
Swedish expert: why lockdowns are the wrong policy - jamesblonde
https://unherd.com/thepost/coming-up-epidemiologist-prof-johan-giesecke-shares-lessons-from-sweden/
======
standardUser
Sweden's deaths per capita attributed to COVID-19 is currently the 8th highest
in the world (exempting a few tiny city states). That's about 20% more deaths
per capita than in the US.

It also has one of the lowest testing rates in the Western world at 0.7%,
compared to around 2% in Spain, Italy and Germany.

~~~
rossdavidh
Also lower than the UK, Netherlands, France, Italy, Spain, i.e. a lot of their
neighbors.

~~~
bosie
Counting spain, UK, italy, france as sweden's neighbor is a bit odd. why not
compare it to their actual neighbors, rather than tourism hotspots with lots
of transit?

~~~
thu2111
Because it doesn't matter. Sweden is middle of the pack and not experiencing
the massive hospital overloads that they 'should' be according to the
projections that drove the lockdowns. Not even close.

It appears people are forgetting or retroactively changing the justifications
already. The lockdowns were meant to reduce deaths by ensuring everyone who
got infected could get healthcare. In Sweden that is the case despite having
been much less severe than other countries. Thus, their approach is _de facto_
more successful than elsewhere.

Comparing to their direct neighbours is thus irrelevant, because a total
reduction in deaths was never the goal (it cannot be, because there's no
vaccine). But if you want an explanation for why Sweden may differ, for
whatever reason it appears the virus hits non-whites much harder. This is
being observed in the USA and Sweden reports that non-whites from e.g. Iraq,
Somalia etc are disproportionately affected. Why that would be so is unclear,
but a higher death rate than Norway is likely to be at least partly due to the
much higher rate of immigration Sweden has allowed than its neighbours.

~~~
simonsaidit
“not experiencing the massive hospital overloads that they 'should' be
according to the projections that drove the lockdowns.”

And yet very sick patients are already being placed in field hospitals with no
running water, laying too close, poor air circulation and on old ventilators
which have received criticism from the doctors there.

~~~
mediascreen
From what I read 13 less serious cases were placed in a field hospital at
Sahlgrenska as a "trial run" to test the facilities, but since there is
available room at in the actual hospital (and people complained) this has now
stopped.

There is still available intensive care space at ordinary hospitals and it
looks like the number of people needing intensive care has stabilized [1]. The
latest numbers are 1072 total intensive care units (not counting field
hospitals) and 528 people treated for covid-19 in intensive care [2].

[0] [https://www.aftonbladet.se/nyheter/a/MRrGxK/patientstopp-
pa-...](https://www.aftonbladet.se/nyheter/a/MRrGxK/patientstopp-pa-
sahlgrenskas-faltsjukhus)

[1] [https://portal.icuregswe.org/siri/report/corona.covid-
daglig...](https://portal.icuregswe.org/siri/report/corona.covid-dagligen)

[2] [https://www.socialstyrelsen.se/coronavirus-
covid-19/socialst...](https://www.socialstyrelsen.se/coronavirus-
covid-19/socialstyrelsens-roll-och-uppdrag/)

~~~
KirinDave
I don't really see why this suggests Sweden's approach should be emulated
though. The reality is that we don't understand the conditions where COVID-19
thrives well enough yet to understand why some areas are hit so much harder
than others.

We've seen hints that blood type, climate, average social distance, average
obesity, average age, etc. But nothing definitive yet.

The costs to the economy from these lockdowns are trivial compared to the cost
of a runaway and persistent viral hotspot like New York or Seattle, even if we
pretend (as some folks here seem to insist we do) that the loss of life is not
worth discussing.

What works in a given area population is great; but until you have some idea
what your local R factors and hospitalization rates are, you really should
play it safe.

~~~
mediascreen
I was not saying that. I was just disagreeing with the statement that Sweden
is over its intensive care capacity.

On the other hand, as a Swede I feel that we ARE playing it pretty safe. Some
of the measures other countries are taking seems extreme to me.

------
jfoster
These seem like made-up statistics:

1\. "The actual fatality rate of Covid-19 is the region of 0.1%"

2\. "At least 50% of the population of both the UK and Sweden will be shown to
have already had the disease when mass antibody testing becomes available"

~~~
bobcostas55
The first one is trivially wrong. In NYC more than 0.1% of the _population_
(not the infected) has died already.

The second is less trivially wrong, but there's a lot of evidence against it:
tests from Wuhan[0], Denmark[1], the Netherlands[2] all show very low
infection rates, around 3-4%.

[0]: [https://www.wsj.com/articles/wuhan-starts-testing-to-
determi...](https://www.wsj.com/articles/wuhan-starts-testing-to-determine-
level-of-immunity-from-coronavirus-11587039175?mod=searchresults&page=1&pos=2)

[1]: [https://nyheder.tv2.dk/samfund/2020-04-17-stor-screening-
vis...](https://nyheder.tv2.dk/samfund/2020-04-17-stor-screening-viser-omfang-
af-corona-smitte-hos-sundhedspersonale)

[2]: [https://nltimes.nl/2020/04/16/3-dutch-blood-donors-
covid-19-...](https://nltimes.nl/2020/04/16/3-dutch-blood-donors-
covid-19-antibodies)

~~~
fouc
17,671 deaths / 8,398,748 population * 100% = 0.21%

~~~
johaugum
Your deaths figure seems to be for New York State, while your population
figure is for New York City.

The correct figures (as of April 18, 2020) is:

New York State: 14,636 deaths / 19.45M population = 0.0752%

New York City: 8,893 deaths / 8.3M population = 0.1071%

~~~
fouc
Worldometers is likely more accurate, it gives 17,671, not 14,636.

[https://www.worldometers.info/coronavirus/country/us/](https://www.worldometers.info/coronavirus/country/us/)

------
AzzieElbab
It is scary how confident people are when discussing the unknown.

~~~
throwlaplace
indeed. here and elsewhere in the blagosphere people have taken this
opportunity to opine at length on everything from epidemiology to virology to
welfare economics. it's been the case for a long time that people online have
had very little sense of humility about their opinions but somehow
experiencing a pandemic has given them even less pause to consider what
they're ignorant of.

~~~
lordnacho
I think the Internet makes it worse, but it's not as if it was hard to find
someone who was too confident in their layman's opinion in the real world.
Witness any sports event. How often do your friends say "favorite will
definitely win" when it's been known that they lose now and again?

Same with the stock market, predictions about the house market, the weather,
political events, and so on.

Overconfidence is the rule, not the exception.

I'm certain of it.

------
meerita
I live in Spain. It's about one month and 7 days of lockdown and the official
data isn't realistic. Although we are having lower numbers, it will take many
months of lockdown to stop having deaths. I don't think this strategy of full
lockdown will help, to be honest, we should lockdown risk factor people.

~~~
TheChaplain
It's not about stopping deaths completely, it's about not putting more strain
on an already overworked health care system.

------
erdos4d
Thank goodness at least someone with credentials is saying what is obvious.
The lockdown approach is not sustainable for much longer out of basic economic
concerns and the virus will absoluteley start spreading again when the masses
break and go back to work. Protecting the most vulnerable while the rest of
the society works to support them is the only sensible approach and should
have been the plan all along. I'm personally very sad that so many will
sustain great economic damage on top of this reality, but this is what happens
when people run scared. I just hope this reality is recognized and accepted
before even more damage is done.

~~~
DennisP
If you use your lockdown time to set up solid testing and tracing, it can work
out pretty well.

~~~
jdminhbg
That’s a theory, but nothing more. Nobody has successfully done that yet. The
testing and tracing success stories started before they needed to lock
anything down.

~~~
yongjik
They (South Korea, Taiwan, etc.) did not _need_ lockdown because testing and
tracing were successful! Of course there's no success stories with lockdown
_and_ successful tracing - the early successes didn't need full lockdown
(unless you count China), and the ones going through lockdown now will need
weeks or months to contain it.

Sigh.

~~~
jdminhbg
Right, but that still does not tell us whether testing and tracing will work
once it got past the point of lockdowns. Hopefully it does, but we don’t know
if it’s possible to do once the scale of tracing gets so huge.

~~~
DennisP
That's why if you've got significant spread you have to do a long hard
lockdown first, instead of jumping straight to test and trace. Get the
effective R0 below 1 and you can reduce your current infection count.

~~~
nradov
But that's a moot point because it's simply impossible to do a hard lockdown
in an open society like the US. There are too many essential activities, and
the government lacks the resources to strictly enforce orders.

~~~
DennisP
R0 is currently less than one in many states:
[https://rt.live/](https://rt.live/)

So right now they actually are locking down sufficiently to shrink the number
of cases.

------
iso1631
In the UK, week ending April 3rd, rather than the expected 10k deaths there
were a (preliminary) 16k deaths. 60% above background level

Stats for week ending April 10th aren't out yet, however they are alluded to
in
[https://assets.publishing.service.gov.uk/government/uploads/...](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/879714/Weekly_all_cause_mortality_surveillance_week_16_2020_report.pdf)
at being over 20k deaths, twice the number.

(The week 15 report predicted 5k excess deaths for week ending apr3, more
concrete figures had it at 6k. Week 16 predicts about 12k excess deaths for
w/e april 10.

60% extra deaths isn't "slightly above background level"

If covid is burning itself out then that's great, we'd be looking at a total
100k excess deaths, or 20% above background level for the year.

However there is no evidence that we're anywhere near 20% of the country
having had it, let alone 70%.

Those dying in week ending april 10th will likely have contracted covid before
lockdown

    
    
      w/e | reported covid deaths | actual excess deaths
      w/e mar 27 | 842 | 1.5k
      w/e apr 3 | 3294 | 6k
      w/e apr 10 | 5562 | 10-15k
      w/e apr 17 | 5589 |
    

So we're likely looking at 30k excess deaths in the last month, or about 80%,
but that's because we locked down in mid-end march and the number of deaths 3
weeks later hasn't increased at the non-lockdown rate we'd expect.

Tobacco kills an average 2k per week in the UK, covid is killing 5 times as
many, and that's with all the controls.

Cars kill an average 30 per week

~~~
rpiguy
This is a stunning difference. In the US we had no excess mortality in March,
in fact total deaths from all causes were down year over year.

Cases didn’t peak in NY until April so we may see some increase after this
month.

I realize the U.K. locked down later than many countries, but there must be
other factors driving mortality as there are other countries that did not lock
down and aren’t being ravaged quite the same.

What is it? Level of care in the NHS? Higher prevalence of secondary
conditions like diabetes? Hygiene? Crowding?

~~~
iso1631
We didn't really have any excess mortality in March either - total deaths in 4
weeks upto 27th march was 43,406. 5 year average for that 4 week period is
43,700.

We're slightly ahead of New York state in covid breakout too (about 4-5 days
at the occurrence of both 10th and 100th death)

I suspect that the excess numbers are undiagnosed covid cases - especially
those dying in care homes.

In w/e 3rd april compared with the week before

    
    
      Place      | Excess Deaths | Excess covid deaths
      Home       | 1079          | 105
      Care Home  | 1280          | 175
      Hospital   | 2779          | 2609
    

Tests in the UK are almost entirely to people going into hospital.

Where are the stats for deaths in New York? UK (Or rather England and Wales,
but that's 90% of the population of the UK) are at
[https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...](https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales)

~~~
rpiguy
Google has made the statistics query-able. Google “Covid NYC deaths,” etc. and
they graph it for you in the search results.

We are at about 8800 COVID deaths for all of NYC (this includes the city
boroughs) so out of a total population of about 8.5 million. We will have a
more accurate population after this year’s census.

Public transit appears to be a big spreader with outbreaks tracking closely to
subway stops. Unfortunately we keep it going because it is essential some
people couldn’t get food without subway access. This is also probably why
suburban America has a far lower number of cases, outside of nursing homes.

Even in states like NJ all the counties in trouble have rail lines to and from
NYC and are densely populated.

~~~
iso1631
That's not total deaths registered, that's just deaths that are released as
covid related.

In the UK all deaths must be registered with the date of death. Normally we
expect X deaths per week, we're seeing far more excess deaths than covid
deaths in homes and care homes.

Two possibilities

1) Non covid deaths are happening at home rather than hospital because people
aren't being taken to hospital. I'm sure this is happening in some cases
(people being frightened of going to hospital when they have tell-tale signs
of strokes etc), but if it was happening a lot then non-covid deaths in
hospitals would be down. They aren't.

2) Much more likely, people are dying at home/care home frmo covid but it's
not being reported on the death certificate because they haven't been tested
for covid.

~~~
rpiguy
Sorry that information used to be available here but is no longer maintained:

[https://www1.nyc.gov/site/doh/data/data-sets/vital-
statistic...](https://www1.nyc.gov/site/doh/data/data-sets/vital-statistics-
data.page)

I do not think Covid deaths are being under-counted in NYC they recently
changed to a very liberal policy for labeling Covid-related deaths. No test is
required and all deaths not clearly from another cause are now being counted
as Covid. This has conspiracy theorists crying foul, but it’s probably
prudent.

You piqued my curiosity and this change in death classification added 3500
deaths to the count on top of the 8800 confirmed/tested mortalities that
Google publishes, and so far NYC is on track to double their monthly deaths
from all causes for the month of April :-(

------
lymeeducator
It's unknown how long symptoms typically last. I am pushing 4+ weeks with mild
symptoms I have never experienced with the flu. My doctor indicates 4+ weeks
until ~mostly recovered based on her patients. How does this deplete nutrients
necessary for continued immune function relative to the flu? We need more data
and that Swede doesn't have it.

------
nradov
Why is this flagged? The interview is intellectually interesting. Prof. Johan
Giesecke literally wrote the book on infectious disease epidemiology, and
works as a senior advisor to the WHO and Swedish government.

~~~
specialbat
Agree, he is not some crank. I don't understand the flagging system on this
site at all

------
jamesblonde
"The actual fatality rate of Covid-19 is the region of 0.1%"

"At least 50% of the population of both the UK and Sweden will be shown to
have already had the disease when mass antibody testing becomes available"

"The results will eventually be similar for all countries"

"Covid-19 is a “mild disease” and similar to the flu, and it was the novelty
of the disease that scared people."

~~~
mgsouth
Sweden already has 1 death per 10,000 population (0.01% _per capita_ , not per
case) and rate is increasing. Spain is 1 per 2,500 (0.04%). NY state is 1 per
1,200, soon to be 1 per 1,000 (0.1% _per capita_ ). _This is with lockdown_
[0]

[0] [http://91-divoc.com/pages/covid-
visualization/](http://91-divoc.com/pages/covid-visualization/)

~~~
glofish
the whole point of the argument is that it does not matter what you do
everyone will end up in the same situation

~~~
twic
"Hiding infections in the future is not the same as avoiding them":

[https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-
mo...](https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-
modeling-5c156686a64b)

------
Markoff
I agree with most of the things besides 50% of infected population, in Czech
250+ branches (that's at least 5000 people) of Lidl they had only 4 confirmed
infected until now, in Globus supermarket chain out of 5000 workers only 2.
yes, Czechia is enforcing mandatory masks (although like 90% of population
wear only cloth masks due to lack of access to medical masks and respirators)
but still you would expect, if it would be that contagious through surfaces
and other ways as some scare, there would be much more infected in these
busiest businesses right now

------
simonsaidit
“The correct policy is to protect the old and the frail only.”

How is it working out with that. Last I heard old people in Sweden don’t go to
the ICU but is left to die and they have a large spread in care homes for
elderly. And as if their economy is in a vacuum they think they won’t be
struggling with the same recession as the rest of us

~~~
toomuchtodo
The old and frail will die eventually. It’s reasonable to discuss how much
we’re willing to sacrifice for the additional time afforded them in aggregate.

This is not to sound cold or callus. I’ll be old one day (but am also not
going to expect extraordinary resources to live a few extra months). These are
necessary discussions in a finite world.

~~~
maxerickson
It's likely enough that lockdowns are the better strategy for the economy. If
that is the case, it's not even a sacrifice.

Severe infection and death rates are still quite high among people that are
not especially old or frail; and then it sort of depends a lot of whether
'frail' is an apt description of the people that are more susceptible.

~~~
toomuchtodo
> It's likely enough that lockdowns are the better strategy for the economy.

I would like to see data supporting this. Because at the moment, things are
pretty bleak.

~~~
simonsaidit
[https://www.nytimes.com/interactive/2020/04/03/upshot/corona...](https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-
cities-social-distancing-better-employment.html)

I think everyone would like better data but one point I can follow is that
scared people are bad consumers. I can’t find the exact story but I recall
some research on Denver vs Philadelphia where the hard lockdown came out ahead
later and the psychology of dealing with the disease contributed to this.

------
m3kw9
He is of course inclined to say what he thinks is right because he suggested
such a plan.

------
lazylizard
Sweden is the only country that has a scientist in charge of covid response?
All other countries have politicians in charge? I'm not sure that they're
definitely wrong?

------
elesbao
Good that Sweden is using the same rational inside that they applied to other
countries during WWII, cruelly neutral wrt w/death toll.
[https://en.wikipedia.org/wiki/Swedish_neutrality](https://en.wikipedia.org/wiki/Swedish_neutrality)

