> A risk factor that we want to highlight, however, is the low vitamin D levels found in the Swedish-Somali population. Vitamin D status is strongly related to low sun exposure and dark skin. In two different studies, the great majority of Swedish women of Somali origin had very low levels of S-25(OH)-D (< 25 nmol/l).[3,4] In Finland, Somali women required more than twice the amount of vitamin D in order to maintain recommended vitamin D status. [5] In addition, vitamin D deficiency was twice as common, regardless of gender, in immigrants from Africa compared with those from the Middle East.[6]
Sweden only messed up if you consider the variable to optimise to be the number of deaths. If you attempt to minimise sum decrease in quality of life as a consequence of the pandemic, then as callous as it may sound, the severe lockdown strategies come out of the equation quite poorly.
Strictly, Sweden messed up if you consider the variable to optimize to be the number of short-term coronavirus deaths. If no vaccine or effective treatment comes available soon enough, then other countries may pay the same cost in mortality after reopening, just later. Theirs could even be worse, if e.g. they accidentally push their second wave into winter and the weather effect turns out to be significant.
And that's before considering the second-order cost in mortality. Society has existing treatments for various diseases that we know statistically would save lives, but that we don't pay for because they're not cost-effective, often defined around $100k per quality-adjusted life year (QALY) in the West. Assuming about 10 QALY lost per coronavirus death, the coronavirus has so far cost Sweden the same mortality as a $4B cut in health spending, about 1% of their GDP.
So if you favored an intervention that would have cut that mortality to zero but cost Sweden an extra 2% of GDP, then in a meaningful statistical sense, you're killing people--you're proposing to allocate limited resources from a place where they save more lives to a place where they save fewer. The only difference is that we see coronavirus victims dying now, but the future deaths due to an under-resourced medical system will be lost in the noise.
None of this is to say that Sweden's response is obviously right. For example, if a treatment is discovered next month that dramatically cuts the IFR, then they'll regret not delaying cases until after that. To criticize Sweden's response solely on the basis of their current death count is not useful, though.
Better optimize then for haircuts. How many haircuts can we trade for one death? Haircuts are so much more important that we should accept some number of deaths so that people can get their haircuts. What's this number to you? Callousness doesn't even begin to address the stupidity of this argument.
Depends on who's dying, but somewhere between 10k and 500k haircuts per death. (A teenager or child is "worth" more than someone in a nursing home - and if you go by life expectancy, it's more than 50x higher)
So 10k @$20/haircut is $200k, near the top of the statistical value of a year of life. (And the life expectancy of someone entering a nursing home in the US is less than a year) 500k @$20/haircut is $10m, or at the top end of what federal agencies put as the value of a life in the US.
At either conversion rate opening up for haircuts alone is remarkably silly.
If you think the debate is about haircuts, I'd wager you have a work from home friendly job with direct deposit where you don't have to decide between "staying home & going broke" vs "working & feeding my family."
I'd wager you don't get sarcasm. I'd also wager the people who are out of work aren't protesting with signs demanding haircuts. Then again, I might lose this second wager if these protestors are that stupid, dumber than even I previously thought.
What tangible things is the US not doing that others are?
I don’t see much difference from here in Canada and people seem happy with how it’s going and our politicians.
The main difference I see is the US has a higher obesity problem (30% US vs 20% Canada last I checked) and cities like Toronto are far less densely populated than NYC. Although Montreal is more dense and is having a worse time than Toronto.
I wish we closed our border faster instead of spending a month attacking the US for doing it.
The lack of masks and temperature screening seems to be common among all western countries. And something that seems like a obvious thing to me that could be changed. Our top doctor only started formally recommending masks last week.
The US has a spectrum of responses. San Francisco and the entire state of California shut down early and hard and therefore is doing pretty well both in absolute cases and per capita.
New York shut down much later and actually sent covid-19 positive patients to nursing homes and New York City kept the subway open throughout, so they represent roughly 25-33% of the US's cases and deaths on its own. If you add adjacent states (New Jersey and Pennsylvania), it gets over 50%.
Iowa never had to shut down because people aren't on top of each other.
Dig into the reports and media that you're reading and watching and pay attention to how many are about New York versus everywhere else.. NY goofed.
I agree that NY's response was bad; but how much of the difference between NY and CA is attributable to their response, and how much to pre-existing behavioral, genetic, environmental, or other factors? California (where I am) has lower population density than NYC, lower reliance on public transit even in SF or LA, an Asian population accustomed to wearing masks, fewer black people (who seem worse hit even adjusting for socioeconomic status, for a yet-unknown reason), warmer weather. How do you know what fraction of the difference in mortality is explained by those attributes vs. the government response?
I say this not to excuse sending infectious patients into nursing homes, but with the goal of recognizing the tremendous uncertainty in almost all aspects of society's management of this disease. For example, Japan seems to be doing great, with no major lockdown and testing that's missing ~80% of cases (assuming 1% IFR, their 830 deaths imply 83k cases; but they've found only 17k). I strongly suspect that the Japanese response would have brought disaster in NYC or Lombardy, but I'm not sure anyone can confidently say why.
> *Edit: To the people giving me shit, I am pointing out that this commenter is using a strategy (I don't know if there's a formal name) to tangentially push an agenda. 1. Sweden did the right thing, and 2. Brown people are 'invading' Sweden.
And this is libel. I’ll be seeking legal action if you don’t remove it (and if you are subject to US tort law). Also the term you’re looking for is “dog whistle”.
Blaming it on Vitamin D instead of socioeconomic policies of the ruling government is deflection and dismissal of more substantial class and race issues in responses to Covid, especially Sweden's which is broadly considered to be especially fucked up.
"Nope, Sweden didn't mess up, it's just that they have more brown people and uhhh vitamin D". The hell prior do you have that you think such a conjecture makes more sense than "Sweden's COVID response not only sucked, it sucked especially for poor and marginalized people"?
I don't want to jump in on the topic of whether Sweden's response was correct, but there is data to indicate that there is likely some other factor, possibly vitamin D deficiency, at play in addition to social factors. In the UK there's roughly a 4.2 times higher overall fatality rate for blacks than whites, and 1.9 after controls. That isn't enough to explain Sweden's rates, but it does look like it would plays a substantial role alongside socio-economic issues.
> Areas with large proportions of Black/African American residents are at markedly higher risk that is not fully explained by characteristics of the environment and pre-existing conditions in the population.
> There are now seven observational preprints (Abstracts and links below), based on COVID-19 positive patient data, indicating vitamin D deficiency and insufficiency, do indeed factor significantly in COVID-19 severity and mortality – for example, and thought provokingly, 10 to 20 times increases were seen in ICU and mortality in Asian studies.[5, 6] One further USA based study observes vitamin D may factor in COVID-19 infection.[7] Whilst differing in, size and exact approach, results of all preprints point clearly in the same direction.
> Concerningly, vitamin D is often low in high-risk COVID-19-groups, such as, BAME including African Americans, elderly in care-homes, and the obese. Low vitamin D is also increasingly common in young.[8] Studies suggest low ‘D’ factors in Kawasaki disease[9, 10, 11] ; occurrences are increasingly being linked with COVID-19.[12,13]
Yes there is a correlation between Vitamin D deficiency and COVID mortality. But you are not just saying that. You are saying that the effect size coming from Vitamin D explains a significant portion of the excess mortality in Sweden. That's just a guess and it's weird that you would make that conjecture when there's the wildly spectacular policy difference between Sweden and everyone else. Neither of the studies you linked support that.
I don't have time to read the studies you linked. If you did, what is the relative impact of socioeconomic status, the fact that the most polluted zip codes in NYC are predominantly black neighborhoods, and vitamin D deficiency?
https://www.sciencedaily.com/releases/2020/05/200512134426.h...
https://www.bmj.com/content/368/bmj.m1101/rr-10
> A risk factor that we want to highlight, however, is the low vitamin D levels found in the Swedish-Somali population. Vitamin D status is strongly related to low sun exposure and dark skin. In two different studies, the great majority of Swedish women of Somali origin had very low levels of S-25(OH)-D (< 25 nmol/l).[3,4] In Finland, Somali women required more than twice the amount of vitamin D in order to maintain recommended vitamin D status. [5] In addition, vitamin D deficiency was twice as common, regardless of gender, in immigrants from Africa compared with those from the Middle East.[6]