Sweden is moving away from its no-lockdown strategy
businessinsider.com
businessinsider.com
But because of the two degrees of separation, it seems to have lost something. I suggest "Sweden is tightening it's light-lockdown strategy ... " as a more accurate description.
I say this because I was confused. It's titled "no-lockdown strategy", but as the article points out, the end result of these new changes is not lockdown, so it would still be a "no-lockdown strategy" - using the Business Insider's definition.
However, Sweden has had restrictions. Public events with 50 or more people were cancelled, many schools went to distance learning, and more. See https://www.folkhalsomyndigheten.se/the-public-health-agency... for the FAQ in English, listing many of the restrictions.
For example, the BI article says:
> It will give local authorities the power to strongly recommend people to avoid busy public places like shopping centers, museums, gyms, concerts, and sports matches. Swedes may also be asked to avoid public transport and contact with the elderly and vulnerable.
But we (I live in Sweden) have that already. School sports venues, for example, hosted games without audiences. The signs at the bus stops and train stations ask to avoid non-essential public transport. Places cap the number of people allowed.
The source article in The Telegraph is more accurate with "It's more of a lockdown situation - but a local lockdown" as it acknowledges that there has been a lockdown, defined as a restriction in allowed activities.
> Dr Tegnell said on Thursday that the autumn resurgence in infections had changed his agency's understanding.
> "I think the obvious conclusion is that the level of immunity in those cities is not at all as high as we have, as maybe some people, have believed," he said.
Sweden has been the poster child for folks trying to wish away the danger of allowing a relatively dangerous, highly infectious pandemic to run its natural course. Now even the Swedes are conceding that, you know, letting people die unnecessarily was ... unnecessary.
Those folks you mention seem to deliberately use "no lockdown" to describe Sweden, when clearly (I linked to a source, and gave personal observations) there are restrictions, and so is more accurately "light lockdown". I can't help but wonder how it came to be used in this title.
BTW, I looked for mention of upcoming substantial changes at https://www.gp.se/ and found https://www.gp.se/nyheter/sverige/platserna-i-g%C3%B6teborg-... . Google Translate at https://translate.google.com/translate?sl=auto&tl=en&u=https... .
You can see the changes are in the "sharpness" of the recommendations, and in case of a local outbreak. For example, from "you shouldn't take public transport unless you can book a seat" changes to "you shouldn't take public transport."
But it's still as voluntary as it was a few weeks ago, so if we were "no-lockdown" then we'll still be "no-lockdown" tomorrow.
The stats are at https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utb... . For non-IE browsers see https://experience.arcgis.com/experience/09f821667ce64bf7be6... for plots.
On the right top is "Sjukdomsfall per dag" - "illness cases per day". You can see the big peak ending around early July, and the new peak rising. Of course there's better ability to detect cases.
On the right middle is "Nya intensivvårdade fall per dag" - "new intensive care cases per day". IT's about 1/10th of the April peak, but at 2-3/day is several times higher than the low point of 1 about every 2-3 days.
On the right bottom is "Avlidna per dag" - "deaths per day". It's harder to tell without smoothing, but it seem to have increased too.
The fact you can’t really infer anything from the other graphs without a microscope might be a clue as to how much of a deal this is.
Though to point out, https://en.wikipedia.org/wiki/Disease#Concepts says "many cases, terms such as disease, disorder, morbidity, sickness and illness are used interchangeably" and "The terms illness and sickness are both generally used as synonyms for disease;" so I'm not clearly wrong.
It then goes on to make your point "however, the term illness is occasionally used to refer specifically to the patient's personal experience of his or her disease. In this model, it is possible for a person to have a disease without being ill."
As you can see from my earlier comments, I agree that the "sharpening" of Swedish recommendations is nowhere the big deal that the referenced article implies it is, and the local media is not making a big deal of it. It's preparations for any local outbreaks, ahead of time so people can be prepared, and knowing that existing practices are no longer as effective.
But, why the emphasis on "without a microscope"? Isn't early the right time for things like this?
How long should we wait before we can accept that the increase here is tiny and much smaller than elsewhere?
Again, eyeballed numbers, but you make it sound like something is significantly different.
Isn't the goal to keep the numbers from getting larger, like we see elsewhere?
Don’t forget that you can’t take prevention measures without causing other effects; if you keep people locked into their homes they will become unhealthier, if the economy crashes they will have a lack of food and health care.
But as is very well known - it's the topic of this HN posting! - we here in Sweden aren't locked into our homes, even with these new recommendations in place.
So since this posting and conversation is about Sweden, I don't really see what you're getting at. Are you expressing frustrations you have with the restrictions where you live?
I don't think it's impossible to keep the Swedish economy going, with enough food and health care, while also keeping the infection rate low by being a bit more mindful of what we do when there are local outbreaks.
And I think the 4x rate since 1 September is enough cause to be more mindful. Otherwise, it'll be 10x in a month, and more after that.
Have another cup-o-joe and tell me why I'm wrong ;)
As I wrote in the comment you replied to, "Of course there's better ability to detect cases." I thought that was obvious enough to not need further elaboration. I seem to have been wrong, so I will further clarify.
June is roughly when covid screening was available to everyone. Eg, the local pharmacy offers antibody testing. You'll see that's when the number of known cases went up even though the intensive care and death rates decreased.
Thus, it makes no sense to compare as you did October's reported case incidence - when widespread testing was available - directly with April's - when it was not.
In addition, the question I replied to was "has the spike in cases corresponded with a spike in hospitalizations?" The answer is still "yes". There has been a roughly four-fold increase in reported cases over the last six weeks, and there has been a roughly four-fold increase in the number of intensive care cases over the same period of time. That's by eyeball, so increases might not match that precisely, but it's still a correspondence.
Since the lockdown we have is no longer effective at keeping the rates low, it makes sense to "sharpen" the recommendations.
Tell me how I'm wrong that that's not a correspondence. And hopefully with less snark.
As for the curves. Do I interpret your point correctly as follows? The major factor of the discrepancy was the undetected cases in April vs October, due to lower testing? Does that hold true when comparing with the quite low numbers coming out of antibody screening? I remember this being drastically overestimated (4x?).
I cannot say if the major factor was due to lower testing. I can only say that the testing regimes were significantly different and so cannot be compared as directly as you did.
My point was that Swedish policy has been used a counterargument against lockdowns, social distancing and use of masks.
Flattening the curve as a goal wasn't unique to Sweden. The decision not to follow the same policy settings as its neighbours were. The result? Sweden has a far higher death rate and is now edging towards the same policy they could've had from the beginning.
> Sweden has been the poster child for folks trying to wish away the danger of allowing a relatively dangerous, highly infectious pandemic to run its natural course.
Also:
> jacques_chester 3 hours ago
> I didn't say anything about Swedes wishing away the pandemic.
----- For posterity.
Rather than meaning Sweden itself is doing so.
----- for posterity.
Party B: Acting like there is no consequence and believing it.
To observers, highlighting the difference makes no difference.
I don’t know what to call this fallacy. The ‘folks’ are unnamed and unspecified so I don’t think stating that they think anything is a useful argument at all.
That said I am open to changing my mind and think it is good that the authorities are stressing more precautions again. People have been getting a bit careless again and infection rate is increasing. It hasn't resulted in rise in death yet but we have to be vigilant.
ETA: It is concerning that even several months into the epidemic, with time to prepare better to protect vulnerable populations, Sweden now feels that stronger general restrictions are the right approach. It’s hard to see how that isn’t also an admission that those restrictions shouldn’t have been used in the early phases as well.
Folks who don't like lockdowns keep looking for reasons why Sweden's original policy is great, but also excuses for why its substantial deaths can be hand-waved away.
It's just time to give up on the idea that Sweden's worse performance is a fluke rather than the direct consequence of a predictably dangerous policy setting.
>On 28 April 2020, Tegnell was interviewed by Kim Hjelmgaard of USA Today. During the interview he "denied that herd immunity formed the central thrust of Sweden's containment plan"
> “One point would be to keep schools open to reach herd immunity faster,”
The most reasonable interpretation of "reach herd immunity faster" is that he saw that as a positive outcome.
He's tried to avoid the herd immunity label, but then, what is the policy goal? Because what's left is "letting people die unnecessarily is fine".
Highly infectious yes, but dangerous relative to what?
Current best data from CDC and elsewhere says that compared to flu:
- COVID is far less deadly if you are healthy and under 70
- COVID is a bit more deadly if you are old, unhealthy or both
The reason is that flu is willing to kill young and healthy people but COVID virtually never does this, is preference for people who are about to die anyway is so strong that the average age of COVID death is older than the average life expectancy.
If you look at the Swedish data there are ~no deaths either of or with COVID since about the end of July. It's been riding the noise floor, probably all false positives, since then, usually between 1-3 per day. Something that's not killing anyone is hard to describe as "relatively dangerous" unless you're comparing it to some kind of unnatural lifestyle in which as much risk as possible has been removed.
The new 'second waves' of COVID are not correlated with similar second waves of deaths. This is not predicted by any epidemiological model and frankly nobody seems able to satisfactorily explain it, but an increasing number of people testing positive may mean very little when the huge ramp up in testing and unknown/untracked (!) false positive rate is considered. At any rate, it hardly justifies lockdowns.
Did you also know their positivity rate is the highest in the world? [2]
1 - https://jordanschachtel.substack.com/p/200-days-the-worlds-l...
2 -https://www.nbcnews.com/news/latino/argentina-has-world-s-hi...
> BUENOS AIRES - Argentina has the world’s highest rate of positive COVID-19 tests, according to Oxford-linked tracker Our World In Data, with nearly six out of 10 yielding an infection, a reflection of low testing levels and loose enforcement of lockdown rules.
If you were implying that strict lockdowns have paradoxically failed, then you've picked the wrong evidence.
A more accurate comparison that controls for location, culture, political structure, economic situation, etc is between Sweden and the other Nordic countries where it had both higher mortality and worse economic outcomes than its sister nations. Carefully consider your preexisting biases when it comes to interpreting something as complex as the respond of entire nations to an unprecedented pandemic.
Maybe Argentinians just refuse to listen to their government? Maybe environmental factors or lack of infrastructure made it way worse down there and it would be even worse if it weren't for the lockdowns?
The most recent stat I read showed that Sweden currently has less than a dozen people in the hospital with Covid conditions. We're 8-9 months in to this and so far the Swedes are not dropping like flies. They had an early spike in deaths and it since fizzled out.
As of today[0]:
Norway (pop 5.5Mn): 16,136 confirmed cases, 278 deaths in total, 915 new cases in the last 7 days.
Finland (pop 5.2Mn): 13,133 confirmed cases, 351 deaths in total, 1,553 new cases in the past 7 days.
Sweden (pop 10.3Mn): 103,200 confirmed cases, 5,918 deaths in total, 3,280 confirmed new cases in the past 7 days.
On each of these measures Sweden fares far worse. They have 4x the cases of Finland and Norway combined, 9x the deaths of Finland and Norway combined, 1.5x the new cases of Finland and Norway combined.
In absolute and relative terms, Sweden are not worthy of emulation.
There's no evidence that coronavirus has a climate-related outcome, save for vitamin D sufficiency, which is only partly related to climate.
According to this: https://www.statista.com/statistics/1104709/coronavirus-deat...
Sweden is at number 13 and falling. Many latin American countries as well as UK, Spain, Belgium, US, and Italy have all fared worse on a per capita basis than Sweden.
Coronavirus does not discriminate based on economy. Many first world nations have been hard hit. Coronavirus does not discriminate based on climate, many warm latin american countries are in the top 10. Coronavirus has hit many areas of the US the hardest during the summer.
Sweden has never locked down, never mandated masks, and they currently have only a couple dozen hospitalizations. Their deaths, even by your chart, have completely flatlined at near zero for now going on three months.
In any case, you've fixated on one similarity and missed the larger point. Comparing Sweden to its immediate neighbours is a stronger comparison than any other. No other countries in the world are as comparable, not even close. When you control using that natural experiment, Sweden comes out much worse.
Anyway, regarding this point; there's wildly different infection-rates etc in different big cities in Sweden as well.
The way the beliefs are repeated is just as interesting as why the Groupthink has come about in the first place.
It’s a worldview. Note that the elderly have to be protected as though they are cattle rather than being told they can choose to protect themselves if they want.
Top down vs bottom up
> “Is there isolation? There is none. Are there (enough) tests? No there aren’t,” one pediatrician in Buenos Aires said.