More deaths caused by non-religious people: millions in Sweden

The comment section below the Hans Bergström article is interesting. It reflects the fact that we don’t ultimately know which model is better - and probably won’t know for quite some time (assuming we can agree on what “better” even means). Bergström (as many others) suggests that the higher number of deaths in Sweden as compared to Norway and Denmark is due to its model of social distancing wich relies more on recommendations than orders. I don’t think he’s made that case.

We know that Sweden was caught unprepared when it comes to testing and protective equipment, not least in the nursing homes and that this has influenced the numbers of deaths. A lockdown would not have made test kits and PPE magically appear so that problem would have persisted no matter what social distancing measures Sweden would have taken. We also know that a lockdown doesn’t stop the virus from getting into the nursing homes. Norway has recently reported that many nursing homes in the Oslo area have been infected.

As for the rest of your post, I agree. There are many lessons to learn from this pandemic - I hope they’re taken to heart.

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We do know what’s better. We have clear examples from countries which have handled this properly. What I see all over the place is dogged nationalism, with various people defending the their government has handled the situation, despite the obvious drawbacks and despite their mounting body counts.

Of course. A lockdown should not have been needed in the first place.

Well obviously it does stop the virus getting into the nursing homes, if the lockdown is enacted before the virus is already in the nursing homes, and if the lockdown is adhered to properly. But again, a lockdown should not be necessary.

All this talk about whether or not a lockdown and social distancing is better or worse than no lockdown and various degrees of social distancing (or no social distancing), keeps avoiding the point that a lockdown is avoidable. As I said before, a lockdown itself is already a sign of failure.

To date in this discussion I have seen no one citing the best examples of handling the pandemic, from the nations which have the lowest infection rates and the lowest body counts. I live in one of them, and I’m astonished it has yet to be mentioned given that it has proved itself a world leader in this crisis.

No, we don’t. For one thing, we don’t know if there is going to be a second wave. The more successful a lockdown has been, the more uninfected people there will be in circulation once society opens up, which means a higher potential for a second round of infections. If there is a second wave, governments will be put in a very tough position. I don’t know that it’s even going to be politically possible to go back into lockdown.

Sure, if we’d all gone into a perfect lockdown back in January things would have been very different. I’m talking about the lockdowns that actually happened, not some idealized theoretical case.

You are not reading what I am writing. We do know what’s better. We know it’s better to do what other nations have done, which have a lower body count even after their second or even third wave. We know it’s better to do what other nations have done, which didn’t even need a lockdown.

When you say “a lockdown doesn’t stop the virus from getting into the nursing homes” that’s obviously speaking of hypotheticals, not the past. You can’t say “Well we did a lockdown of our nursing homes and they still caught the virus, so obviously a lockdown doesn’t work for nursing homes”. Just because one country messed up a lockdown doesn’t mean they don’t work.

Still no mention of any other nations, most notably those on the other side of the planet who have been handling the situation well. Calling this mere Eurocentrism, is becoming generous.

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You’re making my point - Sweden’s problem isn’t the lack of a lockdown, it’s the lack of testing and PPE. The Asian countries that have been the most successful have also been the countries that were best prepared in these areas, largely due to lessons learned from the SARS epidemic (which sadly weren’t learned in Europe).

I’m talking about what actually happened in the country we’re being mostly compared with. If Norway is now not a valid example of a lockdown country, what are we even discussing? What would be a valid example of a lockdown country?

I think it’s natural that comparisons are made with countries that are closer geographically and culturally. This doesn’t mean that no mention is being made in Sweden of the Asian Coronavirus response or that no-one is interested in learning from their experience, far from it. I think this is one thing that distinguishes a pandemic from a more regional epidemic - it’s kind of hard to ignore.

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@swamidass

Good heads up warning!

Unless secluding the elderly separately from the rest of the population actually WORKS … the underlying reality of Sweden’s scarce resources of beds (ICU beds AND general beds) could be a disaster!

The reporting from Swedish ICU wards is that the number of Covid-19 patients in intensive care has held steady at just over 500 for more than a week.

https://www.icuregswe.org/data--resultat/covid-19-i-svensk-intensivvard/

The field hospital that was built inside the Älvsjö Exhibition Center outside Stockholm specifically to receive Covid-19 patients has been ready for weeks but hasn’t been used yet. It currently has 140 beds but can quickly be expanded to 600.

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As I watch this and other models I’m still curious about the their accuracy.

If the model is accurate, Sweden should be by now experiencing significant overloads in their hospitals, due to a lack of ICU beds.

Do we know if that’s the case?

On a different tangent. I’m very interested in Sweden’s model, with a focus on secluding the elderly. It seem’s to me, that it is at least a logically reasonable approach to balancing population safety and economic activity.

In Canada, the vast majority of deaths have been in long term care homes. I wonder if we had focused (time & energy) more keeping the virus out of them, than on the general populace whether that might have been more effective. (This to some extend ignores the underfunding of long term care which at least to some extend is the cause of the death’s in these homes).

Finally, I think its interesting to see the difference in perspective from the US and Sweden or Canada, which have a more socialized culture and model of government. In Canada the governments of all political stripes, have done a pretty good job of getting financial support out to the people economically effected, and companies (at have generally been good about allowing vulnerable employees to stay home, while continuing to pay them. This seems to have reduced the fear and angst around the lockdown compared to what I see in the US.

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You’re conflating two different issues; what Sweden should have done in the first place, and what Sweden should do now. I am saying that if Sweden had managed the situation properly in the first place, they would not have needed a lockdown, or even the kind of social isolation they’re practicing now.

As it is, they let the situation get away from them, by responding only reactively rather than pro-actively. Consequently the situation has steadily worsened (instead of improving), and they’ve had to react with more strict containment measures. If the situation gets totally out of control, a lockdown will be unavoidable.

Sweden’s initial very relaxed response was irresponsible given the lack of PPE and the public’s very obvious ignorance of how to act in a pandemic. It’s possible to control a pandemic without a complete lockdown, even if you don’t have PPE, but you don’t do it the way Sweden tried to do it. I think it’s fair to say that Finland and Denmark have done a better job.

Looking at Sweden’s response, we see it reported like this.

  1. Lockdown, what lockdown? Sweden’s unusual response to coronavirus (29 March).

“The business community here really thinks that the Swedish government and the Swedish approach is more sensible than in many other countries.”

  1. Coronavirus: Sweden stands firm over its controversial COVID-19 approach (9 April).

But the nation’s daily coronavirus death toll jumped by close to 100 both on Tuesday and Wednesday, raising fears that the outbreak might be spreading.

  1. Sweden: 22 Scientists Say Coronavirus Strategy Has Failed As Deaths Top 1,000 (14 April).

The criticism comes as the Swedish death total hits new heights. 1,033 people have now died from COVID-19 in Sweden, according to the Swedish Public Health Agency. That’s an increase of 114 in the past 24 hours. The daily update also confirms that 11,445 people have tested positive in Sweden with 915 receiving or having received intensive care treatment.

  1. Sweden has nearly 10 times the number of COVID-19-related deaths than its Nordic neighbors. Here’s where they went wrong (20 April).

Sweden’s Nordic neighbors, Norway and Finland, approached the virus differently, and it could be why they’re facing just a fraction of COVID-19-related deaths.

I wouldn’t call that a vindication.

I am talking about your claim that locking down a nursing home won’t stop the residents being infected. Why would you say this? How would they become infected?

That’s natural because of ethnocentrism. It doesn’t make sense if you actually want to think rationally about what works and what doesn’t.

But I don’t see any evidence of Sweden altering their response according to what they’ve learned from the Asian coronavirus response. After all, they didn’t learn anything from the way nations like Taiwan handled the SARS outbreak. If they had, they wouldn’t be in this mess. I don’t see any evidence that Sweden is interested in learning from their experience. I think there are pretty obvious systemic and historical reasons for this.

Yes. I am hoping rather wistfully that this pandemic will hit home the importance of inter-regional cooperation. That’s certainly a message Taiwan is trying to send, which is why it has been so upset about the WHO’s behavior, and why it has been supplying other nations with PPE to help compensate for their shortfall.

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I feel I’m not getting through here and it’s getting a bit frustrating so I’ll probably be winding down my participation in this discussion. My objective has not been to argue that Sweden has done a great job at handling the Coronavirus pandemic - it clearly hasn’t. What I’m reacting to is that Sweden is being singled-out because it didn’t opt for a hard lockdown and that the narrative being sold is that this is the full explanation for Sweden’s higher number of deaths as compared to its neighbours. I don’t buy that - and nothing that has been presented here has convinced me otherwise.

Take care. And wash your hands.

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I understand you’re probably feeling under fire here, and I’m sorry to have contributed to that.

As I’ve made clear, I think Sweden could have avoided a hard lockdown, and still could. But this would require better management from the government, and crucially better cooperation from the citizens. As I’ve also made clear, I don’t think the lack of a lockdown is the full explanation for Sweden’s higher number of deaths; I cited lack of PPE and the public’s ignorance about how to behave in a pandemic as significant contributing factors.

But when I look at what Sweden is doing, I feel there’s a significant disconnect between what is being done and what a government should be doing. Specifically, your government made the deliberately choice to deprioritize saving lives. To me that’s a shocking decision under any circumstances, but in this particular case it’s baffling. This was the initial response of the UK, and while that disgusted me it didn’t surprise me given who is in charge over there right now. But it’s not what I expected from Sweden, which has a reputation as being an enlightened social democracy, and one of the most enthusiastic and ethical upholders of human rights in the entire world.

Your government made the decision that instead of taking steps to protect its citizens, it would be better to gradually infect most of the population over a lengthy period, knowing that a significant proportion would die, in order to reach herd immunity through sheer attrition. I am sure that when they made that decision they’d been informed that the death toll would be sufficiently small to justify the policy (whatever “sufficiently small” meant to them), but I doubt that they thought it would go this high.

Looking at this graph, I have to ask “What are they aiming for here? Is this all going according to plan?”. This is containment through a firebreak of dead bodies. I don’t understand why they chose this path despite the fact that there were far safer options. I don’t understand why they didn’t prioritize the safety of their citizens.

Right now there are schoolchildren in Taiwan writing essays on the world’s response to the coronavirus. A repeated theme coming up is “Why are Western nations doing so badly?”, with associated questions like “Why don’t they understand about masks?”, “Why weren’t they prepared?”, “Why don’t they practice proper social distancing?”, “Why did they have to go into lockdowns, when our schools and bussinesses are still open?”, and “Why are their governments not protecting them?”. Schoolchildren know that Taiwan is donating masks to the US, UK, and Europe, because your governments couldn’t supply their own people with them.

Meanwhile the SCMP is taking the opportunity for a pretty sharp stab at Western societies in general, revealing the ever-present undercurrent of East-West rivalry which is still alive and well in the Far East.

Governments across Europe and North America have showed an almost callous disregard for the health of their citizens, and the world
In Asia, meanwhile, oases of single-minded purpose have sprung up, sincere in their efforts to ‘flatten the curve’ of transmission

There’s a general sentiment in the Far East that Western societies don’t care about their elderly (which is why they send them to nursing homes), and believe the individual is more important than the community, so they don’t feel it’s necessary to follow laws or cooperate with others for the good of society, especially if it inconveniences them.

This is a gross caricature, and the SCMP is taking a particularly low road here, especially given the fact that Singapore itself messed up its own response and its infection rate has yet to peak. But it’s revealing of a certain dominant trend of thought here in the Far East (don’t get me started on how they also think Westerners are morally degenerate and sexually promiscuous).

I realise that since your government doesn’t even recognize Taiwan as a sovereign nation, it might be difficult for you to acknowledge Taiwan and its success, but I’ll leave you with these articles for your consideration.

  1. How Taiwan minimized the spread of corona (Swedish perspective, from https://kvartal.se).

Sweden and Taiwan both maintain that their efforts to control the corona virus are informed by experts in the field – still, they seem to have chosen different methods and their analysis varies greatly. Some hard-won experience from the Sars epidemic has contributed to Taiwan’s reputation as being a model for the rest of the world. Stringent and early controls at the border have been a deciding factor.

  1. Taiwan donates medical masks to Sweden (from the Taipei Mission in Sweden; unfortunately the Swedish government doesn’t permit Taipei to have a proper embassy).

Taiwan donates medical masks to Sweden. On behalf of Taiwan, Ambassador Daniel. T. C. Liao complimented Sweden for being a role model in giving and sharing to the world and said that it is the least that Taiwan can do to share our love and care with our friends in Sweden.

  1. State epidemiologist: Corona virus does not pose a threat in Sweden (this article is from January, and it has not aged well).

The Corona virus outbreak has led to Swedish companies imposing travel restrictions and to a run on protective face masks, but Sweden’s state epidemiologist says there is little reason to worry about getting infected in Sweden.

“Right now, I think the most important thing for Swedes to know about the disease is that it doesn’t exist here and there’s no reason for the Swedish population to be worried about it,” Anders Tegnell, state epidemiologist and co-director of the Public Health Agency of Sweden, tells Radio Sweden.

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@Jonathan_Burke’s opening sentences to @Radix: - - Absolutely correct!

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This COVID-19 patient in Taiwan stayed in an isolated negative-pressure room with daily medical care. Total length of their stay? Twenty two days. Total cost of their medical bill? US$72. Welcome to the joys of public healthcare.

After 22 days in isolation, Schoko was discharged from hospital April 11, and her bill was less than NT$2200 (US$72). With her national health insurance coverage and government subsidies for patients with transmittable disease, she was required to pay only 1.2 percent of the total cost.

“I really want to express my gratitude for the National Health Insurance (NHI) system and to the medical personnel who took care of me,” Schoko said, “The healthcare workers are all angels.”

This is something Sweden gets right. The US, not so much. I’ve never understood the aversion to public healthcare in the US.

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I’m used to the NHS in the UK so I will still grumble about having to pay <$40 for a doctor’s appointment or a maximum of $10 per day spent in hospital in Sweden. I’m spoiled, I know.

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Sweden is definitely doing healthcare right. I’m originally from Australia, so Taiwan’s healthcare system was what I expected from a modern civilized nation. Nevertheless it’s still significantly cheaper than Australia, since Australia’s is a hybrid public-private system.

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I’m not seeing a lot of learning on your part. Speaking for myself, I learn from reading the primary scientific literature. My graduate training was in virology.

You won’t see that from me, so please don’t lump me in that group.

OK, Australia, South Korea, New Zealand. Singapore, but only up until the last couple of weeks, as their dependence upon and contempt for imported labor has blown up. For those of us who live further north, it suggests that warmer weather will not help very much.

It’s neither reasonable nor logical in the relative absence of testing.

That’s not true mathematically. The harder the lockdown, the fewer tests and PPE needed. A total lockdown (impossible to achieve) eliminates all transmission.

You’re getting through. The problem is that you are portraying this as some sort of a zero-sum game.

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The US economic response is almost as bad as its epidemiological response. Our social safety net is very selective. Many people are fine, many others have zero support.

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Yep, noted.

I was thinking about places which have actually done a really good job like Vietnam and Taiwan. Especially Taiwan, which hasn’t had any lockdown and hasn’t closed either schools or businesses, and has actually seen an uptick in the economy.

Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China.1 The country has 23 million citizens of which 850 000 reside in and 404 000 work in China.2,3 In 2019, 2.71 million visitors from the mainland traveled to Taiwan.4 As such, Taiwan has been on constant alert and ready to act on epidemics arising from China ever since the severe acute respiratory syndrome (SARS) epidemic in 2003. Given the continual spread of COVID-19 around the world, understanding the action items that were implemented quickly in Taiwan and assessing the effectiveness of these actions in preventing a large-scale epidemic may be instructive for other countries.

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I’m unclear what you mean. Do you mean

  1. It was unreasonable and illogical to start down this approach as there was an absence of prior test data.
  2. If they were going to start down this path, Sweden should have made sure there was testing being done to validate effectiveness of their approach?
  3. Or something else?

In a business environment, I often have to make decisions without enough data available to know what the correct decision is. In this environment, all you can do is make a reasonable decision (which may not be the same decision someone else make) and be prepared to change your decision as more information becomes available.

I see governments being in the same boat, with some being more and less effective at both making reasonable decisions quickly & being able to re-evaluate those decisions. I’m a bit of a geek when it comes to risk, and decision making under stress, so I find both the decisions and how different people react to them fascinating.

I mean #2. That was all known at the time the decision was made.

I don’t, as virtually everyone arguing against measures is ignoring the known.

Moreover, in this situation, the unknowns tend to make the picture worse, not better. You’re almost certainly not going to find that the pandemic started later than you thought it did, for example:

I’d find it more fascinating if more people were making more informed decisions.