
Sweden Says Controversial Covid-19 Strategy Is Proving Effective - throwaway888abc
https://www.bloomberg.com/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective
======
koyote
I think we'll have to wait for the end of this to see which strategy has been
effective and which one has not.

Sweden might not be at a plateau yet and turn into the UK in a couple of weeks
time. Or they are indeed at a plateau and they will reach herd immunity with
minimal societal and economical damage.

Other countries with hard lockdowns might look good in comparison to Sweden at
the moment but might have a hard-hitting second wave.

Whatever the outcome, we won't know until this is over. Which is why I am not
a big fan of comparing 'effectiveness' at this early stage.

~~~
monkeydreams
> Which is why I am not a big fan of comparing 'effectiveness' at this early
> stage.

The state broadcaster in Australia (ABC) broadcast an hour-long episode of
their program "Foreign Correspondent" in which the Singaporean government were
granted a platform to explain how their approach was far more civilised and
liberal, with better results and more freedoms than the efforts of Australia.
They prated on and on about the benefits of their system of both disease
control and government trust and how low their disease numbers and civilian
discontent was.

The disease control aspect has not aged well.

------
DavidVoid
If you're interested in hearing about Sweden's strategy, what has and hasn't
worked, etc. then I can highly recommend this interview with chief
epidemiologist Anders Tegnell from earlier this week [1]. It's one hour long
but he answers most questions I think people would have about Sweden's
strategy.

To give a very quick summary: One-third of the fatalities have been in elderly
homes which were not protected as well as they should have been and this is
something that they are working on. It seems like recommending that people
stay home if they have any symptoms is good enough to keep reduce the spread
of the virus enough for the health care system to keep up. And a lot of
measures have voluntarily been taken by individuals and companies to reduce
the spread as well so it's not like Sweden is just business as usual or
something like that.

[1]: [https://youtu.be/Wo10IIMHYXk?t=651](https://youtu.be/Wo10IIMHYXk?t=651)

~~~
Yetanfou
Tegnell has quickly become a rather controversial figure in Sweden with a
large host of detractors on one side and a fanclub on the other side. There
have been several calls from experts in the field for Sweden to change its
policy [1, 2, 3], the latest of which saw 22 professors, researchers and
doctors call for politicians to step in and take control. While it undoubtedly
is interesting to hear Tegnell speak about his strategy you need to keep in
mind that there are many experts in the field who disagree with the way
Folkhälsomyndigheten deals with the pandemic.

[1] [https://lakartidningen.se/Opinion/Debatt/2020/03/Sverige-
bor...](https://lakartidningen.se/Opinion/Debatt/2020/03/Sverige-bor-byta-
strategi-for-att-bromsa-spridning-av-coronaviruset/)

[2] [https://www.dn.se/debatt/folkhalsomyndigheten-har-
misslyckat...](https://www.dn.se/debatt/folkhalsomyndigheten-har-misslyckats-
nu-maste-politikerna-gripa-in/)

[3] [https://www.svt.se/nyheter/inrikes/forskare-kritiska-til-
fhm...](https://www.svt.se/nyheter/inrikes/forskare-kritiska-til-fhm-lat-
politikerna-ta-over)

~~~
DavidVoid
There will always be people who don't agree with whatever policy is chosen
ofc. Judging by opinion polls Tegnell is actually much less controversial now
than he was when the pandemic started here (trust in Folhälsomydigheten rose
from 50% in March to 71% in April) [1].

And as is mentioned in [3] the numbers cited by those researchers were not
accurate. That doesn't mean that they're automatically wrong, but it's worth
keeping in mind.

We'll ofc have to wait a year or two to find out if Sweden's strategy was
ultimately a good or a bad one. But if you want to know what's being done and
why it's being done then Tegnell is the person to listen to since he's very
much at the center of it all.

[1] [https://www.aftonbladet.se/nyheter/a/70OzwW/fortroendet-
for-...](https://www.aftonbladet.se/nyheter/a/70OzwW/fortroendet-for-tegnell-
och-lofven-okar)

------
jnurmine
I see a lot of the "Sweden is sacrificing the elderly for money"-arguments in
media. But of course that's not the intent.

What options do countries have? Any vaccine or cure is at least one year away,
if not more. There is no miracle cure (Tweets don't count).

Let's say you are a country with SARS-CoV-2.

So, your goals are A. stop the spread, and B. protect the most vulnerable and
C. try to keep the number of hospital visits low enough to not collapse the
healthcare system, so that people ending up in hospitals have a chance of
making it out alive.

Do you 1. lock down the country hard; or 2. keep the country (semi) open,
reaching for herd immunity, or 3. do nothing?

If you do #1: prepare to be locked down until a vaccine/cure exists and gets
deployed. This is at least 1.5 years. Are you ready for this? Sure, this keeps
the death rate low. If you open the lockdown early, people start dying again.
Prolonged lockdown hurts the economy, and the healthcare system will also
suffer greatly. If the economy collapses, things go to shit really fast, and
don't expect help from the hospitals. And, in general, any immunization within
the population will proceed slowly if at all.

If you do #2: some people in the risk groups will die because the virus is
everywhere. And, for this choice to work, immunization must be a possibility,
so that herd immunity can develop in the first place. Over time, the
population may resist the virus.

If you do #3: many people in the risk groups die, the healthcare system
collapses and you'll be in a really bad place. The population may become
resistent, though.

Option #3 is not really good.

Assume you choose #1, i.e. total lockdown. Once you open up the lockdown,
you'll be in situation #2. So why not do #2 directly?

If you don't believe that immunization through exposure to the virus can
happen, then #1 is the only choice -- hope for a vaccine and be prepared for
economic carnage.

But, in all other cases #2 is the saner alternative. I think this is why
Sweden is doing what it's doing.

~~~
akmarinov
Option #2 sounds great if you know what immunity means in this case.

We don’t know how long immunity lasts or what it looks like, there are even
reports of reinfection.

There are also severe complications to the heart, lungs and liver after the
disease, which wouldn’t occur with option #1

------
brianchu
You can view Swedish ICU admissions data yourself here:
[https://www.icuregswe.org/en/data--results/covid-19-in-
swedi...](https://www.icuregswe.org/en/data--results/covid-19-in-swedish-
intensive-care/). New admissions to the ICU due to Covid-19 appear to be flat
or possibly even declining.

~~~
Yetanfou
You do have to keep in mind that hospitals in Stockholm - which is currently
the epicentre of infections in Sweden - have adopted a policy to not admit
people with a 'biological age' of 80 or over to intensive care, nor will they
admit people with a 'biological age' of 70 with at least three serious
conditions or 60 or over with at least two serious condition [1, 2, 3, 4].
These guidelines have been in use for a few weeks now even though there still
is enough capacity to admit at least some of these people. The guidelines also
state that intensive care treatment of patients who fall into one of the two
categories should be discontinued. According to these guidelines people who
will be denied intensive care will be offered palliative care instead. The
concept of 'biological age' is not well-defined here which makes it hard to
actually apply these guidelines. It is used because it is not allowed by
Swedish law to deny care based on physical age whereas the law does not say
anything about triage based on 'biological age'.

[1]
[https://www.aftonbladet.se/nyheter/samhalle/a/lAyePy/dokumen...](https://www.aftonbladet.se/nyheter/samhalle/a/lAyePy/dokument-
visar-de-prioriteras-bort-fran-intensivvard)

[2] [https://www.expressen.se/nyheter/coronaviruset/ingen-
intensi...](https://www.expressen.se/nyheter/coronaviruset/ingen-intensivvard-
for-personer-over-80/)

[3] [https://www.dn.se/sthlm/dokument-visar-vilka-som-inte-far-
in...](https://www.dn.se/sthlm/dokument-visar-vilka-som-inte-far-
intensivvard/)

[4] [https://cached-
images.bonnier.news/cms30/UploadedImages/2020...](https://cached-
images.bonnier.news/cms30/UploadedImages/2020/4/10/57973d61-eed9-4b57-8987-085a74af8f59/bigOriginal.jpg)
(the actual guidelines for Karolinska university hospital)

~~~
DavidVoid
That policy is precautionary to give doctors guidance on how to prioritize
patients if/when the hospitals run out of space/resources.

To my knowledge, these decisions have not had to be made yet. As mentioned in
[3] Stockholm has space over and is accepting patients from the Sörmland
region.

~~~
Yetanfou
> To my knowledge, these decisions have not had to be made yet.

According to people working in health care in Stockholm they have used these
policies for a few weeks now [1], the article (from the 2nd of April, 2½ weeks
ago) contains two references to cases where patients were denied intensive
care (and, as a consequence, died) who would have received care before these
policies were enacted. The (anonymous) nurse states that _Sjukvården är inte
öppet ärlig med att vi redan har en katastrofsjukvård där man inte prioriterar
de som man bedömer är sjukast, utan de som man bedömer har störst chans att
rädda_ which (loosely) translates to _care givers are not open about the fact
that we already optimise for throughput instead of prioritising those who need
the most care_

[1] [https://www.aftonbladet.se/nyheter/a/9v4z2q/sjukskoterska-
vi...](https://www.aftonbladet.se/nyheter/a/9v4z2q/sjukskoterska-vi-har-redan-
katastrofsjukvard)

~~~
mediascreen
The article is almost three weeks old. The anonymous nurse predicts the
imminent total collapse of the health care system where even the field
hospitals will overflow and it's too late to do anything about it. This has
clearly not happened.

The nurse goes on to blame deregulations and financial aid to banks and
corporations. This seems more like the personal feeling of a rather leftist
nurse published by a left of center tabloid.

I am sure there have been misinterpretations of the directives and there have
probably been times where prioritizations have been done based on local and
short term conditions. But it is not an active and commonly used policy.

------
the8472
They have 3x the deaths per capita than germany and 30x that of south korea.
"Better than italy or spain" is a rather low bar.

~~~
DavidVoid
One-third of which were in elderly homes [1]. This is an issue that's being
worked on but apart from the failure to protect elderly homes, the Swedish
strategy seems to be working well enough at the moment.

[1] [https://www.svt.se/nyheter/inrikes/en-tredjedel-av-alla-
dods...](https://www.svt.se/nyheter/inrikes/en-tredjedel-av-alla-dodsfall-
fran-aldreboenden-i-sverige)

~~~
the8472
If you discount those 1/3rd (why should you? it's still a policy failure) it
would still be 2x the rate of germany.

~~~
DavidVoid
It would still be high but it's honestly way too early to tell if Sweden is
doing better or worse than Germany since the virus will likely be around for
quite a while.

It's also worth pointing out that different countries haven't been reporting
COVID-19 deaths in the same way. Finland, for example, have just now started
including nursing home deaths in their statistics [1]. In Sweden, it's my
understanding that pretty much anyone who was infected with and suspected of
dying due to COVID-19 has been included in the statistics, even if the actual
cause of death might have been something else.

[1]
[https://yle.fi/uutiset/osasto/news/finlands_coronavirus_fata...](https://yle.fi/uutiset/osasto/news/finlands_coronavirus_fatalities_likely_under-
reported_by_dozens/11312030)

~~~
enra
Even if other countries are missing some deaths (most are), these charts look
still very different. Sweden 1200 deaths vs Finland&Norway at 80-150:
[https://images.app.goo.gl/krLeDxnBHCdQ9817A](https://images.app.goo.gl/krLeDxnBHCdQ9817A)

------
zxcvbn4038
I’ve noticed that whenever NY Gov Cuomo says the curve is flattening it has
the same effect as Gillian saying the words “smooth sailing”. I think Cuomo
really needs to stop trying to characterize trends based on one day’s data. He
sounds like a youtube “How To Beat Baccarat” video - bet you could learn to
master his strategy get a cool t-shirt for only $29.95.

~~~
SpicyLemonZest
He can't stop everyone else from characterizing one day's data, so even if he
knows it's mostly meaningless it's best to get ahead of it. And it's seemed
like he does know that - he's consistently tagged "we need a consistent trend
over multiple days to be sure" to his analysis.

------
29athrowaway
Social distancing has been a thing for a while in that region.

Look at the "Swedish bus stop meme".

------
neonate
[https://archive.md/2eyP2](https://archive.md/2eyP2)

------
101404
Isn't their strategy basically the same that Johnson was doing in the UK
initially?

------
droithomme
Here's an article from a far more reputable news media organization published
today also which says the policy is a disaster:

[https://www.theguardian.com/world/2020/apr/19/anger-in-
swede...](https://www.theguardian.com/world/2020/apr/19/anger-in-sweden-as-
elderly-pay-price-for-coronavirus-strategy)

~~~
zyberzero
And here is one [0] from another reputable news source that says more or less
the opposite.

I think it's too early to call out a "winner strategy" \- I think there will
be a new wave when the different countries opens up - but that's my guess, and
hey - I program computers on a daily basis, as far away as you probably can
get from this kind of science.

(and yeah, I am a Swede)

[0] [https://www.washingtonpost.com/graphics/2020/world/corona-
si...](https://www.washingtonpost.com/graphics/2020/world/corona-simulator/)

~~~
eveningcoffee
None of them is reputable in this question. Both are heavily biased.

------
Kkoala
I guess if you call killing bunch of innocent people "effective". But I think
it's way too early to start comparing strategies.

