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1. After an almost full day of talking about the new version of our preprint ( https://doi.org/10.1101/2020.08.13.249847) on reddit, it’s time for an update on Sweden. What’s the status? Any changes? Regulations? Another #COVID19 thread.
2. First I’d like to clarify. I am not here to interpret results so they fit my point of view, I’ll just present data and facts and people can make up their own mind.
3. Once again we have to understand that we can’t compare Sweden with any other country because we have to account for different demographics and lifestyles. Density of population e.g., is likely to make a pandemic worse and Sweden, except Stockholm is not densely populated.
4. As a matter of fact, there’s more people living in Paris + Suburbs than in the whole of Sweden for instance. Some numbers on density of population follow to give an idea of what we are talking about. All the data is based on wikipedia.
5. Paris = 20,000/km2 (total=2,148,271)
London= 5,666/km2 (total=8,961,989)
Stockholm= 5,200/km2 (total=975,904)trat
Copenhagen= 4,400/km2 (total=794,128)
Helsinki=3,070.08/km2 (total= 656,229)
London= 5,666/km2 (total=8,961,989)
Stockholm= 5,200/km2 (total=975,904)trat
Copenhagen= 4,400/km2 (total=794,128)
Helsinki=3,070.08/km2 (total= 656,229)
6. So we clearly see that density of population is 4 times higher in Paris than in Stockholm and the number of inhabitants between London/Paris with Copenhagen or Stockholm is clearly bigger.
7. In the case of a virus, we know that density of population will play a big role, along with other demographic data that would be too complicated to explain (e.g., population’s age distribution).
8. But in any case we would therefore expect the number of cases and deaths to be roughly similar (per million) in England and France and higher than in Sweden or Denmark, should they adopt the same strategy. However it’s clearly not the case as shown here.
9. Of course it’s more complicated than just density of population in a capital city but we can clearly see when we look at deaths now, than Sweden is much closer to France and the UK than to its neighbours with similar demography
10. Now people would lead you to think (and Sweden and its health minister Anders Tegnell did not deny it for a while) that Sweden’s strategy is herd immunity and that it will help avoid more deaths later. It’s all explained in this article. https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmarna-har-antikroppar-mot-covid-19
11. Although the day after this article, they realised that their model for herd immunity in Stockholm was wrong… https://www.svt.se/nyheter/inrikes/nya-antikroppstestet-baserat-pa-osakert-underlag
12. So Sweden somehow went for the herd immunity strategy and decided against a lockdown and against following scientific evidence/recommendations.
13. And Sweden’s Tegnell’s refusal to see numbers and evidence for what they are is not a first.
14. When Sweden was considered a risk country by WHO, Tegnell explained that it’s because WHO did not contact him and that he could have put these numbers in context. https://www.svt.se/nyheter/inrikes/who-pekar-ut-sverige-som-sarskilt-riskland-hor-tegnells-svar
15. Similarly, when WHO stated that wearing a mask was important, Tegnell replied that it did not fit Sweden’s strategy. https://www.svt.se/nyheter/utrikes/who-andrar-riktlinjer-om-munskydd
16. And that’s why, unlike their neighbours Norway, Denmark and Finland, Sweden did not lockdown the country at all. They gave recommendations, but no strict measures. Of course Swedes tend to follow rules a bit better than in other countries… but still.
17. When asked about the terrible numbers of Sweden, Tegnell explained that they had worse numbers than Italy because Sweden tracked their deaths better. https://www.svt.se/nyheter/inrikes/tegnell-darfor-har-sverige-hogre-dodstal
18. So Sweden went for some of herd immunity strategy, against all scientific evidence and had 5 times more deaths than its neighbours together. Terrible outcome.
19. As a matter of fact, natural herd immunity is not a thing scientifically speaking and it was always achieved with the help of vaccins, as this article explains. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32153-X/fulltext
20. While in Brazil some scientists thought they found a case of a city that had achieved herd immunity, this was recently debunked as they are now hitting a 2nd wave too. https://www.reuters.com/article/us-health-coronavirus-brazil-manaus/in-brazils-amazon-a-covid-19-resurgence-dashes-herd-immunity-hopes-idUSKBN26I0I4
21. Today Tegnell is denying that Sweden ever wanted to use the herd immunity strategy, but conveniently removed some of the public emails that the press should be allowed to look at. https://www.aftonbladet.se/nyheter/a/70EW39/experternas-mejl-flockimmunitet-far-kontroll-pa-detta
22. When asked about it, he referred to the health minister’s lawyers. https://www.aftonbladet.se/nyheter/a/70EW39/experternas-mejl-flockimmunitet-far-kontroll-pa-detta
23. But now some people, not the Swedish government anymore though, want us to believe that Sweden won against COVID as they don’t have a 2nd wave and that the high death toll was worth it.
24. Let’s look at that quickly in terms of actual data. It’s a little bit more complicated than that.
25. For that we have to understand that waves do not necessarily hit at the same time. Unfortunately we don’t have enough testing data on COVID from the first wave as massive testing was not a thing yet.
26. But for what we call now the 2nd wave in France, we saw that the number of cases per million reached 150/M on 20th September
27. For Sweden to reach that peak, it took more than 4 weeks, so let’s say approximately 5 weeks for the sake of simplicity
28 In the elapsed time of these 5 weeks, the deaths per million in France went from 0.8/M to 3.6/M
29 This goes to show that it takes a lot of time before we see the ratio of deaths/M augment and follow the pattern of infection, as we’ve seen in the past already and as it has been explained a lot before
30 In the same 5 weeks, Sweden’s rate of deaths/M was multiplied by 5 but is still under 1. However, the number of cases is increasingly higher
31 And this is unfortunately not due to more testing as shown on the increasing share of positive test here
32 Similarly, the number of people in hospital beds because of COVID in on the rise again and the number of people in ICU beds because of COVID too.
33. As show by the data from Stockholm and Gothenburg’s region.
34. Looking at the pattern from France and the time it takes to get an impact on the number of deaths, it’s thus very likely that we will see something similar in Sweden in the rise of deaths soon too.
35. As a matter of facts, the number of ICU beds used for COVID now is similar as the one from April. https://www.dn.se/sverige/sjukvardsdirektoren-jag-tror-och-hoppas-att-farre-ska-behova-intensivvard/
36. And the Swedish government knows of the danger of the 2nd wave… unlike what they did in Mars/April, they are now trying to give more strict recommendations.
37 It started only in Stockholm and Östergötland for instance, but has been extended to other regions this week. https://www.svt.se/nyheter/inrikes/de-har-rekommendationerna-galler-for-regionerna
38 Another sign that cases are on the rise and that the government is not prepared for its consequences lies in the “home tests”
39 If you live in Stockholm like I do, you can test from home with a throat swab. On Sunday, this was cancelled because the demands for it more than doubled https://www.svt.se/nyheter/lokalt/stockholm/stopp-for-hemtest-for-covid-19-for-lang-vantetid
40 And home tests were not available for more than 4 days (which will likely reduce the number of cases reported for the week…) https://www.svt.se/nyheter/lokalt/stockholm/stopp-for-hemtest-for-covid-19-for-lang-vantetid
41 Swedish officials are now admitting that the current spread of the pandemic is worse than their worst case scenario although the deaths are still under control https://www.svt.se/nyheter/lokalt/uppsala/smittspridningen-mer-omfattande-an-folkhalsomyndighetens-varsta-scenario
42 Although that probably is because they killed off most of the risk group people already in April, but that does not mean that more won’t come.
43 So how is it looking here to sum up? Even the government does not appear to be as sure as they were during the first wave, cases are rapidly on the rise, beds and ICU beds too, deaths more slowly
44 As explained thousands of times before, Sweden should not be used as a story of success against COVID, but as cautionary tale.
45 Look at the neighbours right now, no herd immunity strategy, less deaths at the beginning and still doing much better now than Sweden.
46. Now people would say that Sweden saved its economy and will perhaps save more people in the long term. This data from a nordic bank denies this and all nordic countries fair equally well it seems https://insights.nordea.com/en/economics/spending-is-back-the-nordic-recovery-from-coronavirus/
47. And economy is more complicated than just the impact of a lockdown, e.g., what would be the impact of having people sick for months? Or the impact of using all ICU beds all the time?
48. These economic questions are complicated and can’t be answered today, no one really can. And simple figures are not enough to portray the beginning of an answer anyways.
49 So please, stop making comparisons with Sweden without fully understanding the underlying complex politics and demographics that involves.
50. In the meantime, help science instead by giving CPU and GPU time to @foldingathome https://foldingathome.org
