Did Sweden end up taking the best approach?

294,531 Views | 1675 Replies | Last: 1 yr ago by Enzomatic
deadbq03
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Keegan99 said:

Except that's not how seasonality works.


You've showed that before and yes it does. If it followed that pattern it would've been dying off here in April/May while it ramped up in South America.
Keegan99
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We're subtropical and more closely tied to the climate of Mexico and the Carribean than New England.

That states below roughly 35 latitude behaved similarly despite a variety of policy prescriptions is not at all a surprise.
deadbq03
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Keegan99 said:

We're subtropical and more closely tied to the climate of Mexico and the Carribean than New England.

That states below roughly 35 latitude behaved similarly despite a variety of policy prescriptions is not at all a surprise.
First off, I'm a geographer - and no, we're not subtropical. If we were, then flu season wouldn't be a thing here. It is.

Second, even if we were, then it means the uptick would have nothing to do with seasonality. The tropics literally don't show seasonality in dang near anything.

Thirdly, I brought this up the last time you were preaching this - states in the north like Ohio, Wisconsin, Iowa, etc also saw surges at the same time we did.

Seasonality may be at play with the surge in South America and South Africa, but it has nothing to do with us right now.
BiochemAg97
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deadbq03 said:

Keegan99 said:

To what extent do you consider latitude and seasonality difference impacting trends? Particularly when compared to pubic policy? And how do those factors differ in the US in comparison to Europe?

The central conceit of most is the belief that we have some great control over a very primal natural phenomenon, of which we understand very little.
I don't know why you keep beating the seasonality drum.

That's the exact logic of the folks who thought this would be dead in the water in April when weather got warm and therefore did nothing. Conceit indeed.
one problem was the people that said it would be gone in April had a very narrow view of the seasonality data on corona viruses. It varies by latitude. While the data shows an earlier seasonality for norther temperate latitudes (NY, Europe), tropical and subtropical latitudes have a later seasonality. Additionally, there is the obvious difference between northern hemisphere and Southern Hemisphere.

The gulf states across to Southern California are subtropical and have a different seasonality for corona viruses than temperate latitudes.

I would expect as we move from pandemic to endemic, the seasonality will match more closely with seasonality of other coronaviruses, although there is some strong alignment across latitudes already.
Keegan99
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Hope-Simpson was probably a little too simple, as there seems to be a longitude element at play as well. We know flu moves east to west, for example.

Climate. Seasonality. Geography.
BiochemAg97
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I wonder how much of the East to west movement of influenza is due to travel patterns. You could say this was mostly East (China -> Europe -> NY). Although there was some spread from China to the west coast as well.
deadbq03
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Keegan99 said:









Hope-Simpson was probably a little too simple, as there seems to be a longitude element at play as well. We know flu moves east to west, for example.

Climate. Seasonality. Geography.
The east to west with flu is due to new strains evolving in high-population centers in SE Asia, where the flu never dies because they are tropical.

As you said, this is something we know very little about. Can you not at least concede that making geographic claims about a brand new disease is potentially as spurrious as other claims about Covid that you disagree with?
deadbq03
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And as a geography nerd, I'd be remiss if I didn't offer the caveat that Florida south of Tampa, is indeed subtropical, as is the deserts immediately around Yuma. The climate of these areas are dominated throughout the entire year by subtropical weather patterns that originate in equatorial latitudes.

Even though South Texas is just as far south as South Florida, and a good portion of Texas is further south than Yuma, Texas gets continental cold fronts in the spring/fall/winter which means every now and then it can freeze (and wreck the grapefruit industry). Our weather isn't dominated by patterns from the south, we get plenty from the north as well.

In a broad nutshell, if you live in an area where leaves fall off the trees in the winter, you live in a Temperate climate.

I'll get off my soapbox now and let y'all get back to drooling over Sweden and their robust, universal healthcare system laissez faire approach to Covid.
Keegan99
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BiochemAg97
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deadbq03 said:

Keegan99 said:









Hope-Simpson was probably a little too simple, as there seems to be a longitude element at play as well. We know flu moves east to west, for example.

Climate. Seasonality. Geography.
The east to west with flu is due to new strains evolving in high-population centers in SE Asia, where the flu never dies because they are tropical.

As you said, this is something we know very little about. Can you not at least concede that making geographic claims about a brand new disease is potentially as spurrious as other claims about Covid that you disagree with?
This is a brand new disease because? There will likely be more genetic diversity between the next flu strain out of SE Asia and the last flu strain than there is between SARS-CoV and SARS-CoV2. Should we assume the next flu will have completely different seasonality than the last flu?

cone
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wow
GAC06
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Could probably use its own thread
DadHammer
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GAC06 said:

Could probably use its own thread
J. Walter Weatherman
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fig96 said:

J. Walter Weatherman said:

fig96 said:

RandyAg98 said:

You're right. Your virus is going to kill us all. Board up the windows! You watch too much Today Show. Their lead in yesterday was "On The Brink".
So because I said if we'd been responsible all along we'd be in much better shape with case numbers I now think we're all going to die.

And y'all wonder why we can't have intelligent discussions about this.
Out of curiosity when you say "if we'd been responsible" what would you have liked the plan to be? I see vague statements like this or "we should have done better" all the time but never any actual policies offered. At the end of the day we can't stay shut down forever and, as we're learning now, shutdowns seem to just delay the eventual spike anyways.
Specifically, hard to say, this isn't an area I have expertise in and I'm just going by what I've learned in lots of reading. It's also easy to look back and point at things we know now that we hadn't figured out early on.

But it seems obvious at a base level that we failed on a few levels, both governmental response (which admittedly isn't directly addressed in "if we'd been responsible") and personal response.

Governmentally, especially at the federal level, I don't know how we can look at this as anything more than an abject failure. We shut down most of the country for two months, and in that time developed absolutely no semblance of a national plan for testing, response, etc. The virus was politicized early on on all sides and that didn't help matters, but I feel like the federal government in particular did very little to address the pandemic and left it all up to the states. That's something that the states in general weren't equipped to do, and from the top down the name of the game was passing responsibility down to someone lower in the order.

As far as personal responsibility, a whole lot of people seem to be putting their own personal interests ahead of everyone else and not trying to do simple things like wearing masks (and again, politicized). We've had everything from people throwing fits in stores to cussing out employees to faking ADA badges because of whatever beliefs they have about wearing a mask. We've got tons of people out and about now like nothing ever happened, and when things opened back many seem to have generally ignored any safety protocols in places as evidenced by the spike in cases in early June.

Case numbers are absolutely only an indicator, but when we're 10x-20x more than most western countries and not declining in daily case numbers you can't just chalk that up to us testing more. Yes, early failures in New York definitely hurt the overall numbers and I'm glad to see our mortality rates improving as we learn more about how to treat this, but we don't know much about other long term effects yet. And for all the comments of "those other countries spiked early" those other countries had also at least started to taper off by this point in their cycle, and our numbers aren't doing that yet.

What makes me laugh is that by expressing regret that we didn't handle this better I get intelligent responses about how I think the virus is going to kill us all and that I watch too much of the Today Show. I actually do think some of the fear of this is overblown and that we can find a happy medium of responsibility while carrying on with our normal lives. But that doesn't mean I can't also be disappointed that we're the only country that can't seem to get a handle on this.


I'm late and most people have already responded with my thoughts, but thanks for the in-depth response. I agree there are areas we could have done better, but since we are basically 50 small countries increasingly divided over political lines there's not really a comparison and was never going to be a true nationwide response.

And as others have noted, the majority of the countries that are truly on the backside and haven't seen recent spikes are the ones who had high numbers in the beginning. The US' latest numbers are just all of the other high population states catching up with the NY area, and thankfully nobody is sending any sick people into nursing homes anymore.
fig96
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You bet. More than happy to discuss this when there's an actual interest in looking at different views and I'm willing to admit when I'm wrong. Also totally agree that looking at very different conditions across different states makes it challenging for any kind of accurate comparisons.
deadbq03
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BiochemAg97 said:

deadbq03 said:


The east to west with flu is due to new strains evolving in high-population centers in SE Asia, where the flu never dies because they are tropical.

As you said, this is something we know very little about. Can you not at least concede that making geographic claims about a brand new disease is potentially as spurrious as other claims about Covid that you disagree with?
This is a brand new disease because? There will likely be more genetic diversity between the next flu strain out of SE Asia and the last flu strain than there is between SARS-CoV and SARS-CoV2. Should we assume the next flu will have completely different seasonality than the last flu?


Forgive my poor writing.

If I could rewrite it would read:

"As you said, since Covid is new, there's still a lot we don't understand. Can you not at least concede that making claims that geography is the primary reason for the uptick of cases in the South is potentially as spurrious as other claims that you disagree with?"

I don't take issue with the notion of the seasonality of diseases. I take issue with the notion that this is the primary reason for the uptick in the South.

Again,

1) If this was following the pattern of the flu, we would've seen a decrease in cases across the US this summer - even in the South, just like we do with the flu.
2) The charts for many of the northern states also climbed in June and July.

My point in bringing this up isn't to deny that this could be a seasonal disease, I think it likely is, and yet our spread this summer is showing the opposite tendency.

This is the first wave of a brand new disease, and it's virulence may be so high that - unlike the flu, it's still highly transmissible even in its low season, and since we stunted its natural spread with lockdowns in the Spring, there are communities it's just now reaching.
BiochemAg97
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That's the thing. We shouldn't expect it to follow the seasonality of the flu, because it isn't an influenza virus. That doesn't mean it doesn't follow the seasonality of corona viruses, which partially overlaps with the flu but is a little different.

Also, since we don't have new corona viruses as often as we have new influenzas and the dominate coronaviruses in humans are endemic, the East to west progression is not seen in a typical coronavirus season, but we did see a migration out of China similar to influenzas.
RGV AG
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I think a much more apt country to look at in terms of lockdowns and or lack thereof is Nicaragua. In many cases it is probably more similar to the US than Sweeden is. Temperature, a like population to large percentages of population in states such as FL, TX,CA, AZ.

Nicaragua never locked down and for the most part a large percentage of the population never even had PPE or anything else. The poor, of which there is a huge majority, in Nicaragua do not have access to great health care. The wealthy have access to pretty decent care. All the countries around Nicaragua locked down tighter than Dick's hatband, and the borders are still closed.

Now, the official numbers coming out of Nicaragua I do not think can be trusted at all. But lets say for the sake of argument, lets increase everything 2.5X, I wonder how that compares to their neighbors and to the US?

Again, there was no lock down of any kind and very little precautions were taken.

We lived there for 11 years so I have extensive contacts there. I personally know 3 people who have died in Nicaragua from Covid. Many that get very ill are dying, not a lot of terribly ill are recovering. But from friends that run large factories down there, that didn't have the option to close down, I understand that it ran through the population pretty hard in May and early June, and is waning way off now. Plant I opened that has about 1250 employees now, had 2 deaths. That is a .0016 death rate out of that group. There is lots of malnutrition there, well basically poor nutrition, so I think plays a factor as well.
DadHammer
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Did you enjoy your 11 years? Thanks for posting.
RGV AG
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Yes, wonderful people, beautiful country. But that country is like the beautiful girl you went to HS with, that has everything; beauty, charm, wit, personality but no matter the choice she makes in men, and it is always the wrong one, it turns out bad. Everyone loves her and laments her plight, but alas she keeps making bad choices. But all that know her still love and care for her.

To answer your question, it is where I plan to spend a major portion of my retirement.
HotardAg07
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Regarding Sweden being back to "normal", here is the SwedishMinister for Health and Social Affairs:

https://www.healtheuropa.eu/swedens-response-to-covid-19-life-is-not-carrying-on-as-normal/101515/
Quote:

Sweden is tackling the COVID-19 pandemic through both legally binding measures and recommendations. The government and the Swedish Public Health Agency have taken a number of decisions involving a wide range of new regulations and recommendations that affect the whole of society, including people's private lives. There is no full lockdown in force, but many parts of Swedish society have shut down.

Life is not carrying on as normal in Sweden. Many people are staying at home and many have stopped travelling. This has had severe effects on Swedes as well as on the Swedish economy. Many businesses are folding. Unemployment is expected to rise dramatically. The Government has taken several measures to mitigate the economic effects and to stabilise the economy.

Sweden shares the same aim as all other countries: to protect the life and health of its population. Fundamentally, Sweden's measures only differ from other countries in two regards: we are not shutting down schools for younger children or childcare facilities and we have no regulation that forces citizens to remain in their homes.

In addition, Sweden is still urging people to work from home:
https://www.thelocal.se/20200730/sweden-announces-new-guidelines-public-transport-work-home

And Swedes are complying, conjestion levels during peak rush hour are 80% less than their peaks in 2019:
Fitch
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Interesting discourse. Sweden discussion comes in around 2:40, though the first few minutes and afterwards are with listening to.



As an aside, I had never heard of post-polio syndrome before. Flippin crazy something can lay latent that long.
dragmagpuff
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There was a post earlier predicting Sweden's GDP drop at 4.2%. Based on Sweden's released numbers, it was actually 8.6%.

8.6% vs Eurozone average of 12.1%. That's a still significant difference.

Spain at -18.5%!

Germany, probably the best European country's response using the lockdown strategy, dropped 10.1%.

For reference, the US was -9.5%.
twk
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dragmagpuff said:

There was a post earlier predicting Sweden's GDP drop at 4.2%. Based on Sweden's released numbers, it was actually 8.6%.

8.6% vs Eurozone average of 12.1%. That's a still significant difference.

Spain at -18.5%!

Germany, probably the best European country's response using the lockdown strategy, dropped 10.1%.

For reference, the US was -9.5%.
And next, we'll have people post, see, Sweden took a hit anyway--they might as well have shutdown and prevented all those deaths. This is wrong on several counts: (1) the eurozone as a whole did 50% worse, and that's nothing to sneeze at; (2) the point of this discussion is not so much where would one isolated country be by pursuing the Swedish approach, but rather, what if the whole world had--if global GDP loss was one third less than what we're seeing, that would be worth quite a bit, not only economically in the short run, but also, to lives in the long run; and, (3) there's no guarantee that Sweden's death numbers would be much different, apart from nursing homes, which they know they should have treated differently (but see New York for an example of screwing this up while locking down).
tysker
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An interesting data set that some on this thread may appreciate.
https://www.euromomo.eu/graphs-and-maps

Quote:

The aim of the EuroMOMO project (European monitoring of excess mortality for public health action) is to operate coordinated timely mortality monitoring and analyses in as many European countries as possible, using a standardized approach to ensure that signals are comparable between countries.

EuroMOMO thereby aims to enhance European capacity to assess and manage serious public health risks such as pandemic influenza and other emerging infections, as well as environmental conditions with an impact on public health, e.g. heat waves or cold snaps.
Interesting to see deaths trend down across the EU over the last several years and then see spikes during the winter months (flu season I assume).

Seeing the decreasing deaths trend line, it makes me wonder if COVID is not only pulling forward deaths, but also could COVID be a sort of catch-up for deaths that should have occurred in previous years?
Keegan99
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RGV AG
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That is good practical information. Thanks for posting that.

Throughout this whole mess I have felt that the US, at all levels, and many other countries have taken a "shot gun" approach at what in all likely hood be a precision or more specific problem. I have never seen, at the governmental level anyway (and maybe I missed it if it did happen), a "Pareto" type analysis of victims, patients, and deaths in terms of then trying to protect them and focus on the highest and most likely victims.

I could be wrong, but I bet Doc's that are fighting this deal are by default having to treat in some kind of segmented manner, as it seems the care in the US, and some other places, is really becoming effective.
Jet Black
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Yes. Sweden wins.
fightingfarmer09
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Jet Black said:

Yes. Sweden wins.


This.

EOT.
DadHammer
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Where did all the corona bro's telling us Sweden was doomed disappear too?

Oh yea, now it's " we don't know the long term effects" we must shut down crowd.
fig96
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I don't know WTF a corona bro is, but like lots of people I'm still curious to see how this all plays out long term everywhere.
Jet Black
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fig96 said:

I don't know WTF a corona bro is, but like lots of people I'm still curious to see how this all plays out long term everywhere.


Yep, just two more weeks.
plain_o_llama
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Here is a chart showing the seasonality of a few viruses from a Northern Hemisphere perspective



from
https://www.annualreviews.org/doi/pdf/10.1146/annurev-virology-012420-022445
Cepe
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That's a pretty cool chart
Cepe - its pronounced "Ceep" and stands for my initials - CP.
Complete Idiot
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Don't really want to start a new thread, but maybe this is a decent place to share this UK info. They attempt to quantify something very difficult - impact on those that don't die or maybe even get Covid, but are impacted by shutdowns, etc.

Impacts of the coronavirus (COVID-19) on mortality and morbidity in England
Today, the Scientific Advisory Group for Emergencies (SAGE) released a paper estimating the impacts of the coronavirus (COVID-19) on England's mortality and morbidity. This was a collaboration between the Office for National Statistics (ONS), the Department of Health and Social Care (DHSC), the Government Actuary's Department (GAD) and the Home Office and was discussed by SAGE on 23 July 2020.
The paper presents a collection of estimates of the COVID-19 virus' direct and indirect effects on the health of the population, including estimates of the quality-adjusted life years (QALYs) lost, through deaths and also for those who do not die but may experience health impacts.
The research estimates that approximately 65,000 excess deaths could take place from contracting COVID-19 between March 2020 and March 2021. It is also estimated that social distancing measures could reduce mortality in England, accounting for 7,000 fewer deaths than expected. However, the negative health impacts of social distancing amount to a loss of 88,000 QALYs up to March 2021, so mortality improves over this period, but health worsens.
Socio-economic effects are estimated to have the greatest impact on quality of life of all categories investigated, over the short- and long-term combined. From March 2020 to more than five years from now, the impacts of lockdown and a resulting recession are estimated to reduce England's health by over 970,000 QALYs. The health impacts of contracting COVID-19 are still unclear in the long -term, but between March 2020 and March 2021, these represent 570,000 lost QALYs.
While these negative health impacts of lockdown exceed the impacts of COVID-19 directly, they are much smaller than the negative impacts estimated for a scenario in which these measures are not in place. Without these mitigations, the impact of direct COVID-19 deaths alone on both mortality and morbidity would be much higher: an estimated 439,000 excess deaths due to COVID-19, and 3,000,000 QALYs lost.
We have published a fuller statement with more detail on the contents of the paper today on our website. The whole paper can be found in SAGE's Meeting 48, 23 July meeting papers.
 
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