Did Sweden end up taking the best approach?

260,932 Views | 1675 Replies | Last: 6 mo ago by Enzomatic
Sq 17
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elementary schools and Junior highs closed also which is probably what you meant,

I think go home and try not to infect your immediate family is bad public policy. Plenty of schools could be converted to shelters quickly. While they were quarantined it would be possible to get data on the infected that were not hospitalized. Seeing as we are going to be fighting this disease for awhile we need lots of data if we are lucky isolating and studying the infected before they end up in the hospital might yield insight as to why some people end up needing to be hospitalized. The other reason to isolate the infected is to slow the spread. The asthamatic and diabetic seem to be at higher risk obviously they need to stay out of the community at large but keeping the infected isolated would be very beneficialm

lastly i doubt antibody testing is going to be helpful except for places that were hit hard Nola nyc i just don't think that many people have been exposed
Complete Idiot
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Sq 17 said:

elementary schools and Junior highs closed also which is probably what you meant,

I think go home and try not to infect your immediate family is bad public policy. Plenty of schools could be converted to shelters quickly. While they were quarantined it would be possible to get data on the infected that were not hospitalized. Seeing as we are going to be fighting this disease for awhile we need lots of data if we are lucky isolating and studying the infected before they end up in the hospital might yield insight as to why some people end up needing to be hospitalized. The other reason to isolate the infected is to slow the spread. The asthamatic and diabetic seem to be at higher risk obviously they need to stay out of the community at large but keeping the infected isolated would be very beneficial
Anyone tested positive or with obvious symptoms could be isolated, but the challenge is those that have no symptoms, but contagious, for 4-6 days before symptoms appear OR who are contagious and NEVER show symptoms.

WHile typing that I realized I had never looked up how many people with influenza never show symptoms. Only clicked on one article - https://www.nhs.uk/news/medical-practice/three-quarters-of-people-with-flu-have-no-symptoms/ - from 2014 and it suggest as much as 75% of people who develop influenza antibodies never had symptoms worth reporting. And an interesting snippet from that article:

This is very much a "good news, bad news" story. It is good news in that so many people with a flu infection are spared the burden of a nasty infection. However, limiting the spread of a future pandemic could be challenging, as it would be unclear who is infected.
DadHammer
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Good find
PJYoung
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16 and under can attend schools. Or maybe its 16 and over cant. I forget which.
Sq 17
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schools are not open here not sure about your district yes the asymptomatic are an issue but still want the positve and symptomatic out of the population and having their blood drawn twice a day. Of course with their consent
plain_o_llama
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Here is the underlying paper, in case anyone wants to read it.....

"Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study"

https://www.thelancet.com/action/showPdf?pii=S2213-2600%2814%2970034-7

Findings Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 1622) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (1334), suggesting most influenza infections are asymptomatic. 25% (1835) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (1026) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2.

They only looked at symptoms of unvaccinated people because vaccination affects serology results.
fig96
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DadHammer said:

Sq 17 said:

4. desperately need antibody tests and let those people lose to live and work immediately.

I feel like this is really our major issue right now. Without regular and antibody testing everyone is just making best guesses with not enough data.
Sq 17
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based on hiw dadhammer replied that is actually his take, more testing good I am not optimistic on antibody testing I just dont think in places like bcs very many people have had it , hope i am wrong
Complete Idiot
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Yes, the whole point of a vaccine is to create antibodies making you more resistant to the infection, or reduce impact at a minimum. Everybody vaccinated should test positive on an antibody test.

It was an interesting study, I hadn't considered having had influenza but no symptoms. Or maybe symptoms so mild I just brushed it off as allergies or a common cold.

As I typed THAT I was thinking, I guess this is just how all viruses work, to varying degrees - you can have the virus but have a response be anything from nothing perceptible to the far extreme of dying from the infection. And then I thought, surely not all viruses? Not Ebola, right?

https://www.sciencedaily.com/releases/2016/11/161115150637.htm
plain_o_llama
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None of this is in my wheelhouse, but it makes fascinating science.

I've seen virologists speculating on the impact of the initial viral load on disease severity. They know from animal research that too little virus might not produce an infection while too much may reliably kill the subject. They end up needing to find the right amount. Similar issues apparently present in vaccine dosing.

So for Covid-19 the question is whether disease severity is related to your level of virus exposure? Might it also matter whether you rub the virus into your eye, inhale through your nose, inhale into your lungs, or get it into your GI track? Lots of variables that may or may not be important.
Player To Be Named Later
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Sq 17 said:

schools are not open here not sure about your district yes the asymptomatic are an issue but still want the positve and symptomatic out of the population and having their blood drawn twice a day. Of course with their consent


I've seen nothing to suggest you'd get very high rates of people consenting to that.
Zobel
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I went hunting for that and found that people estimate anywhere from 10-75% for flu. It may vary season to season. A meta-analysis found 16% asymptomatic for flu.
Sq 17
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Let's say an EMT with a wife and kids test positive and is given the option of go home and try not to infect your family or go to a shelter for 7-10 days

Some people would take the shelter I personally would
Player To Be Named Later
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Some. But if all of the "you can't stop me from going wherever I want, when I want" crowd had their say, not a chance you'd get them to isolate somewhere with blood draws.
plain_o_llama
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Here is a somewhat related study that found virus shedding, including Influenza and Coronaviruses, in asymptomatic tourists during a summer season.


"Asymptomatic Summertime Shedding of Respiratory Viruses"

https://academic.oup.com/jid/article/217/7/1074/4782481


DadHammer
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This quick video kind of explains why Sweden took the approach they did. More and more data and studies are showing they might have the best approach. I said might.

https://www.foxnews.com/media/david-katz-coronavirus-vaccine-herd-immunity
DadHammer
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Plain, from what I have read the severity of initial virus contact does impact how sick you get. But the main factors seem to be age, diabetic, prediabetic, lung issues, heart disease, and underlying issues. Apparently if healthy and 45 and under you are most likely just fine. You might feel bad but that age group recovers with very low death rate. The at risk need to home quarantine and the rest of us decide for yourself if you want to go about your life starting today. If you home quarantine then why not let other people Risk what they want, your quarantined and the rest of us get sick and then get immune without even having contact with the stay at home crowd.
NASAg03
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Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective
Mike Shaw - Class of '03
NorCal
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Yep. According to their Chief Epidemiologist, they appear to have reached a plateau and are flattening their curve. Only ~1,500 dead in their entire country with many immune (assuming you can be immune to this virus). A ways to go to see a final verdict, but as long as they keep protecting the vulnerable, they're trending on the right side of history.
fig96
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NASAg03 said:

Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective

This is great to hear, but also mentions several key things that a lot of folks overlook when saying "be like Sweden and open things up!"

Quote:

Pomeroy pointed to some Swedish characteristics that may be helping the country deal with the current crisis. More than half of Swedish households are single-person, making social distancing easier to carry out. More people work from home than anywhere else in Europe, and everyone has access to fast Internet, which helps large chunks of the workforce stay productive away from the office.

And while many other countries have introduced strict laws, including hefty fines if people are caught breaching newly minted social-distancing laws, Swedes appear to be following such guidelines without the need for legislation. Trips from Stockholm to Gotland -- a popular vacation destination -- dropped by 96% over the Easter weekend, according to data from the country's largest mobile operator, Telia Company. And online service Citymapper's statistics indicate an almost 75% drop in mobility in the capital.

Sweden also recently pushed back against the notion that there's little to no social distancing going on.

"We don't have a radically different view," Foreign Minister Ann Linde said in an interview with Radio Sweden. "The government has made a series of decisions that affect the whole society. It's a myth that life goes on as normal in Sweden."
Player To Be Named Later
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fig96 said:

NASAg03 said:

Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective

This is great to hear, but also mentions several key things that a lot of folks overlook when saying "be like Sweden and open things up!"

Quote:

Pomeroy pointed to some Swedish characteristics that may be helping the country deal with the current crisis. More than half of Swedish households are single-person, making social distancing easier to carry out. More people work from home than anywhere else in Europe, and everyone has access to fast Internet, which helps large chunks of the workforce stay productive away from the office.

And while many other countries have introduced strict laws, including hefty fines if people are caught breaching newly minted social-distancing laws, Swedes appear to be following such guidelines without the need for legislation. Trips from Stockholm to Gotland -- a popular vacation destination -- dropped by 96% over the Easter weekend, according to data from the country's largest mobile operator, Telia Company. And online service Citymapper's statistics indicate an almost 75% drop in mobility in the capital

Sweden also recently pushed back against the notion that there's little to no social distancing going on.

"We don't have a radically different view," Foreign Minister Ann Linde said in an interview with Radio Sweden. "The government has made a series of decisions that affect the whole society. It's a myth that life goes on as normal in Sweden."

I think that's why we saw increasingly incremental stricter policies here..... because in general, a large percentage of our society isn't responsible enough to do many things unless told to. If more of our society was able to just exhibit a little common sense like the Swedes, we may not have had gradually stricter policies here.

fig96
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Nailed it.
Fitch
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Probably helped by the fact their national population is something like 40% larger than Dallas but spread out over the geographic area of California.
BeowulfShaeffer
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A lot of things work in Sweden that are hard to implement elsewhere because of the simple fact that Sweden is full of Swedes. It's a much more monolithic culture--they all pretty much buy in to the way their society is set up (cradle-to-grave services, etc.). So you get much more "voluntary" compliance, etc.
KidDoc
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fig96 said:

NASAg03 said:

Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective

This is great to hear, but also mentions several key things that a lot of folks overlook when saying "be like Sweden and open things up!"

Quote:

Pomeroy pointed to some Swedish characteristics that may be helping the country deal with the current crisis. More than half of Swedish households are single-person, making social distancing easier to carry out. More people work from home than anywhere else in Europe, and everyone has access to fast Internet, which helps large chunks of the workforce stay productive away from the office.

And while many other countries have introduced strict laws, including hefty fines if people are caught breaching newly minted social-distancing laws, Swedes appear to be following such guidelines without the need for legislation. Trips from Stockholm to Gotland -- a popular vacation destination -- dropped by 96% over the Easter weekend, according to data from the country's largest mobile operator, Telia Company. And online service Citymapper's statistics indicate an almost 75% drop in mobility in the capital.

Sweden also recently pushed back against the notion that there's little to no social distancing going on.

"We don't have a radically different view," Foreign Minister Ann Linde said in an interview with Radio Sweden. "The government has made a series of decisions that affect the whole society. It's a myth that life goes on as normal in Sweden."

Interesting that the article fails to mention their awful 9.3% CFR as of today.

If USA had a 9.3% CFR that would be 226,057 deaths.
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NASAg03
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KidDoc said:

fig96 said:

NASAg03 said:

Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective

This is great to hear, but also mentions several key things that a lot of folks overlook when saying "be like Sweden and open things up!"

Quote:

Pomeroy pointed to some Swedish characteristics that may be helping the country deal with the current crisis. More than half of Swedish households are single-person, making social distancing easier to carry out. More people work from home than anywhere else in Europe, and everyone has access to fast Internet, which helps large chunks of the workforce stay productive away from the office.

And while many other countries have introduced strict laws, including hefty fines if people are caught breaching newly minted social-distancing laws, Swedes appear to be following such guidelines without the need for legislation. Trips from Stockholm to Gotland -- a popular vacation destination -- dropped by 96% over the Easter weekend, according to data from the country's largest mobile operator, Telia Company. And online service Citymapper's statistics indicate an almost 75% drop in mobility in the capital.

Sweden also recently pushed back against the notion that there's little to no social distancing going on.

"We don't have a radically different view," Foreign Minister Ann Linde said in an interview with Radio Sweden. "The government has made a series of decisions that affect the whole society. It's a myth that life goes on as normal in Sweden."

Interesting that the article fails to mention their awful 9.3% CFR as of today.

If USA had a 9.3% CFR that would be 226,057 deaths.
From a previous article:

"For example, the number of deaths as a share of total cases is a useless statistic, since countries have completely different testing regimes. It is at best an indication of a country's testing capacity and how many people with more mild cases are being testedan area where Sweden has not impressed. "

They are also including deaths with covid-19 (not from) in their death count. As such, their CFR is going to be much higher. And if the virus spreads much easier with less measures, then initial death count should be higher.
Mike Shaw - Class of '03
California Ag 90
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Player To Be Named Later said:

fig96 said:

NASAg03 said:

Things are looking good so far with public support for decisions. Volvo opening with 20k jobs this week.

https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-04-19/sweden-says-controversial-covid-19-strategy-is-proving-effective

This is great to hear, but also mentions several key things that a lot of folks overlook when saying "be like Sweden and open things up!"

Quote:

Pomeroy pointed to some Swedish characteristics that may be helping the country deal with the current crisis. More than half of Swedish households are single-person, making social distancing easier to carry out. More people work from home than anywhere else in Europe, and everyone has access to fast Internet, which helps large chunks of the workforce stay productive away from the office.

And while many other countries have introduced strict laws, including hefty fines if people are caught breaching newly minted social-distancing laws, Swedes appear to be following such guidelines without the need for legislation. Trips from Stockholm to Gotland -- a popular vacation destination -- dropped by 96% over the Easter weekend, according to data from the country's largest mobile operator, Telia Company. And online service Citymapper's statistics indicate an almost 75% drop in mobility in the capital

Sweden also recently pushed back against the notion that there's little to no social distancing going on.

"We don't have a radically different view," Foreign Minister Ann Linde said in an interview with Radio Sweden. "The government has made a series of decisions that affect the whole society. It's a myth that life goes on as normal in Sweden."

I think that's why we saw increasingly incremental stricter policies here..... because in general, a large percentage of our society isn't responsible enough to do many things unless told to. If more of our society was able to just exhibit a little common sense like the Swedes, we may not have had gradually stricter policies here.


usually its the spring breakers in Florida or the sips tripping to Cabo (among other examples) that are cited as examples of why Americans have to be treated as infants by our wise overseers in government in this particular crisis.

but lack of wide public awareness of the risks of this disease, pre-booked flights, mixed media messages (young people not affected) etc., all conspired to create the situation that led to those 'violations' of distancing.

i suspect by April we'd have seen similar compliance as the Swedes - this 'need' for imposing infantile oversight creates much of the resentment now starting to boil. treating people like adults is almost always preferable in obtaining broad public support to imposing nanny state directives.

and interestingly, we never saw 'spring break' outbreaks as Florida spring breakers returned (mostly to the midwest and northeast), which surprises me.

just my view.
We're from North California, and South Alabam
and little towns all around this land...
Player To Be Named Later
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Lots of people threw fits about the Houston Rodeo and SXSW being canceled. I'd imagine Houston and Austin would have been significantly worse off had those events gone off as usual. And crowds there would have been packed.
DadHammer
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That's true, and seems to be more evidence that initial viral load exposure is a big deal and that massive crowds, group dancing, and events like that cause much more initial virus exposure vs picking it up at work or the grocery store.

The fewer number of virus you are infected with the better your body can respond, apparently.
Zobel
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Quote:

i suspect by April we'd have seen similar compliance as the Swedes
Right, I totally agree. But at what cost in both economic damage and lives? The measures that have been taken in the US have completely precluded panic. Two thousand deaths a day barely registers in the public conscience.

Hypothetically speaking, if we wind up in the same place two months later, we would have what amounts to the same economic damage (or even worse) with a worse outcome in terms of epidemic management. If the epidemic got worse to where people spontaneously reacted, the outbreak would have been larger, the time to peak longer, etc.

This is a rare case where individual rationality contributes to bad outcomes. Individual motivations and collective ones are fundamentally mismatched, because for the majority of the population a precautionary quarantine is irrational in the face of the personal and collective economic cost vs the personal health benefit. We're so soaked in our capitalist mindframe that this is a does not compute for most Americans. We need people to behave irrationally on a personal level to achieve a rational response on the collective one. That takes civic virtue, which we don't have a lot of.
Zobel
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DadHammer said:

That's true, and seems to be more evidence that initial viral load exposure is a big deal and that massive crowds, group dancing, and events like that cause much more initial virus exposure vs picking it up at work or the grocery store.

The fewer number of virus you are infected with the better your body can respond, apparently.
This is a popular theory gaining traction but I haven't seen any reliable basis for it.
cone
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it fits with young health care workers dying and/or getting very sick

but yeah it's just a guess. but pretty much everything is still a guess at this point.
Squadron7
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k2aggie07 said:

DadHammer said:

That's true, and seems to be more evidence that initial viral load exposure is a big deal and that massive crowds, group dancing, and events like that cause much more initial virus exposure vs picking it up at work or the grocery store.

The fewer number of virus you are infected with the better your body can respond, apparently.
This is a popular theory gaining traction but I haven't seen any reliable basis for it.

I haven't actually seen any studies on the 20 seconds of hand washing now that you mention it.
Zobel
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Ask and ye shall receive
https://onlinelibrary.wiley.com/doi/full/10.1111/risa.13438

https://www.cidrap.umn.edu/news-perspective/2019/09/hand-sanitizer-shown-less-effective-hand-washing-against-flu

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891197/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC203232/
California Ag 90
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Player To Be Named Later said:

Lots of people threw fits about the Houston Rodeo and SXSW being canceled. I'd imagine Houston and Austin would have been significantly worse off had those events gone off as usual. And crowds there would have been packed.
no argument about those events.

thank God they were canceled - i've posted that before.

but both would have been packed due to early lack of understanding/awareness of threat. authorities did their jobs and canceled events early in the pandemic to protect an uninformed/underinformed public.

we are talking about the presumption that an informed US population in April or May would be ignoring this and acting recklessly.

Sweden saw Italy happen and understood the risks by the time their case load started to ramp. Swedes exercised good judgment.

i reject categorically statements by 'authority figures' that Americans are somehow unworthy of their roles as citizens and incapable of exercising good judgment when properly informed of risks.

dredging up early events when the entire world was unaware of the situation as evidence of our collective stupidity is not relevant to this point.

many of the most punitive restrictions on Americans have come in the past few weeks, long after the collective public awareness of risk has been known and people have been using good sense.

its a dangerous thought process when you decide the judgment of everyday Americans, upon which this country's entire system of governance is based, cannot be trusted.

We're from North California, and South Alabam
and little towns all around this land...
 
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