
Anders Tegnell defends Sweden's virus approach - whydoyoucare
https://www.startribune.com/scientist-admits-sweden-could-have-battled-virus-better/570980492/
======
ptero
The guy is a scientist and his answers have to be viewed from that angle. A
politician goes for spin and tries to project confidence; "I am not sure this
is the right approach" from a politician usually means "hell, no!". Tegnell's
answer means just that -- he is not sure. Which is a normal way for a
scientist to feel as there are always uncertainties and when we choose an
action we are often not sure for a while if that action is optimal or not.

I personally feel a lot of respect to Tegnell. Sweden might have taken a
better or a worse approach than, say, France but it is clearly not
catastrophic: there are no mountains of corpses on the streets there are a
number of countries with lockdowns and worse per capita death rates; second
wave, if appears, will likely go much easier on Sweden, etc.

I think other countries should take a page out of Tegnell's book and instead
of trying to exorcise dissent and label opponents, admit to uncertainties in
their policies. This will not make their argument weaker; it might still mean
that lockdowns are a better option. But it would also open policies for
discussion and debate. Good policies will still win. But then they win by
merits, not because of trying to silence any opposition. My 2c.

~~~
bildung
_> Sweden might have taken a better or a worse approach than, say, France but
it is clearly not catastrophic_

The only countries worse off than Sweden are significantly poorer - besides
Belgium, which seems to be the only country counting correctly (e.g. untested
excess deaths in Covid proximity are included).

The most similar countries to Sweden, regarding political structure and
wealth, are Denmark and Norway, which have 20% and less than 10% of Swedens
death rate, respectively. I'd say it's safe to assume that at least 80% of
Swedish deaths could have been avoided with a conventional approach.

~~~
guygurari
If Sweden has a significantly higher percentage of the population infected (as
they claim) then it doesn’t make sense to compare death rates at this point,
because it may be that these other countries will reach the same numbers
(infection rate and death rate) later. This is a likely outcome because
Sweden’s healthcare system has not been overwhelmed, so it’s not obvious that
their policies will lead to excess deaths in the long run. The thing to
compare is the final death toll (as well as economic damage), and we don’t
know that yet.

~~~
bildung
Why do you think Norway will eventually approach the same number of infections
as Sweden? Norway only has a few hundred active cases left, and is testing 2
times as much than Sweden. They are on their way to normal life in a few
weeks. If new outbreaks occur, they are well prepared to isolate them.

~~~
marvin
Just got a snap from a friend of mine. First pub beer of the season yesterday.
15 days with no new cases in my hometown. City of 300,000, West Norway.

Testing capacity of >1000 per week locally. No way it can sneak up on us
without a large external influx.

Tourism is dead, music festivals are off and the oil industry is in a
shambles, but otherwise things are close to normal.

Plenty of routines to limit contagion, lots of care and social distancing, but
life goes on with no disease for now.

------
heracles
The amount of misinformation (or the very least, confused statements) in this
thread is high for being HN. Soo many people know much about Sweden without
ever setting their foot here. Interesting that.

The world's apparent obsession with the Swedish strategy isn't about Sweden at
all. It is about their own strategies, trying to prematurely pat themselves on
the back for doing the right thing, whatever that was. There's myriads of
variables that differ between Any two countries.

~~~
JoeAltmaier
Well, Sweden's 4:10000 death rate is alarming. In only a few months. And their
confident approach (doing very little) in the face of scant information was
bold. With lives at stake, its natural to be alarmed/scandalized at their lack
of effort to control a pandemic.

~~~
cwhiz
That rate is in line with the US and most European countries. The US lost 40
million jobs and spent $4 trillion dollars to achieve the same outcome as
Sweden.

And now the US is reopening and attempting a similar approach to Sweden. You
can’t shut the world down for months and months waiting for a vaccine.

~~~
MagnumOpus
You compare two of the worst approaches in the world and present a false
fallacy of "shut down the world" when in fact the countries with stricter
quarantine/tracing/tracking approaches had far better outcomes:

Germany, and Japan, and Korea, and Taiwan lost far fewer jobs, killed far
fewer people per capita and nearly eradicated the pandemic while it is still
rampant in the US and Sweden.

~~~
tlear
Japan is an interesting one. They did next to nothing.

Life is almost back to what it was before atm. How did Tokyo not have a
massive outbreak is an absolute mystery. But it did not.

Was it that 99% of people when told to started wearing masks and people do not
hug or shake hands? We have no idea, no tracing, very small amount of testing,
no house arrests of any kind.

~~~
claudeganon
They didn’t do “next to nothing.” They used a cluster-based approach through
their public health center network, that was put in place to combat TB in the
30s. Turns out, that was pretty effective at combatting COVID.

> In 1935, with funding from the Rockefeller Foundation, Japan opened its
> first public health centre (PHC) in Tokyo. The country then put in place a
> programme that led to the building of another 187 nationwide. They survived
> the war and the occupation. But the thing of note is that before and after
> the war, their priority, says Taniguchi, was always to “stay watchful all
> the time” for the emergence of TB cases. If one was found, they were tasked
> with rushing to the patient's residence, checking for clusters and
> sterilising the house Seventy-five years on, 469 PHCs are in operation
> across the country, with each manned, on average, by 64 medical
> professionals, including one to two licensed doctors. They still locate
> clusters, track links and conduct tests. It is this “accumulated wealth of
> expertise, rarely found elsewhere” that has made the difference. Japan has
> not had to rely on mass testing strategies because it’s health care history
> had already left a cluster-crushing strategy embedded in its system

[https://moneyweek.com/economy/global-
economy/601264/cluster-...](https://moneyweek.com/economy/global-
economy/601264/cluster-busting-japan-success-fighting-covid-19)

~~~
ardy42
> They didn’t do “next to nothing.” They used a cluster-based approach through
> their public health center network, that was put in place to combat TB in
> the 30s. Turns out, that was pretty effective at combatting COVID.

Also, IIRC, their culture is naturally more socially distanced than western
ones (e.g. mask wearing was already common in some situations, bowing instead
of hand shaking, etc.).

~~~
claudeganon
Mask wearing, yes. I’m not sure about the other parts. Unmarried people live
with their parents well into adulthood. There are less children, so maybe
that’s a factor. But most stores, restaurants, and other venues in Japan would
seem cramped and overcapacity by Western standards.

------
somewhereoutth
Sweden made some very bad choices and a lot of people died unnecessarily.
Compare with Portugal, same population, right next to Spain, lower GDP, a
fraction of the deaths. There is no excuse, no 'second wave', no economic
payoff, no wait and see.

Scientists are trained to make judgments based on experimentation and
evidence. In a fast moving novel pandemic situation, where there is no time to
carry out experiments, where evidence is confused and hard to corroborate,
their utility is much reduced. That is why politicians exist, to make these
hard decisions. It is unfair to pillory scientists such as Tegnell, as it is
the politicians who abdicated responsibility in the face of this crisis that
should rightfully face condemnation.

Except of course, there _was_ evidence, from China, Taiwan, South Korea and
elsewhere. It was clear what needed to be done, and how to do it. Shame on
Sweden, and other places, for not heeding that guidance.

~~~
dependenttypes
I was under the impression that quarantine was an option only to "flatten the
curve" (and make it easier for the hospitals to treat people) and that the
same amount of people would die regardless (from the virus), is this wrong?

~~~
viraptor
That's only assuming we never get a vaccine or an effective treatment. If we
do, then the number of people to die before that point matters a lot, because
we would get a sharp decline after.

~~~
octodog
In addition to your points, another reason for "flattening the curve" is to
give time for hospitals and health care systems to prepare for a spike in
cases, so that every patient who needs critical care can receive it. For
countries like Italy that were hit at the start of the pandemic, this was a
serious problem.

Where I live, in Victoria, Australia, the state government has used the
lockdown time to plan for and deliver a huge increase of ICU beds [1].
Thankfully, it looks like these beds may not even be necessary, but initial
modelling suggested a peak of 10,000 active cases with only 500 IUC beds
available.

[1] [https://www.theage.com.au/national/victoria/thousands-of-
bed...](https://www.theage.com.au/national/victoria/thousands-of-beds-
promised-for-coronavirus-pandemic-may-never-be-used-20200420-p54lip.html)

------
thawaway1837
Sweden’s strategy failed on its own terms. There is absolutely no arguing
that. Their first goal was to protect the vulnerable, and they failed
miserably at that. Fundamentally because Tegnell resisted the fact that
asymptomatic carriers existed.

One could argue, like some Iraq war proponents do, that the idea was ok for
Sweden, but the failure was in execution. But one can not argue that it wasn’t
a significant failure.

~~~
jmauritz
We're barely 3 months into this and your calling it a failure? could it be
done better: yes, it is failure? no. "no arguing", "can not argue" Yes, you
very much can, and we'll see in a few years what the "correct" choice was.

~~~
dpau
the comment was referring to failure in execution, not necessarily failure in
choosing the correct approach. it's hard to argue that sweden shouldn't have
been more careful with its elderly and vulnerable, even if going for herd
immunity.

~~~
svrtknst
It's fairly impossible to say "Sweden should hav ebeen more careful with its
elderly" \- The measures put in place by Sweden were designed with that in
mind.

That's why elderly care facilities were the first, if not only ones, to face
quarantine.

However, when you have years of poor management of elderly care, and elderly
care companies that refuse to heed the recommendations, there's not much
"Sweden" can do in the moment wihtout severe effort.

~~~
jacobush
And the politicians should have put in that severe, very expensive effort. But
that would have required them to be fast, which is not a very Swedish thing.
Everything is extremely decentralised and in many cases privatized.

Either the state (highest level) should have forced an intervention, or all
actors should have acted responsibly. But there is too much inertia. The
elderly care is so poorly managed, it was not only a disaster waiting to
happen, it actually was a slow burning dumpster fire even before Covid19.

So many wasted opportunities.

~~~
svrtknst
How would they do that? I think it's safe to assume right away that the
companies aren't going to act responsibly, because, well, they haven't for
years. So that leaves the state, and what should they do?

Not like they can push a button and invent more caretakers, fix internal
routines, etc, across an entire country.

I'd love it if they could, but in general, there is going to be inertia when
trying to affect change in a system that has been degrading for years, with
actors actively working against those changes (in this case, companies putting
profit over welfare).

It's so very, very easy to say "the state should have done something, fast",
but it gets very difficult when you're trying to specify which parts of the
state should have done what, to which actors and on which level.

------
rfrey
Seems to me that we won't really know if the Swedish approach was a disaster
or not until economies are reopened, second waves happen or don't, etc. The
game isn't over.

~~~
alkonaut
Indeed. The strategy _if it works perfectly_ was never going to have fewer
deaths than a lockdown strategy after 3 months.

That much should be obvious. The criticism early on was "Oh my god look at
these simulations you'll have 25k ICU beds needed and you have only 1k", 50k
will die before july!

When that didn't happen, somehow now the message is that 4k dead and emergency
hospital capacity never even used is a complete failure - because _Norway_ has
fewer deaths?

I think if anything we should be happy that most of Europe managed to actually
contain this disease and people weren't left to die without ventilators as the
early alarms said. Whether 500 or 5000 die in a country is a big difference,
but remember we were fearing tens of thousands in every countruy.

------
nounaut
90% of all covid-19 deaths in Sweden have been people over the age of 70 [1]
which is the only group of the population which have been quarantined. So it's
arguable what difference a nation wide quarantine would have made.

Of those over 70, half of the deaths were in care homes and another 26% had
home care [2].

Many of the workers in care homes have reported that their companies/bosses
won't allow them to stay home when they're showing symptoms and some have been
forced to work without protective equipment.

There have "only" been 42 deaths under the age of 50 [2].

[1] [https://www.svd.se/90-procent-av-alla-doda-i-
covid-19-over-7...](https://www.svd.se/90-procent-av-alla-doda-i-
covid-19-over-70-ar) [2] [https://www.svt.se/nyheter/inrikes/halften-av-alla-
doda-over...](https://www.svt.se/nyheter/inrikes/halften-av-alla-doda-
over-70-ar-med-coronasmitta-bodde-pa-sarskilda-boenden)

~~~
ptx
Those numbers are a month old. There have now been 64 deaths[1] under the age
of 50.

In the age group between 50 and 70, which you didn't directly mention, 455
people have died.

[1] [https://www.svt.se/datajournalistik/har-sprider-sig-
coronavi...](https://www.svt.se/datajournalistik/har-sprider-sig-
coronaviruset/)

~~~
nounaut
Doesn't change the fact that the high death toll have been among the part of
the population that were in fact in quarantine and would most likely have been
the same had Sweden chosen a more common tactic.

~~~
addicted
They were in “quarantine”.

Tegnell didn’t believe in the existence of asymptomatic carriers so younger
care workers were allowed to visit them freely as long as they didn’t show
symptoms.

He made a huge mistake but is simply unwilling to admit it.

~~~
nounaut
Care takers have been forced to work with symptoms, and there's even one known
case where a woman went to work at her care home after testing positive for
covid-19 and staying quiet about it.

This would not have changed with a different strategy.

------
viburnum
It’s still too soon to tell but it seems like the economic impact of a
thorough lockdown (New Zealand) isn’t much greater than most people staying
home voluntarily (Sweden). The difference seems worth it to control the
pandemic. Two weeks from now it looks like New Zealand (with zero cases left)
with have fewer restrictions than Sweden.

~~~
Mediterraneo10
New Zealand is an island. It knew that it could pursue the full eradication
option because it had few cases and could fully close its borders. European
countries with their large numbers of infected and more porous borders
(economy requiring movement of migrant workers for agriculture, etc.) never
pursued full eradication, only curve-flattening.

~~~
viburnum
So what if New Zealand is an island? How many people are walking to Sweden?

~~~
Mediterraneo10
Few people might be walking on foot to Sweden (though in Tornio/Haparanda,
some do walk over the border), but Sweden has land borders with two countries
and a bridge to a third. Traffic has continued to move over those border
crossings during the time of the pandemic. In fact, there has been a steady
flow of traffic over most European border crossings along major motorways,
though that traffic has consisted of only drivers and passengers who could
show they are moving around for work purposes etc.

The only common way into New Zealand is a flight or an occasional ship. NZ has
no immediately neighboring countries that it runs freight trucks to and from
day in and day out, and it doesn't need to move large numbers of agricultural
workers around internationally. Therefore, for New Zealand traffic is
obviously going to be smaller and easier to control than European countries.

~~~
roca
You can close roads and bridges. You can punish people who try to cross in
secret.

There may be reasons why you would choose not to close the borders, but it's a
choice.

------
butler14
Tegnell was wrong.

He predicted that the virus was circulating many times more widely than people
thought (20-25%) -- and posited much of his strategy on that.

In reality that appears to be closer to 7%.

He was also particularly wrong in attacking other countries - and the
underlying Imperial College study that influenced them - for locking down in
the way they did.

18.1m people came in and out of the UK between January and March in the UK --
nearly twice the entire population of Sweden. What was optimal for Sweden
would never have been optimal for others.

~~~
sbt
The 20-25% immunity was for the Stockholm area, not for the country as a
whole. In reality they were off by something like 5%.

~~~
butler14
The 7% figure is also for the Stockholm area

------
hkai
It's mind blowing how the media spinned his defense, with headlines like
"Sweden admits they were wrong and should have locked down", whereas he said
exactly the opposite.

He said: we should have had more labs, locked down retirement homes, but we
shouldn't have asked students to stay home.

------
bobthemover
There is no convincing evidence that Sweden’s approach has led to a materially
worse outcome, and in fact if you look at the overall health of the country
considerable evidence that outcomes will be much better in the long term.

Every country will have to adopt the Swedish approach eventually or find
themselves caught in an endless cycle of lockdowns.

It seems to me that the experiment is countries trying to eradicate the virus
through lockdown as opposed to just slowing it down, with no evidence that
this is working or could ever work.

NoW that the virus is better understood and we know that the people at risk
are mostly people at the end of their life the continued tyrannical lock down
Of the general population in many countries is a failure of leadership, not a
success.

The large number of hysterical articles condemning the Swedish approach
reflects the fact that people don’t want to admit that they made a mistake and
want to desperately justify doing something really stupid.

~~~
microtherion
> the people at risk are mostly people at the end of their life

The estimates I have seen suggest that the people dying lose, on average, 10
years of their life. That's not exactly insignificant.

~~~
bobthemover
10 years is the average life expectancy of a person that is between 75 and 80
years old in North America.

So on average everyone dying at that age loses 10 years of life.

75 to 80 years old is also the mean age of death from covid.

Im going to go out on a limb and say that it is likely that people on average
that die from covid do not lose 10 years of life.

This does not make it less of a tragedy for the individuals involved.

~~~
microtherion
The study in question does adjust for long-term health conditions:
[https://wellcomeopenresearch.org/articles/5-75](https://wellcomeopenresearch.org/articles/5-75)

~~~
bobthemover
Thank you. That was interesting.

I am skeptical about the methodology and the results of the paper.

It does not make sense to me, and it looks like the authors knowingly chose to
increase the YLL with the choice of their data sets and how they analyzed the
correlation between covid deaths and comorbidities.

I’m happy to admit that I might just not fully understand it.

------
geoffreymcgill
Making a comparison of Sweden (10,094,432 population) vs Czech Republic
(10,707,502 population) seems to reveal a very different story.

New cases (7 day average):
[https://i.imgur.com/fciq4Ra.png](https://i.imgur.com/fciq4Ra.png)

Total deaths:
[https://i.imgur.com/do9Zbvn.png](https://i.imgur.com/do9Zbvn.png)

~~~
pedrosorio
Masks can do wonders

~~~
alkonaut
If there is a clear sign of the mask requirement being introduced in graphs
from various countries (e.g. these graphs) I can't see it...

I think there is a lot of "I believe X would give outcome Y and I see outcome
Y therefore X must work". This mistake is called Affirming the Consequent.

Without clear signs of causation we can't know.

~~~
heracles
Thank you. There's sooooo much "I think like this therefore I will find two
variables out of 10000 and link them" going around. The easy with which one
could argue the exact opposite using some two other variables seems to go
unnoticed by the original makes of the claim, whatever it was.

------
buboard
I think epidemiologists shoot themselves in the foot as a profession when they
started talking about herd immunity, which is the one situation we are trying
to to avoid in infections, and really the entire reason their profession
exists. We could reach herd immunities without them but the toll is dramatic
and untenable. Politicians mistook the term to mean some kind of solution and
made it a buzzword, but it really is the worst solution.

Swedens situation is not the worst in the world, but they really did not win
much with their "strategy" either. Talk of "reaching herd immunity in a few
months" was irresponsible and heavily fatalistic. As a country with a big
public sector they could easily have followed a slightly more conservative
approach. An "initial freeze, then plan accordingly" would be a more rational
way to go. It was also irrational to assume that their economy can "rebound
faster" when most of the rest world is shut down.

Epidemiology did not wear its best suit in this pandemic, and will lose a lot
of respect in the eyes of many[1]. Scientists have a duty to inform people
when their results are being misused or misinterpreted

1\.
[https://marginalrevolution.com/marginalrevolution/2020/04/wh...](https://marginalrevolution.com/marginalrevolution/2020/04/what-
does-this-economist-think-of-epidemiology.html)

------
confuseshrink
I find it very surprising that someone would rely on unvalidated mathematical
models for this, that goes for the Imperial College people as well as Sweden.
Are they even able to fit the parameters in retrospect?

Anyone with a background in mathematical modelling should be extremely
cautious of applying models in situations where there are serious
ramifications to getting the wrong answer.

Hubris.

~~~
alkonaut
> serious ramifications to getting the wrong answer.

I think "locking millions of people inside" is one of the most serious
ramifications you can imagine too. It's like we lost all grip of what
suffering and cost is so long as we save lives. I'm not saying we should value
lives highly but we sure didn't value them this highly last year and we
probably won't next year...

------
hyperpallium

      Sweden's economy, which relies
      heavily on exports, is expected to
      shrink 7% in 2020
    
      [neighbours] dropping mutual border
      controls but would keep Sweden out
    

Sometimes it's better to go with the crowd, even if you're right.

------
wycy
My takeaway from the NYT article[0] was that Sweden's approach to coronavirus
hasn't left them totally overwhelmed primarily because Swedes willingly self-
lockdowned and distanced almost as much as people under government-mandated
lockdowns. So while some like to point to them and say "see, we could've
stayed totally open," the reality is that they did lockdown but it came as a
decentralized decision rather than a centralized order. Because they did
effectively lockdown, their economy is expected to be impacted similarly to
the rest of Europe[1]. Is my interpretation incorrect?

[0]
[https://www.nytimes.com/interactive/2020/05/15/world/europe/...](https://www.nytimes.com/interactive/2020/05/15/world/europe/sweden-
coronavirus-deaths.html)

[1] "Preliminary evidence shows Sweden has suffered similar economic effects
as its neighbors: The Swedish Central Bank projects the country’s G.D.P. will
contract by 7 to 10 percent this year, an estimate on par with the rest of
Europe. (The European Commission projects the E.U. economy will contract by
7.5 percent.)" (Ref [0])

------
nickbauman
There's a deep problem of all these comparisons of economies with public
health policies:

Markets and money are vehicles for making agreements. They are all about
negotiation. They are imminently and manifold fungible. They are contrivances.
A deadly virus is not.

Let's also not forget for every death from C19 there are a handful-dozen
people who survive to lifelong health problems from the episode. That has a
cost, too.

------
DeonPenny
I'm glad he came out against that Bloomberg article it was a obvious misquote.
You could tell. not only did they not attached the audio. He literally has
interviews about a week or 2 before talking about how well it was going.

Regardless about how you feel about Sweden's strategy Bloomberg's obvious
manipulation is garbage.

------
ggrrhh_ta
Other countries in Europe also have lead epidemiologists and scientists (or
technical bodies) making the recommendations that then get turned into policy.
Those scientists in Denmark, Germany, Switzerland, Finland, Norway, France,
Spain, Italy are as good as Tegnell is.

Also, the medical approach to people getting sick with COVID-19 has
significantly improved over the first month (e.g., early hospitalisation
instead of sending a sick person to isolate themselves at home, weeding out
drugs that did not work from those that worked, introduction of drugs to
control trombosis and secondary damage from the virus, better approaches to
when and how use ventilators, etc.).

That means that a number of the deaths that have occurred within the Swedish
policy could have been avoided by delaying the infection. More importantly,
Sweden's approach has not even achieved a significant level of immunity, as
Swedes have been self-imposing social distancing and even a 'lockdown'
(working from home).

In an interview in "unherd", Giesecke estimated that the deaths in UK without
lockdown would be in the 12,000 (when they where 13,000), then corrected
himself to 24,000 (they are almost 40,000 now), and then said they will not be
10x 12,000.

On freedom. The lockdown for reasons of public health is a limitation of our
freedom that has been accepted (except in Sweden) by their citizens in their
respective contracts as a society (constitutions, laws, etc.). So, per se,
it's a limitation akin to not driving over a certain speed in certain roads.
Moreover, many people (and students) have reported that the lockdown has been
"liberating" \- and for others have been depressing (it never rains to
everyone's liking)

On ending the lockdown. Tegnell and Giesecke repeat and repeat and repeat that
countries imposed a lockdown without a strategy out. Well that's just dire
false. When the lockdown was being discussed, the press was already pointing
that issue and several strategies were being considered (press from March
already discusses the measure by measure approach).

But, whereas other countries are looking conservatively with the evidence
(that could be flawed because it is small and incomplete) that they already
have, Sweden is relying in an evidence that will only be apparent in the
future (if the events turn out to be advantageous for that approach).

If each country had been given an "ant population" with some infected
individuals and their epidemiologists needed to manage the epidemic long term
while a cure for the ant's illness is found, maybe, the Sweden's approach
would have made more sense... At least, most people wouldn't have had much
feelings for those ants that could have lived a couple of days longer.

~~~
Kiro
Giesecke has no official position. He's an attention-seeking troll.

~~~
Henk0
He is, however, the former state epidemiologist, Anders Tegnells former boss,
and - as was recently reported in the big dailies in Sweden - is currently
working as a paid consultant informing the Swedish strategy. Quite the
influential troll...

------
ReticentVole
Deaths in Sweden are at their highest level since 1993:

[https://www.reuters.com/article/us-health-coronavirus-
sweden...](https://www.reuters.com/article/us-health-coronavirus-sweden-
toll/coronavirus-pushes-swedish-deaths-to-highest-since-1993-in-april-
idUSKBN22U1S4)

What happened in 1993?

A Flu Pandemic...

That no one has ever heard about, that seemed to have no lasting impact, and
occurred when the population was younger and 25% smaller (thus having a
proportionally much greater impact).

Without the media panic, COVID-19 would have come and gone as a unusually
deadly flu wave, nothing more.

~~~
WildParser
In the Gompertz-Model (that worked perfectly for China) Sweden is converging
to R~0,8 - with a total death-count <6000\. Germany is going to R~0,7 / <9000.

Given the explosive dynamics of COVID-19 that soon converges to R<1 going for
herd immunity was most likely a bad choice.

For Germany cutting the flu in half worked - while the bad math of the
epidemiologists-community seems to last forever...

~~~
alkonaut
> going for herd immunity was most likely a bad choice.

I think this has been repeated a lot. No one is "going for herd immunity".
Every country including sweden has two goals: having as few as possible
infected and preventing healthcare from being overwhelmed. If partial or full
immunity makes the virus go away that's a fortunate side effect of slow burn,
not the "goal".

------
misja111
To me it seems that there is only one fundamental assumption that determines
how to handle the pandemic: do you believe that we can have a lockdown until a
vaccin is on the market, or do you think the vaccin will take too long.

If you believe the first, then yes a lockdown like in Denmark or Norway is the
best choice. If you believe it will take too long, then what matters is to
minimise economical damage by containing the virus just enough making sure
that the health system is not overwhelmed and to protect the most vulnerable
groups. This is what Sweden chose and what most countries believed in as well
in February. Sweden's health system was never overwhelmed, so the higher death
rate in Sweden must be due to the higher infection rate in combination with
the fact that they could have protected their elderly people better. But if
the vaccin takes too long then neighbour countries will catch up.

------
raverbashing
More important seems to be his previous statement (which is also quoted in the
article):

> Tegnell's statement to reporters came after more contrite comments earlier
> in the day to Swedish radio in which he said “I think there is potential for
> improvement in what we have done in Sweden, quite clearly.”

> Asked if the country’s high death toll has made him reconsider his unique
> approach to the pandemic, Tegnell told Swedish radio “yes, absolutely.”

------
yogthos
That same guy who now admitted that his strategy to fight Covid-19 resulted in
too many deaths, after persuading his country to avoid a strict lockdown.

[https://www.bloomberg.com/news/articles/2020-06-03/man-
behin...](https://www.bloomberg.com/news/articles/2020-06-03/man-behind-
sweden-s-virus-strategy-says-he-got-some-things-wrong)

~~~
andreasley
Actually, both articles are based on the same quotes – just very different
interpretations and headlines.

~~~
heracles
This is the situation in a nutshell. Would be comical if the topic was
different.

------
adthomsen
I believe it's way too early to make conclusions about which approach would
have been the best from a scientific/public health perspective.

The reason I think Sweden's approach is wrong is that other countries are much
more hesitant to work with them now. An example being Denmark opening the
borders to Norway and Germany but not Sweden.

------
scott_meyer
Just watch this chart for a couple years:

[https://ourworldindata.org/coronavirus-data-
explorer?zoomToS...](https://ourworldindata.org/coronavirus-data-
explorer?zoomToSelection=true&deathsMetric=true&totalFreq=true&aligned=true&perCapita=true&smoothing=0&country=USA~SWE)

------
dr_dshiv
How would one rationally model and determine a multifactor policy on covid
lockdown, balancing for health, economy, and overall wellbeing? Is it even
possible to balance those, if it means making x lost life years equal to y
many bankruptcies or z lost jobs, etc?

~~~
alkonaut
This is what authorities like the FHM (the public health authority does every
day). You use tools like counting QALY, for example.

~~~
dr_dshiv
But how do you equate or make commensurable those different measures? How many
job losses equal a lost life year?

~~~
alkonaut
That’s the difficult part, but that’s the job of the public health authority.
Same thing with missed semesters of a school. How many add up to an 80 year
old dying? And so on and so forth. I don’t envy those that have to do this
arithmetic, but it can’t be avoided.

~~~
dr_dshiv
I don't see how it is arithmetic nor the job of a public health authority.
It's a philosophical, ethical and political issue.

There are bounding conditions, like research showing that job loss increases
rates of suicide. [1]

But we still argue about whether it is fair to treat the life of a 12 year old
as more valuable than the life of a 92 year old. So it isn't just arithmetic.

[1]
[https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...](https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366\(20\)30141-3/fulltext)

------
curation
The book Necropolitics by A. Mbembe makes these conversations more productive.
I am part of many groups abandoning the constraints of the assumptions that
act as thresholds throughout each back and forth on this page.

------
acd
I am happy we let our expert government agency in this matter make the
decision and not the politicians. There will be an autumn. Countries which let
politicians shutdown early have numbers that look good now, but there is
autumn and there is shutdown stamina. If you shutdown early there is little
herd immunity in the autumn. There is also psychological effects of keeping
people in total isolation for too long. In prison isolation is a punishment
which I do not wish upon anyone.

Then has to see that its also a group decision from the health authorities in
Sweden where there is consensus on the direction board on how to act. Its not
a one person decision.

~~~
glangdale
But you didn't achieve herd immunity, and you're going to be in the same place
as everyone else (except with more dead). There might be a marginal advantage
but antibody studies show Sweden is nowhere near even the more generous
estimates of what herd immunity might require.

Everything about the Swedish approach is a failure, and the amazing thing is
that not only was the approach bizarre, but the Swedes have a very low testing
rate relative to the number of cases - which seems like a weird move (innovate
both in approach and in terms of "not knowing what's going on"). Positively
3rd world cases:deaths ratio - it's just embarrassing.

------
contemporary343
Scientists are human and prone to as many cognitive biases as anyone. As one
myself, I see here an effort to contort oneself and one’s model/framework to
somehow explain the data. When the data seems fairly clear that this has been
a failure for Sweden. That being said, I think our failures here in the US
have been vast and worse.

------
eveningcoffee
I think that Sweden mistake has been to not react to the realities and keep
the line and cover their mistakes by propaganda. This and complete failure to
increase testing capacity and find even essential PPE. For example people who
took the swab samples whore nothing more than a visor.

------
hajderr
Also the way countries report deaths may be different.

------
whydoyoucare
BBC, WaPo and NPR have conflicting titles, but I found this to be better
worded and balanced article.

~~~
vesinisa
Tegnell has previously categorically denied any mistakes were made, but is now
saying a stricter approach should have been taken in hindsight. In Swedish
political culture, it seems to be a big thing if even a hint of a mistake is
admitted by an authority figure. Directly criticizing public policies is
almost a taboo for ordinary civilians.

~~~
zlorch
> Directly criticizing public policies is almost a taboo for ordinary
> civilians.

This could possibly be the worst lie I've heard this week. And I've listened
to Trump.

~~~
null_object
There have now been several articles documenting the attacks that have been
the consequence of questioning Tegnell's decisions in public. This is one
example (in Swedish)

[https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-
er-f...](https://www.aftonbladet.se/debatt/a/kJr5b6/jag-anklagar-er-for-att-
tysta-coronadebatten)

But in DN (behind a paywall) there have been other articles where those that
questioned Sweden's policy have even been personally threatened.

Tegnell has been wrong about pretty much everything - from saying that the
pandemic had reached its "peak" in Sweden when we had 137 cases[1] to being
consistently wrong about how far we've supposedly come with 'herd immunity' \-
which was supposed to be around 50% by the beginning of June, but which has
shown itself to be only around 7-10% in the worst-affected areas in Stockholm.

There is also a lot of finger-pointing in articles and comments by Swedes,
accusing other Nordic countries of purposely under-estimating their covid
figures - whereas the actual statistics[2] show that Sweden itself is the only
Nordic country with massively under-estimated deaths.

[1]
[https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiolog...](https://www.aftonbladet.se/nyheter/a/RRpj0A/statsepidemiologen-
toppen-kan-vara-nadd-nu)

[2]
[https://www.nytimes.com/interactive/2020/04/21/world/coronav...](https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-
missing-deaths.html)

~~~
jojje2k
Regarding [1], it sounds more like Aftonbladet is either misquoting him,
quoting out of context or The title claims he said we had reached the peak,
giving the impression of peak infections across the whole population, but the
contents only covers a specific group of people who had returned from their
vacations in Italy.

I'm not saying he didn't mean or say peak total infections in the interview.
I'm just saying that particular article is all over the place.

Edit: On the contrary, according to the article he said we could very well be
hit by a new wave from new arrivals.

------
nickthemagicman
The irony of demonizing Sweden...is that as we speak...every single other
country in the world is starting to do what Sweden is doing and opening its
economy with basic social distancing.

The model of exponential infections used to justify quarantine and flattening
the curve has not happened any of the places opening up.

Coronavirus appears to reach a steady-state in the rate of infections in
populations, just like numerous other infectious diseases.

The people in my town are absolutely terrified. Unemployment has skyrocketed
poverty riots. This is a sad failure of leadership and science.

Sweden and Tegnell appear to have been right.

