That's not true in the 80% use case of SWAT teams which is drug offenses and executing search warrants. This is the core argument for demilitarization, not the straw man of "I don't want police to have the equipment needed to respond to school shooters." Showing up with militarized teams to mostly non-violent situations just causes escalation after escalation and is why militarized units kill at a far higher rate than just the police alone.
> but those teams are only deployed in situations like bank robberies, hostage situations, school shootings, etc
That's not true and is the reason people are upset. Nobody disagrees with the use of SWAT teams for school shooting and the like. However, that isn't how militarized units are used in real life. There simply isn't enough violent crime in most areas to justify a full time force dedicated to it. Instead, SWAT is used to target drug offenses (often times w/o an indication that there will be violence). In fact, the federal 1033 program (which funnels military hardware to the police) was founded to help fight the war on drugs.
The other big use of SWAT is for search warrants where they have replaced patrol officers in 80% of cases, the vast majority of which don't involve any suspicion that things will get violent.
The short version is that there is a global ring of powerful pedophiles that Trump is the only one capable of stopping who also happen to be anyone the far right hates... and also jews.
Exactly this. It has been frustrating watching basically any other news about this administration get flagged to death (or at least shoved off the front page) because "politics isn't allowed on HN." Then, we get an article like this and are expected to pretend that it isn't politics when it's happening in the context of the election being weeks away and while people are literally at the polls casting their votes as we speak.
There's loads of interesting news coming from the administration each day, but when only the items that least offend people's sensibilities make it through the flagging brigade, it acts as a politically biased filter.
I'm still surprised at how many "Sweden is a success!" stories keep showing up on HN.
The country had TEN TIMES the per capita death rate of its neighbors (IE the countries you'd conpare it to if you want to control for everything except the pandemic response). It also still has the highest unemployment rate of all the Nordic countries and its infected count is rising currently.
Not only that, but Sweden is already a country of "lonely conformists" and have been keeping six feet away from their neighbors long before the pandemic. They would have been the ones where a light lockdown was appropriate and it still didn't give good outcomes.
Trump is in multiple risk groups: his age, his weight, plus a high stress lifestyle. Implications of him dying weeks before the election are kind of scary.
I'm confused why stories about Sweden's success keep popping up here. The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries. Seems to me like the worst of both worlds.
Because the outbreak slowed without any strong controls.
Sweden had a light response to the pandemic, and it quickly found itself with a major outbreak, and a high rate of deaths. Yet without implementing any major controls, with significantly less social distancing among the population, without significant mask usage, the outbreak seems to have slowed substantially.
It's almost impossible to make these comparisons in real-time, without the benefit of hindsight. We won't know if this approach made sense until after the pandemic is over. But it's certainly an interesting data point.
One thing that is clear is that it's far too complex to look at a couple metrics, compare them against wildly different populations, and form a conclusion. Sweden had a higher unemployment rate than many of its peers before the pandemic. Exports are a staggering 47% of GDP in Sweden. Sweden made the same mistake as many other countries, putting COVID-positive patients in nursing homes.
But the longer the pandemic remains under control in Sweden, with comparatively little social distancing and mask usage, the more interesting it becomes, particularly as countries which implemented strong lockdowns see renewed outbreaks.
Weasel word "major". Everyone who can work from home has done so since April. I'm basically isolated at home all day. The difference is that it's voluntary because the government thinks we are adults. Turns out we are!
> with significantly less social distancing among the population,
Than what? And citation needed. I have cut down my physical interactions by crazy amounts and this is extremely common.
> without significant mask usage,
This is true.
> the outbreak seems to have slowed substantially.
The most vulnerable have died already if that's what you mean.
Now there IS a good argument for Swedens approach being good for Sweden and that is that we have had lower than average total mortality a while now. Meaning probably that the deaths we saw were dominated by people who had their lives cut short by 6 months or less.
"X dead" is an obvious crap number if you think about it for 1 second. The actual interesting number is how many years have the disease cut from people's lives. Seems like not a lot actually. We took a huge gamble on this entire thing though.
> it's voluntary because the government thinks we are adults.
Or, a country of lonely conformists.
Over half of households in Sweden (52 % of all households) were one person households in 2017, the highest in the EU by a considerable margin (Eurostat data.)
Also, Swedes have extreme levels of social conformity, more comparable to Japan than even its Scandinavian neighbours.
It's easy to forget that Sweden also has a much stronger social system than the US. I vaguely recall reading that Sweden also expanded some compensation for people who stay home because they show want symptoms at all. Can you elaborate on that?
It used to be that you didn't get any sick income the first day to prevent frivolous usage, this was changed back in March.
Now it is 80% for a year, you need a doctor's note after three weeks. This used to be one week but to limit the strain of the health services it was increased. If the company want one earlier they need to pay a private doctor to do it.
You also get 80% of your income if your children younger than 12 get sick and you need to stay home to take care of them.
Due to corona any respiratory illness is included in this, and it is a crime to go out in society if you have confirmed or serious suspicion of infection. (Infectious disease law)
> Due to corona any respiratory illness is included in this, and it is a crime to go out in society if you have confirmed or serious suspicion of infection. (Infectious disease law)
So, what you are saying, is that compared to say, the US, Sweden has been subjected to a truly draconic lockdown.
Edit: I'm not sure I understand the karmic sentiment. In the US, closing movie theatres and requiring patrons to wear masks was controversial.
Being criminally charged for going outside would be considered tyranny - so it's a little odd to hear that Sweden is given as example of a less-locked down country.
> So, what you are saying, is that compared to say, the US, Sweden has been subjected to a truly draconic lockdown.
Exactly. Coronavirus truthers point to Sweden only as an example of a country that avoided a catastrophe despite not instituting a lockdown, then change the subject when you talk about what Swedes actually did do that they are also not going to do.
It fits under the standard argument "We don't need to do [X] when [Y] would work just as well. We're also not going to do [Y]."
People get criminally charged for gross bodily harm or intent to commit gross bodily harm. It's not "tyranny" to ban knowingly spreading a plague more than it's "tyranny" to knowingly kill someone.
I live in the UK. We had politicians who tried to appeal to reason, and they got shouted down in the media. The most popular politicians today are the ones who wanted to lockdown fastest. Everyone in care homes still died. We had to spend hundreds of billions to pay people through lockdown. People have still ended up getting infected. And (most) people are still avoiding out anyway, irregardless of lockdown. It is just chaos.
The politicisation of this issue was totally catastrophic. There was right-wing and left-wing science, no-one could accept that some things are unclear, and anyone who opposed the "correct science" was a conspiracy theorist nutjob.
I am glad that some places took another path though. I thought masks would be effective, where I am you are legally obliged to wear masks inside, and our rate of infection is higher than it was a few months ago...I was wrong. The UK won't learn from this (we would have locked down irregardless, I have had people tell me earnestly that they won't stop socialising, irregardless of other people's health...btw, these are not right-wing/freedom people...this was a lefty software developer who likes going to the pub...as a society, we deserve to suffer), other places hopefully will.
My perception is that it wasn't a gamble for Sweden either, the guy in charge seems to have had experience with infectious diseases at the WTO..tbf, a lot of our people had experience in this area too (and specifically with coronaviruses/influenza)...maybe in terms of public/international opinion but...the UK took that path, it didn't work.
Unfortunately your lockdown appeared to have been a case of closing the barn door after the horse has bolted - or in this case, after the horse is already widespread in the community.
Feel sorry for you lot, you got the worst of both worlds through what appears to be confused leadership.
Because the outbreak slowed without any strong controls.
Well, yes, people wake up eventually, when their friends are dying. That said, new cases per capita in Sweden are still an order of magnitude higher than in Finland and Norway. Denmark caught up last month, but that may be because they are so much more urbanized there.
Why is this a relevant metric at all?? UK (where I am) has more confirmed cases than in March, yet comparatively negligible death rate. So the raw new cases metric is obviously completely useless and uninformative, there's clearly something else going on (better management of disease, more medical resources, less extremely vulnerable people, more testing, ...)
If you're looking at human cost, then yes, deaths is what matter. If you're evaluating protocols to prevent infection, then cases per capita is exactly what you care about. The likelihood of death when you get infected could be a better measure of how well the hospital can treat it, for example. But if you're evaluating how well mask-wearing impacts the spread of the virus, then looking at new cases per capita is the metric of interest.
Cases per capita is still very misleading without accounting for number of tests though, no?
Looking at some countries that offer more detailed data, you can sometimes see the cases double, while hospitalizations and deaths grow at a much lower rate (if at all).
> If you're looking at human cost, then yes, deaths is what matter. If you're evaluating protocols to prevent infection, then cases per capita is exactly what you care about.
But there is no reason to care whether infection is prevented or not, unless infection carries some sort of cost. That metric has no value on its own.
I'm genuinely confused at what you're trying to get at here. I mean, in the abstract, sure, if an infection had no "cost" we wouldn't care about how widespread it was. But it's fairly well-established by now that this specific infection carries not only a small but obviously real risk of death, but a risk of lingering, debilitating effects that go far beyond the respiratory system.
It's a metric of interest, but it's uninteresting if we can't measure it properly.
To get a good estimate we'd have to randomly test the population, instead of measuring people with symptoms. Since a lot of people are asymptomatic or don't get a test since they don't feel too sick. Picking people at random would give us a good overview of active cases.
In March in Germany they were reporting a doubling of cases on TV every day, but they failed to mention that they had administered almost twice the tests as well. So basically the number we were measuring was the number of tests we could administer, which was naturally rising as testing capacities expanded, not the number of Corona cases.
Well you are correct about the reliability factor. In theory, we could have randomly tested, but for reasons that escape me this was done almost nowhere. Deaths is more reliable.
However, the metric that is actually at least attempting to measure the underlying reality of interest, here, is not deaths, but cases, that's my only point. But I totally concede that in some cases deaths may be the less bad metric for cases, than confirmed cases.
If you are looking at human cost, it is not just death that matters. The people who have long term consequences matter too. It is that if you dont die you walk away scott free.
It is that there is range of consequences from absolutely nothing to death through "sick for months" and through "maybe lifelong consequences but we dont know yet".
Even if 10 % of patients end up with permanently reduced lung function it's a lot because the disease is so infectious, given the right conditions, and it isn't going anywhere soon, at least not this winter.
I think you have misread the article. It says that less than 10% will even have intermediate-term damage. There is no evidence that any significant numbers of people will have long-term, let alone permanent, damage.
We don't know enough about long-term problems affecting those who caught it, although one glance at Boris Johnson should get anyone worried.
Convalescence is protracted, and there are reports of lung damage and cardiomyopathies in a good number of recovered patients. We don't know yet for certain about neurological problems, but there are indications that covid might cause demyelinating disease, and until that's settled I'm not going to find out.
> one glance at Boris Johnson should get anyone worried.
He always looked disheveled. Has it gotten worse?
Agreed on he longterm effects, I don't think we know all of the longterm impacts yet and as such I'd prefer to avoid it until a safe vaccine is available.
The uncertainty was all the more reason to be more aggressive!
We are freaking lucky that COVID’s death rate is by the lower end of all the estimates. If the actual rate was closer to what Italy was seeing, or even a smaller fraction of thst, Sweden would have had far more dead.
And the death rate is down because we understand the virus better and so are able to take actions that do not involve locking down to control it. And also it wasn’t a massive emergency at this time with massive shortages of PPE etc.
We are freaking lucky that COVID’s death rate is by the lower end of all the estimates. If the actual rate was closer to what Italy was seeing, or even a smaller fraction of thst, Sweden would have had far more dead.
If you think that was luck, then you didn't understand the difference between CFR and IFR.
The Case Fatality Rate (CFR) is the fraction of reported cases that result in death. This is easier to measure. And if you're sick enough to become a reported case, it is the best back of the envelope estimate of how likely you are to die.
The Infection Fatality Rate (IFR) is the fraction of infected people that will die. For estimating how many will wind up dead if you hit herd immunity, that is the relevant figure. It is also harder to produce.
Early on we were seeing CFRs in the 5-10% range. That is the figure that you remember
But the first estimates of the IFR was an analysis of the Diamond Princess. It estimated an IFR of around 0.5%. In late March, Fauci reported that it was about 1%. Both estimates had significant error bars. The figures that Neil Ferguson used in his model was in the same range. All of this happened while we saw CFRs in the 5-10% range.
And therefore there should have been no surprise from the beginning that the CDC estimate of the IFR for the Spring would come out where it did, 0.65%.
Diamond Princess has a raw IFR of 1.8%. The studies you were likely referring to were all done in March when the total number of fatalities was 7. That number is now 13.
Anyone who claimed to know what the fatality rate was back then is full of it. Even in places that had gotten the spread of the virus under control, there were still significant numbers of unresolved cases. And it will likely be another year or two before we have a good idea what IFR is, as COVID has demonstrated differing levels of severity in different populations, and adequate health care capacity has show to have a large impact, which large portions of the world do not have access to.
> And therefore there should have been no surprise from the beginning that the CDC estimate of the IFR for the Spring would come out where it did, 0.65%.
Note that 70+ years has an IFR of 5.4%. https://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf says that in 2010 there were 308,745,538 Americans, 40,267,984 of which were over 65 and 12,435,263 in the 65-70 age bracket. That makes 70+ around 9% of the population, which means that expected deaths from people who are 70+ are an IFR for the general population of 0.49%.
That's the bulk of the deaths. Add in the other age groups and, if you do the numbers correctly, you should get close to my figure. (With a small difference because you're quoting updated numbers and I'm quoting figures that are a few months old.)
Part of the problem is that early on the US media actively misinformed people about this crucial point for partisan reasons, describing the naive CFR as the real WTO-confirmed fatality rate and lower figures as Trumpian lies created to downplay the severity of the disease.
People in general are looking at outcomes in countries and states (selectively) and interpreting them through lenses that correspond to their policy preferences and their feelings about the governments in general.
The Atlantic [1] has an interesting article on the role of super-spreaders. It possibly suggests a particular contact tracing approach but it also suggests that, especially early on, there was probably a great deal of randomness in how events unfolded in a particular place. I can't speak to the medicine but it has certainly seemed as if a lot of outcomes have been pretty random. (With some exceptions like nursing home deaths that were just bad policies.)
Yes, the randomness between even neighboring countries with similar cultures (say Spain/Portugal) indicates that there's a lot more going on. Good research on the success and failures of Sweden's approach (and therefore indirectly of the general approach of the global consensus) will require much more thorough investigation of the various factors and confounding variables. It's going to be a center of research for years.
I suspect that some things may be ultimately unknowable. But we might also well conclude that some behaviors that a lot of people feel very strongly about don't really seem to have mattered much.
Look how things have changed since even early March. I was at my last in-person tech event at the beginning of March, a few hundred people, and lots of care was being given to not shaking hands and wiping down surfaces but there wasn't so much as a thought of distancing or mask wearing (and who knows how important those things will turn out to be either).
In another comment I mention one piece of research indicating that overall our non-pharmaceutical interventions didn't do much of anything other than small short term effects. There's a fair bit of data showing that while people feel good about masks and social distancing, it doesn't appear to affect the pandemic. However, more focused efforts like protecting nursing homes could've saved half the lives lost in this pandemic (https://www.washingtonpost.com/local/baltimore-nursing-home-...). But it generally takes well trained professionals to do it consistently enough, IMHO.
Portugal and Spain is interesting. Spain response is probably one of the worst in the world, with things getting so bad that the army had to clean out the dead from the living from abandoned nursing homes. I don't think you can compare the two really, since Spain's response seems so chaotic and mismanaged?
I got a feeling that picking the low hanging fruit in time (i.e. concerts, clubs, packed public transport) is enough to not get a big spike at all. Otherwise most European countries should explode since social distancing is no way taken as serious anymore.
> Spain response is probably one of the worst in the world,
I don't think so. This problem is not monolithic. Response is just one factor but not the only, structural factors are other.
An example on structural factors is the population size. Biggest countries will have a higher absolute mortality (more deaths) than smaller ones for example. Just because they had a bigger pool of people vulnerable.
Small ones, on the other hand, could end having a much higher relative mortality.
Is unclear at this point who types of factors have more weight here, but all the hot spots in the first part of the first wave share several common denominators. All except one, and they are structural ones.
Spain and Portugal do not have similar cultures at all. The Portuguese are known for their "brandes costumes", their restrained manners, as much as the Spanish are known for the opposite. That might explain the difference in case numbers.
And people also tend to only look at policies that were implemented due to COVID and leave any pre-existing policy differences out of the picture. In Sweden it's likely much easier to stay home when you show symptoms without risking your livelyhood than it is in the US. Things like that might make a difference when looking at other measures that were out weren't taken
The idea that places where generous sick time and healthcare policies cover more of the population might have better COVID outcomes is not an unreasonable hypothesis--and there are at least anecdotal examples of urban immigrant/poor communities in some places, including both Sweden and the US, being especially hard hit.
But you'd need to study how much correlation on this dimension there is in general worldwide to conclude it's a major factor.
Very much agreed. My point wasn't that this definitely matters or doesn't matter, but that there is more going on on countries than just the policies specificly put in place for COVID. It's easy to fall into the trap of only looking at which country took what steps.
> Yet without implementing any major controls, with significantly less social distancing among the population, without significant mask usage, the outbreak seems to have slowed substantially.
Are you saying that social distancing wasn't mandated by the government or that people didn't choose to do it all? Because there is an obvious potential explanation that once people started dying, Swedes chose to social distance on their own without being told to do so.
That's a potential explanation, but is it based on anything?
Per the IMHE's COVID page [1], mobility has been depressed, around -30%-35% at peak, and that does line up with the peak of deaths, so there's some merit to your argument there.
What doesn't really line up is that mobility quickly rose again, up to around -25% and then -15% from base line, without a corresponding increase in cases, deaths, or hospitalizations. It dipped again, and then went back up, and is now hovering closer to -10%.
There's also been virtually no mask usage throughout the entire pandemic.
Compare this to the US [2], which fell to -50% at peak, and has never risen above -20% this entire time.
>What doesn't really line up is that mobility quickly rose again, up to around -25% and then -15% from base line, without a corresponding increase in cases, deaths, or hospitalizations. It dipped again, and then went back up, and is now hovering closer to -10%.
If I go to that mobility stat and plug in a bunch of other countries they almost all look the same and Sweden is no outlier. That is also true for the lack of increasing deaths which is nowhere to be seen compared to the first wave.
So either everyone is doing what Sweden does or Sweden is doing what everyone else does, depending on your perspective I suppose.
I gave one very big counter example: the US is social distancing at a rate roughly double that of Sweden and is getting worse results. It's also had multiple waves of deaths.
Canada isn't getting worse results, but is also roughly socially distancing twice as much as the Swedes.
The UK went down even further, down to -70% mobility.
Leaving the Anglosphere (what I'm most familiar with, sorry), Germany is now closer to Sweden, but was also below ~50% mobility. France was down to -84%!
And the Scandinavian countries: both Denmark and Norway was down to around -60%, and Finland was at around -50%.
All of these countries also rebounded from their social distancing "peak" much more slowly than Sweden.
At least among Western countries, I think a fair characterization is that while Swedes may have socially distanced on their own, based on mobility data, they did so less and for a shorter time.
These extreme values for France etc are projections into the future, I'm not entirely sure what they're basing it on. I've only looked at the graphs up to this day. For some reason they are saying that France will drop from -12% to -84% in one day, I guess they're saying the country will go into complete and utter lock down which I don't believe is true and definitely not a fact.
Cases are doubling each week in Stockholm right now. This article seems to have jumped on the bandwagon too late: the slow up-tick of cases was due more to people staying longer at their summer cottages, than anything special about Sweden’s strategy.
> Because the outbreak slowed without any strong controls.
Maybe not mandatory, but Sweden had/has voluntary controls in place. People there seem to actually listen to their government and try to do the right thing. The US could be in a similar situation, but we all know how that has gone.
While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people.
“Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.
This appears to be true, in Sweden at least. The measures did work nearly as well in getting people to change their behaviour. Adam Sheridan at the University of Copenhagen in Denmark, for instance, has used data from a bank to compare spending patterns up to April in Sweden and Denmark. Denmark introduced a compulsory lockdown on 11 March, one of the first in Europe.
> Because the outbreak slowed without any strong controls.
Perhaps, but Finland and Norway only took about 50 days to reach steady state on deaths per capita while it took about 120 days for Sweden.
The current data suggests that Sweden did not do better than Finland or Norway unless one of those two countries has a sudden spike that Sweden does not have. Anybody crowing "Sweden did better" needs to present some evidence that Finland and Norway are going to get some spike in the future that Sweden will not--and currently Finland and Norway have about 150 days (and increasing) of evidence to the contrary.
> But the longer the pandemic remains under control in Sweden, with comparatively little social distancing and mask usage, the more interesting it becomes
And if Sweden has another outbreak? You'll revisit those arguments? Really it seems like everything you're saying is predicated on the idea that Sweden hast his "beaten" in a way that just doesn't seem rational. What's the argument that they won't see a phase 2 just like everyone else has, or will?
(Obviously someone is going to chime in with "herd immunity", but that's simply wrong: other nations and regions with similar initial outbreak sizes saw second outbreaks.)
There's no science showing a higher antibody prevalence in Sweden than other places like NYC that had large outbreaks. You need to cite something if you want to claim that.
There is no science showing antibody prevalence is required for herd immunity either; you need to cite something ..... (but you might want to look at: [0]).
Everywhere except Sweden implemented legally mandated strategies -- often with police and military enforcement - that were designed to limit virus spread, including places that had just-as-bad-or-worse death outcomes such as NYC, Italy, Spain, Switzerland and France.
Really, almost nothing can be said for certain, and it's definitely possible for Sweden to experience a second wave soon, but it won't if this virus' dynamics is similar to other viruses - which, by all studies, it very much is.
> it's definitely possible for Sweden to experience a second wave soon, but it won't if this virus' dynamics is similar to other viruses - which, by all studies, it very much is.
Again, that seems like you're just trying to argue by fiat. There's NO EVIDENCE that Sweden has reached herd immunity. It's initial outbreak was less severe than Spain or France, both of which are now well into a very large phase 2 outbreak. What's the argument that this is impossible in Sweden that doesn't rest on arguing that it hasn't happened yet?
> What's the argument that this is impossible in Sweden that doesn't rest on arguing that it hasn't happened yet?
What's the argument that Sweden will experience one, given that there is no reason to believe a phase change in Sweden (or a change in circumstances, like measures in other places cause), other than that other countries experienced ones? It goes both ways.
> What's the argument that Sweden will experience one
That everyone else has? Again, the only way for you to make your argument work is to argue that Sweden is somehow special in a deeply unique way. All I need to say is that they're probably just lucky.
Not everyone else has. NY's graphs, of both disease and death, are similar to Sweden's, and SURPRISE it doesn't have a 2nd wave either.
All I need to say that is that they did something different to postulate that the result might be different (and so far, has). I acknowledge there is no proof either way, but you are just putting hands in your ears and saying "I can't hear you, my position is right by default so there". This argument is over as far as I am concerned.
Do you care to revisit your assurance that this couldn't happen and that the one outlier (no longer an outlier) of Swedish data might not have been the best reference for informing US policy?
(Edit: I love the near synchronous downvote in a week old thread. That's just... <chef's kiss>)
Cases are increasing everywhere due to increased testing. Increases in hospitalizations and deaths are much lower or nonexistent, even after taking into account the expected delay between infection and hospitalization.
We would expect hospitalisation duration of stay and severity, and therefore instantaneous numbers hospitalised, to improve anyway, because the medicine has improved a lot since earlier in the year.
And that chance to significantly improve the medicine was helped, hopefully, by the "flatten the curve" policies intended to delay the spread of the disease regardless of whether the number of people getting it would end up the same.
So you can't directly compare both waves. A lot of things have changed between them.
This is substantially wrong. Medicine has not improved at all over the time period. There are still no accepted treatments for the virus. They stand by the same treatments they have always used for treating the sick For a non-curable virus, fluids and steroids.
Well, a few reasons. One is that their death rates per capita were better than several major western European countries, such as Spain, Belgium, Italy, and the U.K., that did a lot more lockdown, and this suggests that the "if you don't lock down you get more deaths" idea cannot be right.
The other is that, for example, Denmark opened up their elementary schools again in late April, and Finland in early May. So even the comparison to other Scandinavian countries is missing a lot of nuance. Plus, I am led to believe that Sweden DID close their high schools and colleges, since it was easier for older kids to do distance learning.
The nasty secret that neither most news articles, nor this one, admits to is that, if you take all available evidence, national policy doesn't seem to have mattered much one way or the other. Sweden is in the middle of the pack among western Europe. Belarus is in the middle of the pack among Eastern Europe. Japan is in the middle of the pack (or better) in east Asia. If national policy were important, they all should be either the best or the worst.
I think maybe we just did stuff, pretending it would matter, while the virus went about its normal pandemic business, and nothing we did really mattered that much.
I wonder if another interpretation might be that culture matters regardless what policies get enforced. I hear that people in Sweden stayed at home more and distanced themselves regardless of enforcement. Similarly asian countries likely already had higher acceptance of mask wearing regardless of what was enforced and so on.
The praising of swedish policies seems to largely come from folks in the US wear we have no social/cultural consensuses because the country is so divided
You're still making an assumption that those culture matters have an effect. For pretty much any country (or smaller region) it's easy to construct an after the fact rationalization of the outcomes.
Asia did better because people accept mask wearing--true but it's still pretty minimal in normal times. But somehow lack of mask wearing probably didn't matter in Sweden--but that's because they hate getting anywhere near another person anyway. But in the US Trump supporters not wearing masks is a big problem. Etc.
I'm not going to argue that nothing matters. (Certainly protecting especially vulnerable populations is something a lot of places totally whiffed on early.) But I expect that some things people are really polarized about don't matter much.
Our efforts (and by "our" I mean "the human species'") were absolutely unfocused. If we had spent the same amount of effort on getting the most vulnerable (mostly, the elderly) well away from the urban areas, we could have done a lot more good.
You cannot trust a damn word coming out of Belarus, or almost anywhere in ex-USSR. You can safely assume that death rate in Belarus is 2x-3x of reported.
Well Belarus' government has its issues, for sure. But I notice that the (very real) issues of reporting, only get noticed when they point the "wrong" way (whatever that is for the person speaking). When Japan had fewer cases than South Korea, the widespread explanation was that Japan must have bunk data. Similarly when China's cases dropped.
I don't claim that Belarus, China, or even Japan have perfect data. But they are not North Korea, and if they had widespread devastation their neighbors would be able to tell. I don't think Belarus' data is particularly less trustworthy than Russia's. Both were willing to report cases going steeply up, when it was true.
Really? How do you know what is "wrong" way for me? In any case, Russian excess death is 3x of the official COVID numbers; it is a relatively well known fact, you can google Alexey Raksha, a demograph from the RosStat; he has a great explanation how Russian and the other ex-USSR numbers are made. You actually do not even need to listen to someone else, go and check RossStat numbers by yourself, they almost certainly are in open access.
Not only that, but according to the JHU dashboard, the number of infections are increasing again and not that far off of their previous peak, unlike their neighbors whose new peaks appear to be lower so far.
I understand, and there's not going to be a way to judge the outcome until after this is all "over." I think articles saying that they've been successful are premature, for the reasons I mentioned before, but it is too early to call it a loss either.
My personal forecast is that by the end I think they're going to have similar levels of economic damage (can't export to closed countries) and higher death rates than their direct neighbors who implemented more restrictive policies and we will never have a clear way to decide if that was better or worse because there is no answer to "how many deaths are worth it?"
It really depends how you define freedom of movement too.
For some, there's more happiness and freedom of movement during strong, compliant social-distancing measures, if you feel safe going outside whenever you feel like it for exercise, and like the shops are relatively safe to go to because people are taking a lot of care.
Compared with if you're justifiably afraid to go outside where other people are mingling densely and without masks, while openly stating their attitude is that their unknown neighbours' health (yours) is just not that important, preventing spreading to you is not something they put any care into because they don't believe it's worth it, holding dense parties that host super-spreaders, and packing into shops and pressing up against you when you go there in a way that makes you feel like you're risking your life to get food, in a way that would be completely avoidable if only other people cared.
If happiness and freedom of movement is the high ideal, it still doesn't point towards one clear policy during pandemic, unfortunately.
I bet that many sweddish exerce their freedom of movement in the harsh and dark winter staying at home as many time as possible, specially those living at the upper half of the country :-)
Previous peak was over 1000 new cases per day (7 day avg), currently at around 415, but was at 150-170 at the beginning of Sept. Well on their way, but still a ways off previous peak.
No real point in comparing case counts at such different times though. The previous peak was right when tests finally had opened up for essentially everyone in the Stockholm and some other regions starting from the first week of June. Previously only severely ill and essential workers could get tested.
The current case count is when everyone in the entire country can get tested without question. People at work having some easy sniffles get sent home and tested the same or next day to not have to substitute them for weeks on end.
The ICU and fatalities rate had already been peaked in early April and correlating the actual spread to those numbers the number of cases already have been trending down for some time.
Also keep in mind, for the Swedish data the PHA takes time to have every case and death be allocated to the correct date, and not when they got the report.
The comparatively higher death rate was mainly elderly in care homes. Some are simply OK with sacrificing the elderly to avoid restrictions on the lives of younger generations. Others would hold that, yes, failing to protect care homes was a screwup on the part of the Swedish authorities, but the avoiding of a lockdown still seems sound.
This is the line that the Swedish authorities repeat at every possible opportunity: effectively victim-blaming the elderly, and implying that “if only all those old people hadn’t died, we’d have been fine”. But in fact deaths are higher across all age groups, compared to other comparable countries.
Again, some people are prepared to sacrifice both some portion of elderly in care homes, and some (much smaller even in Sweden) amount of other people across younger generations. As a top-rated comment points out, one of the aims with which a broad segment of the public sympathizes is “flattening the curve“, not trying to prevent any and all deaths whatsoever at any cost.
New York also sent the elderly with covid back into their nursing/care homes. So New York probably isn't the best example, since they handled the elderly situation so poorly
This is exactly why I have zero faith in any substantive knowledge coming from this pandemic until, what, a hundred years afterward?
So many variables that change the narrative if ignored. This is going to be like everything else (at least in the US). People will seek out sources that confirm their already established belief.
It's hard being positive about, well, anything right now. Is this depression, or is this just a realistic view of humanity?
Unfortunately I think that's the current state of things. It takes a lot of work to get any semblance of the truth, and even then it's extremely localized.
IMHO, C19 was WAY more politicized than it should have been, which caused a lot of the misinformation.
For me to be less despaired, I give up on things like national news (or severely limit it), and hang around positive people, particularly ones doing good things in the community. There are still good people out there doing great things.
I don't think that the media portrayal of many things is a realistic view of reality in most places.
The problem with quoting New York is that New York thought they had Case #1 on March 1 when backmodeling suggests that they were already at Case #10,000. And then they went 3 more weeks before they actually locked down.
So, New York had a WAY higher number of infected per capita than pretty much anywhere other than the early hotspots.
And their numbers are going back up. And their economy was the worst performing among their comparable neighbors. It makes no sense at all because for a few weeks their case numbers are lower.
And even if they remain, say 50% of what their neighbors’ case loads are, their response will still have been worse in outcomes because we know much more about how to handle COVID which has led to significantly better results for people who get it today vs a few months ago.
Even if the total number of cases are exactly the same, having those cases later is a huge win in itself.
Maybe because you are only looking at it’s immediate neighbors. Sweden had nearly exactly the same population size and death rate as Michigan but Michigan had a strong and lengthy lockdown.
66.84 Spain
63.26 UK
62.50 US
59.27 Italy
57.74 Sweden
36.92 Ireland
11.30 Germany
8.81 Turkey
6.14 Finland
5.79 Egypt
3.23 Greece
1.05 Japan
0.45 New Zealand
0.04 Vietnam
0.03 Taiwan
The group of countries with better response than Sweden (or the US) comprise the majority of the world, and also diverse in terms of regions, government systems, economic development, culture, population, and area. It's hard to argue that Sweden actually did well in any subgroup.
Deaths attributed to the disease. Every country counts them differently. In the us if you died while having the disease you counted as a COVID death. In some countries it’s only if the disease is what killed you that you get attributed, in some they haven’t had testing available to test deaths during their peaks, and some just want to keep their numbers low to avoid getting their exports and borders shut down.
Sweden's population is far healthier than Michigan's and has better access to high-quality care. This can be seen from the differences in their life expectancy (82 vs 78).
Imagine how bad Michigan would've been if they followed the Swedish model.
For comparison with the US, Massachusetts might be a better choice. World class healthcare, highly educated population, average life expectancy of 80yrs 8 months [0], and a similar-ish sized population (6.8M in MA vs 10.3M in Sweden).
Despite a lengthy lockdown, excellent social distancing and fairly high mask compliance MA hasn't done so well. As of Sept 29 MA has recorded 9423 deaths vs 5893 in Sweden [1][2].
Unfortunately, like Sweden, MA was not able to prevent COVID19 from spreading to nursing homes with over 64% of deaths (6K+) occurring in long term care (LTC) facilities alone. In fact MA was #1 in the US for deaths in LTC homes with 12.35% of the _entire_ LTC population in the state dying from COVID19 and #3 in the US for COVID19 infections in LTC homes with 35% of _all_ LTC residents contracting COVID19 [2]. This is really a terrible, awful (and avoidable) failure on the Commonwealth's part.
America had an appallingly incompetent Covid response, with poor testing, tracing, and compliance. This makes it a poor benchmark for updating your priors, unless one of your previous beliefs was "America can muster a coordinated response to a pandemic".
Sweden seems to have become a Dem/Rep arguing point in the USA and unfortunately that means you can't discuss it anywhere online without loads of hot takes. But I think there is stuff worth looking at in Sweden's approach. It certainly can't be dismissed as trivially as you are trying to dismiss it.
[Sweden’s COVID] policy can only be understood as inseparable from Sweden’s developed welfare state, social system: universal healthcare, paid sick leave, paid leave to care for sick kids, subsidized daycare & pre/after-school care.
Exactly, and news headlines praise them for not having the same second surge of cases as denmark right now. While 5800 people dies versus 650 in Denmark.
Except they are now rising again rapidly in Stockholm for instance [1]. You can use the html console to remove the overlay to read the article. They also were never on "almost no cases", they have been higher than the neighbours all the time except for a very brief period where they were on the same level.
They are not. Cases are up slightly in the past few weeks, but on par with where they were in July (after
which they saw a decline). You have to be extrapolating wildly to call this a rapid increase.
Sweden started July with a bit more than double their current cases, and ended it with a bit less than half. Four weeks ago was as low as it ever got in Sweden, and since then it has risen steadily, up to more than double what it was. It's also 30% higher than the last local maximum, in the middle of August.
That's not unreasonable, though you referred to cases and not deaths in your original post. Deaths lag a couple of weeks behind cases, so maybe the local minimum in deaths in Sweden corresponds to the local minimum in cases 4 weeks ago. But maybe not!
> I'm confused why stories about Sweden's success keep popping up here. The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries. Seems to me like the worst of both worlds.
Because a lot of people, mainly for ideological reasons, would have preferred the US and the rest of Europe have done similar. A key part of justifying that view is to be convinced it was a success, true or not.
It's amazing how quickly people forget about Dunning-Kruger effect and how often people widely acclaimed for their academic prowess will reveal themselves ignorant when trying to act as an authority outside their field.d
I honestly don't know why you're being downvoted. This board skews young, and techy. Not young and medical.
Why would the comments or upvoted articles be any less problematic here than on facebook? Being really good at one thing (mostly tech) does not mean you're really good at all things.
It's fascinating on this board right now. So many medical experts. So many people who are experts at what metric is the best and most relevant metric. So many people who are, I'm betting, talking out of their knowledge base, but doing it articulately, instead of through memes, so that makes it better?
They need to do away with downvotes and use flagging as a means of getting rid of trolls and low-effort posts - f.e. "lol" and such replies. The same drivel they harp on about how FB is stifling contrarian thinking is very well present on HN.
Turns from amazing to expected after awhile. The more I read the comments the more I agree with the Gell Man Amnesia Effect. I don't trust HN with any commentary about anything anymore - not even software development.
The numbers cannot really be compared.
In Sweden they count any death where the patient had the virus, or had it in the last two weeks, as a COVID death. The other countries count differently.
Most deaths in Sweden where in care homes of elderly. In Finland, for example, I believe only deaths at hospitals are counted as COVID deaths.
We will see in a couple of years what is up and what was down of this whole debacle.
Focusing on comparisons to geographically nearby countries doesn't make sense to me, and feels arbitrary. That's also not controlling for all the factors that differ between the countries. Reducing the conversation to total deaths and unemployment rates also doesn't give credit for the various benefits of having permissive COVID guidelines.
Sweden had a big spike in COVID deaths very early on, and it was in large part from adult nursing homes, where appropriate precautions were not taken. As of late July, 70% of COVID deaths in Sweden were from adult nursing homes (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369443/). But they first hit no excess mortality in early June (https://news.yahoo.com/sweden-records-first-week-no-15544144...), while still retaining many of their freedoms. That's noteworthy.
As for unemployment - making a comparison across countries doesn't control for all the other confounding factors that are relevant to economic health. And in a globalized economy where we have suppliers and customers in foreign countries, it is hard to remove all exposure to OTHER countries' COVID economic impacts. Perhaps if more countries implemented Sweden's plan, everyone's economic outcomes would be better.
Getting back to the unrecognized value of Sweden's approach: there is value in having the freedom to move around, in holding gatherings, in patronizing businesses, in having kids receive a normal education, and so forth. I am shocked Americans have accepted top-down authoritarian restrictions on their lives so readily, as the goals changed from flattening the curve to seemingly trying to save every last life. I would rather individuals make decisions about their own lives while assessing the risks for themselves. Those who are risk averse are free to restrict their own lives - but they shouldn't impose restrictions or demand actions of others.
We can't operate society around trying to save every last life. If that is the bar, then even in a typical flu season we should be keeping everything on lockdown. Could you imagine living like that permanently? Clearly that isn't acceptable. But if THAT isn't acceptable, then we are already saying that there is a finite value in saving a life (rather than infinite), which has to be taken in balance against the value in everything else.
Moreover, given how low the infection mortality rates are for those under 70 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...), we are simply robbing the young [of socialization, education, summer vacations, memories with their family, etc.] to keep the old alive longer. I don't think that tradeoff makes sense, and we should simply ask those at risk to stay home while others are free to go about their lives.
Here's the thing: all over the Internet people are quoting this modelling paper as fact without understanding that the numbers are a range of estimates.
These numbers are not meant to be accurate. That's why they list 5 different sets of numbers.
> The country had TEN TIMES the per capita death rate of its neighbors and still has the highest unemployment of all the Nordic countries.
So far.
Lockdown strategies will always look better than Sweden's strategy at the beginning, because Sweden's strategy gets most of the deaths over with in the first few months.
If a vaccine takes long enough, the countries that locked down might eventually catch up to Sweden's per-capita death rate, although it's worth noting that some of them have already surpassed it.
If you look at the charts here, you will see that Sweden had a big spike in deaths at the beginning of the outbreak and now it's daily death rate is far below that of most other countries: https://ourworldindata.org/coronavirus/country/sweden?countr...
Sweden's approach looks better relative to other countries with every passing day. The longer it takes for a vaccine to be developed and distributed, the better Sweden's strategy will look. People who insist that Sweden made a horrible mistake are overconfident. Whether or not it was a mistake really depends on how long the pandemic lasts.
You seem to falsely assume that all the deaths Sweden has suffered so far would have happened at some point regardless. Given the development of better treatments already some of those who died would, if they had caught it later, have survived. Given three GDP hot is similar to their neighbours all they've done is needlessly kill some of their population.
Lockdowns are a rate limit, not a cure. Flattening the curve does not reduce the area under the curve, it just spreads it out over time to prevent the hospitals from being overloaded.
So yes, most of the deaths would have happened anyway, but over a longer period of time. The improvement in treatments has not been substantial. Most of the deaths in Sweden were among high-risk groups, such as elderly people in care homes, who probably could not be saved if they got the virus today rather than several months ago.
Sweden intentionally set themselves up with a policy they can sustain for a long haul. They were betting that the pandemic will last a long time, certainly longer than a lockdown can be sustained.
> Flattening the curve does not reduce the area under the curve, it just spreads it out over time to prevent the hospitals from being overloaded.
In fact, Yes it does. Flattening the curve means that less people die because hospitals are unable to deal with a sudden flood of cases in a narrow period of time.
Moreover, as doctors have more time to focus into figthing against covid damage instead to give priority to just keep as many people alive as possible, sequels are also less serious
Less people died means that area under the curve represents a lower value now. The problem is that the common people are not always familiar with statistics. Both curves have a total area of 100 of course but this is a percent from a value. Not the value on itself. 50% of 10 is not the same as 50% of 3000.
> most of the deaths would have happened anyway
But not all of those, and this is a big difference
If you can spread it out to the point where you can develop a vaccine then it will absolutely save lives. Or at least flatten it to the point where you're not overwhelming hospitals or running out of PPE/cleaning supplies then you save lives in the long run.
And remember Sweden has first class healthcare. A similar strategy in the US would have been absurdly expensive and resulted in mass bankruptcy in addition to mass deaths.
That's only true if nothing changes. Discovering that dexamethasone can reduce mortality means that from that point onward the area under the curve is reduced. Once we have a viable vaccine again the area is reduced. Given the economic impact Sweden is facing they have the worst of both options.
The metric that matters to me is this: what was the death rate, per capita, in a country during the entire duration of the pandemic?
Since the pandemic is not over yet, and may not be over for another year or even more, it is far to early to tell. We may still be in the first half of the duration of the pandemic.
It's also sporting a GDP contraction that is... A little worse than some of its neighbors, a little better than others, but entirely in the same ballpark.
I really wonder what GDP really means in todays world when money is "free" and there are no limits on government spending. For example Denmark had less bankruptcies than previous years back in March and April.
Looking at government debt both Finland and Denmark loaned about double compared to Sweden, while having half the population, essentially 4x the loaning per inhabitant with similar results.
Which is exactly the point: Why would you compare it to dramatically different countries instead of ones that mainly differed on the axis of interest, unless you had an axe to grind?
The disease likes dense urban areas with a lot of poor immigrants working in big care homes. Comparing countries is not really "fair". In Canada, Montreal got hit hard. In the USA, NYC, Philadelphia and Boston got it hard. It's a urban centric disease. So yes it's fair to compare to Sweden to Germany, France, UK and Belgium.
Sweden has 11 million citizens, 2.5 millions in Stockholm metropolitan area. Norway has 5 million people, 1.8 millions living in Oslo metropolitan area. Finland has 5.5 million citizens, 1.7 millions living in Greater Helsinki. Lots of countryside elsewhere. The Nordic countries are quite comparable.
Sure, but covid spreads during social events, it's schools, bars, concerts, churches, and you find more of that in urban aggregations than in the flat countryside.
It looks like the first Google result is for the Capital Region (1.1 million people, 1418 per squqare km, 3670 per sq mile). The stat in the comment you're replying to is for Helsinki proper which only has 600,000 or so residents, and Greater Helsinki is less dense than any of these.
No matter how you slice the figures, Stockholm seems to be a bigger denser city than Helsinki or Oslo.
Why compare Sweden to Norway and Finland? Because they're "nordic"? They do have quite different economies, different populations, different healthcare systems, etc.
These comparisons can be made arbitrarily to make Sweden look either bad or good.
I didn't mention culture at all. I'm not sure how you would define culture in this context and to what degree that is measurable.
Instead, I would point out various socio-economic factors, such as Sweden having a higher rate of ethnic minorities (generally over-represented in COVID-19), Norway's GDP being far higher than the others (thanks to fossil fuel) and Sweden having a far greater population in elderly care institutions, compared to Finland.
A great deal of the deaths in Sweden come from nursing homes, where you had the situation that caregivers would travel from one institution to the next, spreading the virus.
Or compared to Vietnam, which has 100 million people and less than 40 deaths.
People have just hung their hat on Sweden’s approach out of some ideological attachment that’s completely independent from how countries across the world have performed.
Vietnam is interesting, they initially were very successfully contained COVID, but have had a resurgence over the summer that they put down to a "more infectious" strain (the "G" strain that has been prevalent in the US, Italy/Europe vs the supposedly less infectious "D" strain in Asia):
You need to look the excess death. The only true indicator. There might be hidden deaths, keeping in mind that Vietnam is not a country where the press is free.
I too call B.S. There is an ongoing concerted and heavily proactive campaign being orchestrated in the press about Sweden, at their own behest (I'm sure other foreign governments that like to meddle in elections). And it seems almost entirely to prevent comparing them to their more successful neighbors.
That's a really interesting point that I didn't realize. Does anyone have a good history of how QI came to be like this? I can't imagine that it was the intention when this started.
According to this [1] it was founded because of the war on drugs. It's purpose was very much to have militarized units that respond to drug offenses.
[1] https://www.motherjones.com/politics/2015/08/new-documents-r...