
Sweden: higher Covid-19 death rate while failing to collect on economic gains - vonmoltke
https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html
======
bjourne
You have to look at the excess deaths figures. That is, how many usually dies
from January to June in a normal year and compare that to how many extra that
died in 2020. For Sweden the excess deaths almost exactly matches the number
of Covid deaths, give or take 10%.

That is not the case for many other countries. For example, the UK had almost
twice the number of excess deaths as Covid deaths in a few weeks in April.
That indicates that Covid deaths were under reported in the UK. There are also
some indications that Covid deaths have been under reported in other
countries.

In other words, comparing countries by their Covid deaths/capita rates is
meaningless. The statistics are likely completely wrong because different
countries use different definitions of "Covid deaths" and different reporting
procedures.

[https://www.theguardian.com/world/ng-
interactive/2020/may/29...](https://www.theguardian.com/world/ng-
interactive/2020/may/29/excess-deaths-uk-has-one-highest-levels-europe)

~~~
ptx
Taiwan has 7 COVID-19 deaths[1]. It seems far-fetched to suppose that they
would be somehow covering up the 12000 additional deaths that would be
required to reach Sweden's per-capita numbers.

South Korea would have had to neglect to report 99% of COVID-19 deaths.

[1] [https://www.cdc.gov.tw/En](https://www.cdc.gov.tw/En)

~~~
latchkey
Vietnam is zero deaths and <400 total (most of those were imported), with no
new infections in 80+ days.

At first, I thought it was the govt covering something up, but after so many
months, along with closely monitoring things, I trust their numbers.

It is literally a source of national pride for them to have done so well, it
would be very hard for them to hide things.

Quarantine, masks, isolation, cleaning, testing, contact tracing. ALL WORKED.

~~~
tux1968
What if next year a more virulent strand of Covid comes along that kills
almost everyone in the world who didn't get exposed to Covid-19. Will you
still consider their measures as ALL WORKING? We have no idea how the future
is going to unfold. Everyone is faking it while demanding that everyone do as
they say.

~~~
TheOtherHobbes
What if next year aliens arrive and eat us all?

There's no plausible argument from counterfactuals here.

But let's pretend anyway - do you not think that even if a more virulent
strain of Covid did arrive, country with proven measures in place has a better
chance of dealing with the problem than a country whose current response is a
chaotic shambles?

~~~
tux1968
What i'm saying is there is a problem with monocultures. They are more
susceptible to being wiped out in a single stroke. I'd say that following a
scientific approach, we might want to consider not advocating for everyone to
take the exact same course of action. Also, that we have to be careful to not
judge success or failure too soon, that assessments can change after a bit
more time has passed.

~~~
latchkey
If the course of action has the effect of saving lives, what is wrong with
that?

The measure of success is all past and current. If Vietnam loses control over
covid, then we can definitely blame them for that. Why? Because they
effectively controlled it in the first place.

If they continue their direction, they will be one of the only countries on
the planet, not totally infected. Pretty amazing really. If they start
experimenting and doing things differently, at least they've setup the
protocols for managing things correctly.

Here in the US, we go through these bullshit 'phases' where we go from phase 2
to phase 3 and then back to phase 2. Well, anyone with half a brain could have
figured out that wasn't going to work. At least Vietnam is taking this
seriously.

They shut their borders entirely... we (the US), can't even do that.

------
argonaut
The jury is still out on "economic failure." The evidence cited on the economy
is thin at best.

The main piece of evidence is that "Sweden’s central bank expects its economy
to contract by 4.5 percent this year, a revision from a previously expected
gain of 1.3 percent." Economic forecasts are _ridiculously_ unreliable. In the
US, economists forecast (on average) that 8 million jobs would be lost in May.
Instead there was a 2.5 million gain in jobs. Not a single economist surveyed
by Bloomberg though there would be any gain at all
([https://www.bloomberg.com/opinion/articles/2020-06-06/may-
jo...](https://www.bloomberg.com/opinion/articles/2020-06-06/may-jobs-report-
forecast-miss-could-have-policy-ramifications)). The hard data we have on GDP
so far: Sweden's GDP grew by 0.1% in Q1 2020 (0.4% annualized), Germany and
the UK's GDP fell.

The other evidence is that unemployment has risen in Sweden and spending in
Denmark has only fallen 4 percentage points more than Sweden. But Denmark has
propped up employment by "covering 75 to 90 percent of all worker salaries
over the next three months, provided that companies refrain from
layoffs."([https://www.nytimes.com/2020/03/28/business/nordic-way-
econo...](https://www.nytimes.com/2020/03/28/business/nordic-way-economic-
rescue-virus.html)). And from the numbers in the article, Denmark's
unemployment rate has still risen proportionally more. Granted, Sweden has
very generous unemployment benefits, but I'm not aware of a similar layoff
prevention program.

~~~
mc32
The NYT has fallen into the bad habit of writing to a narrative, conscious or
unconscious, rather than investigating more honestly.

In this case they want to paint the alternative path as wrongheaded and
foolhardy. I’m glad someone tried something different in light of a lack of
hard evidence. Time will tell if one or the other was better, but at least
we’ll have baselines to compare against.

~~~
dmix
Looking at the John Hopkins graph a significant amount of countries are still
peaking (including the global trendline):

[https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...](https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)

Just because a few countries in Europe and the early big ones in China/SK have
slowed down they act like it's over. Yet there's still plenty of very major
outbreaks in South America, Middle East, India, Russia, south east Asia, some
African. They all have upward hockey stick growth still. Not to mention the
delayed US south/west wave.

It's far too early to pick winners/losers of COVID in the midst of the global
peak, assuming this is actually near the peak. Let alone measuring the
economic consequences.

------
frereubu
One thing missing from this report is that a large proportion of the deaths
were in care homes, and ministers have publicly stated that not entirely
locking down care homes from the outset was a big mistake. If they had done
this, the figures may well not look nearly as bad.

Also, what will count is not the first few months but the entire lifetime of
this pandemic. I'll be interested to see where countries are a year or two
from now.

This isn't to say I support the Swedish government's strategy - I don't feel
like I know enough to say what the best strategy is, although I do think that
that the worst strategy is to have no strategy, seemingly like the USA and UK.

~~~
makomk
This. It's pretty obvious at this point that a general lockdown is worthless
as a replacement for locking down care homes specifically - Spain had one of
the strictest lockdowns in Europe but massively screwed up their handling of
their care homes, and ended up with an even worse per-capital death toll than
Sweden. Unfortunately, mainstream media publications have been spinning this
instead as evidence that herd immunity wouldn't work by taking the incredibly
high infection fatality rate from Spain, scaling it up, and claiming this is
the best measure of how many people would die to achieve herd immunity.

~~~
EdwardDiego
> It's pretty obvious at this point that a general lockdown is worthless as a
> replacement for locking down care homes specifically

New Zealander here, our general lockdown went very well and enabled us to
isolate clusters of transmission and prevent it becoming community
transmission. While two of our clusters were rest homes, several others were
not - a school, a St Patrick's Day celebration at a pub, and a wedding, are
significant "not rest home" examples.

So yeah, I think your focus on rest homes is too specific.

~~~
tomerico
New Zealand is a special case where it may be feasible to isolate yourself
from the rest of the world and reach zero cases. With that said, it remains to
be seen that it is possible to maintain zero community spread over the long
term, and whether the economic impact of isolating yourself from the rest of
the world is worth it.

~~~
roca
We aren't _economically_ isolated from the rest of the world. We're still
exporting and importing. Exports in some industries are higher than ever.
We're still bringing in workers in certain key roles. NZers can leave (though
they'll probably need to pay for quarantine when they get back). The main
things that are suspended are international student and tourist arrivals, and
when the flood of NZers returning home abates, we'll probably be bringing them
in through the quarantine system.

------
cortic
Deaths per 1M population are significantly higher in Italy(577), Spain(607)
and the UK(654) than they are in Sweden(539). And Sweden have been a lot more
honest in counting than most countries.

There seems to be a drive to discredit the _inalienable human rights_
approach, in this case by implying it was a financial decision; but i have to
say i am impressed by the way they have handled this situation, the only
response on earth that involved treating their citizens like adults.

~~~
claudeganon
South Korea never had lockdowns, outside of shutting down bars when they
traced some superspreading events back to them. The idea that they’re somehow
less committed to human rights when they’ve preserved freedom of movement,
while avoiding mass deaths, is laughable on its face.

~~~
fomine3
SK traced people in a bar by cellular location data and payment data without
permit. I think it's not good for human rights.

~~~
claudeganon
The entire digital advertising industry is in greater violation of human
rights, by this measure.

~~~
fomine3
Tracing real individuals rather than "anonymized" statistics is significantly
worse.

[https://theconversation.com/tracing-homophobia-in-south-
kore...](https://theconversation.com/tracing-homophobia-in-south-koreas-
coronavirus-surveillance-program-139428)

~~~
claudeganon
Thank you for bringing this to my attention. Apologies for minimizing it
before.

------
twblalock
Any coherent explanation of this pandemic is going to need to explain why some
countries that didn't do very much (e.g. Japan) ended up with far fewer deaths
per capita than countries that locked down (e.g. EU countries and the United
States).

Sweden is somewhere in the middle -- they are being criticized, yet other
countries in Europe which locked down have ended up with a higher per capita
death rate.

Why is it that Cambodia and other nations in southeast Asia have negligible
deaths despite doing very little to combat the virus, while countries in the
EU which locked down have way more deaths per capita?

Somehow the models about the spread and death rate of this virus seem to
differ on a geographical basis, and that needs to be explained.

At this point, any analysis of the pandemic that does not attempt to tackle
this problem is selectively ignorant.

~~~
j7ake
It’s not about comparing policy from the top down but rather comparing public
opinion of the virus from the bottom up.

Asian cultures have take the virus much more seriously than European cultures
and regardless of government policy that is going to be a major determinant of
how much the virus spreads.

Put in another way, two countries can apply the exact same policy against the
virus but have diverging outcomes because of public opinion of the government,
of the virus, and of their fellow citizens.

~~~
georgespencer
My partner (American w/ Chinese parents) strongly believes a major difference
is the sense of collective responsibility in Asia. A kind of deferral of
individuality to benefit society.

~~~
twblalock
Fine, but how does that explain disparities in outcome between European
countries?

~~~
fluffything
A German college truly believes that this virus was created by Adolf Gates to
enrich themselves with the pandemic while helping China destroy the German
economy.

~~~
solarkraft
The scene around conspiracy theorists Heiko Schrang and Attila Hildmann sure
is fascinating. Wearing masks is the ultimate evil to them, for some reason.

------
cm2187
To me this is moving the goalpost.

The stated objective of the lockdown was not to overwhelm the ICUs. As far as
I know the ICUs in Sweden have not been overwhelmed. So how is that a failure?

As for the economic impact, given the amount of life support injections into
the economy, I think the real economic impact of the shock is yet to be seen.
Defaults are only starting to rise.

~~~
vmception
I have been willing to be frustrated with moving the goal post, but there is
new information that mayors and governors know that the general public doesn't
have a good way to know:

The low mortality rate and managed ICU capacity isn't the whole story. there
is a large population of recovering and recovered that have serious
complications, that seem random and are unproductive to our society. Blood
clots resulting in amputations. 90 day recovery time periods. Other unknown
and randomly targeted blood oxygen issues.

The mayors and governors and public health ministers are reacting to that in
their own municipalities and countries. The outcomes are not equal, the
variables have many different names between jurisdictions, and therefore the
stats are not easily collectable. But for people on the front line and getting
briefed by those on the front line, they see something horrible that they need
to move the goal post to "cases" instead of just deaths and ICU capacity.

~~~
TMWNN
99% of the cases that last for months, like Nick Cordero, are from the early
days of the pandemic where doctors mistakenly put people who didn't need
mechanical respiration on ventilators, damaging healthy lungs and causing
breathing dependence that doctors found difficult/impossible to wean from and
all sorts of other complications, such as deep vein thrombosis (again, see
Cordero's case).

The mean time between symptoms and death is two weeks
([https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-
scena...](https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-
scenarios.html)). Anyone with symptoms is in two weeks, three at the most,
either going to be at home wondering what the fuss is about—the vast, vast,
vast majority of cases—or dead.

~~~
vmception
that's reassuring, and also validates the general idea of trying to avoid
exposure until more was/is known.

for some reason the term 'early adopter' comes into my mind

~~~
TMWNN
>for some reason the term 'early adopter' comes into my mind

As one who foolishly bought not one, not two, but _three_ first-generation
Apple notebooks, you are not wrong.

------
oxymoran
I find this article a little disingenuous and here is why: Sweden-5420 deaths
out of a population of 10 million while no lock down. Michigan-6005 deaths out
of a population of 10 million and we have been locked down since mid March.

To be clear, I was in favor of the lockdown at first and I still am in favor
of keeping things like bars and casinos closed but it’s become clear that the
virus doesn’t have much affect on younger populations and that the death rate
has been dropping. Here in Michigan, while our daily new cases is still
creeping up, our 7 day moving average of deaths has continued to plummet.

~~~
akmarinov
Well Sweden closed its borders, where Michigan can’t close its borders to
other states, so Michigan’s is naturally higher.

~~~
Svip
Sweden did not close its borders, although it followed EU guidelines to close
its borders beyond the EU. The US closed its borders to certain areas of the
world, which is what this is comparable to.

~~~
akmarinov
Well all other countries in the EU closed their borders to them, so it’s
effectively the same thing.

~~~
username90
No they didn't. Danish, Finnish and Norwegian tourists are still coming to
Sweden. It is just that Swedes can't go to them.

~~~
NoSubstitute
And that is a textbook example of insanity. To be fair, I do think that they
are supposed to self-quarantine when returning home?

------
mettamage
Edit: I'm letting my original comment stand as it shows how I was subtly
misinformed regarding the situation of Sweden. I don't think I'd be the only
one.

Wait, with all due respect, 5420 deaths on 10 million people? On a country
left completely unchecked? That doesn't sound like the impending doom I
thought the virus would bring.

I thought the novel corona virus had a death rate of about 1% to 2% and a
bigger spreading rate that was bigger than 1, if no measures were taken. So,
I'd expect between 100,000 to 200,000 to have died. I'm really happy that
didn't happen. It also makes me curious as to why. Is it because of Sweden's
demographics (people living alone)? Or is it because the virus isn't as deadly
as we think it is?

How come 0.05% died and not 1% to 2%? Isn't this evidence that the coronavirus
isn't as big as a threat as we thought? I mean 0.05% deaths is 40 times
smaller than 2% deaths.

It's awful what happened, but the highest flu season in The Netherlands, for
example, killed an estimated 9444 people [1] on 17,280,000 people, which is
slightly higher than what the Swedes had to go through now (also rounded to
0.05%). I know that the novel coronavirus is not a flu, but if this is it,
then well, I've seen worse, apparently.

I know the virus isn't done, but it had months to roam free in Sweden. One
would expect it would double up every 5 days in terms of how many people would
be infected.

Edit: they did need to maintain social distance apparently. I wouldn't call
that "doing nothing". Sure a lot more can be done, but I feel the media are
framing the Swedes a bit inaccurately. Belgium seems to be way worse (9774 on
11,460,000 people, ~0.1% is getting truly uncomfortable)

[1] In Dutch, unfortunately: [https://www.rivm.nl/monitoring-sterftecijfers-
nederland](https://www.rivm.nl/monitoring-sterftecijfers-nederland)

~~~
Barrin92
>How come 0.05% died and not 1% to 2%? Isn't this evidence that the
coronavirus isn't as big as a threat as we thought? I mean 0.05% deaths is 40
times smaller than 2% deaths.

Because the 1% death rate is a reference to people catching the disease, not
the size of the population. Sweden as of now appears to have about 73k
officially confirmed cases.

Swedes still voluntarily distanced and closed down, hence the economic damage
mentioned in the article. Given that there is no widespread immunity still
with total infections in the single digits, those deaths will eventually go
up.

I'm not sure if the American attitude of indifference is taking hold here now,
but 5000 deaths when 4000 of them could have been avoided is no matter to
brush aside, it's in fact a straight up disaster. This is an unprecedent
amount of needless death in modern Swedish history.

~~~
mettamage
I'm not American, I'm Dutch. And there's a huge difference between WOII levels
(which is what 2% deathrate in The Netherlands would be), versus an extra
amount of death people comparable to the worst flu season.

In The Netherlands, the worst flu seasons still have a higher death toll than
corona. I hope it stays that way for everyone.

~~~
DanBC
> the worst flu seasons still have a higher death toll than corona.

Do you have a link to the statistics please? I think you're comparing two
different methods of counting death. I think for covid-19 you're counting
people who died after testing positive, or people where covid-19 is listed as
the cause on the death certificate. But for flu I think you're counting excess
mortality.

~~~
nkurz
Not a scientific article, but this blog post gives some numbers for Sweden:
[https://emanuelkarlsten.se/more-swedes-died-in-one-
month-199...](https://emanuelkarlsten.se/more-swedes-died-in-one-
month-1993-and-2000-compared-to-april-2020-why/).

One big question would be why they chose April 2020 as the comparison point
rather than May or June -- did the number of deaths per month in Sweden
actually drop?

(I haven't read the article closely, and don't have a horse in this race --- I
just thought it was apropos. Feel free to tear it to shreds if appropriate.)

~~~
DanBC
I'm not going to tear it to shreds!

When people say "covid is like flu" sometimes they mean "flu is a big deal,
and a bad flu year kills lots of people". (I agree with that).

But sometimes they mean "flu isn't so bad, it's a bit like a cold, doesn't
kill so many people".

------
jpangs88
I feel that so many of these articles on Sweden fail to mention the reason for
Sweden's strategy and often say it due to another reason. The reason that the
Swedish government has given for the strategy is that they think that people
can follow the restrictions long term. It's not to save the economy or to
create heard immunity (which I have heard from many people.) I think it's too
early to judge Sweden's strategy as presumably the intent is that things will
be better down the line.

On a more personal note, I live in Sweden and I am not a Swedish citizen and I
can say that things aren't "Business as usual here" and plenty is being done
to stop the spread of the COVID 19. I can't say I 100% agree with the policy
but I also don't think it's the huge mistake people make it out to be.

I have linked below an explanation for the strategy by one of Sweden's top
epidemiologist and the one that's often credited as the architect of Sweden's
strategy.

[https://www.bloomberg.com/news/articles/2020-06-28/sweden-s-...](https://www.bloomberg.com/news/articles/2020-06-28/sweden-
s-covid-expert-says-the-world-still-doesn-t-understand)

[https://www.krisinformation.se/en/hazards-and-
risks/disaster...](https://www.krisinformation.se/en/hazards-and-
risks/disasters-and-incidents/2020/official-information-on-the-new-
coronavirus)

~~~
DoingIsLearning
One thing I don't see discussed and it's an unbacked intuition is that all the
different government strategies seem to revolve around differences in 'group'
trust levels.

Both the Swedish 'no-lockdown' and the Dutch 'intelligent' lockdown are
government policies that actually work locally because the government trusts
that the population will follow the guidelines given (which they do for the
majority).

Equally when I discussed with Dutch and Swedish people (anecdata) they all
believed their national strategy was correct because they trusted their
governaments competence and the science advisors that were being consulted.

I think many of these strategies cannot be translated to other countries were
there isn't a shared trust level, i.e. population trusting the government's
competence, and equally the government trusting civil society (biggest example
being the US).

------
leandrod
This is meaningless. There were no economic gains expected, just avoiding a
greater disaster. Given that Swedish economy is fairly integrated with its
lockdown neighbours, it would be surprising if there were any economic gains;
instead, it is probable its neighbours benefitted from Sweden having avoided
lockdown.

Also, the higher death rate is normal and acceptable, in a tradeoff against
deaths caused by confinement and the unnecessary prolongation of the epidemic.
Herd immunity will arrive earlier, and lockdown-caused deaths will perhaps
make Swedes survive more and better.

Now vote me down.

------
a3_nm
I think it's misleading to phrase things, as the article does, as just "more
deaths" vs "the economy". The drawbacks of a large-scale mandatory lockdown
(as opposed to asking people to do their own social distancing) also include
other things like psychological effects on the population, political
consequences (setting a precedent of severely restricting personal freedoms),
and, well, enjoyment: making 10 million people more happy for a few months
doesn't seem entirely negligible from a utilitarian perspective.

This isn't to take position for or against Sweden's policy here, but there are
far more variables than simply excess deaths (or DALYs) and economic impact.

------
pxpm
It's my first comment on HN. I am not a native english speaking person so I am
sorry for some wrong wording in my answer.

I am from Portugal. In first 2 months we were considered an example on how to
deal with an pandemic.

Today, our best business partners, I list UK in this scenario, does not give
Portugal a safe destiny badge.

People tend to overcome rules. UK people are flying to Spain an then get a bus
to Portugal.

Today's news was about 2000 students from Netherlands partying in Portugal,
Algarve.

I am a young and healthy person AFAIK, but my mother is not. Neither my father
in law or some of my closest friends.

Any death caused by irresponsible behaviour should be treated as an law
infringement.

I really don't care if I get Corona. Pretty much I do, or in this case, I
don't do, is thinking about people that does not have the chance of saying:
fuck it.

It's the world we have, but I am sure it's not the world I wanted.

Bare with me: any death that could be avoided they should be avoided. And we
could avoid alot of deaths if we think about others, an not that much about
ourselves.

60 years ago you didn't have internet, lot's didn't even have light or
bathroom in house.

Divorces are up with confinement. Are those people really meant to be
together?

Don't look to much to your belly, and look around. Learn how to respect others
without expecting the retribution.

You will feel great when you give up something you think it's aquired by right
to something you think it's just right.

Best

------
glofish
Sweden is much hated because it demonstrates how the scientific
epidemiological models, the studies on mask effectiveness, lockdown
estimations etc are all junk science. None of their models would have
predicted the trajectory for Sweden, not even close.

And that is because none are based on sound science but are guesstimates at
best yet are paraded around as the product of the best minds in the world.

Much is made about the growing anti-science sentiment in the world, the rushed
pseudo scientific justification will only strengthen that.

Give it a year and most of the justification will be walked back, it will turn
out that wearing a mask is actually detrimental to public health. It boggles
the mind that people assume there must be no ill effects to breathing through
a mucus-laden cotton sheet filled with microorganisms captured from the air,
...

~~~
latchkey
> I don't understand how people assume it is healthy to breathe through a
> mucus-laden cotton sheet filled with microorganisms captured from the air,
> ...

Tell that to the millions of people who go skiing every year, or the people
who work in hospitals all day long, every day.

I wash my mask every time I use it and I rotate through several of them.
Nobody is asking you to wear a dirty mask.

~~~
glofish
none of that mask wearing is done at the scale and in the manner forced upon
the population

nurses change their masks all the time, nobody skis every day for eight hours,
(FWIW the vast majority of people skiing don't wear masks over their mouths)

> I wash my mask every time I use it and I rotate through several of them

Like every hour? If not good luck with that, it is a pit of infection, a wet
and warm substrate for bacteria and fungi.

~~~
latchkey
> nurses change their masks all the time,

Do they? Are you a nurse?

> nobody skis every day for eight hours, (FWIW the vast majority of people
> skiing don't wear masks over their mouths)

Show me the statistics on that.

> Like every hour? If not good luck with that, it is a pit of infection, a wet
> and warm substrate for bacteria and fungi.

This is the most inane argument ever. You're basically saying those same exact
bacteria and fungi magically don't go into our airways without a mask?

Masks magically breed this within a day? Also... who says they are bad? Hate
to break it to you, we are FULL of bacteria.

Seriously, take a step back and think hard about your logic. Something in your
brain isn't firing correctly.

~~~
glofish
do yourself a service and read a real scientific paper on masks (pre-covid
when people dared studying the negative effects) and read what happens on the
inner side of a mask

in a nutshell stuff that would leave your body when you exhale will now be
trapped on the _inner_ side of your mask where it gets more and more
concentrated, far more concentrated that what normally enters your lungs, the
new stuff gets deposited on top the old, building it up to form a biofilm
unlike any other part of the body

The microorganisms in the warm and wet environment breed, bacterial growth
happens fast, doubling times can be 15 minutes. Within an hour you got
yourself a bacterial colony right there in front of your mouth, every breath
you take is filtered through that mucus laden bacterial colony

~~~
latchkey
Would you like to quote a 'real scientific paper' for me to read? Or just have
a snarky response.

People have been wearing face coverings since the dawn of time.

Can you tell me the number of deaths attributed to wearing a mask? I can't
even google it since all the things that come up now are recommendations to
wear a mask.

> in a nutshell stuff that would leave your body when you exhale will now be
> trapped on the inner side of your mask

If you want to take the 'it is just a flu argument'... I'm more worried about
catching covid than I am about the microorganisms coming out of my own breath.
They are already in me, in a very concentrated form.

------
CryptoPunk
This highly cited April 11th study projected that Sweden would have 96,000
deaths by July 1st if it didn't institute a lockdown:

[https://www.medrxiv.org/content/10.1101/2020.04.11.20062133v...](https://www.medrxiv.org/content/10.1101/2020.04.11.20062133v1.full.pdf)

The actual death toll was 5,400, and now the deaths are declining
precipitiously. Of course every death is a tragedy, but the harm done from a
national lockdown, which includes youth missing out on a year of school, and
thousands of small businesses being destroyed, would have been more of one.

Like Michael Levitt, who's the 2013 Chemistry Nobel Laureate for research in
complex systems, says, society has forgotten that people die.

10,000 people per million die every year in Sweden. That rate increasing by
500 is not that abnormal - it happens in bad influenza seasons. If every one
was forced to stop working and shelter at home for months every time an
infectious disease temporarily rose the death rate by 10%, it would lead to
disaster over the long run.

90% of deaths in Sweden have been of those over the age of 70. If the
statistics are anything like those in Italy, almost all of these victims had
pre-existing conditions.

This is not to lessen the tragedy of their death. This is to point out that
most of this tragedy predated their coronavirus infection - their life
expectancy was already very limited due to other factors.

------
mips_avatar
One interesting thing about Sweden is the high percentage of people who live
alone. It's a big deal because in China most deaths came from an infected
person spreading it to their family. Makes you think that if Sweden's numbers
are as bad as they are without large-scale family spread, it would be
absolutely horrific elsewhere.

------
ojhughes
Sweden are a model of pragmatism, taking a sensible choice to not have an
authoritarian lockdown. Freedom of choice, freedom of movement and freedom of
commerce are sacred.

~~~
GaryNumanVevo
Disagree, it was incredibly reckless. We still don’t fully understand the
virus’ transmission vectors, R-values, etc. It very easily could have had a
higher fatality rate or transmission rate potentially killing many more
people. Claiming it’s a model of pragmatism is a post-hoc rationalization of
poor policy.

------
thisrod
What went wrong in Sweden? I genuinely don't understand that.

The news keeps showing Swedes walking in parks and down streets, but that's
not how people catch the novel coronavirus. Meanwhile, people were working
from home and mass gatherings were banned; the public were trusted to figure
out the details, but they're not idiots. It could have worked.

What was everyone doing in Sweden that people weren't doing in Finland and
Australia? Or were there less visible differences, in surveillance and contact
tracing maybe, that haven't been so widely reported?

------
jnwatson
I don’t believe the article has addressed Sweden’s main argument for not
shutting down: that herd immunity should be the prime driver. Essentially,
that everyone is going to eventually have roughly the same death rate, so
might as well get it over with.

That remains to be seen; if Sweden’s peers can prevent flare-ups, it looks
like Sweden was wrong.

~~~
Traster
Well it's not only that, if you overwhelm your healthcare system you're going
to end up with excess deaths even if the same number of people get the virus
in the end. Also, we've learned _some_ mitigation techniques over the last few
months (like steroids in late stage treatment) which means that the idea that
'everyone will get it eventually' just isn't relevant - its likely that our
survival rate will go up over time even without a proper vaccine.

~~~
nradov
Ironically, medical researchers wouldn't have learned those mitigation
techniques (like Dexamethasone) without a large population of patients to use
as experimental subjects. In other words, if we succeed in slowing down the
spread (which would be a good thing) then medical research into treatments and
vaccines will also slow down.

~~~
stallmanite
Would work on a vaccine really slow down? There are many thousands of patients
and how many does a vaccine study require in practice?

~~~
kalleboo
[https://news.sky.com/story/coronavirus-disappearing-so-
fast-...](https://news.sky.com/story/coronavirus-disappearing-so-fast-oxford-
vaccine-has-only-50-chance-of-working-11993739)

------
MasterYoda
Statistics is just statistics. Many compare Swedens death/capita to other
countries figures and conclude it is bad. But this is in fact not a god
measure at all because this figure dont account for how far the spread is over
the population, Sweden is very different here. Because Sweden have been more
open they are also far ahead of other countries and much more people have been
exposed and got antibodies. Sweden cant simply be compared to others that are
more in the beginning in the pandemic. Sadly media forget this.

The virus cant be stopped so sooner or later other couties must open up and
then they going to get more death. Just look at Spain that open up now had to
lock down a reginon now with 200.000. Saying Swedens way is bad right now is
far to early to conclude, when the pandemic is far from over. We have to wait
at least a year or two.

------
reddog
Sweden is right to be concerned about their economy. Its not just about
skipping a few haircuts -- a shattered economy kills people as sure as
coronavirus does. Every shuttered manufacturing plant has a body count
associated with it and its own case mortality rate.

I don't know how many people died as a direct result of the Great Depression
but based on what I've been told by relatives the suffering was considerable
with deaths due to lack of food, homelessness and despair. I _do_ know that
the Nazi party would never have come to power in Germany without the world
economic collapse. They were a minor party on the wane in the late 20s only to
get their second wind in the elections following the crash. It's also possible
the Japanese militarist would never have come to power without the Great
Depression for more complex reasons. WWII was the result at the cost of 45-70
million lives. Economic catastrophes are not just about money -- they have
life and death consequences. I wish more people would have taken this into
consideration before they carpet bombed the US economy to combat the pandemic.
I guess they figured that no matter what, the US was safe from the kind of
civil unrest that gripped the Weimar republic. A strong man taking control of
the US? Fascist and antifascist battling in the street? That could never
happen here.

------
throwawaysea
Sweden recorded its first week of no excess mortality over a month ago:
[https://www.reuters.com/article/us-health-coronavirus-
sweden...](https://www.reuters.com/article/us-health-coronavirus-sweden-
mortality/sweden-records-first-week-with-no-excess-mortality-since-pandemic-
struck-idUSKBN23F1WK)

The economic gains part of it is not really relevant. Today each country is
exposed to the global economy. If everyone else has economies that are broken
then that will trickle over to Sweden inevitably. But that doesn’t mean that
it is not worth pushing for Sweden’s strategy. If more countries did so,
perhaps Sweden would collect economic gains.

------
martindbp
As a Swede that did not agree with the strategy at the time (it was hugely
risky), given what we know now, I'm starting to think it was the right
decisions (for the wrong reasons). The reason the economy is in trouble has
more to do with that the rest of the word shut down, it being a highly export
dependent economy. Sweden did not shut down, practically nobody wears a mask
(still), social distancing is minimal (crammed subways, buses and beaches),
schools have remained open, yet there has not been a single death in the worst
hit area of Stockholm for the past 5 days. Again, I think given the
uncertainty and lack of evidence in March, not shutting down was an extremely
stupid risk, and Tegnell and crew have shown to been wrong at practically
every turn, but at this point you have to look at the evidence and reassess.
It would seem Stockholm has reached the point of significant herd immunity,
which is probably true for other hard hit areas like NYC. Less hit areas will
probably have second waves, and unless a vaccine is here soon, my guess is
most of the world will go through the same thing eventually.

~~~
kanox
> I'm starting to think it was the right decision

Sweden is #6 by deaths/population according to this page:
[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)

This would indicate that the swedish response is among the worst. Several
countries with comparable health systems have a death rate which is many times
lower, for example Germany. This saved many thousands of lives.

What am I missing?

~~~
marcusverus
If the pandemic is expected to continue for many months, isn't it a bit
premature to talk about current death rates as a metric for success? Given
Sweden's 'herd immunity' plan, higher death rates _at the beginning_ would
seem to be a given. They didn't flatten their curve. But as they approach
something like herd immunity, the number of possible carriers should plummet
permanently (assuming immunity is a thing with COVID), and infections and
deaths would permanently decline.

Nations which have held down infection numbers with shutdowns have, of course,
flattened their curves. But they may well suffer from second/third waves which
will hike up their total numbers.

~~~
kingkawn
Herd immunity cannot be considered the plan given that herd immunity has not
been proven to be possible

~~~
tripletao
Herd immunity is certainly possible--we could hold a parade, and spray it with
cultured virus. Obviously no one is doing that, because no one actually wants
natural herd immunity. Sweden just thinks the cost to control the epidemic to
the point that it doesn't end in that way is unacceptably high. If a treatment
is discovered next month that cuts the IFR by a factor of ten, then Sweden was
wrong. If no safe and effective vaccine is ever developed and treatment never
improves, then Sweden was right. Reality will fall somewhere between those two
unlikely extremes, and we don't know where.

Fewer infected is always good news[1], in Sweden or anywhere else--it means
fewer dead now, more infections pushed until later when treatment will
probably be better, etc. It's weird to see low infection rates twisted around
as if they were bad, "evidence that herd immunity may not be possible". This
is particularly true when the prevalence is compared to herd immunity from a
model assuming a well-mixed, homogeneous population, which we know
overestimates the herd immunity threshold (though not by how much, since
estimates of the heterogeneity of the coronavirus are even more uncertain than
those of R0).

Finally, herd immunity is a gradual process. Even in a crude homogeneous SIR
model, you may approach it asymptotically but never get there. This is good--
the only case where a disease "burns itself out" abruptly is when there's big
overshoot, which implies many avoidable deaths. Perhaps that kind of overshoot
could be desirable in a population of young people, if the small excess
mortality in the young people were more than offset by their decreased ability
to spread it later; but that's a narrow needle to thread.

For the avoidance of doubt, I believe Sweden did a bad job protecting elder
care facilities (though many places that locked down did too), and I disagree
with their position on masks. Their response otherwise seems reasonable to me,
not obviously better than stricter approaches but also not obviously worse.

1\. Unless you know the death count and you're looking for the denominator for
your IFR, since more infected then means lower IFR. That was true early in the
epidemic, before the first high-quality serosurveys, but not anymore.

------
mekkkkkk
Swedish officials has said over and over again that neither herd immunity nor
economics is the basis for the strategy chosen. They tried to strike a balance
between the impact of containment measures (isolation, mental health, lack of
education etc) and minimizing the spread of the virus. Of course the first
point is extremely hard to quantify, and thus the hard numbers are horrifying.

Most people in Sweden are taking plenty precautions and isolate on a voluntary
level, highly encouraged by all institutions. However, if you are stuck inside
with abusive parents or are getting depressed by the isolation, you have the
choice to go out.

As others have mentioned, the true failure has been in elder care. How the
virus was allowed to ravage care centers is completely unacceptable.

------
anang
I think one aspect missing from the discussion of whether or not Sweden has
done the right thing is just how much power a government has over its
citizens.

In many cases I think the consensus in Sweden is that the government doesn’t
have the right to keep people at home or force people to wear masks. The
current government had to push to get legislation passed that allowed them to
shut down primary schools and preschools, if needed.

When this is all said and done a lot of countries are going to have evaluate
what all of this has meant for their democracies.

------
natch
Economics aside, there may be mental health wins for keeping a different mix
as they have. Or losses, too — it’s really too early to say one way or another
imho.

------
jfoster
The idea of prioritising the economy is a falsehood. You can't have a strong
economy with a virus like covid ripping its way through the population. Some
people might go on as normal, but a huge portion of the population will be
afraid of going outside.

The only feasible path to economic recovery is:

1\. Keep the borders closed. Mandatory & monitored quarantine for anyone
entering.

2\. Lock down, test & contact-trace until the virus is basically eradicated.
Mandating mask use outside of abodes or any other measure will help speed this
along, too.

3\. Open up, but keep borders closed except to places applying a similar
approach.

The swifter the action, the easier it all is.

------
Markoff
this was supposed to be about economy? I thought they just wanted to preserve
their way of life without draconian measures of countries which took those
measures and got Fd anyway in matter of deaths or economy

it was pretty clear from beginning it won't have big impact on their economy
either way

------
raxxorrax
Hard to say already since many small businesses will close but haven't done so
officially yet.

------
x87678r
Nice to see all the Swedish commenters on the NYT pointing out how biased the
article is.

------
mirekrusin
Little bit too early to proclaim this kind of conclusions, isn't it?

------
catears
The opening paragraph of the article shows to me that the journalist in
question has done a poor job researching exactly what happened in Sweden.

> Sweden has captured international attention by conducting an unorthodox,
> open-air experiment.

Almost every interview available with Anders Tegnell (swedish equivalent of
Anthony Fauci) mention that the international community prior to covid had
agreed that following a strategy similar to the one sweden are following now
is the best choice. Somehow this translates to an "unorthodox" strategy. Never
mind that during previous epidemics, like SARS, the current Swedish response
was "the normal response".

> It has allowed the world to examine what happens in a pandemic when a
> government allows life to carry on largely unhindered.

I am really disturbed by this sentence. While it is technically correct that
no lockdown has been _imposed_ on the swedish people by the government, saying
that life has "carried on largely unhindered" is straight up dishonest.

Ever since February or March there have been regular press conferences with
the FHM ("swedish CDC") broadcast over public radio (and obviously you can
listen to it on internet and in their app, with push notifications). The
hospital system has almost completely shifted to handling covid, nationwide.
Most companies have tried to shift their work to peoples homes as much as
possible, just like FHM has suggested. Buying groceries online has increased
by a large margin. Even the cars at my local supermarket are now practicing
social distancing! Swedes, overall, have really taken the gravity of the
situation to heart and made changes in their life to protect their community.

> but Sweden’s economy has fared little better.

This misses the most important points about the swedish strategy and shows a
lack of knowledge about swedish economy and EU economy. The goal of the
swedish strategy has been to preserve peoples health as good as possible.
Locking everyone in their homes for several months is not a strategy that is
resillient. It increases cases of domestic violence, people losing their jobs
cause negative effects as well. The number of deaths related to covid have to
be compared to overall deaths, but most importanlty the overall health. The
goal was never to gamble peoples life away for the economy!

The article jumps straight into saying that Sweden did not gain anything,
economically, from having no lockdown. Well of course not. How could a country
with focus on exports and services thrive economically in a pandemic? If the
inner market of the EU is as good as closed, who would make the bet that an
export focused country would be thriving? Sweden is dependent on other
nations, especially in the EU and Scandinavia, so of course the economy
wouldn't fare well.

> Sweden put stock in the sensibility of its people as it largely avoided
> imposing government prohibitions.

This is factually wrong. From the 27th of March it became a criminal offence
to organize events of 50 or more people, down from the 500 that was decided on
the 12th of March [https://www.regeringen.se/artiklar/2020/03/forbud-mot-
allman...](https://www.regeringen.se/artiklar/2020/03/forbud-mot-allmanna-
sammankomster-eller-offentliga-tillstallningar-med-fler-an-50-deltagare/)

This article is an example of poor journalism. It misrepresents the situation
in Sweden, while containing crucial factual mistakes bordering on
misinformation while also trying to steer american policy making in a specific
direction.

------
h3ll0k4ll3
Disclaimer. I am Swedish.

The amount of deaths in Sweden from Covid19 have been very high and many of
the deaths has been completely unnecessary. This is nothing else than a cruel
state sponsored murder on parts of the elderly population. Its also likely
that the actual death toll is significantly higher than reported since many of
the elderly dying at institutions was never tested for Covid19 In-fact at many
regions of Sweden autopsies has been suspended during parts of the spring. The
recommended treatment for these elderly has been injection of morphine (yes to
elders with breathing difficulties).

There are stories of staff sometimes opening the windows while elderly
confined to their rooms grasping for air. Family was not allowed to visit but
staff was moving without protection gear between the rooms of sick and healthy
( because in Sweden the government early decided that masks are ineffective
ways of protection ). Its still the official stance of Sweden that masks does
not help against Covid19. But apparently sneasing in your armpit and washing
your hands helps. In the beginning this was applied also at the institutions
for the elderly. Some heroes objected and bought gear and significantly
lowered the death rate early on. Others followed the advice from the "experts"
as a good swede does. And the result sometimes was 50-75% dead in the total
population of residents at the care facilities.

The Architect behind these state sponsored acts of murder is a man called
Anders Tegnell. And you will be surprised to learn that this is the second
time this very dangerous narcissist has been causing suffering and deaths in
Sweden. Back in 2009 during H1N1 influenza (swine-flue) he was the person
responsible for the purchasing and injecting the unsafe Pandemrix vaccine in
the Swedish population as head of the vaccine department. Today it has
amounted to a total of 600 then children and youths developing narcolepsy. He
spent the following years defending the government against the victims who was
seeking economic indemnity from the Swedish state medical insurance. When the
Swedish newspaper Svenska Dagbladet later acquired emails of this mater he was
caught on record emailing that the goverment agency he was working for at the
time "was at a point of no return politically".

He was then recruited as the State Epidemiologist of the Public Health Agency
of Sweden in 2013 as a thank you for his service. Now in 2020 he is directly
responsible for the deaths of about 5500 swedes. You could argue that he is
also responsible for some of the deaths in neighboring countries where there
have been imported cases from Sweden.

This person already before the beginning of 2020 had caused 600 direct cases
of mistreatment can now add 5500 deaths to his CV. And likely 1000s of people
with lung-damages, muscle damaged and other severe trauma damage from
intensive care. There are also reports of increased diabetes onset among
Covid19 survivors and the ME/CFS that will likely be the result for many who
got the disease.

If you are interested of the numbers and statistics you can check
[https://c19.se/](https://c19.se/) it has deaths and infected on a regional
level. It can be helpful to understand that the city of Stockholm has had 2344
officially dead and 21490 official cases among its population of 975904. Tests
results of antibodies have been reported in ranges from about 10% - 17%. But
since testing was not allowed for most people until very recently the numbers
can be either spot on or very off.

------
pengaru
It seems obviously wasteful to keep such businesses open where most the paying
customers won't be showing up during a pandemic anyways. Why even pay to have
the lights on? You need to mothball the operation ASAP and lobby for
government assistance for the duration.

I was just poking at rough figures last night out of curiosity regarding when
the other end of this arrives in terms of 60% herd immunity for the US. Just
pulling numbers out of my ass, like 200,000,000 for 60% and an avg infection
rate of 100,000/day. With those figures it's 5.5yrs before 60% gets infected.
We're at more like 50,000/day last I checked, but who knows how accurate that
is.

Either way, it looks like this is going to be a life of masks and social
distancing for a long time. Hopefully a vaccine arrives in volume before 5+
years go by.

~~~
kalleboo
> _It seems obviously wasteful to keep such businesses open where most the
> paying customers won 't be showing up during a pandemic anyways_

In Sweden people still seem happy to go out to bars and restaurants, even in
the middle of a pandemic. It's non-stop work for the government to shut down
venues that are crowded beyond the allowed covid19 congestion regulation.

This whole "even if restaurants and bars were open, nobody would go to them"
narrative just doesn't bear out in reality.

We're seeing the same thing in the UK now as well.

~~~
pengaru
Your comment is in direct contradiction with TFA, did you read it?

~~~
kalleboo
I did read it (and insinuating I didn’t is against the rules).

Nowhere does it have any proof of restaurants losing all their customers. It
says that economists predict a contraction (that hasn’t happened yet), that
consumer spending at one point was down 25%, and that the manufacturing sector
had to shut down due to supply chain issues.

I never said that restaurants have lost customers, just that there is still a
very significant amount of people willing to go out anyway.

The Google Mobility report shows that retail & recreation (which includes
restaurants) for Sweden is currently down only 1%!!! (workplaces -40%, transit
-25%)

------
anderstornqvist
This is a very misleading article. Compare Japan (no lockdown) with Norway,
Finland, and Denmark. Or we can compare some areas of Sweden with Norway.
Sweden has high death rate for the same reason that many of the lockdown
countries have hight death rate: Elderly care centers in some areas where not
properly protected! 20 years of policies for cost reduction of care homes is
the reason for the failure).

