Sweden appears to have been right about Covid

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More detailed data is now becoming available about the Covid pandemic. Sweden was an outlier country because it relied on voluntary measures rather than government mandates and believed that the best approach was to try to achieve the much maligned “herd immunity” by allowing the spread of Covid among the demographic where it was mostly a flu-level illness while trying to protect the most vulnerable. This strategy led to predictions of a potential Swedish catastrophe.

This was a topic of much discussion on the old TMF boards.

The info at the time was mostly limited to measures of Covid mortality. The number per capita dying from Covid in Sweden was initially high and leveled off to a rate several times higher than the neighboring Scandinavian countries. This would seem pretty conclusive against Sweden, however, the definition of Covid mortality varies between nations. In Sweden, anyone who dies while Covid positive is listed as a Covid death, while in Norway a doctor has to identify the cause of death as Covid. For reasons like this, most researchers believed a true assessment of the Swedish strategy had to wait for better data.

We now have Excess Deaths data that compares the number of deaths in the pandemic years to those before the pandemic. This in principle measures the impact of Covid as well as that of the Covid policies on overall mortality rates. Here is the data showing the increase in deaths in 2020-2022 compared to the pre-pandemic years just before. https://www.cato.org/sites/cato.org/files/2023-08/policy-analysis-959-no-link.pdf

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These stats are from Sweden, so one could argue they are biased. However, similar analyses from the Economist (Excess deaths from 2020 to the present) show Norway and Sweden about equal and lower than Finland and Denmark. Nice interactive map. The pandemic’s true death toll

Swedish studies published in the journal Viruses argue that herd immunity was achieved twice in Sweden for two Covid variants without vaccination.

In this scenario, a form of herd-immunity under the given restrictions was reached twice (first against the Wuhan-strain and then against the alpha-strain), and the ultimate decline in cases was due to depletion of susceptibles rather than the vaccination campaign. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415753/

At this point it appears that Sweden had it mostly right about Covid, though perhaps could have done a better job protecting its elderly population.

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The (not mentioned) point is a basic one: Universal health care AND a relatively healthy society (i.e. they get vaccinated as needed, have relatively “good” lifestyles, education, and can spend the time needed to take care of themselves AND others as needed). This would apply to most Nordic countries.

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Not only healthy and with universal health care, but the voluntary vaccination rate in Sweden was very high. So was the right thing to do to make it voluntary, or to have a large percentage vaccinated? (hint: the latter).

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The CATO Institute leans more on propaganda than reality. Just like the Heritage Foundation. Both are major marketing firms.

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Remember that the vaccines only became broadly available at least a year after the beginning of the pandemic. In most countries outside of Sweden, mandatory economic shutdowns and school closings occurred well before.

For example, the US began K-12 school closures in Feb 2020. Sweden recommended high school remote learning in Mar 2020, but closure of primary schools was left to local governance. The vaccine became available in the US in Dec 2020.

# No learning loss in Sweden during the pandemic: Evidence from primary school reading assessments https://www.sciencedirect.com/science/article/pii/S0883035522000891

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You are missing the difference. There are only 10 million people in Sweden. The Swedes do not need to pass a law to get something done.

America is constantly trying to idiot-proof the country with laws but the idiots remain. Last I saw the red states were dropping like flies. The blue states did better. What is the idiot ratio?

The red states did not want anything to prevent deaths. Regardless of the laws that were passed in red states stupid died.

NY and NJ were the exceptions because they were the epicenter. Travel from Europe was an early cause. Trump shut off travel from Asia.

The other issue with NY was Cuomo was forced politically to include nursing home deaths. Yet a lot of the tomfoolery was not the same in other states. There was a lot of crying wolf about how bad Cuomo was in his reporting. He was used like a rag by the opposition when the opposition was not clean at all.

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The data don’t support that conclusion.

It is a myth that Sweden had no COVID restrictions. Sweden actually had extremely strict travel restrictions (far greater than the United States), for example, as well as some school closings and so on. Sweden just had different restrictions and Swedish health authorities recommended many of the restrictions we had but they just weren’t enforced.

Believe it or not, COVID restrictions were measured and tracked. You can see that Sweden’s level of restrictions were generally a bit below or equal to other peer nations, and at times were even more restrictive.

One thing Sweden did extremely well was to promote vaccines and had an very high rate of vaccine penetration. Because American political leaders lack ethics/have extremely low intelligence/subscribe to crackpot anti-vax theories, they chose to downplay the safety and effectiveness of vaccines. So Sweden had high death rates early in the pandemic due ineffective public health messaging, but lower death rates after vaccines became widely available and were promoted effectively. Economically, Sweden fared just about the same as its peer nations, so they didn’t dodge that bullet either.

And philosophically, how do we value human life? Many politicians (for some reason already of the non-vax variety) opined that it is mostly old people who die anyway, and so why should young people not be allowed to bars and have fun? Well, is that the type of society we want to live in? Don’t we want to live in a country that protects the vulnerable and weak? I hope to be old someday. I hope my country doesn’t want to kill me off.

“As a senior citizen, are you willing to take a chance on your survival, in exchange for keeping the America that all America loves for your children and grandchildren? And if that’s the exchange, I’m all in.”

–Prominent politician on COVID restrictions

The message is clear. True Americans should be willing to sacrifice old people if it means younger people can make more money. Keep in mind, sacrificing old people didn’t help Sweden’s economy.

And assuming you are not part of the 52% of country who would rather skip a trip to Disneyworld than see your parents die, there is another metric when it comes to human life. That is, years of life saved.

Roughly speaking (I’m going from memory but these numbers are close enough for illustration) a 60 year old is 10 times more like to die from COVID than a 40 year old. If a 40 year old dies, they lose about 40 years of life. If ten 60 year olds die, they lose 200 years of life. One of those numbers is a lot bigger than the other. So do we value human life or not? If you do, you don’t do it like Sweden did.

The kicker though is that Sweden took the approach they did in order to reach herd immunity as fast as possible. And fact, Sweden estimated herd immunity would be reached fairly quickly.

Guess what? Sweden never attained herd immunity because there is no herd immunity with COVID (the conclusions of the paper you linked to did not indicate herd immunity). The reasoning for what they did was wrong. The data are clear. Sweden’s “success” story is due almost entirely to encouraging vaccine use. Their public health approach in the early pandemic lead to many preventable deaths.

I fully expect American political leaders are too dumb to understand this. That said, at the time no one knew what COVID meant or how to deal with it. Therefore wrong approaches were understandably taken.

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I think you are creating a straw man here. No one suggested Sweden had no restrictions. The difference was that many of Sweden’s Covid response was based on the assumption that the general population could make its own decisions based on transparency of information and recommendations from the government. Compliance for such measures may be higher in a democracy if voluntary rather than through government mandated.

The question is what can be learned before the next great pandemic. Sweden, China, Norway, the USA, etc differed in some aspects to their response to Covid. Now is the time to evaluate what worked and what didn’t, as well as to assess the human and economic costs of shutdowns and prolonged school closures.

Note that the title of this thread is that Sweden was right about Covid. This includes their promotion of vaccines. Another straw man?

The evidence presented in the OP is that loss of life in Sweden during the pandemic was not significantly different from loss of life in neighboring countries. Another straw man?

Why do you suppose Covid variants that were once prominent disappear? Herd immunity. The population through infection or vaccination becomes sufficiently resistant to the variant that it goes away. Herd immunity is what selects for new viral variants that can evade the immune response. Fortunately, each new variant appears to have reduced severity of symptoms.

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You tell me. According to the Economist data in the OP, total deaths in Sweden were about the same as its peer nations and somewhat higher than in Norway, Denmark, or Canada.

So how come the title of this thread isn’t “Canada appears to have been right about COVID?”

I can see that no one has yet clicked on the link I provided that had the statement from Swedish Health Minister saying herd immunity would be reached within a few weeks of April, 2020.

Yet, Sweden had higher death rates–and in some cases much higher–than its peer nations until May, 2021 when vaccines became widely available. It is almost like the herd immunity approach was mostly wrong.

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Viral evolution, not herd immunity (unless you’re going to start introducing your own revision of the scientific nomenclature)

It’s part of the reason why rapidly replicating, single strand RNA viruses can appear to be resistant to vaccines (new variants can appear in a matter of hours). The other, in the case of SARS CoV-2 variants is a fairly rapid degradation of neutralizing antibodies…from either disease or vaccine…and a subsequent reduction in immunity.

I didn’t know any of this before the appearance of Covid-19 and the focus on the TWiV podcasts. Virologists did, fortunately.

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For a a glimpse of the TWiV nuances on this topic…

First few minutes general chit chat but they get to discussing a paper on this very topic (link provided) at around the 3 minute mark.

Of course, anyone familiar with the TWiV episodes since early 2020 will already have grasped some of the background here. Much early discussion and subsequent revisions as new data and understanding emerged.

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You know zero on the topic. I am not saying I am a virologist but sheesh. Normally I’d be happy to have any discussion but you will never admit you are wrong. You will go on and on spreading more false information.

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Well, with the emergence of novel viruses that behave differently from those that’ve gone before, it might well be time for a revision…or addition of a few caveats…to the commonly accepted understanding of herd immunity.

Paper from the TWiV discussion for quick reference

This isn’t a new phenomenon, as the original Koch’s Postulates (defining presence of microbial disease) had to be modified as understanding of microbiology/virology etc developed.

This has the potential for an interesting discussion :thinking:

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It’s amazing what you can learn when you ask someone who actually knows how this stuff works:

Wondering why, when COVID mutates the older variants appear to disappear. Vaccinations killing them off? Herd immunity killing them off? The mutated virus literally kills off its prior selves? It’s just what viruses do overall?

His answer: it’s all of the above. So this notion that “herd immunity can save us” is clearly wrong and fraught with danger. And no, Sweden did not save itself via herd immunity.

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This paper by Fauci concludes there is no herd immunity for SARS-CoV-2.

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Viruses mutate to spread faster. A sort of natural selection. It survives. If the host dies the virus dies. The flip side of the selection process. That propels the mutations from our point of view.

The Spanish flu is still with us. Called the French flu by the Spaniards.

There is more covid going forward. So what in most instances? Admittedly some people are still having horrible reactions. Most covid cases are unreported.

More covid in this instance? I am not sure. More covid over the duration of our lifetimes? Yes.

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There is no single definition of herd immunity. Scientific articles have been written about this and whether there is a need for one. For example:

Therefore, for clarity sake, any disagreements about herd immunity should include the definition being used. Mine is when the resistance to a disease agent (like a specific virus variant) in the population rises to a level that infections by that agent steadily declines. An example of this is data from S. Africa:

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The beta variant was widespread in 2020, peaked Jan 2021 then rapidly declined in infections because most of the population by then was immune. That’s herd immunity. This created a selection for the Delta variant that could avoid the immune resistance to Beta. Delta also reach herd immunity in a few months, with a sharp decline by the end of 2021.

Viral evolution is not an alternative to herd immunity, on the contrary. Herd immunity is one of the major drivers of viral evolution.

My definition of herd immunity is not unusual, though some other investigators call it “transient herd immunity” to distinguish it from the more classic versions associated with more long-lasting examples like measles. Same principle but transient is shorter lasting because of the ability of the Covid virus to mutate. From the Journal of Infectious Diseases:

In the models, daily COVID cases spike when the virus is first introduced. Eventually, infections reach a pinnacle, and case numbers begin to fall during a refractory period when a large proportion of the population is presumed to be immune. This would be the point when the population crosses the herd immunity threshold, Lavine says—there are no longer enough susceptible individuals to support long viral transmission chains. But if the virus keeps evolving or immunity fades over time, say in six months or a year after infection or vaccination, then as people become vulnerable to reinfection, transmission chains will start up again and the conditions of herd immunity would no longer be met. “Our group has taken to calling it ‘transient herd immunity,’” Lavine says. Core Concept: Herd immunity is an important—and often misunderstood—public health phenomenon - PMC

In this case, Fauci is applying the concept of herd immunity to the Covid disease rather than a specific Covid viral variant. Because the Covid disease can be caused by many variants, herd immunity at the disease level is difficult, if not impossible. But at the level of specific viral agents, herd immunity happens all the time.

I prefer thinking about at the level of specific agents rather than the general disease because I think the former is more informative. The initial Covid disease caused by the alpha-variant differs significantly from that caused by, for example, the later Omicron variant with respect to mortality, disease severity, infectiousness, and the frequency of long-term Covid. In many ways it is more accurate to think of these as different diseases.

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It could have been if one wanted to make a point about something Canada did that was unusual. Sweden in 2020 was doing stuff that most of the rest of Europe and the US disagreed with. Yet Sweden didn’t do too badly.

Again, countries use different methods to report covid-related deaths making most comparisons using this metric apples to oranges.

From Bloomberg:

On some of those measures, Sweden has objectively fared better than countries that prescribed lockdowns. Its young people are doing especially well compared to those of other nations…The evidence on mental health tells a similar story. An analysis of 11 countries that had lockdowns and school closures shows that depression and anxiety increased dramatically among young people. By contrast, a study of Swedish university students found negligible effects on depression, and even small improvements in anxiety and stress. https://www.bloomberg.com/graphics/2023-opinion-lessons-learned-from-covid-pandemic-global-comparison/#sweden

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There is no ‘resistance’. The bug kills the host and can not travel onward. That is not resistance. That is a dead end. The bug is mutating and a variant that does not kill the host comes to dominate and generally is more contagious. There is no resistance.

Those who died do not increase the “resistance”. There is no resistance.

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Didn’t do too badly, unless human life is the important metric. In that case, Sweden objectively did poorly in 2020.

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