No excess deaths in Sweden compared to the last ten years
statista.com
statista.com
Chart declares itself to be data "as of November 6". That's the 311th day of our 365-day leap-year 2020. Thus naively scaling the 77,300 number to the full year would predict ((365/311) * 77300 =) 90,721 deaths in 2020. That's higher than 5 of the shown previous 10 years.
But also, the deaths as of November 6 may not be a complete total: often such data series continue to be updated (increased) for a few weeks after the calendar date.
And further: looking at US figures for 2017, November tends to have about an average number of daily deaths, but December is one of the deadliest months, with about 15% more deaths-per-day than is typical in the lowest-deaths Summer months of June-July-August.
So even my extrapolation to 90,721 is likely to be a floor on the true end-of year number, if lagged reporting or a typical December death acceleration means these November 6 numbers aren't an accurate sample for the full year. (And that's not even counting the Covid-19 case surge happening now in Sweden as with most of Europe.)
Everyone trying to draw final conclusions from Sweden is making a call too soon based on incomplete data. We probably won't truly understand whether Sweden is on-net a Covid-19 success or disaster until retrospective analyses balancing all factors in late 2022 or 2023.
So in other words, it's basically exactly the median of the last 10 years? That seems to reinforce the title's claim.
And, for the other reasons I listed:
* the projection is highly likely to be an underestimate of the actual 2020 deaths
* an apples-to-apples comparison of the deaths through November 6 in past years would be quite likely to show a notable excess in 2020, given the seasonal nature of the data left out (higher rates of deaths late-November and December) even in normal years
So only a naive interpretation, or tendentious interpretation, of the 2020 year-to-date numbers supports the headline assurance.
What do you think? A month or two into 2021?
https://i.imgur.com/E1M8eMj.png
The fact the prior "spikes" during April-June, which were way smaller than the current November spike (1678 june peak vs 5764 nov peak) didn't already caused a notable increase is mildly interesting. But really Sweden did great overall until recently when the had the first major spike.
Maybe 1000/day extra covid positive cases really isnt enough to move the fatality needle much compared to the average normal deaths... and in many countries recent spikes (Sept-Nov) have also had much lower fatality rates vs positive rates as well.
Look up Sweden excess deaths by month rather than analyzing an overall year number that compares up to November with the full year of data for the previous years.
https://ourworldindata.org/excess-mortality-covid
Scaling up to Sweden's population and the excess deaths that they're looking to have will probably be comparable per capita with the 200k from the US so far. Nevermind that Sweden's economy has done worse than its peers that did lockdown, with -5 GDP growth since q4 2019 vs. Denmark -3.9.
So really, no world in which Sweden's approach was successful.
the excess deaths that they're looking to have will probably be...
Will probably be normal. That's what this thread is about. There is no evidence of mass death of any kind of Sweden despite that this was supposedly guaranteed without lockdowns. September was one of the least deadly months on record in Sweden. They are on track to experience a basically normal year in terms of deaths.
As for motivated reasoning, it's relevant to this discussion because the thread is full of it. Many of the talking points are absurd. There are people arguing that the Swedes are naturally anti-social and don't meet each other (!), that they're incomparable to other countries due to population density (Stockholm has similar density to London), that they should have locked down because their economy only did a bit better vs other countries (compare against the UK or France and their GDP looks good), and all manner of other things that are either wrong or irrelevant to the reason their death stats are interesting: they didn't lock down and their total, all cause deaths are nothing remarkable. The implication is obvious: lockdowns were pointless, the damage they caused was avoidable, the academic advisors to governments were wrong (except in Sweden), and other countries should unlock ASAP.
Sure, maybe IBM and Microsoft and the banks and Airlines would all be fine, but if a lot of small to mid-size accountancy firms all of a sudden couldn't process payroll for companies or deal with day-to-day needs of their clients, that could very quickly have gotten really had and had knock-on effects, and that's one industry.
The best case scenario for COVID-19 would have been everyone heeding the media and staying in for a few weeks early on and it petering out. Everyone would have said it was just a media fed panic then, but obviously, it's a bit more complicated in that case, because that didn't happen (or at least didn't happen enough for that outcome).
[0] https://www.scb.se/en/finding-statistics/statistics-by-subje...
[1] https://experience.arcgis.com/experience/09f821667ce64bf7be6...
Isn't the word for that "median"? i.e. this years deaths are the same as average median deaths in the past 10 years?
It doesn't make much difference to the calculation, but being a leap-year, 2020 has 366 days.
It's also distorted by accessibility to quality healthcare etc. Covid caused ICU bed nights would be an interesting metric, but again, distorted by that accessibility issue.
Indeed, I'd suggest looking at excess deaths is perhaps misleading for other countries like the US due to the access to care factor. Excess deaths ends up acting both as a measure of infection, and a critique of healthcare policies.
Something like deaths / cases would be interesting, but then you're introducing the variable of "how many cases were actually discovered via testing". I don't think I need to link to the head of the US government's claims that increased testing only causes rates to go up...
[1]: https://www.theguardian.com/world/2020/nov/15/damage-to-mult...
“Case” is problematic due to testing errors and sampling bias (and the fact that “case” in the medical sense generally means you are under a doctor’s care).
“Hospitalization” may mean “with COVID”, to manage hospital resources for infection control, or “from COVID”, the popular interpretation to assess how serious the illness is and how quickly the serious illness is spreading.
We can all agree on what death means. There is still the forensic issue of untangling how much COVID contributed, and that has been a focus of CDC work. But it’s a cleaner metric than most. Another post here gives the CDC site link, but here it is too (gives State-by-State info as well)
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Might be nice to have a QALY-based assessment at autopsy...how many more good years would this person have had without the COVID-associated event? Admittedly a guess, but insightful nonetheless.
> So even my extrapolation to 90,721 is likely to be a floor on the true end-of year number, if lagged reporting or a typical December death acceleration means these November 6 numbers aren't an accurate sample for the full year.
I don't think you can assume that. While November to February are usually the months with the most mortalities, it is not certain that pattern will hold this year. The winter months kills a lot of vulnerable people because it is cold outside so people remain indoors close to each other causing infectuous diseases to spread. But this year thousands of vulnerable people died in April and May and there may not be that many left for viruses to kill, so to speak.
Here is some interesting statistics showing that September 2020 was the least amount of deaths in Swedish history: https://cornucopia.cornubot.se/2020/10/september-2020-den-mi...
An obvious hypothesis is of course that everyone that "should have died" already died in April and May, at the height of the Covid-19 epidemic.
Regardless, I think the takeaway of the article is correct. There's a month and a half left of the year and even in a worst-case scenario Sweden is unlikely to register statistically significant excess mortality for the year 2020.
That is, the graph you would really want to look at is one that shows weekly deaths as a line graph over many previous years, that way it's easy to see, at any week in the year, whether the current year is higher or lower than previous years or averages. That is what the Financial Times graphs show that another commenter posted, and they very clearly show the excess deaths in 2020 vs previous years for Sweden (and many other countries).
What's the point of the graphs in this post? I mean, 2020 isn't even done yet, so the graphs literally tell you nothing about Covid because there are no previous graphs to compare to. So what's the point of posting this, with this title, besides being deliberately deceptive?
I will point out that the US CDC tracks excess deaths on a weekly basis and you can clearly see we are above average from March until the present, as well as for the year overall.
Covid may not have produced excess deaths so far in Sweden compared to US, but maybe they have better work from home and thus fewer car accidents compared to a larger portion of people driving to work in the US.
Don't use this type of phrasing. The only way to know how deadly Covid-19 is compared to other unidentified changes in excess morality is to have access to an alternate reality where we did nothing about the spread.
In our reality, we did a few pretty drastic things about the spread, which means that the comparison is essentially useless from the perspective of excess deaths.
The only Covid-19 lethality comparison that makes sense is to compare the survival rate of those infected with those infected by another disease (or perhaps some other type of affliction).
If you either guess wrongly what to vaccinate against based on the data from the other hemisphere, or Influenza mutates significantly after your cut off date to evade your profile, the vaccine is much less effective than normal, and higher than normal rate of hospitalizations and deaths results.
Influenza is endemic, we never even wiped out the variant from the "Spanish Flu" pandemic last century, it's still with us is an attenuated form.
In Switzerland for instance, the French-speaking cantons have been massively more infected than the German-speaking ones. And while there are different rules depending on the canton (though the French ones tend to be much more strict), the same trend appears in bilingual cantons.
Or people have modified their behaviors to avoid Covid, and thus are less likely to suffer deaths due to other causes of mortality (i.e., they drive less because of social distancing, they die of flu and other contagious diseases less because of social distancing, etc).
If nobody modified their behaviors at all, you might have a point. But because people have modified their behaviors to avoid Covid, they're now trading one kind of risk for another.
ie, people dying of covid are people that would have died anyways from other causes.
For example, there are much less people dying by automobile accidents (a leading cause of death for young people). In 2020, they could be replaced by very different types of death (COVID, Suicide, etc.)
That said, it certainly COULD be relatively similar people. You’d likely see relatively similar individuals dying of pneumonia as dying from COVID.
yes, with some exceptions (Spain, the UK, the US seem to register an actual significant spike in deaths). But overall it's true that the age of the average covid death is as high, or in some countries even higher than the average lifespan, meaning it's likely the person would have died of some other cause.
I've always thought that not comparing deaths, but comparing 'number of high quality life years' lost or something similar would make more sense, even if it is somewhat more abstract.
If people live 100 years, you have 1% of the population die each year. In the US, COVID has killed a quarter-million, which is just under 0.1%, so an increase of under 10%. You'll barely see a 10% increase on a noisy chart.
In practice, that's a 50% increase some months, and a 1% increase others. So it looks underwhelming. But it isn't the same people.
But it's definitely not just people who would have died anyway. We're also at just under 1 in 30 people infected. If everyone caught COVID, you'd naively see 30x as many deaths, or 7.5 million dead.
Practically, not everyone would catch COVID, and by demographics, I suspect fewer would die, so we'd be talking maybe 2-3 million excess deaths if we let it burn. And probably another few million with long-term disability.
Obviously even one life lost is too much, but one has to wonder if that stimulus and productivity loss could have saved more lives if invested somewhere else, such as healthcare, cancer research or motor vehicle safety.
In fact, if we would have indeed 10 times the death rate, the impact on the economy could very well be larger.
It is about the same as all deaths caused by respiratory diseases in 2019: https://www.statista.com/statistics/528942/sweden-number-of-...
The wrong response is to ignore the point of the Swedish numbers specifically, even though the conclusions are painful. A reasonable conclusion isn't "oh that's terrible they're lying with statistics" and then proposing a meaningless alternative (nobody cares if COVID shifts expected mortality around by a few months, they only care about deaths that were avoidable and wouldn't have happened anyway). The correct response is to remember that Sweden was supposed to be a bloodbath in which every single hospital would be overflowing onto the streets, in which people would be collapsing unable to breathe in their hundreds of thousands whilst the rest of the world looked on in pity, safely locked down at home.
Clearly that didn't happen, which invalidates the claims of the 'experts' that said it would. When you read their papers the problems that led to these erroneous claims are very clear, but given the top rated comment on this thread it'll probably be a long time before the wider HN community is able to critically examine the deep structural flaws in the field of epidemiology. If ever.
Even if your numbers were correct, you have to remember these are the numbers we have _despite_ drastic measures taken.
And of course with the amount of hand washing and social distancing going on right now, I could see how it will have affected the "normal" flu deaths.
Edit: let me just add an answer to this statement
> Clearly that didn't happen, which invalidates the claims of the 'experts' that said it would
It did happen in Italy, which forced Sweden to mobilize the whole country to avoid it. And they almost failed.
Except it HASN'T, and nevertheless, if you wanted to make that argument, the graphs and data in OPs post do not support that argument.
This is my entire point: if you want to make an argument about some feature of the Swedish data, that's fine. For example, the argument about "shifting deaths up" is also one you might be able to make with different data sets, but certainly not what was presented in this original article. Indeed, the data on the Financial Times website shows an excess of just under 6k deaths in Sweden that has not, as of yet, resulted in some lower number of deaths later in the year.
Whether or not other countries overreacted is a fine thing to have a debate about, but that debate needs to be made around not just pulling bullshit numbers out of thin air.
https://www.aier.org/article/swedens-dry-tinder-accounts-for...
It is clear from monthly data that from march to may there was excess mortality. From june to september the mortality was lower than previous years.
The main effect of covid in mortality statistics is that it shortens lives by about 6 to 12 months, which causes a bump in mortality followed by a slump.
If you have a data set that clearly shows this, I would welcome a conversation about it. The data I have seen from the Financial Times site does not support this, but again, I'm more than happy to look at other data that backs this up.
If you extend this (taking the rest of the year to be 1 1/2 month) you end up with 89176. Too bad if that doesn’t fit your narrative.
Also deaths are usually reported monthly. I have no idea of how statista got the november figure and apparently I would have to subscribe to see the source.
My Swedish is not good enough to look up the official numbers.
2015 77033
2016 75524
2017 76522
2018 77089
2019 73374
2020 79088
Sweden publishes enough data to do it actually [1] so I did [2]. There is a very strong downward trend in 2018, stability in 2019 then a literal a cliff in 03/2020 suddenly bringing you back to the 2017 figure. The average of deaths per capita (given per 10000) which was generally stable in 2019 jumps from 7.18 in february to 7.24 in march, 7.49 in april, 7.63 in may, 7.69 in june and then is more or less stable until september at which point I have no more data.
So yes, the HN submission title is worthless and most likely intentionally misleading. The statistica data from 2020 are on 10 months. 2020 is going to be an outlier as soon as november and december are added. It's obvious even if you just multiply by 1.2 (december and november typically have more deaths than summer months).
[1] https://www.scb.se/en/finding-statistics/statistics-by-subje... [2] https://docs.google.com/spreadsheets/d/1tovNw9RReZ-8eF8y-Jbn...
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386...
They estimate about a 20% increase in deaths so far this year for Sweden.
Edit: I'm curious why this is getting downvoted.
It seems like you didn't read the FT graph. It's showing the total death rates in a graph, and during initial spike in COVID, Sweden showed 20% increase during the peak. By definition, there's no "skewing" possible, since it's all death - unless you're claiming hospitals are making up death.
If your main point is that reported death due to COVID might be inflated, sure, that's possible but that doesn't mean there's no increase due to COVID related death. If you want to point out the reported number due to COVID might be slightly higher than it really is, you should at least acknowledge that there is meaningful and substantial increase in death due to COVID as there absolutely is. By omitting that, your post can't be distinguished from someone posting with a conspiracy mindset and ignoring actual data on substantial increase in death.
Fwiw - I have been a subscriber to the FT for ages and I've followed that chart (which is free to all) since the beginning.
This is a common theory in the US as well, where the accusation of "they are doing it for money" is most repeated. It's ridiculous and untrue, but that's the logic here.
What could even a theoretical justification for hospitals inflating numbers in a fully government-run system ?
The FT excess mortality graph doesn't care whether anything is flagged as a COVID death or not. If there's a lethal pandemic, you don't need to rely on doctors classifying deaths, you can see it in the total number of deaths from all causes.
That is the population of Fort Wayne or Toledo.
Perhaps you meant "deaths assigned to COVID". The FT work has a few issues. One is that they assume any mismatch in COVID vs excess death means undercounting. This is based on the faulty assumption that lockdowns don't kill anyone, but in the UK the hospitals were emptied out, people were afraid to go to A&E. Admissions halved almost overnight and took months to return to prior levels over the summer, then they dropped again due to the second lockdown. Actual death certificate data in the first wave showed about half of all excess death didn't mention COVID anywhere. The FT's assumption is strange and unsupported by any data.
What assumption are they making here that is weird? Unless there are fake deaths I'm not sure why this analysis is faulty, this analysis doesn't care if something was labeled a COVID death or not.
https://www.aier.org/article/swedens-dry-tinder-accounts-for...
If you take into account the amount by which Sweden's excess deaths were lower in the runup to COVID than expected, and in particular, lower than its neighbours, then Sweden starts to look more like its immediate bordering countries and in particular, 2020 looks like a normal year that simply caught up with an otherwise very non-deadly 2018-2019.
The weird assumption they're making is that excess deaths == COVID deaths. It's stated half way down.
In any case the only reason I posted in the first place was OP had an intentionally misleading bar chart. Arguably +20% was also misleading (since it wasn't excess deaths in 2020, just excess deaths post outbreak) but you can look at the time series here (and posted above) and look for yourself. My personal belief is Sweden saw larger deaths than Denmark/Norway in part due to their COVID policies, but they did not experience the complete disaster many predicted in March. Whether the trade off was worth it will be debated by public policy experts for years, and ultimately no one will agree.
The argument is that (a) not all excess deaths were caused by COVID, only some and (b) excess deaths are very low compared to the apocalypse that was promised, in fact Swedish excess deaths are totally normal and if the modellers had never showed up and told people the world was going to end unless we all lock down, nobody would have thought anything was happening in Sweden. There might have been a few press stories about an unusual form of pneumonia or a new coronavirus but it wouldn't have got more attention than the bad flu year of 2017 did in the USA.
It is possible in 3 years we look back 4 years and find no excess deaths over that time period
Right. The point I'm making is you don't have to wait 4 years. The data to make that call is already in: Swedish excess deaths for 2020 are on track to be normal. Very unlikely there'll be a sudden massive surge in the last month of 2020 given Sweden's near-zero COVID-linked death rate. Outside of the first wave excess death in 2020 has been lower than average for Sweden so it's already balanced out.
My personal belief is Sweden saw larger deaths than Denmark/Norway in part due to their COVID policies, but they did not experience the complete disaster many predicted in March. Whether the trade off was worth it will be debated by public policy experts for years, and ultimately no one will agree.
I feel the Danish economist's analysis is convincing w.r.t. "dry tinder". I fully agree with the last sentence though!
Mortality for the year in total is on average.
But to me it's not even the relevant comparison. Being partisan of Sweden's approach doesn't mean believing Covid doesn't exist. Even a bad flu season will have an impact on year-end mortality stats. The question is rather how much worse did Sweden do vs countries that enforced severe restriction of civil liberties. And not only Sweden didn't do particularly bad, but it's done better than many major European countries like France, Italy, Spain or the UK.
The most interesting stat to me though that I only see mentioned briefly in this post is the fact that over 90% of the deaths was over 60 years old. I think that gives us very clear signs of how to focus the prevention of further deaths.
It also still had people social distancing, wearing masks and disinfecting, a very low population density, a robust healthcare system which at no point in time got overwhelmed unlike let's say northern Italy.
Covid just never really blew up there but at the same time one can't exactly argue that the lack of certain policies contributed to that.
not true at least in Stockholm
This fact is brought up a lot. Isn't nation-wide population density a bad measurement? If a country, like Sweden, has huge areas where nobody lives, it says nothing about the density relevant for a virus spreading. While Stockholm's underground transport is nothing like Tokyo's, it's not different to other medium cities in the world.
1. https://www.nytimes.com/interactive/2020/04/21/world/coronav...
Since King Gustav Vasa who indebted the nation to fund his wars and in order to finance this, forever doomed the swedes to suffer centralisation, in order to establish his taxation regime.
What I mean with this historical tidbit is I’d expect the Swedish state to keep that data in one database, not different databases around the country. But I have no source, and would love to learn, if anyone working in Swedish healthcare IT is on HN.
Also, given my inkling as to why this was posted, please keep in mind that incomplete bar charts (alone) are a bad way to do important statistical tests.
the fact is Sweden is still doing far worse than Norway and Denmark
Minor nitpick, I agree on the other points but Spain objectively does not have a "far worse" Healthcare system than Sweden in 2020. You might need to revise your assumptions.
Looking at the data available up to 2015, Denmark already had a worse HAQ index than Spain in 2015, and Spain had a negligible difference compared to Sweden [0].
Spanish longevity has kept increasing and competing with Japan [1], beyond 'mediterranean diet' effects, which again many attribute to Healthcare quality.
[0] https://ourworldindata.org/grapher/healthcare-access-and-qua...
[1] https://www.theguardian.com/world/2018/oct/16/spain-to-beat-...
Also, I think there are a lot of problems when conducting comparisons between countries, and it is best to be avoided unless conducted in a extremely rigours way. There are absolutely ways ways in which Sweden is more like Spain or Italy than Denmark or Norway, and it take a through analysis to even attempt a comparison.
Sweden 2.02 Finland -0.10 Norway -0.26
https://www.euromomo.eu/graphs-and-maps (notice that mean of z-score per week is not the same z-score for the whole year, as deaths per week have seasonal variance thus are not evenly distributed)
Euromomo description of z-score https://www.euromomo.eu/how-it-works/what-is-a-z-score
https://twitter.com/GaryMarcus/status/1328048295109824512
I follow Gary Marcus because I respect his views on AI, but I don't really appreciate the editorializing.
One of the most horrifically inaccurate predictions in the history of public health.
The obvious difference is that cases aren't deaths (and the amount of testing affects the number of cases, etc.).
But if the plot is to be believed, then you could imagine that Sweden might NOT have excess deaths for 2020 (which is interesting in itself), but it could have many in the beginning of 2021.
Or maybe almost all these cases will be mild and cause few deaths. There seems to be an extremely wide range of COVID outcomes.
That being said, deaths are going up as well at the moment. Still a far cry from April levels though.
It appears that since September 2020, Sweden’s death rate has been about 5-10% LOWER than average, which would push overall yearly rate down a bit
they also noted this "Sweden was the Nordic country that reported the highest number of COVID-19 deaths in 2020."
Point is, Sweden arguably opted for none of this.
Swedish authorities have issued many directives that weren't legally enforceable but which they expected Swedes to follow, and most Swedes did follow them. Surely whether or not a directive formally has legal backing is not that important to whether we call a measure "a lockdown"; what is important is the impact on behavior. For example Swedes in many regions have been asked to refrain from social contact outside their household for the last month. When that happens in other countries it's called a "lockdown".
From April to October no visitors to rest homes were permitted; regardless of the legal status that seems like a kind of lockdown.
Anyway the "no legally enforced lockdown" era just ended in Sweden. They have introduced law-backed restrictions: https://www.thelocal.se/20201116/breaking-sweden-introduces-...
I suspect the fact that they weren’t legally enforcable may have increased responsible behavior.
What matters to me and most other responsible citizens is: what are the rules I need to follow? Can I have social gatherings? Can I go out for dinner? If I can't, I'm calling that a lockdown. This is what determines the effects on the economy, mental health, personal freedom, etc. What is technically legal is irrelevant.
I think what is technically legal is quite relevant.
Making things illegal is not the only tool for getting people to adopt behaviors. Often it is counterproductive.
A key point about Sweden is it appears they had a lot of people behaving responsibly despite not using the force of law.
Contrast that with the UK which had strongly enforced legal lockdowns, but notably poor results.
If you don’t think we should consider whether the mechanisms we are using to get people to behave responsibly are effective, then you don’t have to participate in such considerations.
But when people talk about whether lockdowns are good or bad they tend to be assuming compliance and considering the effects of that compliance, so I think your definition sows confusion.
Compliance rate is a very commonly considered variable in evidence based medicine - there is nothing confusing about considering it.
Compliance very much varies between intervention types and cultures. Also not remotely controversial.
Assuming compliance is almost always an error in considering the outcomes of medical interventions.
If we are going to reason about what kinds of coronavirus interventions are effective, we must consider compliance.
Whether something is mandated by law or not is definitely a variable in determining compliance.
If it were not, and as you claim, Swedes have been complying this whole time, why would Sweden have started using force of law recently?
Presumably they think it will increase compliance.
Here's a typical narrative that illustrates why we should be more careful about the word "lockdown":
Alex: "Sweden has successfully managed COVID19 without a lockdown."
Bob: "Great, so we should just go and live our normal lives then."
Alex: "Actually no. We need to cut off most social contact, ban visitors to rest homes, and work from home when possible."
Bob: "Er, that sounds like a lockdown to me!"
Alex: "WELL ACTUALLY it's not a lockdown as long as the government doesn't assert the legal authority to enforce these restrictions."
Bob: "... but the effects on health, well-being and the economy will be the same as a lockdown?"
Alex: "If everyone complies, which we expect them to, then yes, but the important thing is that we don't call it a lockdown."
Alex: "Sweden has successfully managed COVID19 without a lockdown."
Bob: "How did they manage that?"
Alex: "They gave their citizens a bunch of guidance on how to reduce the spread of the disease, and asked them to be responsible and most Swedes complied."
Bob: "Why can’t we do that?"
Alex: "Good question - something to do with our government or our culture?"
Bob: "Seems like our government might have burned less goodwill if it had used Sweden’s approach and we’d be in better shape going into this second wave.”
Alex: “Yeah, maybe you are right.”
That means defining lockdown as "government restrictions legally enforced" doesn't make sense. Defining it as "government restrictions widely complied with" would make a lot more sense. And by that definition, Sweden has apparently had a lockdown.
It’s a clear distinction.
That why many people are saying ‘Sweden didn’t have a lockdown’.
What they mean is ‘Sweden didn’t have a legally mandated set of restrictions’.
This is just a true statement.
The fact that the Swedish government made recommendations that Swedes followed without using force of law is interesting, and informative.
True for some people, not for others. I have talked to many people who have repeated "Sweden didn't have a lockdown" and think that means Swedes didn't change their behaviour significantly. They are surprised, even disbelieving, when I point out the quite significant restrictions most Swedes have complied with. These people were misled by news reports using the term "lockdown" the way you do.
Whether or not defining the term "lockdown" differently is the solution, there needs to be some improvement in the way we write about this.
https://news.ycombinator.com/item?id=25119518
Which would imply no lockdown by any definition.
Mandated lockdowns are precisely for the people who don't voluntarily behave responsibly. And damn Sweden has a lot of them too.
Worse, those in charge used their authority to mandate NOT using masks: https://www.sciencemag.org/news/2020/10/it-s-been-so-so-surr...
https://time.com/5899432/sweden-coronovirus-disaster/
Swedes failed each other, and the failure to employ legal authority effectively meant their government did too. And their economy is no better for it https://www.nytimes.com/2020/07/07/business/sweden-economy-c...
It’s worth pointing out that roca’s comment contradicts you about Sweden’s compliance rate: https://news.ycombinator.com/item?id=25118200
My reply was partly because of the sentence "The fact that the Swedish government made recommendations that Swedes followed without using force of law is interesting, and informative." However if you weren't claiming that Swedes followed recommendations and meant it as a conditional then I misdirected my reply.
I was replying to Roca and just taking their facts at face value.
Can you quote sources saying compliance with the government's requests was low? Because I see, for example, https://www.politico.eu/article/sweden-coronavirus-lessons/:
> 93 percent of the population say they are following social-distancing recommendations.
https://www.government.se/articles/2020/06/social-distancing...:
> Swedes are largely following the advice and recommendations issued by the Public Health Agency of Sweden.
https://www.bbc.com/news/world-europe-53498133:
> a survey released this week by Sweden's Civil Contingencies Agency suggests 87% of the population are continuing to follow social distancing recommendations to the same extent as they were one or two weeks earlier, up from 82% a month ago.
[It does also say "there have been reports of large gatherings and mingling in some tourist hotspots since domestic travel restrictions were relaxed last month" but that is anecdotal.]
Reports like these formed my view that compliance with the (inadequate!!!) Swedish government restrictions has been high (though I have also read reports of decreasing compliance lately, consistent with trends in other countries). Perhaps these reports were never accurate but I'd want to see sources saying so.
There is a large portion of the population that will fight tooth and nail against an order, but will follow a recommendation.
Obvious hyperbole alert!: I love my wife, but I would be furious if I were ordered to kiss her at gunpoint.
In this case, the public reaction all ties back to how individuals view their relationship with laws and the government.
“Despite North Dakota’s remarkable efforts at testing and case finding, these measures are no longer enough, and we are now in desperate need of implementing stronger measures in order to save lives and preserve our health care workforce and capacity,” said Dr. Paul Carson, an infectious disease specialist, professor of public health at North Dakota State University and physician advisor to the state’s COVID-19 response. “We have a growing body of good evidence that masking, especially when paired with other mitigation strategies, can substantially reduce the spread of the virus. I am very grateful that the Governor has taken the bold measure to implement an enforced mask mandate across the state, and am hopeful this will help to flatten the curve.”
https://www.governor.nd.gov/news/burgum-announces-new-requir...
More and more conservative states are finding that if they don't make masks mandatory all that winds up happening is the ICUs fill up, healthcare workers start getting sick, and things get real scary real quick (e.g. Arizona changed their tune about masks REAL quick when Phoenix ICUs started hitting 90% capacity).
I hate the government telling me what to do as much as the next person, but there are a lot of people out there who just don't grasp the concept of 'just because you can, doesn't mean you should.'
I don't care if you kiss your wife or don't kiss your wife. I do care if you stand 6 inches behind me coughing with no mask in the grocery store, and if you do that I would very much like you to be thrown out by force if necessary, because you're putting my life and my family's life at risk because of nothing other than some bizarre paranoia about how wearing masks makes you less of a man (not that I think you personally would do that, but I had that happen to me pre-mask-regulations during COVID in an Arizona grocery store and it really pissed me off.
A sick-looking guy with no mask on hacking up a lung in front of the deli counter at Safeway isn't freedom, it's stupidity. Stuff like that just happens in the absence of mandatory restrictions, and it puts everyone's life at risk for zero reason. I wish my fellow Americans weren't that stupid, but unfortunately enough of them are.
As for legal requirements. My guess is that if Trump had said - “I’m not going to let those democrats order you around. I’m wearing a mask because Americans know what’s right without needing to be told what to do.” There might be even more compliance.
"As rapidly growing case counts strained health care systems across the South and Southwest this summer, more Republican leaders ordered citizens to wear masks to help slow the spread of the virus. In July, President Donald Trump wore a mask in public for the first time and urged Americans to do the same, marking a change in tone from earlier in the pandemic."
https://www.pewresearch.org/fact-tank/2020/08/27/more-americ...
"A tidal wave of new mask requirements has been issued in the last few days, amid surging cases in many regions, including more than 75,000 new coronavirus cases across the country on Thursday, the most in a single day. Face coverings will be required at stores like Walmart, Target and CVS, and in a growing number of Republican-led states where governors once resisted such mandates."
"More than half the states have issued statewide mask requirements, including Arkansas, where Gov. Asa Hutchinson, a Republican, announced a face covering requirement on Thursday, after previously taking a more hands-off approach. Gov. Jared Polis of Colorado, a Democrat, also issued a mask order on Thursday, after questioning whether such a mandate would be enforceable."
"But there remains firm resistance in many circles, including from some Republican leaders who view mask requirements as a threat to personal liberty."
https://www.nytimes.com/2020/07/16/us/coronavirus-masks.html
Unfortunately (I've been using that word a lot lately), Trump endorsing masks would have conflicted with his somewhat perplexing political strategy of gaslighting his base into thinking the virus wasn't anything to take seriously.
'Speaking on Capitol Hill on 10 March, Mr Trump said: "Just stay calm. It will go away."'
'Nine days later, after the White House declared the pandemic a national emergency, the president told Woodward: "I wanted to always play it down. I still like playing it down, because I don't want to create a panic."'
https://www.bbc.com/news/election-us-2020-54172311
And, of course, then he got it, and even with the best care in the country, and cutting edge therapies not available to normal people still had a hell of a time.
If he had done a photo-op standing in front of a pallet of N95s in NYC during the worst of it there, and pumped federal cash into making sure the country was up to its ass in PPE, this election would have been a cakewalk for him. He would have looked heroic and decisive. But, he didn't. For some reason, he took a different approach. I'm not really sure why, but 2020 is just a year of head-scratchers.
From my perspective, it seems like you come to the same conclusion.
While you say that "Unfortunately mask compliance on this side of the pond has largely been a result of government intervention" it is also clear that non-compliance is largely a result of government intervention, eg Trump and others failing to encourage mask use, and both side weaponizing the issue.
My point is that they tried it without a mandate already. North Dakota, Arizona, Iowa, Arkansas, etc. States without mask mandates saw cases spike, ICUs filled up, health care workers started getting sick, things got scary, and they were forced to implement mask mandates before reaching the point where there was zero available healthcare capacity for non-COVID issues.
Why have so many states that initially refused mask mandates had to turn 180 degrees and mandate masks? Because nobody was wearing masks without the mandate.
Trump failing to encourage mask use is an active decision not to intervene. You seem to be saying that by failing to invade Canada, we have intervened in Canada.
Or maybe I missed your point? That's definitely a possibility.
I think the disagreement rests on this point. From my point of view Trump has done vastly more than not intervene.
The President of the United States has gactively discouraged* mask usage.
That is why states have decided they need mandates.
(Keep in mind that this is a purple rural-turned-suburban district in WA. I didn't notice much difference in more urban areas.)
You've explained a pretty clear and meaningful distinction. You may not think it is important, but it has a meaning. I'm saying this as someone who supports authorities backing their restrictions with legal authority and vigorous enforcement.
1. Government suggesting that wearing masks on public transport would be good
2. Government asking everyone to wear masks on public transport
3. Government issuing a legally backed health order requiring everyone to wear masks on public transport, but saying police will take an "educative approach", i.e. no actual enforcement
4. Government legally requiring everyone to wear masks and the police actually enforcing it a little bit but mostly not
Theoretically we could have
5. Government enforcing mask usage rigorously.
Apparently some people think that at some point we crossed a line that was really important, but was it #3, #4, or #5, and why?
Perhaps if you are leading an organization or have some legal authority, you can insist on a precise definition to be used in a particular context, but in general public discourse, attempts to do that are typically ineffective.
That said, 12/10 * 77.5k = 92.7k, which is at the high end for the charted period. Adding an extra month's worth of late reports gives 13/10 * 77.5k = 100.5k. So, probably reasonable to guess that the real deaths are somewhere between these two, which definitely doesn't support the 'no excess deaths' claim in the post title.
It would be nice to see something closer to the CDC's ongoing excess deaths tracking:
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386...
It’s very hard to say which strategies will be the best at this point in the pandemic, but it is easy to see the worst failures from the excess death figures, like the US, Peru, and a few European countries where the epidemic got out of control initially.
Sweden has not done terribly, but this chart and headline is grossly misleading as it attempts to compare an incomplete year to other full years.
1. Is the data through Nov. 6 actually complete or is there the expected backfilling yet to be done? 2. Sweden is in the middle of another wave, so excess deaths at end of 2020 may not look the same as now
Download "Preliminär statistik över döda", the sheet "Tabell 1" has deaths per day. Both this source and the linked page have been updated to extend to 13/11, and you can sum the 2020 column yourself to end up at the same figure as the linked page (79 268).
Earlier comments suggest that previously the data extended to 6/11 with a total of 77 300, the sum up to that date is now 78 647 (and quite likely not finalized).
Looking naively at the source, I would disregard at least the last 14 days of reporting or so.
Swedish article: https://www.svt.se/nyheter/inrikes/har-ar-dodsorsakerna-i-sv...
[Note: data to May]
"With our consistent and comparable analysis, we identified four groups of countries in terms of the overall death toll of the first wave of the COVID-19 pandemic. The first group comprises countries that have avoided a detectable rise (with a posterior probability of at least 90%) in all-cause mortality and includes Bulgaria, New Zealand, Slovakia, Australia, Czechia, Hungary, Poland, Norway, Denmark and Finland. The second and third groups of countries experienced a low-to-medium effect of the pandemic on overall deaths and include Austria, Switzerland and Portugal (low effect) and France, the Netherlands and Sweden (medium effect). The fourth group of countries, which experienced the highest mortality toll, consists of Belgium, Italy, Scotland, Spain and England and Wales."
Sweden did nothing to prevent Covid and had very few deaths. Some other countries had lockdowns, face coverings and had a lot of deaths.
What is the correlation then? Sweden has less dense population for one, maybe healthier overall too? Younger?
Is there any takeaway from this?
I had a couple of French co-workers that said it was very hard to form friendships outside work there (in Stockholm), while in the US (NYC) they had no problem.
Compare this to Italy, Spain, France, Greece, Albania, or other Mediterranean countries, which are polar opposite. People are friendlier, that talk to each other more, they hug, they kiss more.
If you go to smaller towns, you regularly see older people hanging out with each other, playing chess and socializing. You just don't see that in Sweden. I think this is one of the main reasons that some countries like Germany and Sweden are not fairing that bad, but the south gets hit harder.
Also, from my understanding, many folks in Sweden are practicing some form of social distancing, and many are working from home when they can. It is a 'voluntary' type of thing. Swedes tend to follow civi rules well in general, and are a homogeneous society, so I think that is contributing to the lower rates of transmission as well.
while the US attitude varies from wear a mask, to 'don't take my freedom away', i do what i want, type of attitude.
Ps. Here is what bus line looks like in Sweden (before the pandemic): https://i.redd.it/4q36jg5ofi831.jpg
Their culture just wants/respects people spaces more, and are more 'introverted' by nature. Swedes are friendly/polite, but not necessary 'warm'. And you can see with their social interactions as well. Hope that makes sense.
Good luck trying to replicate that type of distancing in most of the Europe or the US unless it is mandated (i.e. you will get kicked out of a store if you don't respect the line).
This is just an ridiculously offensive stereotype. If you were in downtown Stockholm this weekend, you couldn't even tell there was a pandemic considering how many people there are one the streets.
Is it offensive? Well, maybe, but that's tact. However, is it true? Bear in mind that an excessively gregious society, and yes there are differences in societies, cultures, might view a more reserved culture as such.
And the real reason I'm responding is, how many "people there are on the streets" is irrelevant, in terms of being 'social' or not. People going places != social. It can equal work, needing supplies, traveling, etc.
I grew up in a small town, population < 1000, in a massively large county (>1000 square km), with barely 15,000 people in it at the time. When I first moved to the city, I would walk down the street and wave at people. People reacted, to my perspective, quite oddly. Some actually shied away, others looked at me as if was a lunatic.
Yet where I grew up, not waving would have been beyond rude. In the city, it was seen as absurd behaviour.
I guess what I'm saying is, Sweden could be quite anti-social, without it being "mean" to say so. It's all perspective.
I was not doing value judgment, but just an observation
As per my example, it is rude to not wave, stranger or not, at least where I grew up. Yet when I moved to the city, entirely different! Same language, country, region. Just urban vs rural.
So it is not surprising to see nation-wide cultural differences.
My non-swede co-workers had one thing in common theme while living in there: loneliness...
Swedes usually stay in one tight group of friends... and don't branch out as much as other societies do.
I get you have the FIKA culture and all, but it always within your few friends/group. And during winter, most people hole up most of the time due to the weather.
I am neither american, nor a neighbor of yours, and I am just giving you my experience. (lived there for few months).
I see people on walks in a suburban neighborhood wearing masks. Even if you can't keep 6 feet of distance, the likelihood of contracting it from 3 seconds of outdoor exposure is negligible. CDC guidelines for when someone is exposed are closer than 6 feet for 15 minutes. Clearly people are wearing masks in some situations to make a point, not to make a difference.
Non-compliance however kneecaps the ability of lockdowns to be effective, leaving you in a worst-of-all-worlds situation with a damaged economy and a largely unaffected disease curve. I would say the better way to frame that is:
- "lockdowns only work if you actually take them seriously" (as evidenced by countries that did: NZ, TW, CN, AU -- look at their graphs [1], they work).
- and "lockdowns may not be necessary to achieve sufficient results."
[1] https://aatishb.com/covidtrends/?location=Australia&location...
Thats why it wouldn't work. You want everyone to stay inside for 3 weeks.
Even so, Sweden doesn't prove this. They have had lockdowns, e.g. severe limits on social gatherings. You can only say they haven't had lockdowns if you take the pedantic view that "it's not a lockdown if it's not legally enforced, even if everyone follows your rules".
Also, arguably the excess deaths in March/April (comparing to Nordic neighbours especially) and the surging cases now are not "reasonable results".
> "people won't comply with such police-state dystopian policies"
The "but muh freedom" argument is so tired. If folks had stayed in for a few weeks at the start, it would be substantially over now as evidenced by all the countries in which it's substantially over. Instead by going out like petulant children who won't be told no, we have a giant flaming disaster. That would be an example of 'disagree and commit.'
I'm open to the idea that a lockdown would work, and I'm also open to the idea it's not necessary because some subset of restriction is enough, or because we're willing to pay the cost of excess mortality during vaccine development -- the one argument I'm not open to is "but muh freedom."
I'm sorry that reality doesn't always map to the libertarian ideal. Sometimes you have to compromise temporarily for the greater good. For your own greater good. For a net gain in freedom.
[1] https://aatishb.com/covidtrends/?location=Australia&location...
I'm still open to the idea that a lockdown would work but not for this virus.
>For your own greater good. For a net gain in freedom
You mean for your greater good because it definitely not for my greater good.
And you should be upset about it, I am, it's been an abject failure. We've compromised so much, but just not quite enough, in part because of the uneven distribution of compliance. That has led to huge cost for zero reward.
No, because we don't even need the lockdown in the first place. I'm not saying nothing should be done to about this virus, but if the answer of 'doing something about it' is lockdown then I can't support because the harm is just immense (compared to the risk of this virus).
Yes, I am upset at the government reaction to this virus.
Although I will say, if "freedom" is the "one argument [you are] not open to" I don't think you have the moral high ground.
> Although I will say, if "freedom" is the "one argument [you are] not open to" I don't think you have the moral high ground.
We'll have to disagree on this one. "You can't make me" isn't going to win you any arguments at the supermarket with your mom, it's not going to win you any arguments at home with your spouse, it's not going to win you any arguments at work, and it sure as heck isn't going to win you any arguments in public health policy.
Again, I'm open to the idea they may not be necessary to achieve meaningful results, however that is a conversation that can be had without invoking the toddler clause.
Yes we will, since you are arguing in bad faith. I can smell the condescension from here. I never said "you can't make me" but YOU said "petulant children who won't be told no" and "toddler clause" and "muh freedom"
THAT is the type of rhetoric that "isn't going to win you any arguments at the supermarket with your mom"
In other words, the illness will die out, unless it doesn't. Here's some practical experience with this approach:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130424/
An outbreak of common colds at an Antarctic base after seventeen weeks of complete isolation.
They were effective in NZ, but NZ is still getting new cases, so it's remarkably hard to get 100%.
In fairness, those are due to quarantine failures, which were anticipated and planned for.
Why would a region with one person per square kilometer plan to quarantine people in a crowded hotel in the centre of a crowded city, and respond to the inevitable outbreaks which potentially expose millions of people to the virus, when you could divert all the jets to Woomera and stick everyone in tents for 14 days? That's a question which those responsible are trying hard to ignore.
And a strict lockdown would require most people to have enough supplies in place to last the few weeks, which is likely an impossible demand for our supply chain to meet, and also impossible for those who live paycheck to paycheck.
That's certainly not nothing, but it also doesn't seem to have been enough. Contra the linked article, Sweden seems to be suffering worse than its neighbors with stricter policies: https://marginalrevolution.com/marginalrevolution/2020/11/sw...
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&are...
Keep in mind that giant spike in cases in July led to a reduction in COVID deaths in August and September according to the charts.
Case counts and death counts have been materially diverging for months now, because the early results were marred by adverse selection bias. With few tests available, testing was only done at the point of admission for critically ill patients, who naturally were the most likely to die of COVID. With broader availability of tests, the full picture starts to come into focus.
It's worth paying attention of course, and not hand-waving the spike, but let's not pre-judge yet. We'll have to see what this spike means in the fullness of time.
Lag effects are complicated. In many places young people are the main spreaders of the virus but don't get very sick, and it takes multiple cycles of infection for the virus to reach more vulnerable people (e.g. via care workers who are pretty careful but will inevitably get infected when they live in a COVID-saturated environment). So yes, we shall see.
Preatty drastic measures have been implemented (non essential shops closed, nigtly curfew, restaurants takeout only, all schools closed, mandatory masks in all public spaces) and the numbers are going down to about 2000 per day most recently.
The measures seem to have been effective, but a a cost of about 6000 more dead - and more can be expected due to the inherent delay.
So for that reason, percentage of positive tests really should be watched carefully.
We'll have to wait and see how overall mortality works out, but it seems very likely Tegnell's policy led to 6,000 preventable deaths in the first wave and did not have the benefits he expected.
The Swedes themselves have decided that more intensive measures are needed now: https://www.thelocal.se/20201116/breaking-sweden-introduces-...
Sweden: 60.53 per 100k
Denmark: 13.11 per 100k
Finland: 6.69 per 100k
Norway: 5.53 per 100k
That is misleading. Sweden is currently averaging at about 20 covid deaths per day. Some days they report 0, some days 40, but the weekly average now is about 20 deaths per day.
This is not true. Sweden limited mass gatherings to 50 people, high schools and universities went to remote learning, large part of white-collar work switched to remote (companies did this voluntarily), and many people voluntarily limited their activities. Also, their sick pay system allows every worker to stay home when they are sick.
That's one takeaway: lockdowns only delay the inevitable. Sweden just ripped the bandage off fast, and got all the deaths over with quickly.
As a consequence, there is the other big takeaway, the elephant in the room: covid doesn't kill more people than any other respiratory pathogen.
> covid doesn't kill more people than any other respiratory pathogen
How come then that there were so many deaths in Italy once their healthcare system toppled over?
From what I understand that even if Covid is not more deadly than say the flu, the fact that it spreads without symptoms means that in the end vastly more people get infected.
https://www.euromomo.eu/graphs-and-maps/#z-scores-by-country
https://ourworldindata.org/grapher/excess-mortality-raw-deat...
without some context and understanding, it raises more questions than it answers. like why the spike in deaths every februrary?
> If people stay home there are no accidents, no murders, no party drugs etc.
There are still accidents, murders, etc. In some places they have even increased. And other causes of death like suicide and heart disease are up because people are staying home.
Then you end by contradicting your own good point (i.e. impacts are complex) with "it's bad for everyone" which is obviously untrue.
Quoting Max Roser:
"Tegnell in May: “In the autumn there will be a second wave. Sweden will have a high level of immunity and the number of cases will probably be quite low. … But Finland will have a very low level of immunity. Will Finland have to go into a complete lockdown again?”
Autumn: https://twitter.com/MaxCRoser/status/1328045594099724289/pho...
I've seen the articles that talk about excess deaths, and then the posts are all affirming that yes, we need to fear covid, people are dying, etc.
I think there is obvious evidence that covid is a real disease that kills people, but the cherry picked reactions that people have to data saying different things drives home that analysis is always political, not some kind of objective thing we can hold up as beyond criticism.
See climate change...
For example, say a massive forest fire happens. We see people try very hard to attribute the root cause to climate change, even if the true cause is decades of fire suppression. Repeat for literally anything that could plausibly be explained by climate change.
Similarly, there is a very strong narrative/bias surrounding covid. Any data or study going against the narrative has to fight 10x as hard for survival vs. a study confirming the narrative.
This is not unique to science polarized across political parties. A similar thing happened (is still happening?) with Alzheimer's research. Basically research dissenting from the prevailing theory were systematically denied funding and shut down by the most influential figures in the field.[0]
Do you think the collapse of insects in the protected Peurto Rican rain forest could be because of pesticides? Maybe. But more likely because of the increases in intensely hot days that kill insects in huge swaths. Insects are incredibly sensitive to temperature.
There is nothing lazy about these studies. Climate Change is the most studied science in the world now. Nothing is lazy about the work they are doing.
https://www.theguardian.com/environment/2019/jan/15/insect-c...
To equate intentionally misleading data with legitimate data and say "See data is a matter of opinion!, Why vaccinate, reduce c02, stop smoking, or anything like that!" is irresponsible.
Do you believe in vaccinations? Will you take up smoking? Can we spread lead gas fumes around your house? I'm guessing you would not be on board with those. There's a thousand more examples like that. If you aren't okay with them, then at heard you don't even agree with what you said about analysis being subjective.