November 25, 2020

Covid-19 Myths: What about Sweden? (Part 1)


Today I want to start looking at a few Covid-19 myths that have been endlessly repeated about Sweden. They go something like this:

1. Sweden did just fine when they decided to keep things open.
2. Sweden was able to save their economy.
3. We can be like Sweden, protect the vulnerable, and let the younger people go about their daily lives.
4. The lives saved by shutting things down will be more than offset by suicides and deaths caused by delayed hospital procedures.
5. Sweden has achieved herd immunity and their deaths are not going up.
6. Most of the deaths were caused by co-morbidities.

Today we will cover that first statement.

The graph above shows the seven day average of daily deaths from Covid-19 per 100,000 population for Sweden and its two neighbors, Finland and Norway. I used deaths per 100,000 because deaths is a much more verifiable number than cases, and per 100,000 adjusts for the population differences to give a more accurate comparison.

How big was the difference? Well, the area under each line represents the number of people (per 100,000) who have died from Covid-19. The graph for Sweden peaked at .98 deaths per 100,000 on April 17th of this year. A little bit of high-school math, and we can do a back of the napkin calculation of how many lives that represents in total per 100,000 people.

I have added two triangles to the graph. The first represents the proportion of Swedish deaths. The second is an average of Finland and Norway’s death.

Flash back to high-school geometry – and I apologize if that is a painful memory for some – the area of a triangle = Base / 2 * perpendicular height.

For Sweden then, A = 124 / 2 * 1 = 62.
For Norway and Finland (average) A = 65 / 2 * .15 = 4.8

Of course having done that rough calculation I realize that the graph I was using also would display totals per 100K, and that while the above was an interesting exercise in geometry, the actual numbers at day 150 were:

Sweden: 57
Finland: 6
Norway: 4.7

(Rounded to nearest 1 decimal).

So Sweden per 100,000 population had 9.5 times the number of deaths that Finland had and 12.1 times the number of deaths as Norway. In terms of what I will call excess deaths, Sweden had 51 more deaths per 100,000 people than Finland. At a population of 10.23 million people, it means that Sweden’s excess deaths were 10,230,000 / 100,000 * 51 = 5,217 people. That means that roughly 5,217 more people died in Sweden than would have had they adopted the tighter restrictions of their neighbors.

I have run out of time for today, but will be expanding on this quite a bit over the next few weeks.

As usual your thoughts and comments are welcome. I will address some of your comments and questions in future posts on the topic.

Comments

  1. Pellicano Solitudinis says

    “Sweden has achieved herd immunity and their deaths are not going up.”

    This would appear not to be the case:

    https://www.theguardian.com/world/2020/nov/12/covid-infections-in-sweden-surge-dashing-hopes-of-herd-immunity?CMP=Share_AndroidApp_Other

    • Michael Bell says

      The article is a good starting point, but it misses quite a few important points which I will address in a future post.
      Among them are:

      What are antibody tests showing?
      What does the number of deaths show?
      What does a 20% Covid-19 positive test rate mean?

    • Headless Unicorn Guy says

      “Imagine you’re in a war and the enemy’s air force is bombing your cities round-the-clock. ‘Achieving Herd Immunity’ is when your only defense is hoping they’ll eventually run out of bombs.” — drive-time radio yesterday morning

      And Herd Immunity is now official policy at Trump Tower DC; Caesar’s current court-favorite doctor is an advocate of Achieving Herd Immunity.

  2. I have a contact in Sweden whose older parents AND her health-impaired brother ‘sheltered’ in the family’s traditional northern village (tenth generation of her family).

    Swedish people are neither stupid OR uncaring. For goodness sake, don’t base your understandings about Sweden on that dreadful film ‘Midsommar’.

    I do think the graph is likely accurate and interesting, yes, and I also think that Sweden is not happy about the deaths or callous about them. I suspect that having known then about the consequences (death total) might have changed the way they made their original decisions, yes.

  3. Yesterday I found out through what I believe is reliable rumor (not official channels, through which no information about this been conveyed) that someone in the my department of approximately 30 people at work tested positive for COVID. The vector through which they were infected is a family member who does not work at my workplace. The last time my coworker was on premises was last Tuesday. Info is that the only symptom she had was a runny nose, so she was practically asymptomatic and was only tested because she lives with the family member who was infected. The rumor grapevine says that my employer was made aware of the infection day before yesterday, and night before yesterday fumigated employee’s desk and the department; but as of last night when I left work, the case was not posted on the bulletin board. The rumors seem to have started with one employee who works right next to the infected employee, and who was given more info about what happened; she is a women in her mid-sixties who recently returned to work after treatment for lung cancer. I’m sick with worry about direct or indirect exposure to the virus from this incident, mostly with regard to how it would affect my wife if I were infected; but no information is forthcoming from my employer. I’m in the dark, except for what is coming through the rumor grapevine. I don’t believe I can depend on my employer or the government to keep me safe; their bottom line is keeping us open as an essential business. Please pray for us.

    • Robert F, will pray for you & your wife.

    • it will take a national shut-down to get a handle on this virus, but we can’t do that under Trump in 2020
      January is coming

      • Unfortunately, a national shutdown without a generous social safety net, including provision of healthcare, for those laid off will result in another kind of disaster for people struggling on the margins to make ends meet, living paycheck to paycheck. And the U.S. does not have that kind of safety net, nor is it likely to legislate it anytime soon, especially not with the government gridlock that is only going to get worse over the next four years.

        • Adam Tauno Williams says

          Sadly true. The last round worked; defaults on housing [rents or payments] have not shot up, yet. Even given the very clear success, it is hard to see that happening again. 🙁

          > it will take a national shut-down

          Even a single week would put the curve into a nose-dive. 🙁

        • The U.S. national debt now exceeds $27 trillion. Any bailout package would have to be financed with more borrowed money since a shutdown would cause another sharp drop in tax revenue. Someday our national financial house of cards will come crashing down. And I remember the late Ross Perot fussing about the national debt when it was just over one-seventh the current amount.

          Whoever wins the presidential election, be it Joe Biden or Donald Trump, will likely have to deal with another divided Congress. I expect not much will get done the first two years of the next administration; we’ll have to see how the 2022 midterm election turns out.

      • The economy still hasn’t fully recovered from the shutdowns implemented by state and local officials earlier this year. Millions of Americans, including many from minority groups, remain unemployed. Numerous small businesses have permanently closed; thousands of others will follow if a national shutdown takes place. Even some large retail chains have closed many stores or ceased operations altogether.

        There’s strong evidence that the shutdowns have adversely impacted mental health, including an increase in suicide rates. Also, any shutdown which involves the cancellation of surgeries could adversely impact public health. Two friends of mine underwent successful cancer surgery just before the lockdowns took place. Their cancers were thankfully caught in time. What if they hadn’t been able to get surgery and their respective cancers spread?

        Yes, we need to take this virus seriously. At the same time, we also need to count the high costs of mitigation measures such as shutdowns as well as the damage to our constitutional freedoms. I haven’t attended an in-person church service since early March. Something is seriously wrong when big box stores, liquor stores, marijuana dispensaries, riots and strip clubs are considered more important than public worship.

        • Some thoughts to consider, one for each of your paragraphs:

          1. What would be the economic cost of not shutting down and allowing the virus to spread. Governments are trying to walk a fine line of preventing deaths and keeping the economy going. This is a tricky line to walk.

          2. I will talk more about this in a future post. Let me just say that the data on this is pretty clear, extra deaths from other factors other than the virus are tiny compared to the deaths from the virus itself.

          3. I tune out when people talk about constitutional freedoms. I ask what about “Freedom to Love”.

          Any others want to chime in?

          • Adam Tauno Williams says

            THIS: “””What would be the economic cost of not shutting down and allowing the virus to spread”””

            The lowest cost option was to swiftly and effectively squelch the virus. Debating that answer is now pointless, that option has closed.

            > I tune out when people talk about constitutional freedoms

            Same. Also, on this topic, most people have no idea what they are talking about; additionally they generalize WAY too much and hand wave away considerations like the consequences and precedents regarding private property rights, municipal safety [think: fire codes], etc… Closing [or not] private businesses and curtailing public gatherings – religious or not – simply are not, legally, A = B.

          • I work in the public health field in a politically and religiously conservative state which is predominantly rural with few large population centers. I have so many thoughts on this matter, it will be difficult for me not to scatter shoot willy nilly. But, here goes.

            With too long/ didn’t read at the top:

            The US lacks something mentioned in an earlier post on Alpha Males but needed in our contemporary society, that is “emotional intelligence”. We could have been cooperative and helpful with the goal of limiting cases and deaths.

            The US has no cohesive form of health care at a national level with no form economic help to allow best measures to be realistically used.

            Another economic shut down is too late in most locations and is legitimately devastating without some form of consistent and timely monetary support with guarantees both for small business and employees.

            – The initial “Phase 1” shutdown was much too early and not at all data driven for my state. I had to do contact tracing in March, people are unbelievably uncooperative and not fully truthful. I add that part to acknowledge collecting accurate data is difficult.
            – The lack of personnel to do contract tracing adequately and in a timely manner.
            – The lack testing capacity to follow the positives so to speak. Even months later with much increased testing, capacity is inadequate.
            – The economic shut down or slow down without any means of aid for business owners or for hourly workers was truly devastating, again at a time when doing so was not uniformally necessary in every state at the same time.
            – The above situations in addition to poor national leadership sparked a tremendous backlash to wearing masks, to limiting numbers of people in indoor environments. This created an atmosphere of distrust, anger and hostility to public health measures.
            – My state actually missed the time in mid-June to do a “Phase 1” shut down and opened everything back up ignoring my agency’s own public health metrics.

            – These situations and responses puts my state, along with most, where the virus is in all areas from rural to urban, providing only a few realistic responses.?
            – Public health staple stratagies:
            – Consistent mask-wearing by the general public with some form of actual enforcement. Mask- wearing must be consistently demonstrated and encouraged from local to federal government levels.
            – Actual reduction of capacity in indoor environments with greater than 2-meter distancing between people, while increasing air turnover rates with at the very least fans pointing to outward openings.
            – Washing hands thoroughly and often while increasing awareness to limit touching of ones face.
            – TESTING, where trending positives show us where to go. Massive increases in testing.
            – Contact tracing through AI/Apps for phone and social media and increased numbers of human t racers. Public health measures require this data.

            It is my opinion these final 2 factors require some type of financial insinuative to stay home from work and some means of putting healthy workers in businesses so they may remain open.

            I’m watching our schools close in a domino effect where I live due to the staggering numbers of staff positives with simply no one to replace them. There is an analogous effect rippling through all forms of businesses. We will simply have to endure that until the above measure lessen positive cases.

            The good news is those numbers come down quickly with judicious use and enforcement of the above measures. And, a vaccination is on the way.

        • I agree. To say “shutdown” as if it’s an easy answer to this is either a bit delusional or a bit dishonest. That said, every effort should be made to prevent this thing from going exponential and swamping the health care system.

          Pandemics are a b****, that’s for sure. Some of us knew that from the start, some are beginning to understand that, and still others are holding out that it’s all a conspiracy or not that bad or “don’t tell me what to do.” It’s that last group that’s truly delusional and dishonest.

          • “every effort should be made to prevent this thing from going exponential and swamping the health care system.”

            That would require universal mask-wearing and social distancing. Unfortunately, a critical mass of the population has showed that they will not do so voluntarily. Hence, that leaves mandatory shutdowns as the only alternative. If you don’t like shutdowns, wear your ####### mask.

          • Headless Unicorn Guy says

            I agree. To say “shutdown” as if it’s an easy answer to this is either a bit delusional or a bit dishonest. That said, every effort should be made to prevent this thing from going exponential and swamping the health care system.

            Unfortunately, the only two options we’ve been getting are (1) let the virus rampage until we Achieve Herd Immunity or (2) Everybody Stay Locked Down — FOREVER!

            • Adam Tauno Williams says

              Really? I’ve heard a lot more options, and much more nuanced discussion, than (1) vs. (2).

              • I’ve heard a lot more options, and much more nuanced discussion, than (1) vs. (2).

                So have I. But mostly by the time they get to policy or public debate the nuanced are tossed in the trash. From what I see. I live in North Carolina, have relatives in KY, SC, TN, AL, and GA. And had an apartment in Texas until July.

                Nothing in any of those places ever seems to wind up “nuanced”.

                • Headless Unicorn Guy says

                  It’s continuous “WHOSE SIDE ARE YOU ON — GOD OR SATAN ?????”

                  Now with Donald Trump cast as God and everyone else cast as Satan.

                  The Gospel of Personal Salvation and ONLY Personal Salvation is a very Selfish gospel; why would they not bend towards an incarnate god who IS Utter Selfishness animating a meat bag? Or the pandemic solution of “EVERY MAN FOR HIMSELF!!!!!”?

    • Adam Tauno Williams says

      e-hugs. This is crazy.

    • Susan Dumbrell says

      Yes, will do.
      Susan

    • Sadly, your situation is typical. It’s a calculus that’s made all over the world everyday. What is prudent vs. over reaction? We are living in a strange and difficult time.

    • will pray for you both

  4. senecagriggs says

    Human activity cannot be stopped; the virus will continue to spread thru-out the world leaving death and economic destruction in its wake. Next few months are going to be tough. The medical field certainly has become much more tuned in on preventing unnecessary deaths however. But the “flu” is on the rise.

    • Iain Lovejoy says

      No country has been able to completely prevent Covid. Countries that have instigated effective public health controls quickly have, however, vastly lower death rates *and* have been able to return to normal quicker and with less economic damage than those who “protected the economy” by letting the virus spread freely.
      We will never prevent all car accidents: this is not a reason to abandon road safety laws. And safe roads with effective traffic laws are better for the economy than carnage. This is not either/ or.

    • Even if human activity *can’t* be stopped, humans participating in those same activities but with some common-sense and easy precautions (masks, hand washing, distancing) could save hundreds of thousands of lives.

      This is like saying, “drinking can’t be stopped, so drunk driving will continue to wreak havoc in our communities.” There are ways (both through laws and social norms) to make sure drunk people don’t end up on the streets, and the same is true of covid.

      • The problem is the number of people who refuse to believe this is anything more than the flu. Or even that. I have relatives and people who are college educated in more than French poetry belittling people for wearing masks and claiming that the excess deaths ARE THE RESULT of mask wearing. And that mask wearing is a government test to see how hard it will be to do things like take away their guns.

        A year ago I would have thought that such beliefs were on the edge of the fringe of thought. Now I know better.

    • Headless Unicorn Guy says

      “The “flu”?”
      Are you quoting The Trumpster or Q-Anon?

    • Sen, (and others)

      There are things that make a difference. My Army daughter has spent the last year in S. Korea. Her whole base – largest in the country – was locked down, but things loosened up over the following months. Only ONE of the military personnel – among thousands at that base – has come down with the virus. Yeah, it’s the Army – and that’s just it: people complied with the order, because the fighting force can’t be sidelined by the Coronavirus.

      Meanwhile, the surrounding Republic did the same thing – locked down hard at first and loosened up very slowly, then repeated the same with an outbreak in the summer. Everyone wears masks. By the end of summer, my daughter was able to travel around in-country and do some touristy things she wanted to do. The SK economy hasn’t suffered much, and has bounced back quite well. The liberties of the S. Korean people were in fact not denied. Their freedom didn’t suffer; they just couldn’t move around for a while.

      Meanwhile, the daily death toll from the Coronavirus in the US has reached 1500.

      Dana

    • In mod…

      D.

    • Headless Unicorn Guy says

      “Everybody’s gonna get COVID sooner or later — may as well PARTY!!!!!”
      — Motto of Spring Break 2020

  5. The question I have is why of all the so-called “welfare states” of Northern Europe, Sweden chose THIS approach? It would be interesting to find out what the “thinking” was.

    • Adam Tauno Williams says

      Prime Minister Stefan Lofven. He’s a “local control” guy; and one thing we have learned in America is that “local control” is a generally disastrous approach to anything. But, you know, it sounds great.

      Elections matter.

      • Adam Tauno Williams says

        Anytime you hear someone lead off with:there is “no one-size-fits-all response” [Lofven] – run the other way.

  6. I’m surprised by Sweden. I know nothing of their politics but I would have naively grouped them with their neighbors if I were predicting the approach they would take to the virus.

    • Remember, they were neutral during WWII, unlike their neighbors. (Although Finland went Axis, so there’s that.)

      So maybe their mentality is more “rogue” than we think?

      • Finland didn’t so much “go Axis” so much as they were forced into Germany’s orbit due to the USSR trying to conquer them. If you’ve got a huge bully knocking down your front door, you can’t be too picky about allies.

        Fun WWII trivia – the UK considered declaring war on the USSR over the Finnish invasion. The disasters in Norway and France put an end to that plan, however…

        • Yep, I’m familiar with the main reason Finland went “Axis.”

          Poor Poland didn’t have a chance, basically wolves on both sides coming at them.

          • “Poland, the doormat of Europe! Everybody steps on us!”

            Mr. Bronski (Mel Brooks), *To Be Or Not To Be*

        • Headless Unicorn Guy says

          “Germany was on Finland’s side. Finland was NOT on Germany’s side.”

          • Yeah, that’ll hold up in courts…LOL.

          • Adam Tauno Williams says

            >“Germany was on Finland’s side. Finland was NOT on Germany’s side.”

            Finland was a sparsely populated place with several distinct populations.

            It wasn’t really the integrated nation-state that exists today. It was an all-the-above situation; good and bad.

      • Back to my point about Sweden…

        Is their mentality is more “rogue” than we think? Are they more “counter” what everyone else is doing? Have they been that way historically?

  7. Michael Bell says

    The comment thread has gotten significantly off topic.

    I am deleting all off topic comments with the exception of Robert F (because we always care about the struggles of others in this group – and that will never be off topic.)

  8. I believe that if Americans all believed in:
    1. wearing a mask in public,
    2. meticulous use of hand sanitizer/washing
    3. physical distancing
    4. Limiting alcolhol use in public places
    We could have a more open economy without a shut down.

    The problem in my area is that a dangerous minority of Americans don’t believe the reality of COVD risk.
    These folks often don’t care about the message that they are sending other than “Don’t Tread on Me” and #$%^ You.

    • My church is about 50%, maybe more of the last line there… they just say the messages you cite, with a little more subtlety and peppered with Christianeze…. like “I’m just trying to trust God…, more than those scientists, doctors and big gov… I don’t want to trust them… we gotta trust God!”
      It makes my heart ache… and I’m called to love them…be patience, be kind… it’s hard.

      • Headless Unicorn Guy says

        “Trust God” as in “We’re Protected by the Holy Spirit” (like snake-handlers) or “Trust God” as in “THE RAPTURE BEFORE IT CAN HAPPEN TO US!”?

        I have NO confidence in the CHRISTIAN response.

    • Headless Unicorn Guy says

      Don’t forget “YOU CAN’T MAKE ME! NYAAAAAH!!!!!!”

    • Adam Tauno Williams says

      > a dangerous minority of Americans don’t believe the reality of COVD risk

      Yep. 🙁

      • Headless Unicorn Guy says

        And they have a Friend in High Places.

        Incidentally, Africa – Earth’s hard-luck continent – seems to be coping well with the pandemic. None of the expected mass deaths, actually less spread than a lot of First World countries. The reason being that they went through Ebola multiple times over the past several years, and there is such support for public health measures to limit the spread that even without central authority or policy local villages and clans are stepping up and enforcing masks and quarantines.

        The main exception is Tanzania, who’s Glorious Leader is working entirely off the Trump playbook and then some, to the point of making all figures a State Secret. (“If we don’t test, we won’t have any cases”.) As a result, COVID is on track to hit Tanzania as hard as Tippu Tib and the Zanzibar slavers of 200 years ago.

  9. senecagriggs says

    Okay Mike Bell, on this post World War II isn’t off topic? I need a menu Mike

    • It relates to Sweden’s neutrality and potentially their mindset of “not being like anyone around them.”

  10. Burro (Mule) says

    Let’s see if I get this right.

    Absent a functional vaccine, the virus spreads, either slowly or wildfire-fashion, through the population until everyone except the most isolated are infected. Also, since we don’t have any idea whether reinfections are possible, or how severe they will be in comparison to the original infection, we’re all of us either sick, or not-sick-yet, right?

    Does rigorous mask wearing protect the wearer or those he comes into contact with? Are the BFYTW crowd a danger to themselves or to us? Also, it appears not even our current reserve currency status will sustain the fiscal shock of another quarantine. So, we just take for the team, then?

    • Burro (Mule) says

      Or what would happen if we took the Bolsonaro approach – ‘let’s stop being such ****** about this’. How much worse than 1969 or 1975. I can’t imagine anybody doing a Woodstock right now, and LBJ wasn’t up to guiding the country through a pandemic.

      Nobody I know has even had a sniffle so far.

      • Should we have Bolsonoro conduct the triage at our hospitals as their ICU units fill to capacity around the country while the Holidays approach? He’s making a list, he’s checking it twice…

      • Here in the Seattle area, I’ve known 10+ people who’ve had it, plus several relatives of friends who’ve had it out of state.

        No one I know has died of it yet, but 80% of those I know who’ve had it had severe symptoms, and all those said it was the worst they’ve ever felt.

        BTW… 90% of the people I know who’ve had it fall in the “under the age of 60” category, too.

      • 1968 flu pandemic — somewhere between 34,000 and 100,000 deaths.

        1975? What outbreak are you referring to?

      • “Nobody I know has even had a sniffle so far.”

        I don’t think you’ll have long to wait.

      • Clay Crouch says

        You first.

    • Burro the primary purpose of the mask is to protect others from you when you cough or sneeze but it does provide a degree of protection for the wearer. Stringent use of the mask, social distancing and regular hygiene has a demonstrable effect on the level of infections.

      Of course lockdown procedures have an economic impact. This is the purpose of the stimulus proposals.

      There is a reason countries with strong social safety nets are encountering less disruption than our freewheelin’ devil take the hindmost I’m got mine Jack society.

      As the example of Sweden shows and our example shows, the “ride it out” approach is the absolute worst choice.

    • David Greene says

      “we’re all of us either sick, or not-sick-yet, right?”

      Schrodinger’s virus?

    • Headless Unicorn Guy says

      Does rigorous mask wearing protect the wearer or those he comes into contact with?

      Primarily those the wearer comes into contact with, secondarily the wearer.
      Outgoing, masking cuts down on the effective range of exhaled micro-droplets (and the hitchhiking virii), especially when sneezing, coughing, talking LOUD, and singing.
      Incoming, masking DOES cut some of the incoming virii, and the amount of viral load may determine the severity of outcome.

      Are the BFYTW crowd a danger to themselves or to us?

      BOTH.
      And given the above, probably more to us than to themselves.
      So are the MAGA crowd, DON’T TREAD ON ME FREEDOM crowd, the NO I WON’T AND YOU CAN’T MAKE ME crowd. All of which heavily overlap with each other, the BFYTW crowd, and the CHRISTIAN(TM) crowd.

  11. Headless Unicorn Guy says

    Incidentally, Moderna has their vaccine Stage 3 test results under official review. Seems it’s actually more effective than the Pfitzer vaccine announced last week (95% effective vs 90%) and can be stored at freezer temperatures (-20 C, zero F) instead of the dry-ice temperatures required for Pfitzer’s.

    The Oxford and Johnson & Johnson vaccines are still in their Stage 3 testing; if it passes, the J&J vaccine has an additional advantage of needing only ONE shot instead of the two shots three weeks apart of the Moderna & Pfitzer.

    And with Biden (i.e. a Grown-Up) probably taking charge this coming January, the vaccine will probably be distributed with other priorities than “those bearing the Mark of the Trump and no one else – LOYALTY, LOYALTY, LOYALTY”.