The false promise of herd immunity for Covid-19
nature.com
nature.com
Contrast that to countries having mass lockdown protests or our neighbors who add and remove restrictions on a weekly basis.
Another "inconvenient truth", thanks to good welfare, there is not "come to work sick" heroism in Sweden. You are basically paid to keep your kids and yourself at home, for as little as a running nose.
- More people working from home, both given the type of job they do and the trust by bosses (as opposed to France or Italy where a government suggestion to WFH means almost nothing to the bosses)
- Less people per household
- People might just literally keep their space more
Pre-schools and schools are super strict. It’s tough times as a parent, kids have runny noses in the autumn/winter...
I’m 100% WFH anyways because this is the general recommendation - if you can stay home.
At any rate, with the commonly used meaning of "herd immunity", this is not what Sweden does.
Eg, Newsweek: ' "herd immunity," which is when up to 70 percent of the population have either been given a vaccination or been infected, impacting the rate of the virus spread.'
Giesecke to Tegnell: "it will all come to an end when so many have been infected and become therefore immune that the virus has nowhere else to go (so-called herd immunity)," Tegnell to Giesecke: "as immunity rises in the population, the rate of spread of the disease decreases, ....Is there a way of modelling how the spread comes to a halt?"
https://www.newsweek.com/sweden-emails-anders-tegnell-johan-...
> Earlier in the pandemic, media reports claimed that Sweden was pursuing a herd immunity strategy by essentially letting people live their lives as normal, but that idea is a “misunderstanding”, according to the country’s minister for health and social affairs, Lena Hallengren. Herd immunity “is a potential consequence of how the spread of the virus develops, in Sweden or in any other country”, she told Nature in a written statement, but it is “not a part of our strategy”. Sweden’s approach, she said, uses similar tools to most other countries: “Promoting social distancing, protecting vulnerable people, carrying out testing and contact tracing, and reinforcing our health system to cope with the pandemic.”
https://www.politico.com/news/magazine/2020/07/03/what-swede...
>“I want to make it clear, no, we did not lock down like many other countries, but we definitely had a virtual lockdown,” Tegnell said. “Swedes changed their behaviour enormously. We stopped travelling even more than our neighbouring countries. The airports had no flights anywhere, the trains were running at a few per cent of normal service, so there were enormous changes in society.”
That’s been the case with Covid - but before March Swedish workers were basically docked one day’s entire pay for the first day of their sick-leave (so-called ‘karensdag’).
It’s obviously been essential to limit the spread of covid that this penalty has been temporarily suspended, but let’s not pretend that Sweden has been some sort of specially enlightened welfare haven for the sick. That situation ended a long time ago.
Also, even after eliminating the "karensdag" Sweden was in a way better welfare position than e.g. US, where worker were going unprotected and sick to work, for fear of losing their job.
Life in Sweden changed dramatically with the outbreak and the number of deaths have a few reasonable explanations, IMO.
The Swedish “CDC” have pushed for long term resilience and believe that strict prolonged lockdowns will be impossible to maintain.
Other countries have had a far more political response to this pandemic.
Second wave obviously pushing forwards - other Euro countries locking down again.
This is kind of ironic as Swedes probably would put up with being locked down better than most other populations. We’re famous for “waiting in line” and following signs and directions - we would suffer lockdown, but in general we simply follow directions, so the idea was it would be ineffective.
> Other countries have had a far more political response to this pandemic.
Spain suffered so much from the covid epidemic that they had to commandeer hotels and convention centers to serve as makeshift emergency hospitals to receive critical covid19 cases.
Death rates were so high that in Madrid they had to commandeer an ice rink to serve as a makeshift morgue.
Spain's investment in a lockdown allowed them to contain and lower the daily death count from nearly a thousand to single-digits, and reign back spread rates.
The lockdown decision in other countries is not political. It's common sense.
Have people already forgot what "flatten the curve" means?
Perhaps lockdowns are required elsewhere due to cultural differences.
This is also partly an explanation for Swedens relatively high death rates - our completely botched integration of immigrants over the years.
But how many and harsh lockdown can a population endure?
No it doesn't. Sweden's population density is a fraction of Italy's and Spain's, and even Sweden's largest urban centers are dwarfed by Italy and Spain's.
I mean, to start off Spain has arguably a better national health service than Sweden, and Spain's services were quickly overwhelmed by the epidemic that the country was forced to mobilize their armed forces to respond to it.
Spain's daily death count reached around a thousand deaths per day after the mitigating effects of the first lockdown kicked in. Sweden hasn't even experienced a death count that's equivalent of a single week of Spain's .
The reason why Sweden's strategy consists of letting covid19 spread like wildfire is based on the fact that in Sweden's case it's peculiarities serve as spread retardant.
You’re not from Sweden right? If so you would not say something like this. It is just plain uninformed.
My whole family works in health care - doctor, nurse & in elderly care. Your idea of the situation in Sweden is way off.
We have “reined in” the spread, but we notice something of a second wave starting here as well.
That's less than a weekly count of covid19 deaths in Spain when it's first wave flared up.
You may claim that you know a nurse in sweden as much as you'd like, but that is completely irrelevant and changes nothing.
I claim - living in Sweden, that you know nothing about what’s going on here.
(Direct authority by living in the very community you comment)
Sweden: 10Mi inhabitants
Spain: 46Mi
And yes, in deaths per Million, Sweden has a lower number than Spain (but not much lower)
This is so far from the truth that it's not even funny anymore. You are obviously not Swedish, and you obviously have no idea what the situation is actually like in Sweden.
If you think you're getting an accurate view of Sweden's strategy, response, and outcome through non-Swedish media, you are completely mistaken. The amount of misinformation in foreign media has been absolutely off the charts this year.
Here is the official Swedish strategy, read it yourself and stop spreading crap:
https://www.government.se/articles/2020/04/strategy-in-respo...
"Point 1: Limit the spread of infection in the country
By limiting the spread of the virus, the Government aims to relieve pressure on the health care system and protect people’s lives, health and jobs."
That's pretty much the opposite of "letting it spread like wildfire".
> Sweden's population density is a fraction of Italy's and Spain's
The national average population density tells you absolutely nothing in this case, and the number is that low because Sweden has a whole lot of land where noone lives. You bringing this up in a corona discussion only shows even more that you know absolutely nothing about Sweden and obviously never been there.
For reference, Sweden is 87% urbanized, while Spain is only 81%, and Italy even less at 71%.
https://emanuelkarlsten.se/tegnell-mejlen-sa-fick-flockimmun...
Edit: Just gonna add that downvotes for a post that straightforwardly cites direct quotations about herd-immunity from the relevant authorities says more about the downvoters than about my post.
Yes, and it explains to some extent how a majority of Swedes simply can not digest that the authorities say one thing and do another. It is also a propensity for focusing on the literal that characterizes northern Europe in general, the Nordic countries more so, but most of all in Sweden where it is conflated with widespread conformism, adding to insult to injury (figuratively speaking).
Herd immunity was a definite part of the strategy, but not to be disclosed by any means. The reason for the strategy is however more interesting to discuss than whether it existed at all (which has simply been proven beyond reasonable doubt). My own analysis leads me to believe that it came be a convenient excuse for the absence of proactive response in the initial phases after which it became a matter of internal prestige (within a small circle of initiated politicians and scientists).
My analysis has lead me down a different path.
Our deaths are primarily elderly (50%) and our response in this regard was really really bad.
Much of this is a consequence of communal and regional self governance - the government have for example very little mandate to direct regional resources (something that was changed recently in response to the pandemic).
Other than elderly - immigrants are over represented:
https://abcnews.go.com/International/wireStory/coronavirus-t...
These two parts stand out and it has, imo, nothing to do with chasing heard immunity.
Tegnell sums it up in way that matches up with my perceived reality:
https://www.newstatesman.com/world/europe/2020/10/sweden-s-a...
Really early reports indicated that young children was not spreading this disease to any appreciable extent. This was something that caught me from early reports out of china - almost no children.
This is the real reason schools kept open. Look at studies and data, make desicion.
The school thing is a big part of Swedens corona reputation abroad in my opinion.
It needs pages and pages to make two points:
1: Going for herd immunity has caused more infections and deaths in countries that tried.
2: We are not sure if once infected people will stay immune.
The first point is completely nonsensical. Of course more people are infected when you allow more people to be infected. That idea of this approach is that you come out ahead in the long run.
The second is a valid point.
The healthcare system overload happening or not does matter a lot too. People not being sick at the same time matter.
Then I come and say "Duh! That is the point of investing.".
Now you point out all the great stuff one could buy in the short term.
Yes. That is the point of investing. You trade a negative effect in the short term for a positive effect in the long term. Nobody ever said it is a free lunch.
In fact, the way you chose to frame the consequences of allowing an epidemic to spread as "point out all the great stuff one could [do otherwise] in the short term" makes it quite clear that your point, focused on your own personal convenience alone, is absurd to begin with.
Sadly it is not nonsense to state the fact that Sweden's approach caused more deaths than what would otherwise have happened. The reason is quite simple: some people somehow believe the opposite. There's a crackpot section of society that somehow and unexplainedly believe that lockdowns and wearing masks and any change to their personal routine causes more harm than a disease that already killed over a million patients.
Then there are the inconvenient facts that:
a) patients do get reinfected,
b) allowing an epidemic to run wild creates conditions for it to mutate and change in unpredictable ways, including becoming more deadly and damaging than what it is right now.
Counterfactual unfalsifiable claptrap. Perhaps. Perhaps not. I wouldn't be certain either way.
> allowing an epidemic to run wild creates conditions for it to mutate and change in unpredictable ways
WHO put out an estimate a couple of weeks ago that 750 million people worldwide could have been infected. And yet the IFR keeps going down. I'm gonna estimate the odds of it turning into airborne ebola at this point at 0%.
I'm sad to say that your comment just reads as "I don't like that fact and it bothers me that others acknowledge it".
> WHO put out an estimate a couple of weeks ago that 750 million people worldwide could have been infected. And yet the IFR keeps going down. I'm gonna estimate the odds of it turning into airborne ebola at this point at 0%.
This statement is just purely ignorant and wrong.
Several covid19 strains have already been identified, including a particular strain that brought changes to the virus that greatly increases their spread rate, to the point that since it's appearance it outspread and became the world's leading strain
The rate of reinfections is neglegible.
> b) allowing an epidemic to run wild creates conditions for it to mutate and change in unpredictable ways, including becoming more deadly and damaging than what it is right now.
Unscientific. In fact followup mutations in such an epidemic always mutate to less severe variants (lower IFR) with sometimes higher infection rates (higher R). Because the patient doesn't recognize it as such, and therefore it can spread more. The mutations loose critical parts all over.
Damaging is the only the reemergence of the cold weather, people staying inside.
Same reason as "Summer of the Shark". (When US media exhaustively covered shark attacks, during a year when shark attacks were a little below average.) It's news, so there's a lot of coverage, which makes it news.
A dumb decision that could have been made outside of COVID times for any number of reasons.
Far more scandalous (and getting more media coverage) is the fact that Victorian football teams had to relocate to Queensland to continue their training.
4 babies with cardiac problems have died in Adelaide, but it appears to have been a decision in SA not to send them to the pediatric cardiac unit in Melbourne (their normal referral practice) or anywhere else - victoria says they weren't asked and would not have rejected them. https://www.abc.net.au/news/2020-10-22/unanswered-questions-...
The mother lives in NSW close to the QLD border and wanted to go a Brisbane hospital (Brisbane = capital of QLD) for the birth, but flew to Sydney instead to avoid 14 days of hotel quarantine (probably at their expense) in QLD.
I'm sure the level of care was equally good in both hospitals. The outcome may have been the same regardless.
EDIT: This thread is already getting brigaded by people who apparently think of this as a hoax or some kind of conspiracy so I'm going to leave and take my citations and facts from the article with me.
[0]: https://www.nbcnews.com/news/world/covid-19-may-have-infecte...
[1]: https://rt.live (US-centric)
The jury is very, very much out on that. The 70% number bandied about is extremely naively calculated, it assumes 0 pre-existing resistance or immunity (Which we now know exists), and it assumes all humans are homogenous sphere-shaped balls floating around in a gaseous society, which is also obviously not true.
There are countless reports and studies on transmission among children in school settings, and they pretty much unilaterally state that there's very little spread happening there, contrary to everyone's "gut feeling" about kids being snot-nosed petri dishes.
No, the article explicitly says "Estimates of the threshold for SARS-CoV-2 range from 10% to 70% or even more", and then it sort of handwaves away any studies showing lower numbers, and highlights the ones showing the higher numbers.
That is pretty much the definition of the jury being out on the matter.
No we don't. You've misunderstood whatever you've read.
> and they pretty much unilaterally state that there's very little spread happening there
This is untrue. Just today: https://www.independent.co.uk/news/science/coronavirus-r-rat...
(But there are many others showing that schools increase spread of covid).
That's a myth. Even "long" Covid only lasts for a few months.
Also, disability doesn't have to be permanent. Broke your leg and need a wheelchair? You're still disabled for the duration you need the wheelchair.
ARDS recovery caused by COVID can take months.
How many?
> Also, disability doesn't have to be permanent. Broke your leg and need a wheelchair? You're still disabled for the duration you need the wheelchair.
Why are you arguing semantics instead of writing something constructive? Yes, technically you are disabled if you have "a physical or mental condition that limits [your] movements, senses, or activities". That obviously happens to everyone who gets sick.
Edit: I'm unsure why OP was downvoted. The question is legitimate and deserves an answer.
I'm split on such issues. On one hand, it's tiring to keep putting out fires. On the other hand, I feel the answer one gets depends too heavily on what "side" of the Internet the search algorithm placed you, so it's not only OP's fault that he didn't get the right answer yet.
With respect, people should be looking at facts and coming to their own answers/conclusions. That strategy is more immune (sorry) from search-algorithm errors.
These numbers partly reflect increasingly delayed retirement, although those careers are extreme cases - 25% of americans over 65 still work. I don't believe it would be possible to meaningfully protect even just the group of over 65s, because it would require massive social spending and organization in a way that half the country would simply not accept. Aside from their participation in the paid workforce (presumably doing things that someone in the general population needs, at some point), many families would lose informal childcare. These protected old people would need access to doctors and nurses and hospitals, all filled with the infected younger people (or could we dedicate entire hospitals to them, staffed by elderly medical professionals? Which ones?) They would need to live for free if not able to work, or have their income replaced. They would need to find a place to live somewhere besides the family home, if it was currently shared with younger family. Etc...basically I believe that an attempt to "just protect the vulnerable groups" would fail to protect those groups, and would cause similar chaos among the general population.
(Edit: these are all US numbers. I would be fascinated to see equivalents from other countries - I know that the frequency of intergenerational living varies greatly, for instance, as well as retirement ages)
Second, there isn't really a non-vulnerable population. The risk of dying if you're relatively young is low, but it's not zero.
Third, the death statistics don't really cover the long-haulers; there are people who have serious complications for months at least. Damage to heart, lungs, and neurological problems may be permanent.
Fourth, if you overwhelm the capacity of the local health care system to care for sick people, a lot more of them are likely to die or suffer worse complications.
Fifth, we don't know how long immunity lasts. Having a cycle where all the healthy people get Covid-19 once a year isn't sustainable.
Sixth, if it some point one were to decide (like Sweden did) that herd immunity is a bad idea, your country is now in a much worse position to try to eradicate the virus by social distancing and masks. For instance, the United States reduced new infections by about a half between mid July to mid September; that's about two months. If that's the best we can do, it means that every time we increase the number of cases 2x (like we've just about managed to do in October), it means we've added 2 more months at least until the pandemic is over, if herd immunity doesn't work and a vaccine isn't forthcoming.
The chance of dying doesn’t have to be zero to be a non-vulnerable population. The odds of dying if you’re less than 60 or don’t have a comorbidity is less than 0.03% (and that number avalanches downward the younger you are).
Given that the general random chance of dying hovers around that number, the increased chance of dying from covid for the non-vulnerable groups is statistically insignificant.
Nearly nothing has a zero chance of happening but pragmatically it’s virtually impossible that a non-vulnerable person would die from it.
The US is averaging more confirmed new cases per day now than it has at any prior time, and the rate is going up. Here's a graph [1].
[1] http://91-divoc.com/pages/covid-visualization/?chart=countri...
In general, therapeutics are better than they were at the start. Fewer infected people need ventilators and fewer of them are dying. I don't know what the details are, but apparently doctors are learning what works and what doesn't.
In the U.S. we just surpassed our record of new infections per day set back in July, with an upward slope that's going to continue to who knows where.
There are some places that have Covid-19 reasonably under control, but on average we're in the worst of it right now as far as we know. (The peak in spring might possibly have been worse, we just didn't have adequate testing at the time to know for sure. But right now we know cases are on the rise, and it's not just large population centers but rural areas too.)
> Why proposals to largely let the virus run its course — embraced by Donald Trump’s administration and others — could bring “untold death and suffering”.
This should just be a description of the scientific facts in order to maintain objectivity. Let the political people run with it afterword. And it doesn't even say that it emphatically "will bring <bad thing>", it uses the weasel words "could bring <bad thing>".
This seems politically motivated; at the very least they've made it easy to mistake this as more political than scientific.
Note that our reaction to Covid has caused many deaths, such as from people avoiding treatment for other diseases, efforts to control other deadly diseases like tuberculosis being shut down or set back, economic devastation, etc.
I haven't seen any analysis yet trading off:
1. the Covid deaths from waiting for a vaccine
2. the risk of releasing the vaccine early
3. the other deaths I mentioned from our reaction to Covid
with the metric being a combined "minimum number of deaths".
For the best cases you need ~40%/50% of people with immunity that lasts for months. (And this is a recent revised best case)
Now if you check the serological analysis of even hard hit places and you see there's still a way to go until those 50%. And it is suspected infection induced immunity goes away more quickly than we need it to.
And yet, 2020 is currently on track to be the third least deadly year ever in recorded history in Sweden.
And yet, the total all-cause mortality rate in Sweden for 2020 is on track to be lower than its neighbour Denmark, higher than Norway, and about the same as Finland.
Because the most infurating thing about everyone's obsession about covid19 death numbers is that people seem to have forgotten just how many people die every year from other causes. And there's very little debate about how much suffering and death that the lockdowns themselves are causing. There's no balance, no compromise, no trade-off, no proportions, only a myopic staring contest at a single cause of death across countries.
They're all grabbing and visualizing data from SCB. You are free to disagree with their opinions and conclusions, but the numbers are correct. Sweden loooooooves statistics, which is why we have accurate monthly death numbers going back 160 years.
Here's the last 20 years from the official source, you can check yourself if those "crackpot" blogs got it right or not: https://www.scb.se/hitta-statistik/statistik-efter-amne/befo...
(Spoiler: They did.)
Then you should simply post the data from SBC, and not blog posts from random crank pots what just happened to master the art of copy/pasting.
To put it differently, people are interested in what SBC has to say, not what grannypuncher69 commented on an epidemic.
> random crank pots
> grannypuncher69
You took the time and effort to use a bunch of ad hominems to try to discredit my links, and yet you didn't address the data at all. Does the fact bother you that much that Sweden's all-cause mortality for 2020 is going to be completely unremarkable from a historical and statistical point of view?
(Ok, third lowest mortality in recorded history is actually pretty remarkable, but it's also just the natural consequence of a decades long increase in life expectancy.)
* blog posts and general social media blurbs posted by anonymous or pseudo-anonymous users are not references. They are somewhere between tertiary sources and bullshit made-up nonsense.
* the use of the "grannypuncher69" handle was intended to illustrate how ridiculous it is to pass off random social media posts made by anonymous/pseudo-anonymous users as authoritative sources.
* Primary sources, or at most secondary well-established sources, are the only acceptable forms of references, specially regarding scientific and technical subjects.
* if no primary or secondary source exists then it's pretty clear that the original claims are bullshit.
If you have a hard time following this then I'm sorry to tell you but your problem is linked with your inability to substantiate your claims, not your need to spin this fact into personal attacks directed at those who point any of the gaping holes in your reasoning.
The only thing your comment shows is that you're obviously not Swedish, because you obviously have no idea what SCB is.
This is the best attack you have?
I’m from Sweden. Prove to me that Sweden has done better than Norway, Finland and Denmark - we have death-rates between 11 and 5 times higher than those countries.
I have no idea why you seem to think this is some sort of positive result, but your nationalism seems to have blinded you to simple facts.
Btw I’d rather you argue against posts that disagree rather then the instant downvote.
> Prove to me that Sweden has done better than Norway, Finland and Denmark
What are you talking about? We didn't, and I've never claimed we did.
> I have no idea why you seem to think this is some sort of positive result
What are you talking about? I have never claimed that Sweden's outcome is good or positive.
> but your nationalism seems to have blinded you to simple facts.
What are you talking about? The only fact I've posted in this thread is the historical monthly all-cause mortality figures for Sweden, which is a pretty darn simple fact.
> Btw I’d rather you argue against posts that disagree rather then the instant downvote.
What are you talking about? Projecting, much?
We already have evidence that reinfection can occur within 6 months. And the reinfection can be worse than the original. https://blogs.sciencemag.org/pipeline/archives/2020/10/14/im...
Now, not everybody will get reinfected. And maybe these people wiped out their infection by latching onto a different protein. And one was immunocompromised. etc.
However, reinfection by coronavirii is the general norm, not the exception.
The fact that reinfections can occur on a short (6 months) timescale puts a really big pin in the "herd immunity" balloon.
"The confirmed examples worldwide could possibly be counted on your fingers (depending on whose count you believe) out of at least 38 million total cases."
Statistically speaking, this is 100% immunity. Biology is never perfect.
Either way, a handful of cases of reinfection among hundreds of millions of cases means we're in lightning strike territory. It's completely statistically irrelevant.
1) Reinfection rarity decreases with time and we are barely 6 months into this mess--that's much less than a "cold season" which is known to reinfect. You are betting against a known Bayesian prior (other coronavirii families reinfect with a small but not irrelevant percentage) with no evidence to support your statement.
2) "Confirmed reinfection" has to pass an incredibly high bar. You have to have two symptomatic infection events, AND both infections have to have been sequenced AND the sequences have to be sufficiently different to differentiate from never having cleared the virus. Reinfection would normally be with a virus that is almost exactly the same.
So, reinfection being rare could be that it's amazingly rare. OR it could be that it's only somewhat uncommon but we don't have enough events with sequencing data to confirm.
The low Bayesian prior of rareness means we shouldn't panic about reinfection, but it doesn't imply that we can just ignore it, either.
I can agree that 6 months of data says nothing about what immunity would be like after a year or two. But still, it's hard to imagine how some tidal wave of reinfection remains currently undetected.
But let's postulate that reinfection immunity only lasts 6 months. Ironically, that means that lockdowns and isolation will prevent herd immunity. To stop the disease, everyone would need to get infected within that 6 month window.
No, they would have to get infected on exactly the same day otherwise a rolling window effect would occur where populations roll into and out of immunity.
Herd immunity simply has never happened in the history of disease without a vaccine. Typhoid, smallpox, polio, etc. never went away and smallpox was about 1 in 13 deaths in London.
Ironically, if we do achieve something close to herd immunity, we will wind up confining the disease to mostly children like what happened with smallpox.
Edit: I should also note that this article uses both terms which makes it difficult to read and confusing.
This article is well written with credible verified sources and screenshots. China has been pushing this narrative the this article lays out all the evidence:
China’s Global Lockdown Propaganda
https://www.tabletmag.com/sections/news/articles/china-covid...
> In March, Chinese state media began describing the strategy of “herd immunity”—allowing the coronavirus to spread among the young and healthy—as a violation of “human rights,” an Orwellian formulation given that lockdowns are essentially a blanket suspension of rights.
> Initially, British Prime Minister Boris Johnson also opted for herd immunity. But on March 13, suspicious accounts began storming his Twitter feed and likening his plan to genocide. This language almost never appears in Johnson’s feed before March 12, and several of the accounts were hardly active before then. Britain locked down on March 23.
Please read and share.