Is Sweden the promised land for sensible covid-policies? Reluctantly. 

Sweden is a rich, spacious country famous for IKEA, ABBA, dark cold winters, and its unique covid-policies. We escaped London for a few days to see for ourselves what the deal was with this Scandinavian country of 10 million. It is as rich and well-run as the statistics say it is: Stockholm is full of sporty Swedes, spacious parks, shiny public transport, cyclists, and prams. Getting to talk to Swedes requires alcohol and patience, but once they do talk, you find their English is excellent.

In terms of the statistics, Sweden has had a relatively good covid-experience. The number of covid-attributed deaths is 0.06% of the population, average for the EU, without the huge anxiety and mental health disaster befalling other countries. Also, their economy is now estimated to shrink by only 3% in 2020, with the government running a surplus in September. It did not give up civil liberties and had a well-publicised large glut of infections in April-July that got them close to herd immunity. Whilst measured infection rates are rising again in the autumn, there are very few new deaths, suggesting the vulnerable population is either already immune or by now well-protected in a voluntary manner. Did this relative ‘success’ reflect some unique Swedish attribute or was it just luck?

On the one hand, Stockholm is everything a Covista wants to see. You see virtually no masks, the full pubs have minimal distancing, the generations walk together outside, the theaters are open and sold out, children play in packs, and there is a relaxed vibe in the air with people reacting in horror when you tell them of the descent into authoritarianism elsewhere. The place also has quite a few covid-refugees from the rest of Europe who deliberately came to Stockholm to breathe in a bit of sanity and fun. But….

On the other hand, football stadiums are still closed, you see signs everywhere asking you to socially distance, the crowds in shops are not that huge, distancing is stricter outside of the capital, and the city employs hundreds of covid-marshalls who check on rule compliance in restaurants and pubs. So whilst we did manage to sing to live-bands and even managed to dance, we cant tell you where because venues are not supposed to allow this. It is hence a mixed bag.

You also see this mixed bag in opinion polls and in the election campaigning. Many Swedes work from home, would like to see stricter rules on movements, and are attracted to the narrative that the whole population should give up things to protect the elderly. Ericsson, one of the biggest employers, for instance just announced its employees should wear masks at work.

The Swedes are also about the most politically-correct people on the planet, calling themselves a moral superpower, exactly the types who in other countries are at the forefront of lockdowns. The shops sell organic ice cream and oatmilk cappuccinos, and their national history museum tries to claim that the slave business run by the Dutch and the English was actually the fault of the Swedes. I think if there had been a referendum in April, the vast majority would have been pro-lockdowns and even now, many companies and groups want things to be stricter.

So what explains that the Swedes have gone the herd immunity route? I think the honest answer is sheer luck and a willingness to stick to their previous resolutions on how to handle such crises.

The Swedes were lucky that the health authority charged with running things in a health emergency was a group wedded to the herd immunity idea. It wasn’t just Tegnell, but also Giesecke and others close to the agency: they had a group of scientists and public servants strongly committed to what they sincerely thought was the right thing to do, willing to ignore the large swing in opinion and behaviour among public health people elsewhere in Europe. They have had to hide their early expressed opinion that herd immunity was the sensible long-run strategy and simply stuck to the mantra that they needed to take a long-run view and could not justify the experiment of lockdowns.

The Swedes also got lucky with their constitution which I understand forbids the kind of compulsory social distancing and lockdown policies the other countries in Europe and America went for. The thing the Swedes can be proud of is that during the height of the panic, they stuck to their constitution whilst in other countries they did not: my current understanding is that many American governors and European governments have violated their constitutions, though it will take a while for that to be widely established by constitutional courts (several cases been lost already though by governments, such as in Germany and Pennsylvania).

In short, I think the Swedes are reluctant poster-children for the Covistance. Their policies are not as sensible as those of the Tanzanians or South Dacotans, but they are a shining example to the rest of Europe anyway.

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77 Responses to Is Sweden the promised land for sensible covid-policies? Reluctantly. 

  1. paul frijters says:

    back in London again, which means coming home to many horror stories about the damage the UK covid-policies are doing. The saddest one I found in the press:

    ” 4.05am Sunday morning.
    Hysterical phone call from my business partners 20yr old daughter. ‘Dad’s dead’. She’d been out late with her boyfriend & come home to find her Dad hanging in the hallway.

    I’m totally numb. We set up in business in Jan 2019 making parts for racing motorcycle engines. £50k between us, most of our life’s savings. £350k from government & private investors. When covid came along the contracts we had one by one started being broken by the people we were supplying.

    On Friday the business folded leaving 12 staff with no pay. We put everything into this, it was the product of our lifetimes experience.

    My business partner was the strongest, toughest businessman that I’d ever met. I was the ‘boffin’, I had the ‘knowledge’…

    I’m numb. Can’t even cry. Two of my ex-forces friends have already committed suicide this year. Both my young kids were diagnosed with depression last month.

    I’m not going to do anything stupid, that’s not me but I don’t know where I’m going to find the strength to help Dave’s daughter.

    So it’s personal now, actually it always was but I, like so many others, had just been trying to survive. I thought that I knew what hate meant but I’m just beginning to realise that I knew nothing about what it really meant.”

  2. A Spaniard says:

    I am really, really sorry to hear this, Paul. My deepest condolences. It’s really sad.

    • it’s a horrible story, isn’t it? It goes to the heart of the issue of tradeoffs though. People who say the economy is not about lives or who think its ok that whole industries are going bankrupt or who talk about “non-essential jobs” are denying others their humanity. And that has been done an awful lot in this crisis: wilful blindness to suffering that didn’t fit a particular narrative.

      • A Spaniard says:

        Depressing. Although I guess that many will interpret this episode as another unfortunate consequence of the pandemic…

  3. Chris Lloyd says:

    Could you direct me to the data on covid attributed deaths Paul?

    • paul frijters says:

      Hi Chris,

      I usually take the latest numbers from https://www.worldometers.info/coronavirus/
      They in turn for most countries take them from an officious source in that country.
      Sweden stands at 585 covid-attributed deaths per million, so 0.0585%

      • Chris Lloyd says:

        OK. I wonder how to treat those figures. It is really hard to attribute deaths to covid. And there will be different methods in different countries.

        Nevertheless, using those figures Norway is 51, Finland is 63 and Denmark is 119. Does this comparison not make more sense than with Europe as a whole?

        Not that these figures prove anything even if they are truly excess deaths caused by covid, because the pandemic is not over yet.

        • paul frijters says:

          Hi Chris,
          yes, there is a huge question mark over the covid-death statistics and they are very easy to game upwards or downwards. If you want them up you measure those you know are going to die anyway the next few weeks continuously in the hope of a (false) positive test. If you want them down, you test dying patients in hospital only with clear symptoms and you insist there was a positive test close to death. The UK is now doing the former, the Netherlands was (roughly) doing the latter.

          In the first wave (April-June) the recorded deaths were so in line with excess deaths that both had to be measuring the same, ie lives cut short by covid. But now I am afraid I no longer trust data from various countries, including the UK, on the number of covid deaths because of the very strong political incentives involved to game them.

          The other Scandinavian countries are interesting since they have edged closer to the Swedish model anyway (as Sweden is edging towards them). They have given up more liberties though and their economies seem to be taking a bigger knock so in terms of the wellbeing of the whole population I think we’ll find Sweden ahead of those as well. But as you say, this things isnt done and the damage in subsequent waves will be important.

    • Saupreiss says:

      This is a weekly on developments in Sweden which I have found very useful:
      https://emanuelkarlsten.se/last-week-in-coronasweden-11-18-october/

  4. I am and will always be Not Trampis says:

    Sweden di not come with in cooee of herd immunity. Most people learned on the topic put Herd Immunity at 60-70% of the population.
    Moreover you cannot have second wave as Sweden is having if you have herd immunity.

    you cannot compare Sweden with other European countries on deaths as no country had a proper lockdown. you could still travel anywhere you wanted.
    you compare deaths with Us or the Kiwis. It is a very poor comparison

    If they are near a budget surplus then their fiscal policy is a mess.

    your anecdotes could have almost been from England. Very similar to exasperated poms I know. Anecdotes are no substitute for data as google stats show anther story

    • Saupreiss says:

      “Most people learned on the topic put Herd Immunity at 60-70% of the population.” Source?

      • I am and will always be Not Trampis says:

        You would have to listen to the radio or watch the TV.
        It was a topic of discussion a week back when it was thought the Whitehouse would support herd immunity.

        Locally I have heard Bennet. McClaws however I do not know the names of the epidemiologists in the USA.

        Ask Dr Google if you haven’t done any of the above.

        you cannot have a second or third wave if you are stupid enough to adopt HI. The specialists wil be selecting who and who does not get into ICUs for a start.

      • Saupreiss
        It’s obvious that herd immunity is real but not necessarily always easy .
        When Europeans first invaded the new world and Australia, they carried with them diseases that the Europeans had by say 1600 developed a fair if imperfect degree of resistance to.
        The indigenous populations in contrast had no resistance , they had never previously been exposed to things like small pox.

        Within a few years of the settlement at Sydney a unknown but probably large percent of all the indigenous along the coast within about 300 ks of Sydney died of small pox .
        In contrast the indigenous of far north Australia seemed to have some degree of resistance, a theory is that they were at times in contact with Javanese fishing boats, and the diseases they carried, that made temporary camps on the northern coast of Australia.

        • Saupreiss says:

          I understand that, JRW.

          But Ms Tracey keeps repeating her silly and unsourced claims about HI requiring 70 percent of the population to be immune when in fact there is considerable evidence accumulating that the number may be much lower (cue: crossimmunization, T-cells, etc.; see here for a reference: https://www.bmj.com/content/370/bmj.m3563)

          Ms Tracey also seems to have the misguided belief that herd immunity means no one gets infected any longer which seems rather silly. Now, we can argue until the the cows come home what a reasonable definition is of herd immunity. I’d argue any country that keeps numbers of new cases under control, with non-positive excess deaths is doing reasonably well. By that measure Sweden is doing better than pretty much every other European country. Nevermind the fuck-ups in Trumpland.

          • I am and will always be Not Trampis says:

            both Europe and the USA have now a second wave and hospitals wards are fill up very quickly.

            This isn’t even close to herd immunity which some people clearly have no understanding to even inquire about.
            There are some epidemiologists who believe a mortality rate should be 2% not 1%. I saw one on CNN.

            That is a lot of people dead.

            I repeat no country can have herd immunity if it is getting a second wave as Sweden is now getting.

          • Going off the world infometer the ratio of ( detected )new infections to deaths in much of Europe is nowhere near as severe as the first time round.
            And in Sweden the seven day average for deaths is still around 1 to 3 or 4.
            Pragmatically what Tracy doesn’t get is it is unlikely that ,in the long run ,they can do that much apart from dragging it out. Vaccine is uncertain particularly re protection of the most vulnerable and it’s unlikely to be quickly available in great quantities .

            Locking down over and over again for god knows how long can’t work, every time a nation comes out of it ,it’s that bit poorer weaker and less and less able to cope with the next lockdown.

            So Tracy is really saying that given enough time we are ‘all doomed’ :-)

            • I am and will always be Not Trampis says:

              Of course it is down,
              People who are getting are much younger and doctors are getting better at combatting it.
              Of course as well Europe are bot adopting the evil herd immunity so a lot less people are getting the virus BUT hospitals are getting stretched .
              It does not take a lot of imagination to understand what would occur if Herd immunity did occur although it would take slower to get there as most people would attempt to avoid the virus.
              You are then in the worst of both worlds.

              Terrible health out comes as well as terrible economic outcomes.

              If Sweden has herd immunity why are they not back to normal. google stats show they are not.

              This blog has indeed become like catallaxy. Even the childish names are here

  5. Conrad says:

    “Whilst measured infection rates are rising again in the autumn, there are very few new deaths”

    For reasons unknown to me, the increase in cases in Sweden happened later than other places in Euroland like Spain, France, and the UK (the UK is more similar). You can see from those countries it really took quite some time for the deaths to start, but are now they are slowly ramping up. This leads me to suspect that the transmission has been slowed down because people are being more careful in some place and because young people are getting it because they don’t care as much, but this may not make that much difference in the long run if the endless interactions people have spread it to higher risk groups anyway. So I wouldn’t be so confidant that we won’t start seeing more deaths in Sweden.

    • paul frijters says:

      ” if the endless interactions people have spread it to higher risk groups anyway”

      I think its the other way round in most countries: the virus first established itself in high risk groups via hospitals and nursing homes and is now spreading to some of the lower risk groups who were prevented from getting it due to lockdowns or voluntary social distancing.
      With Sweden, as with many other countries, it is not actually clear whether to see the increase in reported infections as big or small. It depends rather on the number of tests done over time, how sensitive those tests were, and whom they were given to.
      Given the political incentive there now is in many countries to massage figures upwards or downwards, only the excess death graphs are still reliable. They have shown no spikes in excess deaths in the EU since June. Not even in places like the UK that are supposedly having high covid death numbers.

      • Conrad says:

        I think that’s what happened too, but then it was basically contained in Euroland. However, I assume in the new wave people are presumably trying to shield high risk groups better than before.

        I agree about the data massaging. It doesn’t surprise me that you haven’t seen excess deaths — the ramp-up is only just happening if you look at the odometer. Poorer countries presumably don’t even have decent reporting, and I think that’s true of some of the US states also.

  6. paul frijters says:

    On the business of the forging of statistics in the UK, here is some info from a website seemingly run by UK doctors:

    The majority of people who died had significant comorbidities, such as Alzheimer’s, cancer, cardiovascular disease and diabetes.

    Counting death certificates with a ‘mention’ of covid as being a death caused by covid is a gross misrepresentation of the facts and has vastly over exaggerated the death toll.

    The rules for the signing of death certificates have been changed solely for covid by the Coronavirus 2020 Act.

    Doctors do not even need to have physically seen the patient in order to sign death certificates.

    The Act has removed the need for a confirmatory medical certificate for cremations.

    Autopsies have virtually been banned, no doubt leading to misdiagnosis of the true cause of deaths; and also reducing our understanding of the disease itself.

    Worse still, care home staff who largely have no medical training are able to give a statement as to the cause of death.

    Covid was put on death certificates merely on the ‘suspicion’ of people having covid. This may well be unlawful, since it is a crime to falsify death certificates.

    People who die within 28 days of a positive pcr test are deemed to have died from covid, even if they die in a car crash or from a heart attack; clearly over inflating the death toll (2)

    • Conrad says:

      I imagine the basic problem apart from being overwhelmed with reporting or just general hopelessness is that people generally assume the last way you die is the way you died. For example, if you have serious health problems and commit suicide because of them, it is suicide, not health problems. That’s probably part of the reason why you are having such a hard battle even trying to get people to understand more complex things like QALYs. Conceptually, it is a different way of thinking for many. People are not going to split the difference and give you .7 for covid and .3 for obesity (the excess mortality figures obviously don’t care). I doubt the forms let you!

      The other problem with saying lots of people died with comorbidities is that in places like the UK, once you add obesity, heart disease etc. ., I assume you are picking up almost the majority of the population or at least close to it. So people may not see themselves as being ‘unlucky’ when they are e.g., obese, but rather the default, with those thin healthy people being lucky. I suspect that’s a cultural difference but is another reason people would think covid killed someone, not the comorbidity.

  7. In the UK, there seems to be a stark difference between the figures for the north and south https://www.sciencemediacentre.org/expert-reaction-to-latest-nowcast-and-forecast-of-covid-19-from-the-mrc-biostatistics-unit-at-the-university-of-cambridge/
    Why are nearly all of their current daily deaths are concentrated in the north ?

    • could be any number of reasons. the first wave was biggest in the London area so it might be catch-up. It might be due to pressures on test regimes. It might be political (test numbers in London are low, perhaps deliberately so). If I were to guess, I’d say catch-up is the most likely: more of the vulnerable survived the first wave in the North and are now infected in a second wave. The numbers are still relatively small though and the damage done via lockdowns is a huge multiple of the potential gains.

  8. Sebastian Rushworth excerpt from his latest testimony
    https://sebastianrushworth.com/2020/10/24/how-deadly-is-covid-19/?_gl=1*5o9dhm*_ga*YW1wLXN6OGI4eXdEU1BqNkw3TXlObUZaU0E.

    “….There is one final aspect to all this that needs to be discussed. And that is the effect of covid on overall mortality. If it turns out that covid has no effect on overall mortality, then that really brings in to question why we are locking down, since we’re not actually preventing any deaths. So, what is the effect of covid on overall mortality?

    Let’s look at Sweden, since that is perhaps the country that has taken the most relaxed approach of any to preventing spread, and which should therefore also reasonably be expected to have had the highest impact on its overall death rate. From January to September 2020, Sweden experienced 675 deaths per 100,000 population. That is less than both 2017 and 2018. In fact, 2020 is so far the third least deadly year in Swedish history…”

    • I am and will always be Not Trampis says:

      comparing an informal lockdown with formal lockdowns and even then the countries had porous borders.
      It was a claytons lockdown.

    • Conrad says:

      The overall death rates vary drastically for reasons which are often unclear. Singapore had 28 deaths and a tough lockdown. Perhaps we should therefore take a lead from the their books…

      Apart from deaths, the long term costs will only be found later. If, say, 5% of the population gets some nasty disease later in life like Parkinsons or the various types of dementia that they wouldn’t otherwise have gotten, I imagine people might rethink what a good idea catching it was and that waiting around for a vaccine wasn’t such a bad idea after all.

      • I am and will always be Not Trampis says:

        The other thing to remember is a lot less people dies from the flu because they are working from home, social distancing wearing of masks etc.

        Here in OZ we virtually had no flu season

      • That’s if the vaccine really works against those sort of complications,if it’s only 50 percent effective it may not.
        The problem with the longterm aspect is post viral problems are not new and it could really be that something that is not new is simply being seen’in a new light”.

        It doesn’t change the reality that most of Sweden’s Covid19 deaths were in people who probably would have died this year or next year anyway.
        I have also read that it was much the same in Ireland.
        What might be different is that Swedes aged about 55 to 75 could well be healthier overall I.e. less obesity etc than the comparable same age group in the UK and in the US.

      • Conrad
        Sebastian Rushworths response to a question about long term effects
        “24 October, 2020 at 20:12
        “Long covid” is the same thing as post-viral syndrome. It is a rare but long known condition seen in a small minority of people after respiratory viral infections. Almost everyone is fully recovered within three months.

        As to the supposed heart damage after certain MRI studies. No-one has ever looked at the hearts of asymptomatic people after other respiratory viral infections before, so there is no reference to compare to. Most likely, these “findings” mean nothing.”

        • Conrad says:

          I think don’t you know how vaccines work. I don’t what the Australian data is, but typically the influenza one is around 40-50% effective (see Sanofi fluzone which is used in the US where you can get the figures). But you don’t see people vaccinated wandering around being sick for a month, and when people are sick for a week they are outraged because they think vaccines should work like those where there is essentially 100% resistance. This is not how influenza words or how covid will work. So people fail to understand the symptom reduction they would have got, which presumably with Covid would stop death and reduce other symptoms that cause long term problems (i.e., make life tolerable). They also should be stackable to some degree (especially where you get different types of resistance, which the different vaccines are generating). So even 40% is good news.

          • murph the surf says:

            Unfortunately this matters are very complex and while some readers may have spent 10 years+ of studying and working in related fields most ask questions that cannot be answered as the question is based on a poor understanding of the immunology involved.
            Same with regard to infectious disease control.
            I would suggest it must be like Paul and Nicholas reading many contributors efforts at understanding macro economics!

          • Conrad
            The words you responded to are Sebastian Rushworths, not mine.

            • Conrad says:

              Perhaps you might like to post differing opinions too (like the CDC). Here is the efficacy data of the influenza stuff in a readable form incidentally (the main report is behind a paywall) — I don’t notice the CDC changing their recommendation based on it and other similar studies.

              https://investors.vaxart.com/news-releases/news-release-details/results-influenza-challenge-study-published-lancet-infectious

              “Data from the Phase 2 influenza A challenge study demonstrated that Vaxart’s oral tablet influenza vaccine generated a 39 percent reduction in clinical disease relative to placebo, compared to a 27 percent reduction by Fluzone. It also reduced infection rates by 47 percent, compared to 43 percent by Fluzone. The tablet vaccine showed a favorable safety profile, similar to placebo”.

              Also, given deaths are occurring in places like the UK again (unlike as was occurring a few months ago as you noted), have you now changed you opinion to “almost all of the deaths will be people who are going to die very soon anyway?” or is the UK going to be different from Sweden?

              • Re “or is the UK going to be different from Sweden?”
                Expect the median age of death to continue to be about 80. The UKs population is not overall as healthy as the Swedes so the median age could be a bit lower.
                BTW how frequent was the severe Parkinson’s after the Spanish flu?

  9. Saupreiss says:

    “You also see this mixed bag in opinion polls … .”

    Not sure what you consider a mixed bag, Paul, but when almost two-thirds of the population in these daring circumstances thinks the Public Health Authority gets it exactly right, then it strikes me as a very strong endorsement:

    The following article is in swedish but it shows 63% support for strategy, 15% favouring tougher restrictions, and 10% saying restrictions are too tough.

    https://www.gp.se/nyheter/sverige/svenskarna-står-bakom-landets-coronastrategi-1.27349938

    • paul frijters says:

      thanks for having a go at digging this up. But that article is from the first of May. Later polls are not so clear and the health authorities have had to openly consider “local lockdowns” which tells you of the pressure they are under. Still, they have kept their cool and now lifted restrictions on the elderly. By they havent got the support to open the stadiums yet.

      • Saupreiss says:

        Ooops, didn’t check the date. (A Swedish friend who lives in Sydney sent it to me and I assumed it was current.) Alas,

        “Public support for Tegnell has remained high over a period in which life, while very different to before, has been more normal than in many other countries.” This is from a FT Sept 10 piece and in line with what I have read on Karlsten’s weekly blog over the recent few months; I also remember a recent bbc piece which reported even higher numbers.

        https://www.ft.com/content/5cc92d45-fbdb-43b7-9c66-26501693a371

  10. Jerry Roberts says:

    Surely the purpose of a vaccine is to produce herd immunity. I signed the Great Barrington Declaration after reading about it on Paul’s post. The excellent British series of Lockdown TV interviews continues. I have just watched White House medical policy adviser Scott Atlas. Then I picked up a speech by South Dakota Governor Kristy Noem. In Australia the daily reporting of each single new case of Covid 19 is bizarre.

    • paul frijters says:

      it is weird, isn’t it? But the total embrace of the hysteria by most US Democrats is also strange to me. The people hurt most by the restrictions are those they are supposed to champion. The behaviour of the top universities is similarly blinkered. What do you make of this?

  11. Conrad
    Even if the whole of Europe, every last bit of it, did ‘Melbourne’ for 120 days the virus would still be around and they would still be waiting for a vaccine. So ‘if you were king ‘ of Europe what would you do ?

    • Conrad says:

      Europe isn’t homogenous, so I don’t see why one strategy would work. It’s hard to see what they could do in places like France now. It should make an interesting comparison — will the French economy be better than, say, the Irish economy in a year from now?

      In terms of non-economic stuff, I guess thank the old people for their ultimate sacrifice, get ready for lots of deaths and an overloaded hospital all winter, and hope people don’t see China as a shining example of a country that did a better job on human rights.

      • sacrifice , that’s very coloured term to use re people who are already at about average life expectancy and have Alzheimer’s , chronic heart failure or some other terminal condition.

        Given that the EU is by definition,interconnected borderless, your answer doesn’t satisfy.

        • Conrad says:

          EU countries can put in emergency border controls if they want. Denmark was blocking Sweden at one stage.

          It’s also just your assumption from someone who clearly disagrees with the CDC etc. on other issues that most people who die were going to die soon anyway. Maybe that’s largely true when there are few cases and when a country has an exceptional hospital system, but that seems unlikely in the future given the number of cases.

          You still haven’t answered me about whether you have updated your opinion on the UK yet, which seems wrong given the current data. For that matter, I’d be interested to know if you still think these countries with larger covid numbers are still going to be able to keep it out of hospitals and places with other high risk groups.

          • Conrad you still haven’t answered my first question to you:
            given the difficulty of doing really doing contact tracing etc on the scale that Europe would need to do,
            would you lockdown over and over again or not?

            • Conrad says:

              Sure, lockdowns work. They worked all over the EU and other places like Aus and NZ, where, as you noted multiple times, places like the UK got down to almost no cases.

              Whether countries want to have them or not is up to them, and is a discussion individual countries need to make based on what is important to them (and not just on economic issues) and what they think they can achieve.

              • Re your questions to me.
                I expect that the median age of covid deaths will continue to be close to the average life expectancy for that nation (or that for a particular region of a nation .)

                It seems to me that unless a nation got in quite early for example : Taiwan, Vietnam or Korea ,and-or even better is an island.
                Then there are very real limits what can be done by governments, apart from delaying, at the price of an ever increasing collateral damage bill.

                • Conrad says:

                  If it’s close the average life expectancy, then you are losing multiple years (I assume you want to correct for amount of years currently lived).

                  I don’t think you need to get in early, although it certainly helps. Lots of nations didn’t the first time around and still got rid of it. It was opening borders (tourism from the US in Spain!), getting slack on tracing, allowing super-spreader events etc. that appeared to hurt many of them. Some of the border stuff might be solved if these ultra-fast tests are reliable.

                  I also don’t think we will need to delay that much longer. Unlike what you seem believe, once a vaccine turns it will solve most problems even if it has only 50% efficacy. This is because a vaccine with 50% efficacy will mean vastly less people will die because symptom reduction will move them from death to just bad, and the hospitals wont be full because less people will need to go to hospital. If we are lucky the symptom reduction will work well for our smell, and then virus won’t get transferred permanently and cause long term problems for most people — even then one can imagine the development of anti-virals to get rid of it. So the equation between catching it and avoiding it changes massively, which your posting seems to entirely miss and why things like the influenza vaccine are still good even though they are not perfect.

          • As for the CDC and PHE ,last year they got some kind of global medal as ‘best in show for preparedness for pandemics…

  12. Jerry Roberts says:

    I don’t know what to make of it Paul but it is frightening. Scott Atlas warns that political correctness is intruding into science as well as politics and the media. He names respected scientific journals. No wonder people vote for Trump. The extreme isolationism of the West Australian State Government remains overwhelmingly popular with voters in this parochial State but even the draconian measures in Victoria retain majority support. I think you were on to something with your original criticism of limited decision-making processes.

    • Scott Atlas is right about the politicisation of many journals. There is also a lot of rationalisations of the status quo going around that amount to scientific fraud. I have for instance seen many sub-disciplines in economics adopt disproven assumptions (such as that the young are just as susceptible to the virus as the old) just in order to come up with reasons for why restrictions were right.
      Yes, the institutions for giving advice have failed. And continue to fail in many countries.
      I do have to say though that the UK is starting to feel pre-revolutionary. All the energy and passion is now on the anti-lockdown side while the covid maniacs display that hang-dog attitude of someone who no longer believes his own lies. I dont get that sense in Australia yet.

  13. Conrad
    Re life years lost to covid sure dying at 79 instead of 84 is a real loss , however that must be offset against all the lost future life years of younger people who didn’t get their cancer etc diagnosed treated promptly enough.( and for those with advanced Alzheimer’s ,who are still being imunised against pneumonia a premature death by covid might even be a mercy)

    I hope that a vaccine turns up sooner than later, however the chances of it rapidly being produced in the quantities needed to imunise a large slice of Europe’s aprox pop of 500 million, by say the second half of next year seems small.

    Agree that Authorities in a number of European countries (particularly the UK )have not done a great job.And they seem even now to be incapable of emulating say Korea or Germany. It still seems the case that for too many authorities ‘freeze nobody move’ is the only thing in their tool kit.

    However that seems to me to be down to structural-management culture(s) i.e. things that are by their nature very hard to quickly change: for all Authority before all else its first instinct is to protect ‘how we have always done it.
    So it still seems to me that pragmatically delaying by lock-down after lockdown , will only increase the human collateral damage.

  14. Conrad
    Early on in this a family member actually accused me of being a “Nazi “ simply because I was trying to think through the best on balance ,most effective public strategy for Covid19.

    Critics of Paul ,Gigi and Sweden often use very emotive and moralising terms for example: sacrifice, lives vs money, and the like. They imply that its is within human choice.

    However when they are asked are you prepared to , personally choose to own the very real human cost of repeated lockdowns they evade : it’s up to individual governments to decide or they throw smoke change the subject, or they appeal to Authority or they predict the future: the vaccine come soon and it will all be worth it , or millions will develop Parkinson’s .

  15. Conrad says:

    You should be predicting the future — that’s what everyone is doing. If there is a 50% chance that 5 million people get dementia, then that’s easy to cost in terms of monetary value (this one I think we really don’t know unfortunately). Similarly, with vaccines, if there’s an 80% chance of getting one in a year, that clearly means a different strategy to follow compared to if there was a 1% chance.

    I suspect one of the real problems arguing about this is that many people have a discount rate of about 100% on the future, and that’s why so little is done about rather more serious problems (like global warming, the zillions spent on militarisation, etc. ). So if you only care about the now, then obviously not catching covid is the sensible strategy (unless you own a business and lose out from it). If you don’t think about that, you and Paul etc. must be evil for suggesting otherwise (I don’t agree with you, but I don’t think you’re evil :) ). You’re also asking people to consider essentially unknown others in the future, which comes with the assumption that people care about the future of unknown others. If you don’t and many people clearly don’t (just look at how people treat the homeless in the now and how little many people care about inequality in many places), then it comes as no surprise that if you are well enough off to avoid the problems caused, then the main problem you have is catching covid.

    • Conrad
      If it was your responsibility would ,you right now in the Uk be ordering repeated lockdowns?
      BTW Predictions especially about the future are hard work:-)

      • Conrad says:

        To me it’s up to the population as to what they want. I personally think trying to get the spread down would be a good idea, so social distancing, masks, limits on large gathering etc. are a good idea. But different populations evaluate things differently, so it’s up to them how they want to work out trade-offs.

        A good analogy here is with Brexit. I thought the Brits were crazy to do it, but they had a referendum, were well informed, , and so I think they should get it because obviously the majority of them put values on things differently to what I do an that’s the democratic process. With covid, if there are countries where people don’t mind taking the potential long-term risks for an extra year or so of doing what they want (and also the savings if by chance a vaccine never works), that’s fine by me.

        • I asked you what you would order if you were in charge.

          Are you saying that that what you would do, would depend on ,opinion polls ?

          • Conrad says:

            If I was politician democracy, yes it would depend on opinion polls (of course, I’d never be a politican!). In this case, I don’t see that as terrible because the way people evaluate lives differs.

            As for my opinion, I think more limited lockdowns would be a good idea given the hospital system appears to be overwhelmed, which means it will spread to the people who will die, and people will die that don’t get decent treatment.

  16. An after effect of the Spanish flu was ,for some, an acute drastic form of Parkinson’s syndrome. It was made famous by Oliver Sacks book and then the film Awakenings of the same name .
    Is there any data on how frequent that long term effect of Spanish flu was?

    Spanish flu was a lot more lethal than Covid19
    I guess that it’s at lest possible that a much less lethal virus could result in significantly more long term harm than Spanish flu but it seems a bit of a stretch.

    • Conrad says:

      I think the mechanism that people think it is getting into your brain is via your nose, so I assume that severity (especially the loss of smell) is important, since that would affect the initial risk. So if you lose your smell, that might be worse than coughing a lot. If you got it seriously enough to damage your brain without the virus, that would be another mechanism, but that seems pretty rare (probably much rarer than getting concussion playing sport). After that, who knows. Things like HSV affect some people and not others for largely unknown reasons.

      In terms of Spanish flu, about 1% of people get Parkinsons, I think the Spanish flu double or tripled that risk — although risks change for unknown reasons across time. A good example of this in our generation would be getting rid of lead in fuel — it probably helped as that was a developmental neurotoxin that we were all exposed to, but no-one can tell you the actual figures.

      • From memory back in the 70s? in the US there was a batch made of synthetic Heroin, whose molecules turned out to be left-handed and the people who consumed that batch of synthetic Heroin developed rapid severe Parkinsons .

        How much long term fluctuation in the frequency-risk of Parkisons is there?

  17. https://www.worldometers.info/coronavirus/country/sweden/

    Over the past six weeks there has been a large spike in infections . But the seven day average for deaths has not spiked up.

  18. https://www.worldometers.info/coronavirus/country/sweden/
    Still no sign of a rise in Covid19 deaths and it also looks like the spike in new infections possibly may have peaked.

  19. I am and will always be Not Trampis says:

    Master Statistician Kasier Fung on the Swedish mirage.

    Yes it is having a second wave.

  20. Sweden has over the past six weeks seen seen a big rise in infections but no rise in deaths.
    https://www.worldometers.info/coronavirus/country/sweden/

    And this is the view of a MD working in a number of Swedish aged care homes
    https://sebastianrushworth.com/2020/10/28/covid-19-a-swedish-care-home-doctors-perspective/
    It was first published in , Swedish, in one of Sweden s biggest daily’s https://www.svd.se/dodsskrack-bakom-skev-covidrapportering

    To sum it up, Swedes go to aged care when they are already in the last one or two years of their life and nearly all have signed a ,do not resuscitate certificate ,are essentially in palliative care.

    • Conrad says:

      That’s exaclty what you said the UK about a month ago, and you can see what is happening there now (and France, Spain etc.). In this respect, it is curious that cases started going up later in Sweden than other places, but things may simply be slowed as different groups get infected first compared to the first wave (i.e., young people) which then propagates through to other groups more slowly as the numbers get out of control and the virus because especially difficult to stop with so many possible interactions going on.

      • On the 2nd of April the seven day average for new infections was 441, around twenty days later on-around the 20th the seven day average for deaths peaked at about 98. On the 2nd of October the seven day average of new infections hit 519 higher than it was on the 2nd of April, about twenty seven days later on october 27 the seven day average for deaths stands at 2.

        I gather that the Swedes have worked hard at improving the Aged Care home angle.

        As best as I know the situation in London and in the South is not too bad, its the north (which I understand did not have that much of a first wave) that is were most of the deaths are occurring.
        Its clear that nations that were able to quickly lockdown so as to get on top of outbreaks when they were ,relative to total national population, smallish and relatively localised and then were able to implement effective test and trace have done well.
        And its clear that Nations that locked-down too late and also failed to implement effective test and trace are fairing very badly in both health and economic terms.

        Am willing to bet $100 to a charity of your choice that in say six months it will be clear that Sweden’s outcomes in both health and economic terms are better than say the UK Spain and France.

        • Conrad says:

          I think Sweden will better off too — Spain and France look like a disaster. I know next to nothing about Sweden — but I’ve spent perhaps 2.5 years of my life in France in total, and I’ve been to Spain a number of times and it is easy to see what some of the problems are there, and I assume Sweden doesn’t have most of them (feel free to correct me — I will have visit one day!).

          Given this I can think of clear differences that should favour Sweden under any circumstances. In particular, as far as I’m aware, Sweden does not have a vast amount of dense and poor quality housing like France and Spain (and these places are clearly hot spots all over the world), it does not have cities the scale of Paris or Madrid, it is not as dense in terms of people, it isn’t massively dirty like some places in France where the virus has gone crazy (Marseille), and its citizens are comparatively sensible and care about what the government says. The government is probably more efficient too (I don’t see how it could be less efficient than France) and there would be less corruption. Given this, it is going to better no matter what. There are parts of France I can think of that might be more comparable (e.g., Bretagne) although I haven’t spent long enough in them to get a good idea of how they work. My opinions are probably biased from the South of France and Paris (although they contain the two biggest population centers — Marseille and its surrounds and Paris)

          Of course, the above differences are pretty similar to Australia vs. France which is presumably one of the reasons lock-downs worked here but don’t in France. It doesn’t surprise me that no-where land in Australia has done well like where I am now in Adelaide, and that the problems have been worse in the very big cities — but even then, places like Melbourne and Sydney are clean and well spaced out compared to most big cities. The extent of the housing commission style hotspots is also tiny compared to France.

          • Sorry but while I in theory agree I still mostly feel what you’re said is in truth mere special pleading’…

          • Further to this is , Sweden is famous for its near obsession with safety, seat belts became standard in the sixties, Saab’s had crumble zones anti side penetration and all wheel disc-breaks by the seventies well before the rest of the world . And even the 99 turbo “ pocket rocket” “best car in the world, at 100 mph” was actually a side effect of , we need more power, to propel a heavier and thus safer car .

            Can’t be helped but so much of what passes for thought about how to deal with Covid19 is nothing more than mindless group think, ideology and experts that live at the cutting edge of conformity.

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