Swedish virologist says her country's strategy has failed, but nobody admits it | Hacker News Reader

Swedish virologist says her country's strategy has failed, but nobody admits it

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40 pointscolinprince53 comments

Did somebody ever make a serious attempt at defining what "success" and "failure" even mean in cases like these?

Failing at all everything you explicitly set out to do should probably count as a failure.

For example, there was initially an attempt at avoiding imported cases by recommending against visiting high-risk areas. This failed due to the ministry of foreign affairs being ridiculously slow to update the risk assessments, so Italy was not high-risk when people went there on vacation.

Then Sweden was going to handle those imported cases easily through pure excellence in contact tracing, so there was supposedly no need to quarantine anyone in any way. That failed very quickly.

Then, after the complete failure of containment, it was announced we were going to prevent the virus from spreading to particularly vulnerable groups while allowing it everywhere else. The Germans meanwhile said that this couldn't be done - and of course it couldn't. Later, the high number of deaths was stated to be because of those groups being disproportionately affected. So this was a clear failure.

Every part of this absurd strategy has failed.

What a strange narrative to spin, that "X was an attempt to prevent Y" when there's no such clear relationship. You're just making up these connections.

She probably defines appearing in the press as success.

Please don't post shallow dismissals, snarky putdowns, or personal attacks here.

https://news.ycombinator.com/newsguidelines.html

I happen to live in Sweden, and that means for the past 8 months, every news source around the world has written wild, baseless, stories about how either Sweden is a disaster or the a beacon of enlightenment when it comes to corona. Lately Sweden has also become a partisan gambit, in countries all over the world, and the press is eating it up. This means that foreign press will print any criticism of Sweden form anyone.

Are there people in Sweden who disagrees with the approach? Yeah! Are there any other countries where everyone is in total agreement over the handling of Corona? No. The fact that someone disagrees is not news.

Anders Tegnell, heard of the Swedish Corona response has repeatedly admitted the mistakes that where made, so the idea that "no one talks about it" is patently false. This article tries to make it sound like there is a conspiracy when there isnt one.

At the current state its far too early to draw conclusive judgment for a variety of reasons. A long string of people has come out of the wood work, making headline grabbing statements, that are provably wrong, or unknowable. Lena Einhorn is prime example of this. She hasn't worked in medicine for 40 years, and when she did she did not work with infectious diseases. So yes, just like I'm going to be dismissive of articles about "the other side of global warming" I'm going to be dismissive of this.

dang did not say you can't have an opposing view, he just said not to post a "shallow dismissal." if you had originally posted this instead of your snarky one-liner, you would have been fine.

I apologize. After enough "Doctors hate this simple Covid trick", headlines my patience is running short.

It's ok - you made up for it with a much better comment! as allenbrunson pointed out.

success - living people, failure - people are dead

Not necessarily. Sparing ten deaths now at the cost of a thirty in the future is not success.

Would you personally volunteer to be dead to save people in the future?

Would you personally volunteer to have your family die in the future to save 1 person now?

Seems extreme, this makes a lot of countries failures.

The response to covid has been pathetic in a lot of countries.

The secret sauce in places like Vietnam (lower income, high population, effective response to the virus) isn't going to turn out to be immunity, it's going to turn out to be effective government and cooperation among the citizenry.

I'd say if a very simple measure would have halfed your death numbers you can count that as a clear failure.

Failing is still better than actively doing your best to help the virus.

(Edited for a less polemic tone)

Every country has both. What then ?

One thing people don’t seem to understand is that these kind of decisions aren’t made by politicians here in Sweden. They’re made by the Folkhälsomyndigheten (the public health agency) which consists of people (doctors, virologists, statisticians, epidemiologists) that are actually qualified to have an opinion on this kind of stuff. The public health agency isn’t beholden to political will; the government can only affect policy by changing the laws.

So yeah, maybe the Swedish strategy is the wrong one, but if that’s the case then how come all these subject experts agree that this is the strategy most likely to succeed?

One more thing: There’s lots of people being quoted in the media that sound like they should be experts when they’re really not. Doctors, virologists and statisticians are not subject experts in isolation.

>Sweden is changing its COVID-19 strategy — but virologist Dr. Lena Einhorn says it's far too little, too late.

What does she mean 'too little, too late'. Sweden's pandemic impact is inline with the rest of Europe (for good or bad). It looks to be right in the middle of the EU pack. But they didn't lockdown, and the hard large-scale spring lockdowns seem to have been a big, costly mistake.

Also, I'm not sure how much credence to give to public health opinions of a 'virologist', as opposed to an 'epidemiologist.

It is not true that they did well economically. Here is a chart in which countries with either similiar confirmed deaths per million people or comparable economic contraction are charted.

https://ourworldindata.org/grapher/q2-gdp-growth-vs-confirme...

Sweden had horribly high number of deaths compared to others with the same or less economic contraction. Among these countries faring better than Sweden are Norway, Denmark and Finland.

Sweden did economically well compared to others with the same relative number of deaths, though. You might call it the one-eyed king in the land of the blind if you like.

>Sweden had horribly high number of deaths compared to others with the same or less economic contraction.

Sweden, like New York, made one huge mistake. They didn't protect their retirement homes. Swedish high death count, as well as New York's, can largely attributed to this huge mistake. In hindsight, the Swedish approach does look like the right one, but we'll know for sure after the dust settles and this pandemic is behind us.

There were rural regions in Sweden with no deaths and where the economy was essentially uninterrupted. The urban regions, however, were already in the "exponential wall" when covid became a news story.

The difference with Norway, Denmark and Finland is that their urban regions did not have early outbreaks.

The lockdown happened because we had no masks. Simply had none. Once manufacturing geared up and masks started appearing, the lockdown could be lifted.

It's bit weird though seeing all those people with fabric masks around when 3-layer masks are available. Yeah, hard to breathe in a 3-layer mask, but imagine how much worse it will be once you get the virus.

>The lockdown happened because we had no masks. Simply had none.

Masks have their place, but they aren't "be-all and end-all" of policy. In fact, if all you do is mask, they don't work very well. You need to pair them with social distancing and other measures.

At the time we locked-down though, most public health agencies, including WHO, was not recommending masking for the public. We locked down because we didn't know how bad the virus was. Numbers like 3-5% infection mortality rate were being thrown around (which was scary). It wasn't because of lack of PPE.

Noone was taking the 3-5% mortality rate seriously - if you look at the cruise ship studies (the only truly random / fully tested environments), it was fairly obvious early on that the true CFR rate was closer to 0.5% or even lower, or around 5-10x that of the flu.

The lockdown was primarily aimed an not overwhelming the hospital system, primarily based on early reports from Wuhan of overloaded hospitals, and then the videos from Bergamo and early NY data.

Masks not working very well - citation needed. I was in Hong Kong since January, where there was early mask wearing (since mid-January); the virus was introduced from China multiple times, but never took hold there. The social distancing there was so-so. The main keys to avoiding mass spread were: straightforward access to testing, isolation (!) of confirmed cases in hospitals / dedicated housing (and not at home unlike western countries), mandatory testing & forced quarantine of all incoming travelers, and mask wearing.

(Context: I'm from Germany.)

In retrospect, with the 20/20 vision of hindsight, the one thing all Western governments should have done differently early on is not to focus on "don't buy surgical masks (because we need them for hospital staff)". Instead, they should have said: "Everyone get out your sewing machines and make face masks for your friends and family." Publish sewing patterns and instructions for free on a government website. Maybe even video tutorials.

My mother happened to have all the materials at hand, so I got a dozen high-quality reusable cloth masks early on.

Funnily enough, I've seen other people say that Sweden's strategy succeeded and that no one will admit it...

Everyone trying to put the blame on their government response will say that Sweden is a success.

Everyone in Sweden disliking the government response or supporting their own government response will say that Sweden's approach has failed.

Because it's the truth? Let me tell you why from a perspective of "major" vaning power that is UK. The lockdown was a huge mistake with catastrophic economic consequences for a densely populated country like UK. The conservative government did it to save their voting base which is mostly old people who are in the risk group. It was supposed to last a few weeks, but instead went on for 6 months and is still effectively not over. They keep coming up with rules that are more retarded than the previous ones. Right now I can spend the whole day in the office without a mask, but I can't go out to lunch with my coworkers. It gets worse - in my gym I have to wear a mask for those 20 meters between the door and the gym floor where the receptionist sits who is walled off with glass better than a bank teller. They keep millions of people on furlough like chinese government keeps lights on in empty factories to cover up shrinking economy. Most of those jobs are not coming back. Admitting all those incredibly stupid mistakes for the government would mean an instant political suicide.

Also, nobody will probably read this, because I noticed this post has been flagged into oblivion.

My take is that the western world pursued the lockdown purely out of the will of its people, rather than that of its governments.

There's a great post (which I'll look for) that highlights that, no matter which US state you were in, you entered lockdown roughly within the same 2 week period as everyone else, regardless of what measures the state enacted. People in Florida, where the government was very slow, locked down roughly the same time as the people in New York, where the government was very quick.

Under this lens, you can look at the government's response to COVID 19 as not a response to the pandemic, but a response to people's response to the pandemic.

It was similar for us in Germany. The government started issuing (partial) lockdown policies in the second half of March, but a later analysis of mobility data (e.g. statistics from mobile phone network operators) showed that people had already reduced their mobility voluntarily in the first half of March, which helped make the first wave much smaller than most feared.

There is a running joke how people queue for buses in Scandinavian countries - they are all spaced out 1m away.

And there are photos in real life of it. And thats before Covid.

So people care about their personal space. And the population density is low. And people trust the government and are not actively doing the opposite when told to try to self isolate.

Obviously that will have better results than densely populated countries with people protesting that covid is fake and government trying to kill them.

Why are so many prominent media outlets so eager to try to poke holes into the Swedish approach?

> Sweden is changing its COVID-19 strategy — but virologist Dr. Lena Einhorn says it's far too little, too late

This is just completely false, nothing significant has changed, just some sterner recommendations in some localities.

As a Swede I find it so weird and also very disappointing that so many respected newspapers are basically making stuff up, omitting stuff, or just a paper-thin analysis to just spin some narrative (that is also mostly related to their own country's internal politics) about the Swedish approach.

Hard lockdown countries (like mine) are now so invested in their failed approach that they find it difficult to change course. By attacking Sweden, they fight their own admission of error.

Sit back, relax, sipping a beer unmasked and ignore them. I wish I could be there with you.

The interesting thing about Sweden is that they are going through a second wave even though they basically didn't do anything to stop the virus. I'm curious what caused the drop in infections and then the subsequent second wave.

The other thing is that deaths are basically at lows. So high infections and low death rate is basically what they want, isn't it?

> The interesting thing about Sweden is that they are going through a second wave even though they basically didn't do anything to stop the virus.

That's a misrepresentation of what happened in Sweden.

While there was no formal lockdown, people absolutely voluntarily engaged in some level of social distancing.

You only need to look at the economic data, which shows a major domestic slowdown, to see that people clearly changed their behaviour. It just wasn't mandated by the state.

In fact, the same pattern is visible in other nations. That is, individual behaviour changed in advance of lockdowns pretty consistently across a variety of countries.

I'm curious what caused the drop in infections and then the subsequent second wave.

Summer, I'm guessing.

Why would high numbers of infections would be preferrable? Reaching herd immunity by natural spread while not overloading the health system is an illusion as it would take several years. So we are waiting for a vaccine either way. The fewer infections, the better.

If 85%+ of the people are getting infected with mild or no symptoms, and those most susceptible to death are quarantined (those over 60 years old), then you have a best case scenario where the death rate is around 0.5%. What we need right now is a test to determine who that sub-10% are below the age of 60 that will get severe symptoms or worse, and isolate them as well.

We have no idea how successful a vaccine will be. If it's 50% successful, that means that people will be getting Covid-19 regardless, so it seems we might as well front load the infections now.

In addition, recently they found a new variant of SARS-CoV-2 with a mutation in the spike protein. If the spike protein mutates enough such that the vaccine no longer works, then we really have no choice but to reach herd immunity.

0.5% is not a low death rate at all. For Sweden (total population ~10M, assuming just 60% of all people infected are enough for herd immunity) that would mean thirty thousand fatalities in the group of people who are least affected by it. That's not even taking the harm of long term complications into account.

I really do not understand how people can possibly justify such a course of action but obviously they do.

I just hope it is because they haven't properly thought it through - and not because of a disregard for human life.

A 1/200 chance of dying in a free and open society, meeting like-minded friends in the pub, the restaurant. Or two years (if you're lucky) masked, being barked at by Covid wardens, locked down at home for a month in three. If I had the choice I know which I'd take. That's rather the point, the lockdown advocates will not give me that choice.

> That's rather the point, the lockdown advocates will not give me that choice.

That's because it's not a choice you can make just for yourself in isolation without affecting others.

Unlike, say, not wearing a seatbelt in a single passenger vehicle, where its only your own life at stake, if you choose to take risks with an infectious disease, you're also making a choice to endanger others--the emergency services and healthcare workers who have to care for you, the people you come into contact with while you're asymptomatic, etc.

So, by your making that choice, you are also choosing to increase the risks of those around you.

There's a famous quote: Your right to swing your fist ends where my nose begins.

Alas, it seems like some people care more about their personal freedom to swing their fists than they do about the welfare of their fellow citizens...

It seems to me that it is the maskers who interfere with the noses of others, and quote Mill while they do it.

This is true!

The question is: what's the consequence of those two violations of individual liberty?

In one case, it's the inconvenience of your having to put a cloth covering over your face in some circumstances, or being curtailed from having a beer in a public place.

In the other, it's the possibility of my death or disability resulting from your actions.

This bears a resemblance to many many other trade-offs we make between individual freedoms. For example, while curtailing your individual liberty, you are punished for driving drunk, firing a gun into the air, or defecating in public places, due to those actions endangering the health and safety of others.

Yet, for some reason, masks and lockdown orders are the hill folks are choosing to die on (in some cases quite literally).

But, I have to admit that in a world that appears hopelessly infected by American-style hyper-individualism, at a time when it seems we're more distant and disconnected from one another than ever before, and yet paradoxically pushed apart by greater and greater extremes of partisanship and tribalism, while sad and disappointed, I'm not terribly surprised that some prioritize their own convenience over the safety of strangers.

Well, until they're on a ventilator facing their own mortality. That does seem to turn folks around on the whole thing...

Please let's keep this civil, "die on a hill", "infected by American-style hyper-individualism", "on a ventilator". I'd hope to have a conversation here, to exchange views, to increase understanding.

The idea that you masking me is reasonable is predicated on its triviality, "it's only a cloth" right? But it is you that decides that it is trivial, I have no say in that. If I were to demand that you wear a pork chop on your head, equally trivial, would you? No, you must insist that there is some scientific basis that you masking me protects your health, but those numbers are thin on the ground. Some high profile scientist believe that this is the case, some do not, so it is your adherence to this particular group of pro-mask scientists which justifies your (self admitted) denial of my liberty. I adhere to the other group of scientists. (Masks don't work, the second wave in a masked Europe demonstrates that, but that is besides the point, mine is a reasonable belief, as is yours.)

So your beliefs lead you to think you can take my liberty, and to trivialise that. My beliefs say you will not. We call this situation bullying, and this is the reason why the unmasked push back against the maskers, simply because that is the only way to treat bullies: when they instruct you to draw a cock on your own forehead, to do so it to invite more of the same ("it's only a cock, don't be such a baby", sound familiar?).

> Please let's keep this civil

Frankly, no.

I refuse to answer incivility with civility. That way lies the paradox of tolerance.

And make no mistake, your choosing to prioritize your convenience over my safety is fundamentally uncivil.

> Some high profile scientist believe that this is the case, some do not,

The data on this is clear:

https://www.nature.com/articles/d41586-020-02801-8

Go ahead, pull the other one.

> Frankly, no.

To be honest, this is not a surprise.

lols

As soon as a behaviour endangers others, the choice is no longer solely that of one person.

We're in the _middle_ of the pandemic. Current estimates seem to be it'll take another year. Nobody can know if it "failed" or not before it ends. This is stupid clickbait. HN's most trusted fake news source agrees: https://www.washingtonpost.com/world/2020/10/20/coronavirus-...

Surely we shouldn't just look at per capita death rates, because that of course will show Sweden as "bad" because it went a bit wild there for a while.

What are the current per capita death rates, and how do they compare to other countries?

In 6 months will Sweden have a very low death rate while other countries continue to climb?

As with many things, it's too early to call either way.

Between 0 and 3 deaths by day for weeks now which is ridiculously low even if you normalize and doesn't IMHO qualify as a second wave

So will this be removed from Youtube or not?

Reply on news.ycombinator.com