At Lancet Swedish physician and researcher Johan Giesecke leaps to the defense of the approach Sweden has taken to facing the COVID-19 pandemic. After noting that, although Sweden’s mortality rate from the virus is higher than its immediate neighbors, it is lower than that of the UK, Spain, and Belgium, he remarks:
PCR testing and some straightforward assumptions indicate that, as of April 29, 2020, more than half a million people in Stockholm county, Sweden, which is about 20–25% of the population, have been infected (Hansson D, Swedish Public Health Agency, personal communication). 98–99% of these people are probably unaware or uncertain of having had the infection; they either had symptoms that were severe, but not severe enough for them to go to a hospital and get tested, or no symptoms at all. Serology testing is now supporting these assumptions.
These facts have led me to the following conclusions. Everyone will be exposed to severe acute respiratory syndrome coronavirus 2, and most people will become infected. COVID-19 is spreading like wildfire in all countries, but we do not see it—it almost always spreads from younger people with no or weak symptoms to other people who will also have mild symptoms. This is the real pandemic, but it goes on beneath the surface, and is probably at its peak now in many European countries. There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in 1 year from now, the figures will be similar, regardless of measures taken.
Measures to flatten the curve might have an effect, but a lockdown only pushes the severe cases into the future —it will not prevent them. Admittedly, countries have managed to slow down spread so as not to overburden health-care systems, and, yes, effective drugs that save lives might soon be developed, but this pandemic is swift, and those drugs have to be developed, tested, and marketed quickly. Much hope is put in vaccines, but they will take time, and with the unclear protective immunological response to infection, it is not certain that vaccines will be very effective.
In summary, COVID-19 is a disease that is highly infectious and spreads rapidly through society. It is often quite symptomless and might pass unnoticed, but it also causes severe disease, and even death, in a proportion of the population, and our most important task is not to stop spread, which is all but futile, but to concentrate on giving the unfortunate victims optimal care.
There are a lot of assumptions packed in there. For one thing is it really true that “most people will become infected”? It seems to me there is a conflict among assumptions about exposure to the virus, susceptibility, and the figures being reported on antibody testing.
There’s also an unspoken assumption about the Swedish economy. Will Sweden emerge from the pandemic with less economic damage than its neighbors? At this point the numbers don’t really support that.
I have been a bit tough on the Swedish model since supporters claimed it was going to guarantee no financial hit and that didnt make much sense, neither to me nor to the Swedes themselves. However, it looks like it may have at least one big advantage, the Swedes have bought into it. Part of that may be a rallying effect secondary to a lot of criticism, but from afar it looks like more than that. This seems to have been sold well to the Swedes and they have had good, solid leadership that has not undercut the message coming from their scientific leadership. Granted that they also have better followership, wouldnt it be nicety see something like that here?
Steve
All the lockdowns were intended to do is reduce the daily patient load on the medical. The lockdowns do not reduce the cumulative number of cases or deaths. Some have argued that by closing the system non-COVID patients the number of sick and dead people are actually ncreased.
The lockdowns have established a nascent Great Depression everywhere in the World. The longer the lockdowns continue, the more businesses fail, and the more supply chan links are broken. At some point the Great Depression takes on a life of its own, regardless of lockdowns
Moreover, there is no vaccine and precious little treatment for any coronavirus, and the likelihood of a vaccine for COVID-19 is vanishingly small.
We will have to end the lockdowns very soon, and deal with the once-deferred cases and deaths as they show up.
Some economist out there is predicting May 17th is the latest we can put off ending the lockdowns everywhere. After that Great Depression II sets in. Yet another model. Who knows anything.
Seems overly pessimistic, and the diagnosis I would make is that there are too many random super spreader locations/people that make a mess of the plans. The scientist builds a foundation for the winter, only for it to be reduced to rubble by the winds, what else can he do?
But Mousie, thou art no thy-lane,
In proving foresight may be vain:
The best laid schemes o’ Mice an’ Men
Gang aft agley,
An’ lea’e us nought but grief an’ pain,
For promis’d joy!
“The lockdowns do not reduce the cumulative number of cases or deaths.”
Which model says that?
Steve
The Swedish model does not predict no financial hit. That’s a lie. It is fatalistic with respect to infection. You can get infected today, or tomorrow. All you do in the interim is manage the infection rate and who is infected.
You let people have choice and exercise judgment as to how they respond, eliminate the assault on civil liberties, and the assault on the general economy.
Quite rational actually.
Pardon me if I’m not willing to fork over my future to Andrew Cuomo and a career bureaucrat with a short man complex.
“The Swedish model does not predict no financial hit. That’s a lie.”
Correct that the Swedes didnt predict that, but that is the claim of conservatives in the US. Read jan’s comments. She is a good bellwether of broad GOP sentiment.
” civil liberties”
Is the right to infect others covered under the part where the Constitution says all other rights are reserved to the states?
Steve