should have been no surprise from the beginning that the CDC estimate of the IFR for the Spring would come out where it did, 0.65%.

Where are you seeing the CDC say that please?

It's actually considerably lower.

0-19 years: 0.00003

20-49 years: 0.0002

50-69 years: 0.005

70+ years: 0.054

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

That's a ratio. 0.054 = 5.4%, etc.

Note that 70+ years has an IFR of 5.4%. https://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf says that in 2010 there were 308,745,538 Americans, 40,267,984 of which were over 65 and 12,435,263 in the 65-70 age bracket. That makes 70+ around 9% of the population, which means that expected deaths from people who are 70+ are an IFR for the general population of 0.49%.

That's the bulk of the deaths. Add in the other age groups and, if you do the numbers correctly, you should get close to my figure. (With a small difference because you're quoting updated numbers and I'm quoting figures that are a few months old.)

From your link:

> The parameters in the scenarios:

> Are estimates intended to support public health preparedness and planning.

> Are not predictions of the expected effects of COVID-19.

I found that figure in https://www.statnews.com/2020/08/24/infection-fatality-rate-... but I am not sure where they got it from.

Diamond Princess has a raw IFR of 1.8%. The studies you were likely referring to were all done in March when the total number of fatalities was 7. That number is now 13.

Anyone who claimed to know what the fatality rate was back then is full of it. Even in places that had gotten the spread of the virus under control, there were still significant numbers of unresolved cases. And it will likely be another year or two before we have a good idea what IFR is, as COVID has demonstrated differing levels of severity in different populations, and adequate health care capacity has show to have a large impact, which large portions of the world do not have access to.

They were done in March. But furthermore they attempted to quantify based on the age breakdown.

0.5% was therefore the best available early estimate, with a large error bar.

Because the outbreak slowed without any strong controls.

Well, yes, people wake up eventually, when their friends are dying. That said, new cases per capita in Sweden are still an order of magnitude higher than in Finland and Norway. Denmark caught up last month, but that may be because they are so much more urbanized there.

See graphs: https://ourworldindata.org/coronavirus-data-explorer?zoomToS...

> new cases per capita

Why is this a relevant metric at all?? UK (where I am) has more confirmed cases than in March, yet comparatively negligible death rate. So the raw new cases metric is obviously completely useless and uninformative, there's clearly something else going on (better management of disease, more medical resources, less extremely vulnerable people, more testing, ...)

Why is this a relevant metric at all?

We don't know enough about long-term problems affecting those who caught it, although one glance at Boris Johnson should get anyone worried.

Convalescence is protracted, and there are reports of lung damage and cardiomyopathies in a good number of recovered patients. We don't know yet for certain about neurological problems, but there are indications that covid might cause demyelinating disease, and until that's settled I'm not going to find out.

> one glance at Boris Johnson should get anyone worried.

He always looked disheveled. Has it gotten worse?

Agreed on he longterm effects, I don't think we know all of the longterm impacts yet and as such I'd prefer to avoid it until a safe vaccine is available.

Tired look, red eyes and zombie walking is not a uncommon effect after a new baby arrives at home.

His kind has nannies.

If you're looking at human cost, then yes, deaths is what matter. If you're evaluating protocols to prevent infection, then cases per capita is exactly what you care about. The likelihood of death when you get infected could be a better measure of how well the hospital can treat it, for example. But if you're evaluating how well mask-wearing impacts the spread of the virus, then looking at new cases per capita is the metric of interest.

> If you're looking at human cost, then yes, deaths is what matter. If you're evaluating protocols to prevent infection, then cases per capita is exactly what you care about.

But there is no reason to care whether infection is prevented or not, unless infection carries some sort of cost. That metric has no value on its own.

I'm genuinely confused at what you're trying to get at here. I mean, in the abstract, sure, if an infection had no "cost" we wouldn't care about how widespread it was. But it's fairly well-established by now that this specific infection carries not only a small but obviously real risk of death, but a risk of lingering, debilitating effects that go far beyond the respiratory system.

Cases per capita is still very misleading without accounting for number of tests though, no?

Looking at some countries that offer more detailed data, you can sometimes see the cases double, while hospitalizations and deaths grow at a much lower rate (if at all).

Compare for example the UK:

- This chart for the daily new cases shows a dramatic second wave that even exceeds the first one: https://www.worldometers.info/coronavirus/country/uk/

- This chart for the positive rate on the other hand shows a modest increase to ~3% over the past few weeks, far below the 30% in April: https://ourworldindata.org/coronavirus-testing#the-positive-...

- And if you look at the number of tests you'll see it has more than tripled since April, hence the increase in "cases": https://ourworldindata.org/coronavirus-testing#how-many-test...

If you are looking at human cost, it is not just death that matters. The people who have long term consequences matter too. It is that if you dont die you walk away scott free.

It is that there is range of consequences from absolutely nothing to death through "sick for months" and through "maybe lifelong consequences but we dont know yet".

Do you have evidence that permanent damage occurs in significant numbers?

It's studied, of course, but, yes.

Even if 10 % of patients end up with permanently reduced lung function it's a lot because the disease is so infectious, given the right conditions, and it isn't going anywhere soon, at least not this winter.

Here's an overview: https://www.nature.com/articles/d41586-020-02598-6

I think you have misread the article. It says that less than 10% will even have intermediate-term damage. There is no evidence that any significant numbers of people will have long-term, let alone permanent, damage.

It's a metric of interest, but it's uninteresting if we can't measure it properly.

To get a good estimate we'd have to randomly test the population, instead of measuring people with symptoms. Since a lot of people are asymptomatic or don't get a test since they don't feel too sick. Picking people at random would give us a good overview of active cases.

In March in Germany they were reporting a doubling of cases on TV every day, but they failed to mention that they had administered almost twice the tests as well. So basically the number we were measuring was the number of tests we could administer, which was naturally rising as testing capacities expanded, not the number of Corona cases.

Deaths just seem way more reliable a measure.

Well you are correct about the reliability factor. In theory, we could have randomly tested, but for reasons that escape me this was done almost nowhere. Deaths is more reliable.

However, the metric that is actually at least attempting to measure the underlying reality of interest, here, is not deaths, but cases, that's my only point. But I totally concede that in some cases deaths may be the less bad metric for cases, than confirmed cases.

Sweden actually does it. It's PCR tests to track the number and change in ongoing infections in the whole population.

0.9% end of April

0.3% end of May

Zero of the tested were infected end of August

End of September is being published next week

https://www.folkhalsomyndigheten.se/nyheter-och-press/nyhets...

On Tuesday, at the press conference, they said that it was 0 in September as well. The more detailed report is published next week.

> yet comparatively negligible death rate.

Isn't this primarily because it's mostly the younger demographic that was getting covid over the summer?

Steroid usage is now part of the guidelines, it wasn't in March. Non invasive CPAP are preferred to ventilators (which have a terrible survival rate).

A car hitting a wall will come to a full stop eventually without applying the brake. Not a great metric.

Considering that cases seem to be increasing again, there is obviously not herd immunity and thus that's not what happened.

Cases are increasing everywhere due to increased testing. Increases in hospitalizations and deaths are much lower or nonexistent, even after taking into account the expected delay between infection and hospitalization.

We would expect hospitalisation duration of stay and severity, and therefore instantaneous numbers hospitalised, to improve anyway, because the medicine has improved a lot since earlier in the year.

And that chance to significantly improve the medicine was helped, hopefully, by the "flatten the curve" policies intended to delay the spread of the disease regardless of whether the number of people getting it would end up the same.

So you can't directly compare both waves. A lot of things have changed between them.

This is substantially wrong. Medicine has not improved at all over the time period. There are still no accepted treatments for the virus. They stand by the same treatments they have always used for treating the sick For a non-curable virus, fluids and steroids.

> Yet without implementing any major controls, with significantly less social distancing among the population, without significant mask usage, the outbreak seems to have slowed substantially.

Are you saying that social distancing wasn't mandated by the government or that people didn't choose to do it all? Because there is an obvious potential explanation that once people started dying, Swedes chose to social distance on their own without being told to do so.

People aren’t wearing masks in Sweden, though.

That's a potential explanation, but is it based on anything?

Per the IMHE's COVID page [1], mobility has been depressed, around -30%-35% at peak, and that does line up with the peak of deaths, so there's some merit to your argument there.

What doesn't really line up is that mobility quickly rose again, up to around -25% and then -15% from base line, without a corresponding increase in cases, deaths, or hospitalizations. It dipped again, and then went back up, and is now hovering closer to -10%.

There's also been virtually no mask usage throughout the entire pandemic.

Compare this to the US [2], which fell to -50% at peak, and has never risen above -20% this entire time.

[1] https://covid19.healthdata.org/sweden

[2] https://covid19.healthdata.org/united-states-of-america

>What doesn't really line up is that mobility quickly rose again, up to around -25% and then -15% from base line, without a corresponding increase in cases, deaths, or hospitalizations. It dipped again, and then went back up, and is now hovering closer to -10%.

If I go to that mobility stat and plug in a bunch of other countries they almost all look the same and Sweden is no outlier. That is also true for the lack of increasing deaths which is nowhere to be seen compared to the first wave.

So either everyone is doing what Sweden does or Sweden is doing what everyone else does, depending on your perspective I suppose.

Which countries did you plug in?

I gave one very big counter example: the US is social distancing at a rate roughly double that of Sweden and is getting worse results. It's also had multiple waves of deaths.

Canada isn't getting worse results, but is also roughly socially distancing twice as much as the Swedes.

The UK went down even further, down to -70% mobility.

Leaving the Anglosphere (what I'm most familiar with, sorry), Germany is now closer to Sweden, but was also below ~50% mobility. France was down to -84%!

And the Scandinavian countries: both Denmark and Norway was down to around -60%, and Finland was at around -50%.

All of these countries also rebounded from their social distancing "peak" much more slowly than Sweden.

At least among Western countries, I think a fair characterization is that while Swedes may have socially distanced on their own, based on mobility data, they did so less and for a shorter time.

These extreme values for France etc are projections into the future, I'm not entirely sure what they're basing it on. I've only looked at the graphs up to this day. For some reason they are saying that France will drop from -12% to -84% in one day, I guess they're saying the country will go into complete and utter lock down which I don't believe is true and definitely not a fact.

You're misreading it I think; France dropped to -84% March 24-28th.

People in general are looking at outcomes in countries and states (selectively) and interpreting them through lenses that correspond to their policy preferences and their feelings about the governments in general.

The Atlantic [1] has an interesting article on the role of super-spreaders. It possibly suggests a particular contact tracing approach but it also suggests that, especially early on, there was probably a great deal of randomness in how events unfolded in a particular place. I can't speak to the medicine but it has certainly seemed as if a lot of outcomes have been pretty random. (With some exceptions like nursing home deaths that were just bad policies.)

[1] https://www.theatlantic.com/health/archive/2020/09/k-overloo...

Yes, the randomness between even neighboring countries with similar cultures (say Spain/Portugal) indicates that there's a lot more going on. Good research on the success and failures of Sweden's approach (and therefore indirectly of the general approach of the global consensus) will require much more thorough investigation of the various factors and confounding variables. It's going to be a center of research for years.

I suspect that some things may be ultimately unknowable. But we might also well conclude that some behaviors that a lot of people feel very strongly about don't really seem to have mattered much.

Look how things have changed since even early March. I was at my last in-person tech event at the beginning of March, a few hundred people, and lots of care was being given to not shaking hands and wiping down surfaces but there wasn't so much as a thought of distancing or mask wearing (and who knows how important those things will turn out to be either).

In another comment I mention one piece of research indicating that overall our non-pharmaceutical interventions didn't do much of anything other than small short term effects. There's a fair bit of data showing that while people feel good about masks and social distancing, it doesn't appear to affect the pandemic. However, more focused efforts like protecting nursing homes could've saved half the lives lost in this pandemic (https://www.washingtonpost.com/local/baltimore-nursing-home-...). But it generally takes well trained professionals to do it consistently enough, IMHO.

Portugal and Spain is interesting. Spain response is probably one of the worst in the world, with things getting so bad that the army had to clean out the dead from the living from abandoned nursing homes. I don't think you can compare the two really, since Spain's response seems so chaotic and mismanaged?

I got a feeling that picking the low hanging fruit in time (i.e. concerts, clubs, packed public transport) is enough to not get a big spike at all. Otherwise most European countries should explode since social distancing is no way taken as serious anymore.

>Otherwise most European countries should explode since social distancing is no way taken as serious anymore.

A cursory look suggests most of them actually have been exploding in new cases since mid-july/early-august

> Spain response is probably one of the worst in the world,

I don't think so. This problem is not monolithic. Response is just one factor but not the only, structural factors are other.

An example on structural factors is the population size. Biggest countries will have a higher absolute mortality (more deaths) than smaller ones for example. Just because they had a bigger pool of people vulnerable.

Small ones, on the other hand, could end having a much higher relative mortality.

Is unclear at this point who types of factors have more weight here, but all the hot spots in the first part of the first wave share several common denominators. All except one, and they are structural ones.

Spain and Portugal do not have similar cultures at all. The Portuguese are known for their "brandes costumes", their restrained manners, as much as the Spanish are known for the opposite. That might explain the difference in case numbers.

And people also tend to only look at policies that were implemented due to COVID and leave any pre-existing policy differences out of the picture. In Sweden it's likely much easier to stay home when you show symptoms without risking your livelyhood than it is in the US. Things like that might make a difference when looking at other measures that were out weren't taken

The idea that places where generous sick time and healthcare policies cover more of the population might have better COVID outcomes is not an unreasonable hypothesis--and there are at least anecdotal examples of urban immigrant/poor communities in some places, including both Sweden and the US, being especially hard hit.

But you'd need to study how much correlation on this dimension there is in general worldwide to conclude it's a major factor.

Very much agreed. My point wasn't that this definitely matters or doesn't matter, but that there is more going on on countries than just the policies specificly put in place for COVID. It's easy to fall into the trap of only looking at which country took what steps.

Swede here.

> Yet without implementing any major controls,

Weasel word "major". Everyone who can work from home has done so since April. I'm basically isolated at home all day. The difference is that it's voluntary because the government thinks we are adults. Turns out we are!

> with significantly less social distancing among the population,

Than what? And citation needed. I have cut down my physical interactions by crazy amounts and this is extremely common.

> without significant mask usage,

This is true.

> the outbreak seems to have slowed substantially.

The most vulnerable have died already if that's what you mean.

Now there IS a good argument for Swedens approach being good for Sweden and that is that we have had lower than average total mortality a while now. Meaning probably that the deaths we saw were dominated by people who had their lives cut short by 6 months or less.

"X dead" is an obvious crap number if you think about it for 1 second. The actual interesting number is how many years have the disease cut from people's lives. Seems like not a lot actually. We took a huge gamble on this entire thing though.

> it's voluntary because the government thinks we are adults.

Or, a country of lonely conformists.

Over half of households in Sweden (52 % of all households) were one person households in 2017, the highest in the EU by a considerable margin (Eurostat data.)

Also, Swedes have extreme levels of social conformity, more comparable to Japan than even its Scandinavian neighbours.

Not a good environment for a virus.

Indeed, if you want to spread the virus to your neighbor here you'd have to catch them not avoiding you first.

It's easy to forget that Sweden also has a much stronger social system than the US. I vaguely recall reading that Sweden also expanded some compensation for people who stay home because they show want symptoms at all. Can you elaborate on that?

It used to be that you didn't get any sick income the first day to prevent frivolous usage, this was changed back in March.

Now it is 80% for a year, you need a doctor's note after three weeks. This used to be one week but to limit the strain of the health services it was increased. If the company want one earlier they need to pay a private doctor to do it.

You also get 80% of your income if your children younger than 12 get sick and you need to stay home to take care of them.

Due to corona any respiratory illness is included in this, and it is a crime to go out in society if you have confirmed or serious suspicion of infection. (Infectious disease law)

> Due to corona any respiratory illness is included in this, and it is a crime to go out in society if you have confirmed or serious suspicion of infection. (Infectious disease law)

So, what you are saying, is that compared to say, the US, Sweden has been subjected to a truly draconic lockdown.

Edit: I'm not sure I understand the karmic sentiment. In the US, closing movie theatres and requiring patrons to wear masks was controversial.

Being criminally charged for going outside would be considered tyranny - so it's a little odd to hear that Sweden is given as example of a less-locked down country.

> So, what you are saying, is that compared to say, the US, Sweden has been subjected to a truly draconic lockdown.

Exactly. Coronavirus truthers point to Sweden only as an example of a country that avoided a catastrophe despite not instituting a lockdown, then change the subject when you talk about what Swedes actually did do that they are also not going to do.

It fits under the standard argument "We don't need to do [X] when [Y] would work just as well. We're also not going to do [Y]."

People get criminally charged for gross bodily harm or intent to commit gross bodily harm. It's not "tyranny" to ban knowingly spreading a plague more than it's "tyranny" to knowingly kill someone.

It is my perception that Swedes don't enjoy agglomerations much.

e.g.: the Swedish bus stop meme shows that social distancing has been the standard for years before COVID-19.

Yet, Malmö- which is not as isolationist as Stockholm and has incredibly few cases.

I think it’s something else. Probably the working from home has a large impact.

A Swedish colleague joked that soon they will be able to drop the recommended 2m social distancing ... and go back to their traditional 5m

That bus stop meme picture is from Finland, FWIW.

I live in the UK. We had politicians who tried to appeal to reason, and they got shouted down in the media. The most popular politicians today are the ones who wanted to lockdown fastest. Everyone in care homes still died. We had to spend hundreds of billions to pay people through lockdown. People have still ended up getting infected. And (most) people are still avoiding out anyway, irregardless of lockdown. It is just chaos.

The politicisation of this issue was totally catastrophic. There was right-wing and left-wing science, no-one could accept that some things are unclear, and anyone who opposed the "correct science" was a conspiracy theorist nutjob.

I am glad that some places took another path though. I thought masks would be effective, where I am you are legally obliged to wear masks inside, and our rate of infection is higher than it was a few months ago...I was wrong. The UK won't learn from this (we would have locked down irregardless, I have had people tell me earnestly that they won't stop socialising, irregardless of other people's health...btw, these are not right-wing/freedom people...this was a lefty software developer who likes going to the pub...as a society, we deserve to suffer), other places hopefully will.

My perception is that it wasn't a gamble for Sweden either, the guy in charge seems to have had experience with infectious diseases at the WTO..tbf, a lot of our people had experience in this area too (and specifically with coronaviruses/influenza)...maybe in terms of public/international opinion but...the UK took that path, it didn't work.

Unfortunately your lockdown appeared to have been a case of closing the barn door after the horse has bolted - or in this case, after the horse is already widespread in the community.

Feel sorry for you lot, you got the worst of both worlds through what appears to be confused leadership.

Cases are doubling each week in Stockholm right now. This article seems to have jumped on the bandwagon too late: the slow up-tick of cases was due more to people staying longer at their summer cottages, than anything special about Sweden’s strategy.

> But the longer the pandemic remains under control in Sweden, with comparatively little social distancing and mask usage, the more interesting it becomes

And if Sweden has another outbreak? You'll revisit those arguments? Really it seems like everything you're saying is predicated on the idea that Sweden hast his "beaten" in a way that just doesn't seem rational. What's the argument that they won't see a phase 2 just like everyone else has, or will?

(Obviously someone is going to chime in with "herd immunity", but that's simply wrong: other nations and regions with similar initial outbreak sizes saw second outbreaks.)

But none of those 2nd wave places took Sweden’s relaxed policy, which is likely to promote herd immunity (likely the only one to not fight it)

There's no science showing a higher antibody prevalence in Sweden than other places like NYC that had large outbreaks. You need to cite something if you want to claim that.

There is no science showing antibody prevalence is required for herd immunity either; you need to cite something ..... (but you might want to look at: [0]).

Everywhere except Sweden implemented legally mandated strategies -- often with police and military enforcement - that were designed to limit virus spread, including places that had just-as-bad-or-worse death outcomes such as NYC, Italy, Spain, Switzerland and France.

Really, almost nothing can be said for certain, and it's definitely possible for Sweden to experience a second wave soon, but it won't if this virus' dynamics is similar to other viruses - which, by all studies, it very much is.

[0] https://sebastianrushworth.com/2020/09/28/herd-immunity-with...

> it's definitely possible for Sweden to experience a second wave soon, but it won't if this virus' dynamics is similar to other viruses - which, by all studies, it very much is.

Again, that seems like you're just trying to argue by fiat. There's NO EVIDENCE that Sweden has reached herd immunity. It's initial outbreak was less severe than Spain or France, both of which are now well into a very large phase 2 outbreak. What's the argument that this is impossible in Sweden that doesn't rest on arguing that it hasn't happened yet?

> What's the argument that this is impossible in Sweden that doesn't rest on arguing that it hasn't happened yet?

What's the argument that Sweden will experience one, given that there is no reason to believe a phase change in Sweden (or a change in circumstances, like measures in other places cause), other than that other countries experienced ones? It goes both ways.

> What's the argument that Sweden will experience one

That everyone else has? Again, the only way for you to make your argument work is to argue that Sweden is somehow special in a deeply unique way. All I need to say is that they're probably just lucky.

Not everyone else has. NY's graphs, of both disease and death, are similar to Sweden's, and SURPRISE it doesn't have a 2nd wave either.

All I need to say that is that they did something different to postulate that the result might be different (and so far, has). I acknowledge there is no proof either way, but you are just putting hands in your ears and saying "I can't hear you, my position is right by default so there". This argument is over as far as I am concerned.

Coming back after a few days to point out that, as SHOULD SURPRISE ABSOLUTELY NO ONE, Sweden seems to be well into what appears to the start of a second wave: https://91-divoc.com/pages/covid-visualization/?chart=countr...

Do you care to revisit your assurance that this couldn't happen and that the one outlier (no longer an outlier) of Swedish data might not have been the best reference for informing US policy?

(Edit: I love the near synchronous downvote in a week old thread. That's just... <chef's kiss>)

> Because the outbreak slowed without any strong controls.

Maybe not mandatory, but Sweden had/has voluntary controls in place. People there seem to actually listen to their government and try to do the right thing. The US could be in a similar situation, but we all know how that has gone.

https://www.newscientist.com/article/2251615-is-swedens-coro...

While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people.

“Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.

This appears to be true, in Sweden at least. The measures did work nearly as well in getting people to change their behaviour. Adam Sheridan at the University of Copenhagen in Denmark, for instance, has used data from a bank to compare spending patterns up to April in Sweden and Denmark. Denmark introduced a compulsory lockdown on 11 March, one of the first in Europe.

> Because the outbreak slowed without any strong controls.

Perhaps, but Finland and Norway only took about 50 days to reach steady state on deaths per capita while it took about 120 days for Sweden.

The current data suggests that Sweden did not do better than Finland or Norway unless one of those two countries has a sudden spike that Sweden does not have. Anybody crowing "Sweden did better" needs to present some evidence that Finland and Norway are going to get some spike in the future that Sweden will not--and currently Finland and Norway have about 150 days (and increasing) of evidence to the contrary.

If you compare it to its more sparsely populated immediate neighbors, sure, Sweden looks bad.

If you compare it to UK, France, Spain, Italy, who all did a severe lockdown, Sweden does not look bad.

Which is exactly the point: Why would you compare it to dramatically different countries instead of ones that mainly differed on the axis of interest, unless you had an axe to grind?

Stockholm is actually the only big, dense, international city in the Nordic countries. See: https://en.wikipedia.org/wiki/List_of_the_most_populated_mun...

The disease likes dense urban areas with a lot of poor immigrants working in big care homes. Comparing countries is not really "fair". In Canada, Montreal got hit hard. In the USA, NYC, Philadelphia and Boston got it hard. It's a urban centric disease. So yes it's fair to compare to Sweden to Germany, France, UK and Belgium.

Sweden has 11 million citizens, 2.5 millions in Stockholm metropolitan area. Norway has 5 million people, 1.8 millions living in Oslo metropolitan area. Finland has 5.5 million citizens, 1.7 millions living in Greater Helsinki. Lots of countryside elsewhere. The Nordic countries are quite comparable.

Perhaps we should also be looking at population density:

Stockholm: 11,802/sqm

Oslo: 4,268/sqm

Helsinki: 3,670/sqm

Sure, but covid spreads during social events, it's schools, bars, concerts, churches, and you find more of that in urban aggregations than in the flat countryside.

I do not where you got these numbers from.

Wikipedia:

Helsinki: 3,070.08/km2 (7,951.5/sq mi)

I just picked the first google result, which happens to be metric, so I mixed that up.

It looks like the first Google result is for the Capital Region (1.1 million people, 1418 per squqare km, 3670 per sq mile). The stat in the comment you're replying to is for Helsinki proper which only has 600,000 or so residents, and Greater Helsinki is less dense than any of these.

No matter how you slice the figures, Stockholm seems to be a bigger denser city than Helsinki or Oslo.

Why compare Sweden to Norway and Finland? Because they're "nordic"? They do have quite different economies, different populations, different healthcare systems, etc.

These comparisons can be made arbitrarily to make Sweden look either bad or good.

"They do have quite different economies, different populations, different healthcare systems, etc."

Really? I guess your definition of "quite different" is different from the usual. Would you care to expand?

Language and culture across Scandinavia is very similar, and Finland's culture is different only to a small degree if at all

I didn't mention culture at all. I'm not sure how you would define culture in this context and to what degree that is measurable.

Instead, I would point out various socio-economic factors, such as Sweden having a higher rate of ethnic minorities (generally over-represented in COVID-19), Norway's GDP being far higher than the others (thanks to fossil fuel) and Sweden having a far greater population in elderly care institutions, compared to Finland.

A great deal of the deaths in Sweden come from nursing homes, where you had the situation that caregivers would travel from one institution to the next, spreading the virus.

Yes they had a terrible phase early on.

The stories now is about how they've gone to almost no cases the last few months.

Except they are now rising again rapidly in Stockholm for instance [1]. You can use the html console to remove the overlay to read the article. They also were never on "almost no cases", they have been higher than the neighbours all the time except for a very brief period where they were on the same level.

[1] https://www.dn.se/sthlm/antalet-coronafall-har-fordubblats-i...

They are not. Cases are up slightly in the past few weeks, but on par with where they were in July (after which they saw a decline). You have to be extrapolating wildly to call this a rapid increase.

https://www.statista.com/statistics/1102193/coronavirus-case...

Sweden started July with a bit more than double their current cases, and ended it with a bit less than half. Four weeks ago was as low as it ever got in Sweden, and since then it has risen steadily, up to more than double what it was. It's also 30% higher than the last local maximum, in the middle of August.

Here's a better source, which also isn't out of date by 6 days: https://ourworldindata.org/coronavirus-data-explorer?yScale=...

I think deaths is the real metric to follow, and this curve shows the development I described: https://ourworldindata.org/coronavirus-data-explorer?zoomToS...

That's not unreasonable, though you referred to cases and not deaths in your original post. Deaths lag a couple of weeks behind cases, so maybe the local minimum in deaths in Sweden corresponds to the local minimum in cases 4 weeks ago. But maybe not!

Yeah, I did confuse the discourse there...

My problem with counting cases is that it's heavily dependent on how much testing is done, while deaths are always count.

5 days later: Deaths in Sweden continue to fall, per your own source.

And their numbers are going back up. And their economy was the worst performing among their comparable neighbors. It makes no sense at all because for a few weeks their case numbers are lower.

And even if they remain, say 50% of what their neighbors’ case loads are, their response will still have been worse in outcomes because we know much more about how to handle COVID which has led to significantly better results for people who get it today vs a few months ago.

Even if the total number of cases are exactly the same, having those cases later is a huge win in itself.

Maybe because you are only looking at it’s immediate neighbors. Sweden had nearly exactly the same population size and death rate as Michigan but Michigan had a strong and lengthy lockdown.

America had an appallingly incompetent Covid response, with poor testing, tracing, and compliance. This makes it a poor benchmark for updating your priors, unless one of your previous beliefs was "America can muster a coordinated response to a pandemic".

You can count on one hand the number of countries with a “good” COVID response.

Most Asian countries did pretty well.

And many countries in Africa also

Sweden's population is far healthier than Michigan's and has better access to high-quality care. This can be seen from the differences in their life expectancy (82 vs 78).

Imagine how bad Michigan would've been if they followed the Swedish model.

For comparison with the US, Massachusetts might be a better choice. World class healthcare, highly educated population, average life expectancy of 80yrs 8 months [0], and a similar-ish sized population (6.8M in MA vs 10.3M in Sweden).

Despite a lengthy lockdown, excellent social distancing and fairly high mask compliance MA hasn't done so well. As of Sept 29 MA has recorded 9423 deaths vs 5893 in Sweden [1][2].

Unfortunately, like Sweden, MA was not able to prevent COVID19 from spreading to nursing homes with over 64% of deaths (6K+) occurring in long term care (LTC) facilities alone. In fact MA was #1 in the US for deaths in LTC homes with 12.35% of the _entire_ LTC population in the state dying from COVID19 and #3 in the US for COVID19 infections in LTC homes with 35% of _all_ LTC residents contracting COVID19 [2]. This is really a terrible, awful (and avoidable) failure on the Commonwealth's part.

[0] https://www.mass.gov/news/life-expectancy-rises-in-massachus...

[1] https://www.worldometers.info/coronavirus/usa/massachusetts/

[2] https://www.worldometers.info/coronavirus/country/sweden/

[3] https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bk...

Deaths per 100,000 for selected countries:

    66.84 Spain
    63.26 UK
    62.50 US
    59.27 Italy
    57.74 Sweden
    36.92 Ireland
    11.30 Germany
     8.81 Turkey
     6.14 Finland
     5.79 Egypt
     3.23 Greece
     1.05 Japan
     0.45 New Zealand
     0.04 Vietnam
     0.03 Taiwan

The group of countries with better response than Sweden (or the US) comprise the majority of the world, and also diverse in terms of regions, government systems, economic development, culture, population, and area. It's hard to argue that Sweden actually did well in any subgroup.

Source: https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_...

Deaths attributed to the disease. Every country counts them differently. In the us if you died while having the disease you counted as a COVID death. In some countries it’s only if the disease is what killed you that you get attributed, in some they haven’t had testing available to test deaths during their peaks, and some just want to keep their numbers low to avoid getting their exports and borders shut down.

> I'm confused why stories about Sweden's success keep popping up here. The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries. Seems to me like the worst of both worlds.

Because a lot of people, mainly for ideological reasons, would have preferred the US and the rest of Europe have done similar. A key part of justifying that view is to be convinced it was a success, true or not.

Here is why I consider success:

- shop can stay open normally

- kids can go to school normally

- not being forced to wear mask

- low (very subjective, I know) death number

Another detail that the new Sweden fans fail to mention is that over half of Swedish households are single-resident[1].

To put it mildly, this is... not the case in the US.

[1] https://www.statista.com/statistics/526013/sweden-number-of-...

What? Your own link plainly contradicts your assertion.

Only the first category is single resident, and even just the next two categories put together are clearly larger.

You are right, I don't know how to explain that chart. I was searching for a different one and got it instead.

This was the one I meant to use:

https://ec.europa.eu/eurostat/web/products-eurostat-news/-/D...?

I cannot explain the difference between the two. I would trust the EU more than a facts compilation site, but YMMV.

That is certainly interesting, though the fact that we have heavily conflicting data concerns me.

I'd look at the source, except it's hidden in Statista, behind a premium subscription. Wow, that's kind of dangerous.

Not only that, but according to the JHU dashboard, the number of infections are increasing again and not that far off of their previous peak, unlike their neighbors whose new peaks appear to be lower so far.

Dashboard here: https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...

They had zero deaths yesterday. Sweden is not aiming for a suppression strategy with cases like New Zealand and Australia.

I understand, and there's not going to be a way to judge the outcome until after this is all "over." I think articles saying that they've been successful are premature, for the reasons I mentioned before, but it is too early to call it a loss either.

My personal forecast is that by the end I think they're going to have similar levels of economic damage (can't export to closed countries) and higher death rates than their direct neighbors who implemented more restrictive policies and we will never have a clear way to decide if that was better or worse because there is no answer to "how many deaths are worth it?"

>there is no answer to "how many deaths are worth it?"

And, in many cases, there may not be a clear answer to why outcomes were so good in Place A and so poor in Place B.

It depends on how you define success. How about happiness and freedom of movement?

It really depends how you define freedom of movement too.

For some, there's more happiness and freedom of movement during strong, compliant social-distancing measures, if you feel safe going outside whenever you feel like it for exercise, and like the shops are relatively safe to go to because people are taking a lot of care.

Compared with if you're justifiably afraid to go outside where other people are mingling densely and without masks, while openly stating their attitude is that their unknown neighbours' health (yours) is just not that important, preventing spreading to you is not something they put any care into because they don't believe it's worth it, holding dense parties that host super-spreaders, and packing into shops and pressing up against you when you go there in a way that makes you feel like you're risking your life to get food, in a way that would be completely avoidable if only other people cared.

If happiness and freedom of movement is the high ideal, it still doesn't point towards one clear policy during pandemic, unfortunately.

I bet that many sweddish exerce their freedom of movement in the harsh and dark winter staying at home as many time as possible, specially those living at the upper half of the country :-)

Previous peak was over 1000 new cases per day (7 day avg), currently at around 415, but was at 150-170 at the beginning of Sept. Well on their way, but still a ways off previous peak.

No real point in comparing case counts at such different times though. The previous peak was right when tests finally had opened up for essentially everyone in the Stockholm and some other regions starting from the first week of June. Previously only severely ill and essential workers could get tested.

The current case count is when everyone in the entire country can get tested without question. People at work having some easy sniffles get sent home and tested the same or next day to not have to substitute them for weeks on end.

The ICU and fatalities rate had already been peaked in early April and correlating the actual spread to those numbers the number of cases already have been trending down for some time.

Swedish public health agency data: https://experience.arcgis.com/experience/09f821667ce64bf7be6...

Also keep in mind, for the Swedish data the PHA takes time to have every case and death be allocated to the correct date, and not when they got the report.

Or compared to Vietnam, which has 100 million people and less than 40 deaths.

People have just hung their hat on Sweden’s approach out of some ideological attachment that’s completely independent from how countries across the world have performed.

Vietnam is interesting, they initially were very successfully contained COVID, but have had a resurgence over the summer that they put down to a "more infectious" strain (the "G" strain that has been prevalent in the US, Italy/Europe vs the supposedly less infectious "D" strain in Asia):

https://asia.nikkei.com/Spotlight/Coronavirus/Vietnam-fights...

https://asia.nikkei.com/Spotlight/Coronavirus/Vietnam-deploy...

But regardless, Vietnam has done quite well.

You need to look the excess death. The only true indicator. There might be hidden deaths, keeping in mind that Vietnam is not a country where the press is free.

It's because they loudly didn't do what experts recommended, and things turned out okay.

Just like sometimes when you drive drunk, you don't die in a horrible accident and actually get home safely. Doesn't mean you did the right thing.

I think that the OP's point is that they are emphatically not OK, and worse in every way.

The comparatively higher death rate was mainly elderly in care homes. Some are simply OK with sacrificing the elderly to avoid restrictions on the lives of younger generations. Others would hold that, yes, failing to protect care homes was a screwup on the part of the Swedish authorities, but the avoiding of a lockdown still seems sound.

> The comparatively higher death rate was mainly elderly in care homes.

The same was true in New York, which locked down.

New York also sent the elderly with covid back into their nursing/care homes. So New York probably isn't the best example, since they handled the elderly situation so poorly

This is exactly why I have zero faith in any substantive knowledge coming from this pandemic until, what, a hundred years afterward?

So many variables that change the narrative if ignored. This is going to be like everything else (at least in the US). People will seek out sources that confirm their already established belief.

It's hard being positive about, well, anything right now. Is this depression, or is this just a realistic view of humanity?

Unfortunately I think that's the current state of things. It takes a lot of work to get any semblance of the truth, and even then it's extremely localized.

IMHO, C19 was WAY more politicized than it should have been, which caused a lot of the misinformation.

For me to be less despaired, I give up on things like national news (or severely limit it), and hang around positive people, particularly ones doing good things in the community. There are still good people out there doing great things.

I don't think that the media portrayal of many things is a realistic view of reality in most places.

The problem with quoting New York is that New York thought they had Case #1 on March 1 when backmodeling suggests that they were already at Case #10,000. And then they went 3 more weeks before they actually locked down.

So, New York had a WAY higher number of infected per capita than pretty much anywhere other than the early hotspots.

This is the line that the Swedish authorities repeat at every possible opportunity: effectively victim-blaming the elderly, and implying that “if only all those old people hadn’t died, we’d have been fine”. But in fact deaths are higher across all age groups, compared to other comparable countries.

Again, some people are prepared to sacrifice both some portion of elderly in care homes, and some (much smaller even in Sweden) amount of other people across younger generations. As a top-rated comment points out, one of the aims with which a broad segment of the public sympathizes is “flattening the curve“, not trying to prevent any and all deaths whatsoever at any cost.

Exactly, and news headlines praise them for not having the same second surge of cases as denmark right now. While 5800 people dies versus 650 in Denmark.

> The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries.

So far.

Lockdown strategies will always look better than Sweden's strategy at the beginning, because Sweden's strategy gets most of the deaths over with in the first few months.

If a vaccine takes long enough, the countries that locked down might eventually catch up to Sweden's per-capita death rate, although it's worth noting that some of them have already surpassed it.

If you look at the charts here, you will see that Sweden had a big spike in deaths at the beginning of the outbreak and now it's daily death rate is far below that of most other countries: https://ourworldindata.org/coronavirus/country/sweden?countr...

Sweden's approach looks better relative to other countries with every passing day. The longer it takes for a vaccine to be developed and distributed, the better Sweden's strategy will look. People who insist that Sweden made a horrible mistake are overconfident. Whether or not it was a mistake really depends on how long the pandemic lasts.

Pretty safe to say we're far enough along to be able to declare it a failure.

By what metric?

The metric that matters to me is this: what was the death rate, per capita, in a country during the entire duration of the pandemic?

Since the pandemic is not over yet, and may not be over for another year or even more, it is far to early to tell. We may still be in the first half of the duration of the pandemic.

You seem to falsely assume that all the deaths Sweden has suffered so far would have happened at some point regardless. Given the development of better treatments already some of those who died would, if they had caught it later, have survived. Given three GDP hot is similar to their neighbours all they've done is needlessly kill some of their population.

Lockdowns are a rate limit, not a cure. Flattening the curve does not reduce the area under the curve, it just spreads it out over time to prevent the hospitals from being overloaded.

So yes, most of the deaths would have happened anyway, but over a longer period of time. The improvement in treatments has not been substantial. Most of the deaths in Sweden were among high-risk groups, such as elderly people in care homes, who probably could not be saved if they got the virus today rather than several months ago.

Sweden intentionally set themselves up with a policy they can sustain for a long haul. They were betting that the pandemic will last a long time, certainly longer than a lockdown can be sustained.

That's only true if nothing changes. Discovering that dexamethasone can reduce mortality means that from that point onward the area under the curve is reduced. Once we have a viable vaccine again the area is reduced. Given the economic impact Sweden is facing they have the worst of both options.

If you can spread it out to the point where you can develop a vaccine then it will absolutely save lives. Or at least flatten it to the point where you're not overwhelming hospitals or running out of PPE/cleaning supplies then you save lives in the long run.

And remember Sweden has first class healthcare. A similar strategy in the US would have been absurdly expensive and resulted in mass bankruptcy in addition to mass deaths.

> Flattening the curve does not reduce the area under the curve, it just spreads it out over time to prevent the hospitals from being overloaded.

In fact, Yes it does. Flattening the curve means that less people die because hospitals are unable to deal with a sudden flood of cases in a narrow period of time.

Moreover, as doctors have more time to focus into figthing against covid damage instead to give priority to just keep as many people alive as possible, sequels are also less serious

Less people died means that area under the curve represents a lower value now. The problem is that the common people are not always familiar with statistics. Both curves have a total area of 100 of course but this is a percent from a value. Not the value on itself. 50% of 10 is not the same as 50% of 3000.

> most of the deaths would have happened anyway

But not all of those, and this is a big difference

Well, a few reasons. One is that their death rates per capita were better than several major western European countries, such as Spain, Belgium, Italy, and the U.K., that did a lot more lockdown, and this suggests that the "if you don't lock down you get more deaths" idea cannot be right.

The other is that, for example, Denmark opened up their elementary schools again in late April, and Finland in early May. So even the comparison to other Scandinavian countries is missing a lot of nuance. Plus, I am led to believe that Sweden DID close their high schools and colleges, since it was easier for older kids to do distance learning.

The nasty secret that neither most news articles, nor this one, admits to is that, if you take all available evidence, national policy doesn't seem to have mattered much one way or the other. Sweden is in the middle of the pack among western Europe. Belarus is in the middle of the pack among Eastern Europe. Japan is in the middle of the pack (or better) in east Asia. If national policy were important, they all should be either the best or the worst.

I think maybe we just did stuff, pretending it would matter, while the virus went about its normal pandemic business, and nothing we did really mattered that much.

I wonder if another interpretation might be that culture matters regardless what policies get enforced. I hear that people in Sweden stayed at home more and distanced themselves regardless of enforcement. Similarly asian countries likely already had higher acceptance of mask wearing regardless of what was enforced and so on.

The praising of swedish policies seems to largely come from folks in the US wear we have no social/cultural consensuses because the country is so divided

You're still making an assumption that those culture matters have an effect. For pretty much any country (or smaller region) it's easy to construct an after the fact rationalization of the outcomes.

Asia did better because people accept mask wearing--true but it's still pretty minimal in normal times. But somehow lack of mask wearing probably didn't matter in Sweden--but that's because they hate getting anywhere near another person anyway. But in the US Trump supporters not wearing masks is a big problem. Etc.

I'm not going to argue that nothing matters. (Certainly protecting especially vulnerable populations is something a lot of places totally whiffed on early.) But I expect that some things people are really polarized about don't matter much.

Our efforts (and by "our" I mean "the human species'") were absolutely unfocused. If we had spent the same amount of effort on getting the most vulnerable (mostly, the elderly) well away from the urban areas, we could have done a lot more good.

In very few places people in EU wear a mask in overall and public Healthcare experts say it's ineffective for general population.

You cannot trust a damn word coming out of Belarus, or almost anywhere in ex-USSR. You can safely assume that death rate in Belarus is 2x-3x of reported.

Well Belarus' government has its issues, for sure. But I notice that the (very real) issues of reporting, only get noticed when they point the "wrong" way (whatever that is for the person speaking). When Japan had fewer cases than South Korea, the widespread explanation was that Japan must have bunk data. Similarly when China's cases dropped.

I don't claim that Belarus, China, or even Japan have perfect data. But they are not North Korea, and if they had widespread devastation their neighbors would be able to tell. I don't think Belarus' data is particularly less trustworthy than Russia's. Both were willing to report cases going steeply up, when it was true.

Really? How do you know what is "wrong" way for me? In any case, Russian excess death is 3x of the official COVID numbers; it is a relatively well known fact, you can google Alexey Raksha, a demograph from the RosStat; he has a great explanation how Russian and the other ex-USSR numbers are made. You actually do not even need to listen to someone else, go and check RossStat numbers by yourself, they almost certainly are in open access.

Focusing on comparisons to geographically nearby countries doesn't make sense to me, and feels arbitrary. That's also not controlling for all the factors that differ between the countries. Reducing the conversation to total deaths and unemployment rates also doesn't give credit for the various benefits of having permissive COVID guidelines.

Sweden had a big spike in COVID deaths very early on, and it was in large part from adult nursing homes, where appropriate precautions were not taken. As of late July, 70% of COVID deaths in Sweden were from adult nursing homes (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369443/). But they first hit no excess mortality in early June (https://news.yahoo.com/sweden-records-first-week-no-15544144...), while still retaining many of their freedoms. That's noteworthy.

As for unemployment - making a comparison across countries doesn't control for all the other confounding factors that are relevant to economic health. And in a globalized economy where we have suppliers and customers in foreign countries, it is hard to remove all exposure to OTHER countries' COVID economic impacts. Perhaps if more countries implemented Sweden's plan, everyone's economic outcomes would be better.

Getting back to the unrecognized value of Sweden's approach: there is value in having the freedom to move around, in holding gatherings, in patronizing businesses, in having kids receive a normal education, and so forth. I am shocked Americans have accepted top-down authoritarian restrictions on their lives so readily, as the goals changed from flattening the curve to seemingly trying to save every last life. I would rather individuals make decisions about their own lives while assessing the risks for themselves. Those who are risk averse are free to restrict their own lives - but they shouldn't impose restrictions or demand actions of others.

We can't operate society around trying to save every last life. If that is the bar, then even in a typical flu season we should be keeping everything on lockdown. Could you imagine living like that permanently? Clearly that isn't acceptable. But if THAT isn't acceptable, then we are already saying that there is a finite value in saving a life (rather than infinite), which has to be taken in balance against the value in everything else.

Moreover, given how low the infection mortality rates are for those under 70 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...), we are simply robbing the young [of socialization, education, summer vacations, memories with their family, etc.] to keep the old alive longer. I don't think that tradeoff makes sense, and we should simply ask those at risk to stay home while others are free to go about their lives.

> Moreover, given how low the infection mortality rates are for those under 70 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...),

From your link:

> The parameters in the scenarios:

> -Are estimates intended to support public health preparedness and planning.

> -Are not predictions of the expected effects of COVID-19.

> -Do not reflect the impact of any behavioral changes, social distancing, or other interventions.

Here's the thing: all over the Internet people are quoting this modelling paper as fact without understanding that the numbers are a range of estimates.

These numbers are not meant to be accurate. That's why they list 5 different sets of numbers.

Sweden seems to have become a Dem/Rep arguing point in the USA and unfortunately that means you can't discuss it anywhere online without loads of hot takes. But I think there is stuff worth looking at in Sweden's approach. It certainly can't be dismissed as trivially as you are trying to dismiss it.

Here's a Guardian article from a few days ago

https://www.theguardian.com/world/2020/sep/15/sweden-records...

And here's a blog post giving some pro-swedish-approach arguments

https://velvetgloveironfist.blogspot.com/2020/09/the-thing-a...

However, here's a good twitter thread about how you can't really translate Swedens approach to the USA

https://twitter.com/ChrChristensen/status/130966885138733466...

[Sweden’s COVID] policy can only be understood as inseparable from Sweden’s developed welfare state, social system: universal healthcare, paid sick leave, paid leave to care for sick kids, subsidized daycare & pre/after-school care.

Do you expect the 10x number to still be true 6 months from now?

The numbers cannot really be compared. In Sweden they count any death where the patient had the virus, or had it in the last two weeks, as a COVID death. The other countries count differently.

Most deaths in Sweden where in care homes of elderly. In Finland, for example, I believe only deaths at hospitals are counted as COVID deaths.

We will see in a couple of years what is up and what was down of this whole debacle.

Yep. It ain't over 'till the fat lady sings. Where "fat lady" is probably a vaccine and "sings" means generally available.

Really? Because they're back to normal while the rest of us don't have lives anymore.

There's so much fear of dying that nobody is living, we survive and endure, but that's about it.

There are worse things than dying, life is risk.

Wasn't the whole point that by the time the pandemic ends Sweden would come out about the same as everyone else but with a more sustainable strategy? Instead of lockdown then no-lockdown, then back to lockdown Sweden just put in place recommendations that can remain the same throughout the pandemic.

Only when the pandemic is over can you evaluate whether Sweden's strategy worked or not.

Yeah... Not sure I'd be spiking the football in the endzone yet on Sweden. Case count is slowly going back up. Looking likely that they'll have another wave here in another month or so.

Every single country has had a second wave. No, the reason why Sweden's covid-19 strategy is flawed, is the high number of deaths per capita, the government refusing to even suggest wearing masks, and failing to protect the elderly at our care facilities.

Our neighboring countries have enacted strict restrictions against Swedish travelers and workers and I totally get why: not only have our numbers been horrible but the government has been so irational at times that it must have been difficult to trust them to make reasonable decisions that wouldn't jepordize the lives of citizens in our neighboring countries.

What a silly comment. The comment about masks seems particularly misguided now that it should be obvious that it was indeed possible to flatten the curve without mask mandates (or even recommendations).

The travel restrictions that countries had enacted are, at least now, unnecessary and are a serious harm to the global community and trust between peoples. At least in Sweden the cases coming from travelers have been insignificant since well before the peak of the first wave. It is now clear that the Danish, Norwegian, and Finnish governments do not care much about the stability of the Nordic cooperation and anyone might hesitate when choosing a job across the border.

> It is now clear that the Danish, Norwegian, and Finnish governments do not care much about the stability of the Nordic cooperation and anyone might hesitate when choosing a job across the border.

So, there's literally a single country going against the grain here (Sweden) but somehow you are trying to blame everyone else in the Nordic Council for not caring about stability.

That's almost as ridiculous as the UK complaining about France, Germany, Spain and Italy 'not caring about the stability of the EU' because they didn't bend over backwards to accommodate the UK's demands over Brexit.

It does not matter if Sweden is the outlier - it is the other Nordic countries that instated (and maintain!) emergency measures regarding travel. I don't know how anyone could claim that changed behaviour is the mark of stability.

I also think that the EU cooperation failed by closing borders and keeping them closed. That, however, comes as less of a surprise to me.

Sweden would definitely be exporting more cases than they would be importing with international travel.

They didn't have any deaths yesterday from what I can tell. They had five deaths today.

7 day average in terms of cases has nearly tripled since the beginning of the month.

Deaths lag cases by about a month. Increase in cases will invariably lead to an increase in deaths.

> "They continue not to wear masks," he said. "That can be a big drawback in the Swedish strategy if masks prove effective and key in fighting the pandemic."

There aren't any randomized trials that look at cloth masks. There is one trial enrolling in Guinea Bissau. It seems likely we may never know because there isn't an interest in doing trials.

This article from Oxford's Centre for Evidence-Based Medicine discusses the issues with masks:

https://www.cebm.net/covid-19/masking-lack-of-evidence-with-...

The current working hypothesis seems to be that wearing a mask protects other people from getting infected by the wearer, rather than the wearer himself. Testing this hypothesis in a randomized control trial sounds extremely difficult, since it is usually not known who infected whom. On the other hand, masks are basically free and reducing the amount of saliva we spit at each other sounds like a resonable measure during a pandemic.

I agree It's difficult to experimentally test using an RTC. Unfortunately the attitude you mention also results (in my observations) in undermining the trustworthiness of the CDC/Government (in the US) for many people who see there is no real data for it, nor do they really see cause effect. It reinforces "pop science" for media outlets. People see ineffective rules such as "wearing a mask walking to a table, but not at the table while dinning" and realize it's not consistent and result in many not trusting other policies that may actually be helfpul.

Extrapolating from small studies of reducing particles to being an effective countermeasure is a big unsubstantiated leap and may result in unintended consequences (e.g. say less healthy people exposed and gaining partial immunity during summer months that). Perhaps it's somewhat effective, but the big problem to me is undermining the credibility of the scientific process and institutions. In the future, it also may lead to less research on truly effective methods as many people (and governments) assume social distancing and masks are effective without backing data and research.

For example of research suggesting lack of effectiviness of masks and social distancing as anti-pandemic methods, there's a research article on my reading queue that by using a non-heterogeneous infection susceptibility over the classic very simplified SIR model shows that the number of US infections is essentially what would be expected of a natural infection based on current parameter estimations [1]. There are several other points of data indicating similar lack of effectiveness, form the considering raw graphs and timelines, to the much lower "soft-immunity" numbers of ~10-25% of the population, to Sweden's numbers being 15x lower than predicted by standard SIR models. I'd list more data but my lunch is over, and if you're interested it's not too difficult to find. There's a lot of research that is needed in other words, not "pop science" which is hard. Giving in to easy answers is an emotional palliative but not a good societal strategy in my mind. To quote the Royal Societies motto: " Nullius in verba".

From the linked preprint:

> Allowing for heterogeneity reduces the estimate of "counterfactual" deaths that would have occurred if there had been no interventions from 3.2 million to 262,000, implying that most of the slowing and reversal of COVID-19 mortality is explained by the build-up of herd immunity. The estimate of the herd immunity threshold depends on the value specified for the infection fatality ratio (IFR): a value of 0.3% for the IFR gives 15% for the average herd immunity threshold.

1: https://www.medrxiv.org/content/10.1101/2020.09.26.20202267v...

This is not the point I was trying to make. Of course it is important to monitor new scientific evidence that arises and to update the measures and recommendations accordingly. I believe that most functional governments are trying to do exactly that in the current situation.

The issue is that politicians usually don't have the luxury of having lots of high-quality studies available. At the same time, it is impossible not to communicate. Not recommending masks sends the message "masks don't work", for which there is not much evidence either. Unlike scientists, politicians constantly have to make best guesses using the limited information that is available to them.

There is also the question as to whether people can safely use masks without infecting themselves. If masks help at the margin they can also hurt at the margin. They can also cause the public to neglect physical distancing and hand washing based on a false sense of security.

It's puzzling why many have assumed a positive or neutral effect for something so untested. It's clear physical distancing has had the most effect as evidenced by Google mobility reports.

The idea that people might infect themselves by handling their own masks sounds very far-fetched to me. What mechanism is supposed to do that?

The risk of people neglecting other measures sounds more reasonable, but most politicians seem to believe that the positive effect of not spitting at each other wins. Again, they have to make educated guesses based on the limited information that is available.

I don't think one can conclude from mobility reports being somehow correlated with infection numbers that physical distancing has had the most effect. Human behavior is much more complicated than that and one surely needs a more complex model.

> The idea that people might infect themselves by handling their own masks sounds very far-fetched to me. What mechanism is supposed to do that?

The article I linked discusses the only study on cloth masks from 2015. The study has some limitations but showed that cloth masks had a higher rate of infection.

In the general population it's not hard to imagine compliance will not be perfect. That is why we need controlled trials.

There have also been assumptions that homeopathy doesn't harm. Scientists did a survey and discovered that therapists were recommending that their patients didn't vaccinate. This is from the book Trick or Treatment.

TLDR: Testing assumptions is very important. Lives depend on it.

> TLDR: Testing assumptions is very important. Lives depend on it.

100% this! Masks are one of those "obvious" things. But scientific inquiry has repeatedly shown we need to test obvious things. Preferably before making legally binding policies.

I've always thought the whole Sweden debate is kind of pointless, because there seems to be some implicit assumption that what's true for Sweden would be true for any other country if they adopted the same policy. And that assumption is pretty clearly false, isn't it? They're relatively sparse, they are disciplined, they listen to and trust recommendations. Relatively.

And also, isn't it also true that Sweden is also somewhat limited in their ability to impose regulations on their population?

So it's kind of pointless in both directions - "Sweden should have locked down a lot more", well maybe they weren't even able to, and "We should have done what Sweden did", well, if we had, the results might have been a lot worse.

It is endlessly frustrating to see the tenor of argument around COVID: mask vs. no mask, lockdown vs. no lockdown, flattening the curve vs. eliminating the virus. All of these strategies have arisen and evolved over a relatively short period of time, necessarily with incomplete data, and in places both different and affected by the virus differently. No sane person should be talking about these terms in black and white.

Speaking as someone from New York City: Doing nothing (as in the very early stages) quickly resulted in overwhelmed hospitals and morgues. Doing a fairly serious lockdown along with masking then reduced cases to a very manageable level. The fine balance between these two extremes is somewhere in between, and will be different for each locale depending on demographic details such as population density, number of multigenerational households, etc.

The goal of flattening the curve while still keeping the economy healthy, as some commenters here seem to desire, surely will be easier the closer we are to eradicating the disease.

"Doing nothing" is, alas, overly generous.

Putting infectious covid patients back into nursing homes isn't nothing. It was a baffling and callous decision, which happened to kill the mother of a good friend, so I'm not exactly neutral on the subject.

I am speaking of the time before that decision, which was only made in response to overcrowded hospitals once COVID was widespread here.

I understand the reasoning at the time was to prevent hospitals from needing to turn more people away, by shifting patients who didn't need intensive care back to other facilities (nursing homes) that could handle them. But I agree 100% it was a bad decision and made the situation much worse in NY.

"For their part, the Swedes admit to making some mistakes, particularly in nursing homes, where the death toll was staggering. Indeed, comparative analyses show that Sweden's death rate at the height of the pandemic in the spring far surpassed the rates in neighbouring countries and was more protracted."

IIRC, Sweden prevented their medical system from becoming overwhelmed by only offering palliative care to the elderly---not including oxygen. Many countries would not find that acceptable.

> The per capita rate is far lower than nearby Denmark or the Netherlands (if higher than the negligible rates in Norway and Finland).

According to this article, Sweden's per capita infection rate is far lower than Denmark and the Netherlands, and slightly higher than Norway and Finland. Compare that to population density: (numbers from Wikipedia)

    Netherlands: 521/km²
    Denmark:     137/km²
    Sweden:       25/km²
    Finland:      16/km²
    Norway:       14/km²

Not so coincidentally in my opinion, Sweden has a far lower population density than Denmark and the Netherlands, and slightly higher than Norway and Finland.

This comparison is too simplistic to be useful. Sweden and Norway have a couple of large cities, and then endless swaths of nearly-uninhabited tundra.

If you count Greenland as part of Denmark, its density probably drops to below that of Norway or Sweden, but it's easy to see why that wouldn't tell you anything useful about covid.

It's much better to compare metro regions (e.g. stockholm metro vs copenhagen metro) against each other, if you can find the appropriate case data.

You should compare persons/km2 for each person really. E.g. median amount of people in a 10 km circle around each person or w/e. Having a lot of empty forest doesn't help much.

I can't find any such data though.

y'know that's too bad, isn't it.

As soon as you described that statistic I realized that normalized population density is a really interesting fact about countries and states, and it isn't one I've seen laid out that way.

Density in Swedish cities is similar to density in cities in other European countries.

Let's see, Sweden has about 10,000,000 people, a population density of 25/km^2. Arizona has a population of about 7,300,000 and a density of 23/km^2. Minnesota has a population of 5,600,000 and a density of 26/km^2.

                Cases Deaths  D/M
    Sweden     92,000   5900  583
    Arizona   220,000   5600  776
    Minnesota  99,000   2100  370
    NJ        209,000 16,000 1829
    Calif.    820,000 16,000  401
    NM         30,000    875  417

The only thing I see eyeballing it is that Sweden is probably under counting cases.

Its interesting how people focus on Sweden as a 'success story', which had a high death rate and a second wave is not out of the question yet. While people ignore the countries that were hit first, like Italy, Spain and Belgium who had horrific death rates too. Are they not success stories for not doing anything either?

Meanwhile where I live there is a single active imported case, and contact tracing being done for every he came into contact with directly or indirectly. Thailand and Vietnam, Hong Kong, Korea etc. have also done a excellent job at controlling the virus and opening society back up. But all you hear about is Sweden and New Zealand.

Yeah, as a Kiwi it's a bit annoying to have the local media only compare us to Sweden and places that have had a terrible time with the virus. I'd like to see us compared more with the places you mentioned, as well as Taiwan. If you want to have the best response to the virus you need to look to the other success stories.

All the remedies adopted in one country cannot be replicated in another given differences in systems. But it’s always good to learn from them.

Besides Sweden, New Zealand, China is the only country which is able to control COVID-19 and return to normal. The golden week holiday is coming and local tourism is booming. Difficult to book hotels, domestic air tickets, fast speed train tickets. Also no need to wear masks, but some people still do when taking airplane or fast trains.

Based on first hand information from friends living in China can say life is normal except for imported cases. All international travellers need to do COVID-19 test and wait in isolation areas until the result came back. If results are negative need to quarantine in designated hotels for 14 days, except for travellers from few countries which needs 7 days if it’s for essential pre-approved business travel.

> Britain, with about six times the population, tested only 587,000 people in the most recent week, far fewer per capita than Sweden. And Britain conducted far more tests than France, Germany or Spain in that period.

Britain has a population of 66 Mio. Germany has a population of 83 Mio. Germany conducted more than a million tests in that period [1]. It does not look like Britain conducted far more tests in that period neither absolute nor relative.

[1]: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

Germany did test more than a million people in that period and so did the UK[1]. The article is way off. UK does test more than Germany both absolute and relative. This isn't surprising since the UK has four times as many cases as Germany. But they also test more than the US and France, both of which have (much) higher case numbers. [2]

[1] https://coronavirus.data.gov.uk/testing

[2] https://ourworldindata.org/coronavirus-data-explorer?yScale=...

Thanks for clarification. I was not sure about a valid source for UK numbers, so I did not check that figure.

People vilified texas as well. We were sideways for 2 months then we definitely opened too quickly. It seemed that bars were the culprit so bars closed and restaurants went to 25% and masks became mandatory in businesses.

As far as I know all other businesses are open. Generally speaking the virus is under control and decreasing. I firmly believe we have found close to the minimum rules necessary to get the R0 under 1.

Our unemployment in aug was 6.8% compared to > 10% for areas with much stricter lockdowns.

The value of having 50 states is the states are "competing" with different solutions and therefore can find the best solutions (e.g. legalizing marijuana).

I'd really want to believe that the Swedish strategy is a good one, but so many countries that were too lax, either by bad regulations or citizens' poor following have suffered dramatic consequences throughout the year.

It's as if the Swedes were simply lucky (due to their demographic characteristics), with no useful insight that we could extract for the rest of us.

I don't get why this keeps coming back. They're 14th in the world in deaths per million. If anyone is to argue that they did a good job we might want to look at those numbers too!

Then the economy! Their numbers are as bad as their neighbours.

Why oh why is Sweden touted as some success?

This is a long game, with many variables in play. I seriously wonder if we'll ever know who took the 'optimal' approach if we are being honest.

It seems you definitely need to protect the very vulnerable. Beyond that, not much is clear.

I love how anyone is trying to make claims about which approach is best. We are probably 30% of the way through the Covid epidemic. We have a long way to go.

We'll likely see an effective vaccine early next year, with several candidates dropping out before then due to toxicity or lack of efficacy.

And even when the FDA approves a vaccine, it's going to take over a year to vaccination a large percentage of the population. Maybe by 2022 we'll have enough immunity to go somewhat back to normal. And that's if a vaccine get approved in the next few months.

And we'll see more and more social strife as people push back against lockdown, mainly because of the slow pulled back on assistance. Canada's deficit will be 10x what it was the year before. That's not sustainable.

Come back in 2022 and see where each country is. Things are going to get a lot worse before they get better.

Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study

Sept 2020, Annals of Internal Medicine

https://www.acpjournals.org/doi/10.7326/M20-5352

People aged 40 or below have a 0.01% chance of dying.

People over the age of 70 have a 1.17% chance of dying.

Overall the chance of dying from the virus is 0.26%.

The goals have fundamentally drifted on covid. In the beginning it was flatten the curve so that hospitals aren’t overwhelmed. The goal wasn’t to eradicate covid but to slow the growth to an acceptable level.

We are way beyond the point where hospitals are horribly overwhelmed, and yet the desire to continue lockdowns persists. I’m left with the conclusion that people are some combination of 1) scared, and 2) spiteful. Wanting to see the economy fail to punish rich people and corporations.

The goal wasn’t ever to save every last life no matter the economic consequences. Unemployment kills, too. I think we’ve effectively lost our minds on covid.

> We are way beyond the point where hospitals are horribly overwhelmed

I ask as someone who genuinely doesn't know either way, but is there a realistic risk of this happening again?

Yes. If the numbers creep up past a certain point, you roll back. Or you do like Sweden and just let free citizens make their own decisions.

87% of the deaths in Sweden were over 70, and they are a net drain on the economy anyway.

-- Jonathan Swift

The “spiteful” people wanting to watch rich people fail are preventing this from happening by being responsible

How might one go about knowing such a thing?

Yes, because in the US, even recently, in covid hotspots hospitals have become overwhelmed. Shutdowns in those areas have managed to get the rates back down.

I haven't heard of this, does anyone have any articles that go into detail about the magnitude of the overwhelment?

Generally, yes. What happened in New York could happen everywhere (Berlin, Paris, London, Tokyo, Beijing). But in practice the virus seems to have somewhat slowed down. With the notable exceptions of France and Spain the second wave so far seems to grow much slower. That might be due to more tests, but I think the effect is caused by a general change in behavior. We are also better prepared, both in the effectiveness of treatment and the diagnosis of severe cases. Also, if shift comes to shove, there are several experimental vaccines already. They might not be very efficient, but they should be comparatively safe by now. So all in all, I would say the worst could be behind us.

Winter is coming. The second wave in Europe was initially driven by the young. Now it's beginning to spread to older people.

"2 more weeks.", "We don't know the long term effects", "Winter is coming". We are ~3 months from 2021, COVID-"2019" most likely will be endemic.

Wisconsin is already heading in that direction.

https://www.jsonline.com/story/news/2020/09/30/wisconsin-hos...

North Dakota has 22 ICU beds left in the state.

Yes, but less than the first time around since a lot of people already had it, we had time to prepare, and social distancing measures (avoiding dense areas, masks, etc) make a fast break out more unlikely.

I don't understand why people can't entertain the argument that a failure to lock down has greater economic cost than a lockdown.

We're on month seven of the lockdown in NYC. 87% of restaurants can't pay rent.

I am happy to entertain the idea that lockdowns are saving the local economy, but you'll need to back it up with some data.

https://thenycalliance.org/assets/documents/informationitems...

Edit: 87% of the entire hospitality industry, not just restaurants.

But... lockdowns aren't happening in New York City right now? They're on Phase 4 reopening. The problem isn't lockdowns. The problem is that people don't want to suffer or die from a horrible lung disease, or have their friends and family die from it. Pretending that the disease is harmless and gone doesn't actually make it so.

And the only reason lockdowns are so difficult in the US is because most people in the US don't have meaningful savings and are in debt, and there isn't an adequate social welfare system in place to smooth out this very rough patch.

>But... lockdowns aren't happening in New York City right now?

Yes, they are. Today is the first day in seven months that NYC is allowing indoor dining, but it is at 25% capacity. Gyms, salons, and other similar industries are operating at similar capacity. Governor Cuomo and Mayor de Blasio are already, this week, talking about rolling it back.

87% of the entire hospitality industry is unable to pay rent.

>The problem is that people don't want to suffer or die from a horrible lung disease, or have their friends and family die from it. Pretending that the disease is harmless and gone doesn't actually make it so.

Adults are capable of making that decision for themselves. This is a free country. If what you are saying is true, indoor dining today should be relatively empty. I'll walk by a few restaurants and let you know how crowded they are.

> already, this week, talking about rolling it back already, this week, talking about rolling it back

Because test positivity rates are spiking in some areas of the city, and they're also trying to open schools.

> Adults are capable of making that decision for themselves

How do you think people in nursing homes died from it? What choices did they get in the matter?

> How do you think people in nursing homes died from it? What choices did they get in the matter?

I suspect people in nursing homes in NY would've done better without government intervention.

"More than 4,500 recovering coronavirus patients were sent to New York’s already vulnerable nursing homes under a controversial state directive..."

https://apnews.com/article/5ebc0ad45b73a899efa81f098330204c

Cuomo's record on it is pretty bad! The UK and Sweden also had really substantial outbreaks in nursing homes.

First off, it's hard to call anything that was done in the US an actual "lockdown" - see Wuhan where they welded people into their apartments, that was a lockdown.

> 87% of the entire hospitality industry is unable to pay rent.

And would it be much different if there weren't restrictions in place? People being afraid of catching a disease that could possibly kill them or leave them with long term disability will tend to not eat out or go to theaters. So maybe instead of 87% the number would be 77% unable to pay rent. Still, as it passes around in a non-restricted environment people will become wary.

Where I'm at (Oregon) people can eat in restaurants (with distancing, so lower capacity) but most seem to be choosing takeout or to eat outside. This seems to be keeping restaurants in my neighborhood going at near normal levels (the proprietor of a nearby pizza place says he's pretty much at normal levels of business with takeout only and there have actually been some new restaurants that have opened recently). Of course when the weather changes... we'll see, but takeout will still be an option.

The problem is that "people can make that decision for themselves" only works if they themselves pay the price for their actions. If you're in the age range that is likely to get an asymptomatic or mild development, the price of you getting infected and walking around infecting others are paid for mostly by others.

"Let everyone decide for themselves" rewards the selfish and makes people that restrain themselves jealous of the selfish people. If that's the kind of society you want to live in, well, that's your choice. But I think a lot of people don't.

Yes, you're describing "Moral hazard". That concept is lost on too many.

I'm sorry, but if you can walk across the street and buy a dollar slice, then it's not really a "lockdown" except in the loosest definition of the term.

I'm glad to hear that New York City finally got the virus in control such that they can start to safely open things back up. Hopefully the adults you speak of make decisions not just for themselves but their communities as well, lest the virus spike again and kill thousands of New Yorkers again.

> lockdowns aren't happening in New York City right now?

New York still has very significant restrictions including on dining out and group size. It is not the complete lockdown that happened earlier.

They are even including restrictions on hours restaurants can be open...

There was never a lockdown. People were never restricted from leaving their houses or visiting family. Public, enclosed spaces were restricted, but nobody was ever locked inside. There have been attempts at imposing quarantines on interstate travelers but it's been almost entirely voluntary in practice.

(this is in contrast with western Europe, where there were and are actual lockdowns that made it illegal to leave home without a permit, etc)

edit: NYC did impose a curfew for a few days, but not as a coronavirus measure

Or Wuhan where they actually welded people into their apartments.

https://www.nytimes.com/2020/09/25/nyregion/coronavirus-orth...

https://www.cnn.com/2020/06/08/us/new-york-reopening-coronav... (June 2020)

I could keep listing stories that clearly say "lockdown". You seem to have a different definition of that word than any other English speaker, including the NYTimes and CNN.

By the way, this included fines: https://abc7ny.com/nyc-social-distancing-fines-coronavirus-n...

No, NYC did not weld anyone inside their homes. The residents were absolutely under lockdown.

I dunno, you can't really have it both ways. Either a lockdown is something stricter than how people would behave in the presence of COVID, or it's not. If the argument is that the lockdown itself has a societal cost, then it's the strict version. If you go by the headlines that refer to lockdowns in the colloquial sense describe the very loose policies of "walk around, order food, wear a mask, sit outside, social distancing, but hey, indoor dining is closed so it's a lockdown", then most if not all of that cost is what would be happening anyway due to human behavior.

This is all really dumb. We need to societally backspace and come up with a couple of popular words that have clearer meanings for this stuff. Lockdown has close to zero semantic meaning.

In my original parent comment, I was more thinking of strict lockdowns. The type where - given sufficient test capacity and responsible contact tracing - a region could limit its borders and strictly lock down for four weeks, and obliterate COVID to the point they could test and trace - and dine indoors.

Data is useless without theory, and theoreticians like Paul Krugman have long argued that lockdowns are better for the economy. A recent science paper also showed that countries that utilized lockdowns showed stronger economic recovery. Cite the science, not the NYC hospitality alliance rent report. These other sources do not argue that the point of lockdowns was to help hospitals, but rather to help the economy itself.

Re: Krugman, it's hard to see him as anything other than a monomaniacal partisan. He says some pretty ridiculous things with increasing regularity.

So what? Krugman is also a Nobelist, if you're merely content with regurgitating decades-old ad hominem promulgated by conservative economists who are in denial about their own partisanship. It is factually true that Krugman early on advocated for lockdowns using an economic argument. Either that's useful to know and look into, or not. But the level of your response to this fact was purely vacuous anti-intellectualism, a kind of partisanship of its own.

Yes, and?

Where I live, well over 50% of all new community cases have been associated with bars and restaurants. The bars have been ordered closed until there's an effective vaccine. The restaurants are open, but patronage is far below pre-pandemic levels because, even without a government order, most people don't want to risk dying for a restaurant meal.

The reality is that bars and restaurants aren't safe to operate as long as SARS-CoV-2 is spreading in the population. This is a catastrophe for their owners and employees, but it is the epidemiological reality.

Most countries don't allow businesses to stockpile explosives in residential areas because the risks of an unintended mass casualty event is too high. During this pandemic, operating a bar or restaurant is similarly unacceptably dangerous and cannot be permitted any more than residential storage of explosives can be permitted.

No amount of bleating about 'muh rent payments' or 'muh rights' will change this, or make patrons decide to risk their own lives for the benefit of the industry.

> We're on month seven of the lockdown in NYC. 87% of restaurants can't pay rent.

You think that's from the lockdown and not from the pandemic? I'm in the one of the red states, and restaurants have been open for awhile. I don't know anyone who is planning to go out to eat, and we all used to eat out a lot. Sure, some people don't care and will carry on like normal, but the pandemic crushed hospitality regardless of a lockdown.

Because of the way people are behaving.

A substantial amount of people did not shelter in place until they were ordered to do so, and they stopped doing so as soon as the order was lifted.

Bars and restaurants and malls were packed until the day the lockdowns started. In places that have allowed them to reopen, they are packed again.

Given that some customers are better than no customers, and that a lot of the customers never would have left and are back now, and given how many businesses failed because it was literally illegal to enter them, how can anyone believe that businesses would be better off with longer lockdowns? It flies in the face of logic and requires some very convincing data to be believed.

We shut down businesses that pollute the water so that people living downstream won't get sick. It's not clear why businesses that pollute the air (that's bars, to be clear, you catch covid in closed environments where people are tslking) should be permitted to operate, they are a risk to public health. And you don't need them. You can make a case that you need teflon, but you don't need indoor drinking establishments or basketball arenas.

> some customers are better than no customers

Running a restaurant at 10% capacity is probably not much more sustainable than remaining closed. At least if you're closed you don't have to pay employees to show up.

A lot of restaurants in states that reopened are at a lot more than 10% capacity.

Given how razor thin restaurant margins are, even running at 70% capacity during what usually would have been peak hours will kill the business. That's why restaurants try to squeeze as many tables in as possible and turn over tables quickly

...which makes them a great place to share infections.

I'm not scared or spiteful. I stay in because it seems logical to minimize exposure. So I reject your crappy generalization.

"Logical to minimize exposure" is a nifty way of saying you are scared of getting covid. You chose to assign a negative connotation to being scared of catching a virus.

Fear is a psychological state.

Doing a cost-benefit analysis and avoiding high-cost tail risk doesn't imply anything about psychology.

Is there any virus that we would want to catch?

Is it really unreasonable to be scared of catching a virus that may leave you with severe long term health conditions? (assuming you survive it to begin with).

I think a better question is why shouldn’t people be afraid of catching Covid-19.

No, it's more respect for my community and a sense of social responsibility. You seem super into this "Are we not free?!" mantra, but reluctant to acknowledge people might choose to stay home even if things were open.

Given that the law protecting pre-existing conditions from disqualifying one for healthcare (Covid is a pre-existing condition) is currently up in the courts to be struck down + the highest court is likely to be highly pro-tear down of this law, IMO it is completely reasonable to not want to catch Covid.

In addition to the reasons given in peer comments, minimising exposure helps to protect other people.

Personally that's my main motivation to stay in and take care. Not to protect myself, but to protect other people.

Including people I know and care about personally, and people I don't know and never will.

Some of those other people will die or live with a horrible disability which may be lifelong, if me and people like me don't collectively adopt that stance.

That's a great reason for me to stay in, be careful, and minimise exposure!

So I do it voluntarily and gladly, and wish others would make the same decision, and when they can't for reasons outside their control, wish that they could if they want to.

> We are way beyond the point where hospitals are horribly overwhelmed

This doesn't seem to be universally and objectively true. The nation overall has about 30 ICU beds and 20 ventilators per 100,000 people. In states were the disease outbreak is out of control, such as N. and S. Dakota, they are reporting 300-400 new cases per 100k people per day, 5-10 new deaths per 100k people per day, and hospital occupancy of 25 per 100k for COVID-19 alone, and rapidly increasing.

So lockdown those places as needed, if that's what the people want. And reopen when the situation is under control.

In our modern world, people have the ability to travel quickly from one place to another. The only place we can block that is the national border.

Therefore, we must have a consistent policy within that border if we ever hope to get this under control.

Or we need to set up internal borders, which is quite against the constitution.

>Or we need to set up internal borders, which is quite against the constitution.

The federal government imposing nationwide lockdowns on each and every state is a gross overreach and completely unconstitutional. It's not an easily solved problem in the US system of government. We're a free country, or at least we pretend to be.

Edit: This seems to be causing some confusion. OP is referring to the need to have "consistent policy across state borders."

> The federal government imposing nationwide lockdowns on each and every state is a gross overreach and completely unconstitutional.

AFAIK, it did no such thing. The federal government advised certain measures, and state and local governments (inconsistently) implemented stay at home orders, etc. based on their own authority.

I don't know if you're referring to reality or something you saw on TV, but the US federal government has taken literally no actions whatsoever to contain COVID domestically. They certainly haven't imposed a nationwide lockdown, nor are they empowered to do anything like that.

The US federal government is funding the development of vaccines and other medical advances.

a country so free that it's functionally incapable of defending against bioterrorism

or even just a highly contagious virus that had nothing to do with terrorism.

I agree with you, but this is one of those cases where the federal government would have a good reason for temporary overreach. Lots of other free countries have figured this out.

Weirdly, I can't bring a grapefruit across state lines. But I can bring a primate carrying a deadly virus.

You can't bring a grapefruit across state lines? What is that a reference to?

https://www.cdfa.ca.gov/plant/factsheets/BringingFruitsVeggi...

You cannot bring cherries into california from almost all USA states (except AZ, NV, CO, and WY). I experienced this personally. The state border crossing took cherries from us while we crossed from Oregon, less than 3 months ago, and dumped the cherries in trash.

This is not limited to businesses, and is not a pandemic measure. This has been a long standing policy, meant to protect california's agriculture. Oh, the free trade exponent country has protectionism practiced by its states.

Or, and I know this is crazy talk, we could use that same national integration to move sick people to places where they can be cared for.

If South Dakota is running out of ICU beds, and Denver isn't, get them to Denver. Yeah, that's expensive... but is it nationwide lockdown expensive? Of course not.

It's not just about ICU capacity though. If we opened everything up, then everywhere would get overwhelmed. We need to R0 down below 1 before we reopen everything.

> The goals have fundamentally drifted on covid. In the beginning it was flatten the curve so that hospitals aren’t overwhelmed. The goal wasn’t to eradicate covid but to slow the growth to an acceptable level.

It's kinda unreasonable to expect strict adherence to an initial strategy formed in such an uncertain and chaotic period. When more effective containment strategies become known (or discovered to be achievable), they should be pursued.

My recollection was that the "flatten the curve" slogan appeared immediately after it became clear that the hope of stopping covid at the border had failed. The main message of the slogan was to maintain optimism because there was still value in social distancing, etc. even though the initial containment had failed. That was also before masks had been widely recommended. Now it seems like masks plus diligent adherence to some social distancing measures can do better than "flatten the curve," but unfortunately too many people aren't interested in doing either, so we have a bigger mess.

If CDC and the Surgeon General had wanted universal mask use, the worst possible strategy would be something like: spend two months insisting that, not only do masks not work, but buying them is unpatriotic and selfish, because we need to save them for health care workers, since masks require a hospital boundary to be effective. Just wash your hands a lot!

Then pivot, pretend universal masking was always the advice, and act shocked when the resulting cognitive dissonance coalesces into a partisan issue.

> If CDC and the Surgeon General had wanted universal mask use, the worst possible strategy would be something like: spend two months insisting that, not only do masks not work, but buying them is unpatriotic and selfish, because we need to save them for health care workers, since masks require a hospital boundary to be effective. Just wash your hands a lot!

You know things can change, right? It's a fact that during the initial stages there was insufficient supply of masks of all kinds, and the ones most available for purchase were N95s which are still in short supply. Now surgical masks are literally given away for free at the door at Home Depot.

In retrospect, they did make mistakes (too much focus on evidence based vs. common-sense recommendations (e.g. use a homemade mask), and much focus simplify the messaging leading to a neglect of education about the subtleties of mask use).

> Then pivot, pretend universal masking was always the advice, and act shocked when the resulting cognitive dissonance coalesces into a partisan issue.

No one serious pretends that "universal masking was always the advice" (at least in the US). However, it's clear that the advice now. Like I said initially: it's kinda unreasonable to expect this should have all been figured out perfectly during the initial uncertain and chaotic period.

> ...because we need to save them for health care workers, since masks require a hospital boundary to be effective

It was way more nuanced than what you are implying. At the time, it was not known that normal masks can have any effect and many pieces of evidence suggested the opposite. It was known that N95 masks were effective, but a) they were, and still are, in short supply and need to be saved for healthcare workers; and b) in a manner of speaking, they stop working beyond the hospital border. Putting an N95 mask on requires training and even many trained healthcare professionals put it on incorrectly and expose themselves to the virus.

Things changed when it was shown that normal fabric masks were effective.

100% agree, that is what was drilled into our heads in California since March/April, flatten the curve over and over again. We never got like NY with hospitals overflowing with the severely sick and morgues overflowing. LA was pretty bad in the summer but Gov. Newsom was closing state parks, beaches and even the Natl. Parks along with all non essential businesses. The parks closure was completely idiotic as you want people to be in the sunshine getting exercise and soaking up vitamin D. Transmission outdoors was never a super spreader event and still it was forced down our throats. Now its an absolute chaotic situation where lockdowns go up and down per county every week with it based on number of cases(colleges are open leading to huge case jumps). I think the leadership in this state is completely incompetent and our unemployment rate and subsequent huge drop in taxes will prove it. I am also conflicted about the severity of the virus as I know a old coworker who died of it in his late 40's and a family member of my Wife's who had it but had no symptoms(he is in his mid 30's).

> Now its an absolute chaotic situation where lockdowns go up and down per county every week with it based on number of cases(colleges are open leading to huge case jumps).

How is a system that loosens and tightens restrictions based on cases and positivity rate "chaotic"?

Yeah, seems like that would be a system that can respond to changing conditions - seems like a good thing.

Technically, it's almost the literal definition. There are just a few constraints more, and those are satisfied.

But I agree it doesn't make a policy bad.

Because the system is completely arbitrary. There is no explanation of why 3 extra cases per XX people means you get indoor dining, but 3 less doesn't. All of the numbers that I saw where never justified, and seemed to be based on someone saying we need a few different tiers so that people think we know what we're doing.

I think the problem is that there is no easy formula for making these kinds of decisions. You need to look at the data and figure out what's going on before deciding what to do. For example, let's say someone has a big party and there are 100 new cases because of it. It wouldn't make sense to shut down indoor dining just because there was a spike. But on the other hand, if you saw 100 cases coming from a lot of restaurants spread out across a county, then you might consider shutting down indoor dining again.

Alot of the cases recently from california are from colleges starting classes. Cases are spiking at the college and instead of closing the college or forcing it to go fully remote the entire county suffers by having its businesses forcibly closed. Or take Lompac[1], a huge outbreak at the prison there caused santa barbara county to possibly enter a restrictive tier(even though the prisoners have no involvement in the community). Also the wording of the level of restriction changed from phases(1,2,3,4) to colored 'tiers' with no explanation. If that is not the picture of dysfunction I don't know what is.

[1] - https://www.edhat.com/news/lompoc-prison-could-delay-reopeni...

> a old coworker who died of it in his late 40's

that’s not old at all

I read it as meaning "former coworker"

Sorry, better term is former coworker, late 40's is very young to die from a virus.

Ha makes sense now, in my 40s so I got a bit defensive there :)

I think the main problem is that there are simple ways to reduce the chances of virus spreading, but people ignore them - the only tool you have left in your tool belt is to shut things down. At this point, opening things up won't change much in my opinion - folks that want to stay at home will stay at home, limit their spendings (no restaurants, entertainment, etc), won't travel, and wait it out till the vaccine is ready. At least I know I will.

A blanket shutdown of businesses in California is/was a bad idea. The people who want to be irresponsible will get the virus, even the CDC acknowledges that it primarily spreads via close person-to-person contact. So we have a situation where businesses are closing at an apocalyptic rate leading to a huge drop in the tax base for the state, the virus is still spreading rapidly amongst those who do not take it seriously and we(who are responsible) still suffer. Counter that in we have open businesses that see a drop in customers but these businesses see some revenue(all the while maintaining social distancing and requirement of masks inside).

My point is mostly that even if you do open everything up, that won't convince everyone to start going out and spending again. After seeing what's happening around mandatory masks ("muh freedoms!"), I don't trust my fellow members of the society to do the right thing. At this point I don't care if you open up or not, I can hunker down a few more months, & I expect I'm not the only one thinking along those lines. The only problem to me is that when you open up, you are forcing people to choose between losing their job or potentially getting sick.

maybe not necessarily spiteful -- just following the experts and politicians. I feel this discussion could have gone much better if the pandemic were not politicized.

> The goal wasn’t ever to save every last life no matter the economic consequences.

My goal is to save my life and my families lives - every one of them

If that means wearing masks we wear masks

If that means not going to restaurants, we eat at home

That means never leaving your house again, you could get hit by a car. And optimizing your meals for nothing except expected lifespan.

Yes, I’m aware of how fortunate I am that WFH is available for me

And how it further reduces my risk of daily commute driving

Do any of your family members rely on tips to stay housed?

One of mine does. It's been pretty brutal.

It's easy to pretend that economic devastation doesn't cause suffering and death, when your only personal consequence is that you finally get that work-from-home gig you always wanted.

Turns out universal healthcare and social safety nets are useful things to have in a crisis.

Are you saying that hospitals currently overwhelmed or not?

It seems to me you're saying "we wanted to stop the kitchen from burning, but once that failed we just let the fire take the rest of the house too".

I may be reading it wrong though? Are you saying there is little risk of hospitals being overwhelmed at this point? Or are you saying that things are already so out of control we might as well stop trying?

In most places in the US, hospitals are not overwhelmed. The situation is under control. In NYS the cases have been hovering at or below 1,000 per day for 3 months. The peak was nearly 15,000/day. Is the curve not flattened? What are we still doing having entire industries shut down?

"I didn't die in a car crash today, therefore I don't need this stupid seat belt."

"You are 50% more likely to die in a car crash if the car is travelling > 70 miles/hour compared to < 40 miles/hour, therefore we should not allow cars to travel > 70 miles/hour."

Bad analogies are available for both sides of the debate.

Any rational discussion on what the right response should've been depends on the trustworthiness of the experts and leadership. Unfortunately, there has been so much bias and politicization from the media, government leaders, policy makers, and even doctors and scientists on both sides that most people are skeptical even if we are making sound decisions based on the stats. The question is - are the stats sound? I'm not convinced we'll ever know. In today's world, the loudest wins the narrative and is considered "right" by the masses.

> Wanting to see the economy fail to punish rich people and corporations.

does anyone really believe that a failing economy will hurt rich people and corporations more relative to... literally anyone else? i would expect the exact opposite, e.g. https://pomp.substack.com/p/the-k-shaped-recovery-is-now-und...

No, it's quite obvious that lockdown would disproportionality impact middle and lower income families. Not to mention that implementing such a spite-based policy would require a massive conspiracy that crossed state boundaries and political ideology, and many of the policymakers themselves would be among the elite that were supposedly targeted.

To quote the op: "I think we’ve effectively lost our minds on covid."

>Not to mention that implementing such a spite-based policy would require a massive conspiracy that crossed state boundaries and political ideology, and many of the policymakers themselves would be among the elite that were supposedly targeted

I think this spite based ideology and policy already exists. It started when we changed goals from economic prosperity to economic equality.

Once the public believes that they don't and haven't benefited from the overall economy, there is no reason to keep it healthy.

Regarding (2), what evidence do you base your conclusion on?

Unemployment can be solved with stimulus. 10 year treasury rates are at records lows, and there is a recent tax cut that can be repealed that can pay for it.

> Wanting to see the economy fail to punish rich people

Come on. This is deeply paranoid and itself rather spiteful.

If you cannot discern the differences between the different ways that people can be well-meaning but wrong and a need to Punish Richie Rich, then you frankly need work on some people skills.

Not at all; I've spoken with several people like that as well, and while the grandparent and I are onlytwo anecdotal data points I have no doubt they're out there.

It's also bizarre. No one thinks that the rich are suffering other than the rich. Poor people don't think that the drifting of numbers on paper that don't affect a person's physical health or quality of life in the slightest count as suffering.

Of course they don't. For a poor person, either jobless or reporting to a low-paid job that exposes them to potentially bankrupting covid infections, with their kids at home, to worry about the upset of the perpetually bailed-out wealthy is like a beaten, starved dog outside on a winter night worrying that its owner might miss their favorite TV show.

I have seen a ton of happy and o see the economy crash for just this reason. For example, they want the housing and stock market to crash so that there is more parity between the haves and the have nots. If you are low income worker in California, every homeowner with a 401k is Richie rich.

>If you are low income worker in California, every homeowner with a 401k is Richie rich.

how many low income workers do you actually know and talk to in california?

Most of my friends and family.

> Wanting to see the economy fail to punish rich people and corporations.

That's a nutty take, since (a) it's been those at the low-end of the income scale hit the hardest, and (b) it's dishonest to claim lockdowns are purely a matter of politics, because we know they slow the spread of the virus. Bars are open around the country. I don't think the few remaining lockdowns are our biggest problem.

> Bars are open around the country.

pointing to bars instead of churches in such contexts clearly shows political undercurrent, and you can see it everywhere.

> I think we’ve effectively lost our minds on covid

the reaction to Covid has never been rational. Instead it has been clearly following the 5 stage model of pure emotional reaction: denial, anger (strict lockdowns when they started), negotiation (rules for staged opening, masks, etc.), depression (entering right now, and we'll get fully into it with the second wave), and several months down the road we'll get to acceptance.

> 2) spiteful. Wanting to see the economy fail to punish rich people and corporations.

It'd be cool if the rich and corporations were actually punished, but so far they've made out like bandits during the pandemic.

> "people are some combination of 1) scared, and 2) spiteful. Wanting to see the economy fail to punish rich people and corporations."

that's an odd conception of what's going on. because they control capital, the well off among us (esp. in CA) imposed restrictions of movement/congregation and economic travesty upon the rest to decrease by tenths of a percent their risk of contracting and dying from covid, while largely ignoring those same restrictions for themselves. this is a serious, existential concern for our democratic republic, and an extremely poor allocation of resources from an economic perspective.

the mode of transmission is straightforward: prolonged exposure to the exhaust of others (not the air, not surfaces, not touching, but breathing exhaust). we could have gotten the same level of mitigation for much less intervention by radically simplifying messaging for the public (hospitals and care facilities should have more elaborate mitigations) down to one simple rule: "distance indoors around strangers, and where you can't, wear a mask." but that didn't serve media or political interests (as expressors of the wealthy) well, so we have the mess we're in.

The desperate attempts to glorify the failed Swedish strategy will never end. The people who claimed COVID19 was nothing to worry about refuse to admit they where wrong despite hundreds of thousands of deaths.

Fact is other Nordic nations took less economic hit than Sweden due to quick lockdown and quicker reopening. Thanks to the time this bought is health workers are able to treat COVID19 victims more effectively now than in the early phase leading to lower mortality rate.

Sweden was the lab rat, having to deal with lots of sick people while the disease was poorly understood. It was a poor strategy.

Sure the rest of us will have an uptick now but we know much more about how to treat people effectively than Sweden knew and we are just few months away from vaccines .

So don’t tell me the Swedish strategy was worth it. More people died than necessary for no economic gain.

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