Comment by dalke | Hacker News Reader

Comment by dalke | Hacker News Reader

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The title is still wrong - Sweden has had a lockdown (light, certainly, but not "no-lockdown"), what appears to be a summary of new restrictions has actually been in place for months, and there's nothing in the article which says there will be new legal enforcements behind the stronger recommendations. If the old policies wasn't a lockdown then the new one isn't either.

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.

My question is, has the spike in cases corresponded with a spike in hospitalizations? My understanding has been that this second wave has been far less deadly throughout the world, and likely because it's hitting younger people, who fend it off relatively easily on average, whereas the first wave tended to hit the most vulnerable (nursing home and assisted living populations).

Younger folks are getting it, folks are tested and treated earlier, treatment has improved and viral load has fallen, meaning it's more likely to be fought off with lighter symptoms. The latter is mostly likely due to masks and social distancing.

Swedes by and large do not wear masks, schools have stayed open the whole time, bars and restaurants stayed open the whole time...https://m.youtube.com/watch?v=jqjorS3oYlk

Yes.

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.

Cmon Andy. According to the graphs you reference: October incidence is comparable to April, while October hospitalisation is much lower than in April.

Have another cup-o-joe and tell me why I'm wrong ;)

I haven't gone by Andy since I was 8 years old. Using an unasked-for nickname feels condescending and even like infantilization - which admittedly is in line with the tone of the your response. The HN guidelines request that we "Be kind. Don't be snarky. ... Please don't sneer, including at the rest of the community."

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.

I honestly apologise. I did not pass my statement through my net post filter, as I should have done. That is completely my failure. No snarkiness or diminutisation intended, just my poor formulation.

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?).

Apology accepted, and thanks for it.

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.

The first graph you reference is not really people being ill, instead it’s people with detected infections.

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.

Yes, it looks like "Sjukdomsfall per dag" is more correctly translated as "Disease cases per day".

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?

In other countries the hospitalizations, transfers to Intensive Care and ultimately fatalities quickly followed the rise in infections.

How long should we wait before we can accept that the increase here is tiny and much smaller than elsewhere?

Isn't that what we see in the Folkhälsomyndigheten site I linked to? There's roughly 4x the number of reported cases since 1 September, roughly 4x the number of hospitalizations, and roughly 4x the number of deaths.

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?

The goal cannot be to keep the numbers from getting larger. The goal must be to keep the disease under control and prevent overloading the hospitals.

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.

Abstractly, sure, there's a possible limit. And concretely, sure, there are other effects. I want to be able to jump on the train to visit friends, but don't because it's not necessary travel.

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.

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