Architect of Sweden's no-lockdown plan says he is surprised by death spike

Well, all European countries are way past that state, and since the virus has been in our midst since at least November, and often misdiagnosed as something else, it has been that way for a long time.

A couple of Mod notes:

  • Until reported otherwise, the idea that masks make it less likely for folks to transmit disease seems to be the majority impetus to wear it, and arguments about “needing training” to protect themselves are missing the point. To avoid dangerous misinformation, comments like these will be removed immediately when found.
  • Additionally, people are dying - suggesting that “the effects of the economic downturn will kill more people” are childish and ignore the fact that social policy can prevent those deaths. Discussions going down that route will be treated the same as comments about “the upside of COVID-19 deaths”, for much the same reason.
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In other words: it’s too far away for me to care what’s happening. Because if you would take a look you’d see that most of europe is absolutely not a ‘disaster area’. The north of italy was bad, and spain was bad as well. Both countries had the bad luck of being the first western countries hit with the least advance warning. Germany, Scandinavia, The Netherlands are doing quite ok. These countries mostly avoided hospital overload so far. Of course there are a lot of dead people, especially in nursing homes and the like, but that’s probably unavoidable and going to happen worldwide because it happened even in countries with quite strict lockdowns.

But I understand how you feel. It’s very hard to estimate the situation in other countries because of the news overload from your own region. I wish our own news agencies would show more of the international context. If I casually browse the papers here it looks like New York and the whole of California are ‘disaster areas’, but I have no real feeling for the situation over there.

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Do you have any link to solid proof of that? I’d really like to see it! All I’ve read is a single french (?) person who after the fact turned out to have COVID-19 way earlier than previously thought possible.

I think it’s unlikely that it has been going around since half november. When it started taking off here it was hard to miss!

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The Tegnell dude that was interviewed is guessing November. The French case got it from somewhere, and he was tested mid December https://www.livescience.com/coronavirus-france-patient-zero-december.html

Basically just a guess, but since the French case did not seem to be a world traveller, it stands to reason that the virus is likely to have been spreading in Europe in November.

EDIT: adding this video so people can grok the science behind the method, or method behind the madness, depending on your preference

EDIT #2: full version

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Current guidance from the World Health Organization, via direct link.

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You might want to read up on that. By which I mean, read anything at all (that was written for adults), because you don’t seem to have more than a grade-school understanding of the subject, which is simplified to the point of being outright wrong. This is kind of important, as some vaccines need to be taken repeatedly over your life for their protection to be maintained. Some viruses aren’t worth a vaccine at all because there’s no (lasting) protection from exposure. In this case, there’s no evidence as of yet that getting infected provides long-lasting, much less permanent, protection from the virus. Everyone is being hopeful and assuming that’s the case, even though we have no evidence it is.

You might want to look up survivorship bias. That’s not the same as herd immunity.

Uh, what? If you can actually keep everyone separate for that long, everyone infected/exposed before you lock things down will have seen the infection run its course and the virus purged from their body within four weeks (one way or another). It’s near impossible to keep everyone actually separate for that long, but even imperfect quarantines have significant benefits.

Because the death rate is relatively low and we have, you know, fucking vaccines.

It’s just fucking math. Jesus, it’s not an opinion for you to agree or disagree with. “Herd immunity” requires a minimum percentage of the population to have immunity to the virus. (Which, in this case, we’re optimistically presuming we get from being infected with it.) The virus kills a certain percentage of those it infects. In a sufficiently large group, that’s millions of people. Even if you could perfectly quarantine everyone who is high risk, it’s still true for a larger population as the virus kills healthy young people, even if at a lower rate. But you can’t perfectly quarantine the high risk population if everyone’s allowed to move around at will.

In the US, with our unhealthy population, it’s likely that the majority of the population is high risk, making herd immunity through only exposing the low risk population theoretically impossible.

Literally all of them asked that. There’s quite a bit that’s been written about it. There are multiple strategies as to how that works, and a number of countries have successfully implemented them to see a vanishingly small percentage of their population get infected. Of course, their efforts are under threat because of the infected populations of countries whose response was determined by dumb/ignorant/assholes.

I’m sorry if I’ve been rude in my responses, but if you’re going to have strong opinions about a serious public health crisis that impacts the entire world, you really should be informed by something other than willful fucking ignorance.

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As the link I provided mentions, duration or geographic distribution of exposure is irrrelevant to the utility of contact tracing. Contact tracing is how smallpox was eradicated, despite centuries of existence as a human pathogen and a broad geographic distribution.

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with higher death toll than their neighbours who are practicing a totally different approach I find myself incapable of understanding the ‘hope it turns out well in the future’ kinda thinking.

is it not like saying world war 2 Dresden was bombed to bits sure but it eventually turned out well?

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It is weird that they suggest to wear a mask only if a person is coughing or sneezing. Isn’t it that the microscopic droplets spread even when talking? Then the mask would certainly help to protect others from carriers who are not coughing.

Another problem is that people who have no healthcare insurance may be afraid of seeking help or seek help too late due to risk of being bankrupted by hospital bills, thus increasing death toll or number of people with irreversibly damaged lungs and other organs. There is also a problem that not every hospital is covered by every insurer.

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The idea is that in the absence of a vaccine, 70% or more of the population is going to get infected, either sooner or later, whatever the policy. The original “flatten the curve” idea was to spread out this infection over time, in order to keep the number of infected people at any one time well within hospital capacity. Sweden is already doing that, their curve was just not as flat as their neighbors, and had a much larger early bump. The suggestion though is that the fraction of the population who die of the disease in Sweden won’t be greater in the long run than if they’d closed down more completely and quicker. (Of course, that is already a matter of criticism, if people died sooner than they needed to.)

The other “long run” issue is what happens as policies are loosened. In Sweden, they can just go on indefinitely as they have done, with the number of cases petering out slowly. By contrast, data suggest that Norway and Finland have less than 2% infected, essentially none at all, so as they open up then it will be like starting out with these new, more open policies.

If a vaccine was imminent the choice would be clear: stomp the disease down as thoroughly and quickly as possible, until the vaccine comes. Since the vaccine won’t be coming soon (if ever), the argument against the Swedish approach is not so clear, and we probably will have to wait a couple of years before we can evaluate its success properly.

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That seems to be true even for people with insurance - the whole health system, stretched as it was before this happened, has been putting people off from seeking medical attention until they’re already pretty sick, e.g. having difficulty breathing. (To make matters worse, it seems the infection can reduce lung function before that point, so people’s blood oxygen level is dangerously low long before they go to the hospital, already doing damage to their organs.)

Which is going to be a problem largely for the aftermath of all this - lots of people with staggering amounts of medical debt. (Most people being rushed to the hospital aren’t in a position to figure out whether the hospital they’re going to is going to be covered by their insurance, even if they had a choice.) More immediately, we’re going to see hospitals collapse, and the sick will have nowhere to go. Rural hospitals are already having financial problems, and ICUs are thin on the ground in many areas. (The small town where my grandmother lived was 20 miles from a city but 50 miles from the nearest ICU.) Hospitals are apparently heavily reliant on ERs for revenue, but people are avoiding the ER. The whole medical landscape in the US will be hugely changed by the pandemic, while it’s still going on.

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I really hope current crisis pushes US for universal healthcare and abolition of medical debt. The current situation is a disgrace, especially for one of the richest countries in the world. You all deserve something better, in fact everyone deserves something better.

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Except in those other countries, they’ve pursued both extensive testing and contact tracing, so as long as people who have tested positive or had close contact with those who have tested positive quarantine for the required timeframe, their low infection rates will go down not up.

Another factor to consider is that viruses are inert outside of a host. It takes infection for viruses to mutate. Mutation occurs in the host cells that have been infected and turned into virus factories. The more infections occur, the more likely the virus will mutate in ways that reduce immunity in people who have already been infected. So, long term, what Sweden is gambling against is that, as they have a high percentage of the population survive infection, they will not be reinfected due to mutations in the virus. This is a bad bet for both Sweden and the rest of the world. One possible outcome of it is that Sweden will reach the hypothetical herd immunity number, accepting tens of thousands or hundreds of thousands of deaths to get there, then in fact face grinding cycles of re-infection as their population becomes a virus mutation factory.

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That’s news to me (in Norway).

There’s actually a fair amount of apprehension here about the results of opening up. Just this evening I learned of a school that had to close again within the last 2 days because of an infected teacher, and in town this evening outside of one club I saw a crowd of at least 40 people packed tightly together.

So, long term, what Sweden is gambling against is that, as they have a high percentage of the population survive infection, they will not be reinfected due to mutations in the virus.

In fact, I don’t think herd immunity is Sweden’s policy, though it is how it is described in the media outside of Sweden. They have been implementing many of the same social isolation policies that have been implemented in Norway and Finland, only voluntary instead of mandatory. And they have brought the infection rate below 1. Of course, that might not be enough, but I don’t think factors like mutation are specific to Sweden’s policies.

I do feel safer here than I would in Sweden, but I honestly don’t know how much of that is based in reality.

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Norway has performed over 200k tests for a population of 5.4 M vs Sweden’s 148k tests for twice as many people. Norway has been doing contact tracing since February. I can’t find any reference to contact tracing in Sweden, though they might be and it’s just not showing up for me.

I was responding to your statement that they are gong to get to 70% infection rate eventually, which implies herd immunity whether it’s a policy goal or not. I was outlining why that is a bad idea, beyond accepting a very high number of deaths.

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You can’t compare lockdown/no lockdown like it’s a binary. The important part is when they locked down in comparison to when the virus was introduced. Italy had a high death toll because it was circulating for weeks before they realised. The UK has a high death toll because they did nothing until it was too late. Countries like Norway, Finland, South Korea and New Zealand took strong measures early enough to reduce infections to a point where their health systems could deal with it.

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I have some idea of what they’re doing here, since I read 3 Norsk newspapers every day, and I think this is a very optimistic statement. As for testing, they have just started testing everyone who has symptoms; up until a week or two ago they tested only on doctor’s orders.

I was responding to your statement that they are gong to get to 70% infection rate eventually, which implies herd immunity

No, it just implies that almost everyone will eventually be exposed, which is the operating assumption I’ve seen in the local discussions.

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With a small fraction of the number of cases accumulating at a lower rate than Sweden, it doesn’t take much effort to do contact tracing.

You keep missing the point. It doesn’t matter if herd immunity or fatalism is the official policy. If action is not taken to slow the spread and isolate those who are contagious, the end is the same. And that end could just as easily be cycles of infection that threaten to spread well beyond their own borders.

This goes for Sweden as well as the US.

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As do you. Here in Norway the idea that what we are doing is that different from Sweden is a matter of daily discussion, as is the question of whether opening things up (as we are currently doing) will put us back onto Sweden’s path, only delayed. Meanwhile, in Sweden there is fairly high confidence, based on the numbers and on their epidemiologists’ analysis, that they are on a path to success. How what is being done here and in Sweden is being portrayed in the media outside of Scandinavia is outside my control.

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