September 2020 least deadly month ever in Sweden
cornucopia.cornubot.se
cornucopia.cornubot.se
1) From the comments of the blog post: "todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
So one theory is that people are less likely to engage in risky behavior such as surgery this year. I am sure that people are driving less, flying less, working less, and in general, doing less that can increase the risk of death.
2) There are three types of lies: lies, damn lies and statistics. I am always wary of some totally random fact. "Least deadliest September on record." There's no implied causation there. Just a random fact. "Draw your own conclusions" is not helpful.
https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
Note that countries have different ways of counting.
Here are the excess mortality statistics for some countries. This statistic takes a while to gather, so it lags 1-2 months, depending.
https://ourworldindata.org/grapher/excess-mortality-p-scores...
Sweden reached no excess mortality sometime in June, and is doing quite well.
Really? I can think of a narrative here about the virus being not as serious as people thought.
I can't relate to your complain at all. We want more straight fact not "helpful" opinions. If someone can't form an opinion on their own it's fine, just dont participate in the discussion. The last thing we want is some people joining some discussion just to magnify other people's thoughts.
Statistics are just so hard to interpret and translate into a narrative that headlining a single data point is often misleading. I'm not interested enough to dive into this particular issue so I'm still not sure which claim is "true".
[0] https://emanuelkarlsten.se/number-of-deaths-in-sweden-during...
In France as well we had severely negative excess mortality in June. The combo of preloading deaths that would have happened later and lockdown measure preventing other diseases/road accidents, etc.
All three things can be true -- bad week in March, good September, good 2020. But March explaining September is more tenuous.
I don't see why? Covid killed a lot of old people early on really quickly who might have died sometime later in the year.
When it comes to analyze why death rates are lower, I guess one thing to consider is that we have been social distancing, working from home and making fewer visits to doctors and had cancelled operations. If Sweden would have managed covid the way some people think we have managed covid (no measures) the death rate would probably been on an ATH for September.
Restaurants have sparser seating arrangement to keep people apart.
Hosting any event with 50 people or more is illegal.
In some regions any private gatherings, like parties, are discouraged.
Schools being kept open in the belief that it is actually a net benefit. Not being a significant contributor to the spread while parents are freed up to do important work. It’s been the goal all along to keep health care capacity above demands.
Last I heard it is still believed that there is no scientific basis supporting masks as an effective measure, if beneficial at all. (It’s often mention with a reiteration that the primary measure for any person with symptoms is to stay at home)
Here's people packed in like sardines on buses. No masks: https://www.youtube.com/watch?v=fevjBA-qq7M
Here's a normal mall shopping experience happening in Sweden, no masks: https://www.youtube.com/watch?v=_JbSbxIhZp8
Everything about Sweden's strategy is just common sense voluntary recommendations (work from home if possible) and there are no penalties:
https://www.youtube.com/watch?v=jqjorS3oYlk
> Schools being kept open in the belief that it is actually a net benefit. Not being a significant contributor to the spread while parents are freed up to do important work. It’s been the goal all along to keep health care capacity above demands.
I agree with that and wish more people were thinking this way in the U.S.
> Last I heard it is still believed that there is no scientific basis supporting masks as an effective measure, if beneficial at all. (It’s often mention with a reiteration that the primary measure for any person with symptoms is to stay at home)
I believe this is correct. Masks only work in sterile environments and only if they are truly medical grade. I see people sniffling all over their masks and they are probably hosting tons of bacteria for the wearer. And people touch them and then touch other things.
We can't simply "stamp out" Covid-19, not even the swedes. Not even temporarily, they never had less than 150 cases per day since summer.
Source: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
They went so far as to force doctors to recant their statements that it was human-human transmissible. For example, the hero doctor Li, who eventually died of the disease.
https://www.nytimes.com/2020/02/06/world/asia/chinese-doctor...
Before 30th Dec nobody knew this was a new disease, they were still trying to identify it. By Jan 10th the WHO was warning people of person-person transmission. Western leaders ignored the warnings.
On 14 Jan, WHO was still saying it was not person-person transmissible.
https://mobile.twitter.com/WHO/status/1217043229427761152
Chinese authorities knew about the disease at least by 6 Dec.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
And were punishing doctors for talking about it on 3 Jan, probably later, too.
https://www.poynter.org/fact-checking/2020/the-2019-coronavi...
That is a responsible scientific response.
Your link says "By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection"
4 days after the first cases were identified.
Clearly there would be unidentified cases before that. Hindsight is very powerful.
I'm currently in the UAE and it's a similarly interesting story. The UAE is divided into 7 Emirates, with Abu Dhabi as the wealthiest, Dubai as the next wealthiest but heavily in debt, and the northern Emirates under the financial leash of Abu Dhabi. The difference between Dubai and the other Emirates is night and day - Abu Dhabi dictated very harsh terms (by fines, and even prison time for those voluntarily spreading the disease by licking groceries, etc) and rigorous testing, and the 5 northern Emirates followed suit. Dubai was hurting (because it's a tourism economy), and opened up much sooner, leading to a very heavy spike in cases - most of the current cases in the UAE are in Dubai, which like Europe could not afford to stay closed. Even now, travel between Dubai and Abu Dhabi is only allowed under exceptional circumstances.
What? Was this kind of behaviour common?
Thailand and Malaysia are interesting, though.
I'm not sure how Singapore kept up with trade, but they benefited form Malaysia being competent. I know that the "quarantine" the UK laughably imposes on people from France is pretty much irrelevant, with the number of people exempt longer than the number of people it actually applies to.
Non native english speaker here - am I misinterpreting "stamp out"?
It seems, probably mainly due to immigration, that the population of ages 20-60 have increased significantly since 2010, while the population of ages 60+ have increased less.
http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE_...
This won't skew the average age very much, but will definitely reduce deaths per capita.
If mortality was calculated as a function of age distribution september would likely be average and april would have had a high excess mortality.
Really makes one wonder about differences in the US and Swedish population, especially regarding widespread obesity and diabetes.
I’m not surprised at all that domestic deaths went up.
Both these facts point towards excess deaths being mostly corona-related, and not lockdown-related.
Lockdowns also reduce other causes of death which may participate in that (reportedly) high correlation between excess death and covid deaths.
Fwiw I can also imagine long term consequences like PTSD in people from heavily affected regions like northern Italy.
"One forgotten contribution could possibly be the large number of canceled surgeries.
The last number I saw was appx 30k canceled surgeries in Sweden since Mar -20. Historical data from Argentina, Israel and Denmark show significant reductions in death rates when doctors go on strike. The last strike was in the 1960's and I have been repeatedly promised (by doctors) that "..it is different now.."
We have also noted a quite dramatic reduction of cancer diagnoses because of reduced screening for breast- and gyn cancer. The common wisdom among "experts" is that there is a large number of undiscovered cases which will show up later and with much more severe and deadly cancer in the months and years ahead. I doubt this. I have read a couple of the research papers defining guidelines for interpretation of pathological finds and they state explicitly that it is better to "overdiagnose" by at least a factor of 10 (and in reality up to a factor of 50) in order to not miss any "real" cases of cancer. Better to cut nine healthy breasts or prostates than to have one undiagnosed case.
Well, in just a couple of years we will have clear and unambigous evidence for or against the efficency of the cancer screening programs. This is a form of full scale clinical trial happening in front of our eyes."
And
"Oh, todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
It doesn't change the problem of the large number of canceled surgeries. The narrative from the linked post is "because Sweden went through a different route to fight COVID-19 than France and Germany, now they are paying the price".. and the comments add some variables to this equation.
Was it definitely after pathology reporting? It's normal to have a low threshold to send people to biopsy. From the number of developed cases you can get some idea about what ratio of "ok" results you should have as a referring doctor. (this is tracked) But once you do biopsy / further checks I haven't heard of overdiagnosis by a large factor - not the "you should have surgery" overdiagnosis anyway. "Wait, see how it develops, retest" seems more common.
a) The spread of contagion before measures where imposed. Sweden was a few days later than the other Nordics in taking action, and may have been in a further advanced state to begin with. b) Safety equipment. Sweden had no functioning central reserves for health care gear. c) Failure to protect the vulnerable. The nursing homes are a mix of private and public, but all are administered at the municipal level. Proper care was not taken to protect the elderly, largely due to lack of local know how and incompetent central response.
I’ve been a staunch defender of the Swedish strategy, but it seems like there’s no avoiding the conclusion that the path taken by the other nordics may have been smarter in that it contained the spread until adequate supplies could be secured, good routines established and treatment options better understood. (To be fair to FHM that devised the strategy, b and c are certainly on other authorities.)
Significantly, although all the nordics now have a climbing number of cases, none has seen a sharp rise in the number of deaths. Mean time from hospitilization to death is around 18 days, so the resurgence has been ongoing for long enough that it’d have been noticeable by now.
It seems like the Swedish path may have two main benefits left:
1) Fewer vulnerable children were hurt by being sent home. Fewer women locked in with abusive partners. Nordic lock downs were less drastic, and may have avoided some of it, but at the global level it’s numbing to think of the suffering of children this year. 2) In terms of GDP growth, the indication is that Sweden didn’t do much better than the other nordics, but I think it’s still to early to gauge the long term economic benefits of a soft strategy. Maybe Sweden ended up taking on less debt per capita, for instance? I haven’t seen numbers on that, but school closings in particular are expensive, and so seems like reasonable speculation. Time will tell.
The economic benefits are probably not going to turn out to be compelling enough to justify the potentially avoidable deaths. From a utilitarian perspective, I think the first point may be though. The deaths have largely been people towards the end of their life. I think the constructive way to view it is that we should consider all years of a humans life equal. Is it worth sacrifying an 80 year old to save a 10 year old from being beaten up at home? If it hurts that kid for life in a tangible way, then yeah, that grim calculus may just work out.
The article is about "September 2020 least deadly month ((...)) 2020 third least deadly year ever so far".
AFAIK there is no normalized way to count COVID-19-induced deaths.
If so there is no way to compare official "COVID-19-induced deaths", because a given case may be counted as such in a country and not in another one, or even in the same nation by a given doctor and not by another one.
The total amount of deaths seems more objective.
Moreover the pandemics is running, therefore any comparison offers only a peek on a fraction of the challenge. Isn't this "herd immunity" approach a sort of "let's endure more short-term deaths, then durably much less afterwards" bet? In such a case any accounting may be moot for years.
If you're summing all effects, you're looking at all data at once, and probably are doomed not to learn anything particularly actionable. Its in the breakdown that we kind find meaningful bits for future reference.
If there is no major other new pertinent factor, then when it comes to compare those solutions (deciding when to assess is a challenge) there are (proportionally) less deaths where the more efficient one is implemented.
Am I wrong?
Besides, counting an integral number of deaths gives you an integral number. You'll only know the cumulative effect of whatever state the country is in, which is the result of many factors, among which the precise state of the lockdown.
Indeed, and this doesn't forbid comparisons if we can assess each effective stage. More datapoints, yay!
Those many factors cumulative effects are indeed difficult to assess, and this is true for each of such analysis.
If we try to find correlations, here between lockdown effective intensity and the amount of victims, and if a trend becomes perceptible for most nations...
And I think it is related to the pandemic but in 2 ways:
- As people said, less activity in general and it was one of the better months in Europe in terms of deaths.
- The mortality in the initial months has probably anticipated possible deaths that would occur later in the year
For the year 2020 so far, ie January - September, the number of deaths per capita is the third lowest ever.
https://www.statista.com/statistics/1115707/sweden-number-of...
It shows 2020 weekly deaths in comparison with a 2015-2019 average which is a good indication of the normal - precovid rate. You can see how there was a massive spike around week 12 to week 21, which is exactly when the initial covid outbreak hit and Sweden's disastrous "herd immunity" policy failed.
Now Swedes have been scared and changed their behavior and covid deaths are less. Furthermore, the defensive behavior of covid prevents other deaths. People, do not drive, do not party, do not engage in sports, do not take drugs, or over-drink or over-eat at parties, so that other causes of death go down.
So it is possible that covid isolation reduces death rate more than the deaths caused by the virus itself. But that is not a solution, people cannot live in covid isolation forever.
Here you can see that in september 2020 road traffic accidents fell sharply from the september average of the previous years.
This is a stronger effect than in many other countries with official measures in place, e.g. Germany has -21% and was at -8% before case numbers started spiking again a few weeks ago.
ICU cases peaked early april, deaths a week later, then a fatter tail happened due to a less restrictive approach. See the official Swedish data by the public health agency. [0] The mobility showed a similar curve, creeping back up to 10% less than baseline early June and staying there. [1]
[0]: https://experience.arcgis.com/experience/09f821667ce64bf7be6...
[1]: https://www.teliacompany.com/sv/om-foretaget/uppdatering/mob...
More formally, the decline after mid April was probably due to widespread immunity and weather effects. That’s only my conclusion, but based on the following:
* https://www.folkhalsomyndigheten.se/publicerat-material/publ... - A model releases mid april bases on march data which accurately placed the peak around mid april. It’s a standard SEIR model, so it predicts that it tapers off only based on population immunity. * https://news.ki.se/immunity-to-covid-19-is-probably-higher-t... - Study showing much higher incidence of T-cell immunity in Stockholm than the incidence of individuals with anti bodies, indicating that the true population immunity is much higher than what anti body studies will show * https://science.sciencemag.org/content/369/6505/846 - Another mathematical modeling study, based loosely on Stockholm dynamics, which demonstrates that hers immunity thresholds may be much lower when accounting for social stratification. In particular, Sweden asked ages 70+ to isolate themselves, so it’s likely the case that immunity rates are much lower in that group. * Finally, warm weather surely helped drive down the spread.
First thing I would do is to check whether they are lost some rows (or columns).
Here is one for Germany:
https://www.destatis.de/DE/Themen/Querschnitt/Corona/Gesells...
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
The excess deaths during the pandemic are not subtle in these graphs. If the data is accurate and the comparison with Sweden is valid, then it does tend to support the importance herd immunity to this virus.
The Swedish authorities never suggested that lockdowns wouldn’t work in controlling the pandemic, in fact they acknowledged that they definitely would work in the short term; their core assertions were that the Swedish population would not be able to sustain involuntary restrictions until better treatments or a vaccine arrived, and that the harms caused by restrictions would be a net negative for their society. The jury is still out on those decisions, but they are rational.
In fact we’ll probably never know who chose the optimal policy mix to cope with the pandemic, and as a result we should give those with differing views an awful lot of slack as they try and negotiate it with limited resources and foresight (i.e. as humans).
For now, let’s just enjoy this good news about the people in Sweden at face value–we need it!
Similarly, Sweden didn't have no restrictions in response to coronavirus.
The image many foreigners have of Sweden is outdated due to mass immigration (HN PC may dislike it, but I call it population replacement) - that image is from when it was a homogenous country.
If we shifted from walking (or biking or horseback riding, though seems less likely) then I'd expect heart disease to be much more of an issue.
The shift is from from buses and trains, heart disease is likely less of an issue, but air pollution still could be. We've also cleaned up our exhaust a lot over the years, which may offset that a lot.
I do think the other poster's comment about lower birth rates meaning an older population would likely be a much bigger contributor.