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EU Government Medicine

Sweden Tries Out a New Status: Pariah State (sfgate.com) 382

Sweden's population is not quite twice the size of Norway's — yet Sweden has reported 21 times as many deaths from Covid-19, prompting many countries to close their borders to Sweden, reports the New York Times: Norway isn't the only Scandinavian neighbor barring Swedes from visiting this summer. Denmark and Finland have also closed their borders to Swedes, fearing that they would bring new coronavirus infections with them. While those countries went into strict lockdowns this spring, Sweden famously refused, and now has suffered roughly twice as many infections and five times as many deaths as the other three nations combined, according to figures compiled by The New York Times. While reporting differences can make comparisons inexact, the overall trend is clear, as is Sweden's new status as Scandinavia's pariah state...

"When you see 5,000 deaths in Sweden and 230 in Norway, it is quite incredible," said Gro Harlem Brundtland, a former prime minister of Norway and the former director of the World Health Organization, during a digital lecture at the Norwegian Academy of Science and Letters in May...

Swedes now find themselves with few options for moving about the European Union. Most countries in the bloc have reopened their borders to member nations, but only France, Italy, Spain and Croatia are welcoming Swedes without restrictions.

On a popular Scandinavian radio program, a journalist with a leading Swedish paper complained about how Sweden was being treated by its neighboring countries, according to the Times. "We are supposed to sit here in our corner of shame, and the worst part is that you're savoring it."

The BBC notes that just days later, on Wednesday, Sweden reported 1,610 new infections — roughly one infection for every 6,354 people in Sweden and its highest number of daily infections since the outbreak began.
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Sweden Tries Out a New Status: Pariah State

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  • No. (Score:2, Insightful)

    by Rei ( 128717 )

    .. on Wednesday, Sweden reported 1,610 new infections — roughly one infection for every 6,354 people in Sweden and its highest number of daily infections since the outbreak began.

    No. On Wednesday, Sweden reported 1610 new cases. For crying out loud, are reporters congenitally incapable of understanding the difference between infections and cases?

    Also, for that matter, are they physically incapable of using running averages rather than cherry picking the worst days? One could also write, "Yesterday

    • Re:No. (Score:5, Informative)

      by Rei ( 128717 ) on Saturday June 27, 2020 @10:49AM (#60234396) Homepage

      In case anyone cares: Sweden's testing has gone way up, so its case rate has gone up. But its death rates continue to go down.

      That said, Sweden certainly isn't doing great. It and the UK keep fighting over the record of "Who in Europe are currently handling the virus the worst?" Belgium and several small states have worse total deaths per capita records, but in terms of ongoing difficulty of control, those two are the heavyweights.

      Sweden's general concept was epidemiologically sound, but its implementation an utter failure. If you can get the low-risk infected while protecting the high risk, and get it over with, you're in better shape than if everyone has an equal risk of infection and such a situation drags on indefinitely. Except that the low risk group (0-19 year olds) had a well lower infection rate than the 20-64 group, and only a little higher than the high-risk 65+ group. So they've accumulated plenty of deaths in the country and still only have limited immunity. And meanwhile we may only be months away from the start of distribution of an approved vaccine regardless.

      Nice try, but fail. That said, thankfully you've got the UK possibly doing even worse than you somehow ;) Mainly England in specific.

      • by q_e_t ( 5104099 )

        Sweden's general concept was epidemiologically sound, but its implementation an utter failure.

        In what sense was it sound?

        • Re: No. (Score:5, Informative)

          by jd ( 1658 ) <imipak@yahoGINSBERGo.com minus poet> on Saturday June 27, 2020 @11:54AM (#60234666) Homepage Journal

          For certain infections, it would have been sound.

          If R has been low enough, the mortality rate low enough, no long-term consequences such as blood clotting and organ failure, few asymptomatic cases, and a strong enough immune response, as is the case for some diseases, the Swedish strategy would work.

          Absolutely every single parameter went against the Swedes.

          It's three times more infectious than the flu, a fifth as deadly as the Black Death, and because of low oxygen even with functioning lungs and blood clotting, you can die from Covid without dying of Covid.

          The lack of symptoms means the disease spreads invisibly, a direct consequence of a poor immune response. Symptoms are often generated by your immune system, so no symptoms, no response.

          No response, no herd immunity.

          • You got it. But the worst has still to come:

            You mentioned a "strong enough immune response" - and as it seems, anticorps do not last very long, as new data shows. So after a few months you may get infected again. And worst: any vaccine would be inefficient and of very limited use.

          • Re: No. (Score:4, Informative)

            by ceoyoyo ( 59147 ) on Saturday June 27, 2020 @03:58PM (#60235506)

            Symptoms are often generated by your immune system, so no symptoms, no response.

            No response, no herd immunity.

            Most of the rest of what you said is reasonable, but that part just is not true. If you mount a weak or no immune response to a pathogen it typically kills you. Viruses, like COVID, kill your cells as part of their reproductive cycle.

            Asymptomatic people are that way because their immune system mounts a successful response and kills off the infection before it spreads enough to cause symptoms and/or triggers their immune system to escalate to responses that involve more collateral damage.

        • Re:No. (Score:4, Informative)

          by Rei ( 128717 ) on Saturday June 27, 2020 @12:57PM (#60234918) Homepage

          It's sound in the same way that someone vaccinating their children helps protect your unvaccinated child.

          If you do nothing (and a vaccine takes too long to come), the disease persists until it establishes herd immunity on its own terms (e.g. infecting a random cross section of society). If you can get many people immune with few deaths (e.g. getting the low-risk immune), you can protect millions via herd immunity. But if and only if you can protect them in the mean time.

          In that critical regard, Sweden failed.

          • by q_e_t ( 5104099 )
            Given the amount that was known about COVID-19 and what is now emerging that seems an enormously risky strategy.
            • Re: No. (Score:5, Insightful)

              by c6gunner ( 950153 ) on Saturday June 27, 2020 @03:36PM (#60235422) Homepage

              What's risky about it? We knew from pretty early on who the high-risk groups were; the "risky" strategy was putting relatively healthy but infected individuals into nursing homes like New York did. I don't see what would have been risky about isolating the nursing homes and having family doctors reach out to other high risk groups to advise them to either self-isolate or check into special accommodations set up for that purpose, then let the disease run it's course amongst the low-rosk population. That seems like an eminently sensible approach.

              • Re: No. (Score:4, Insightful)

                by Chuck Chunder ( 21021 ) on Saturday June 27, 2020 @09:43PM (#60236288) Journal
                I think that plan is risky in the sense that it requires a highly effective wall around at risk groups. But we are talking about human systems here and they just donâ(TM)t work that way. To be effective, defence really needs to be defence in depth, reducing risk of transmission at every possible step, not just the last one. Australia has relatively well on preventing community transmission, but even here we lost a whole bunch of people at one nursing home (Newmarsh House) as the result (probably) of an asymptomatic care worker. Thankfully, here at least, that case is a bit of an outlier.
      • Sweden's general concept was epidemiologically sound, but its implementation an utter failure.

        Communism is a great idea. Just a shame it has never worked so far. Let's try it again on your nation? <\snark>

        The idea was epidemiologically wrong because you have to include things like lack of equipment, pre-symptomatic spread and greater infectiousness of older people and changes in behaviour based on risk in your epidemiological model. If you can't do that then you are failing at your epidemiology. If you had managed to do that correctly you would have predicted that a) leakage into the olde

        • Re: (Score:3, Insightful)

          by mark-t ( 151149 )

          Communism works... it just doesn't work on scales where the number of people involved is so high that personal accountability to each other person within the system cannot be maintained.

          In other words, it works extremely well in small scales, such as individual households, in isolated communities numbering no more than perhaps a few hundred, or in places such as a monastery or the like.

      • Re: (Score:3, Informative)

        by Solandri ( 704621 )

        Sweden's general concept was epidemiologically sound, but its implementation an utter failure. If you can get the low-risk infected while protecting the high risk, and get it over with, you're in better shape than if everyone has an equal risk of infection and such a situation drags on indefinitely. Except that the low risk group (0-19 year olds) had a well lower infection rate than the 20-64 group, and only a little higher than the high-risk 65+ group.

        Actually, that part of their plan seems to be working.

        • Thanks for the very interesting numbers, they seem to be very out of date (Mid May), at which time Germany was only just cleaning up after having been in serious problems due to a much earlier much stronger start of the infection and Sweden was only just starting to be infected. Do you have equivalent numbers for say mid June now that the situation of both countries has changed completely?

          I can't agree with a bunch of your conclusions. Even at this rate (5% infection in about three months) Sweden will ta

        • Re:No. (Score:4, Informative)

          by Kernel Kurtz ( 182424 ) on Saturday June 27, 2020 @12:16PM (#60234782)

          Sweden will hit herd immunity sooner than Germany.

          We don't even know if herd immunity is possible. Most of the research I've seen so far suggests immunity may only last from 2-6 months, and almost certainly less than a year, as is the case with other Coronaviruses that cause the common cold.

          https://www.cnbc.com/2020/06/1... [cnbc.com]

          https://www.euronews.com/2020/... [euronews.com]

          • Re:No. (Score:4, Insightful)

            by Solandri ( 704621 ) on Saturday June 27, 2020 @12:32PM (#60234856)
            That's irrelevant. If herd immunity is impossible, then so is a vaccine. This becomes an endemic disease that never goes away, like the annual flu. We can't keep the economy shut down forever, so we'll all be forced to resume our normal lives and just live with the possibility of catching this and dying. Forever.
            • If herd immunity is impossible, then so is a vaccine.

              A vaccine is still possible. It seems highly unlikely it will be a one time thing though, and may well require regular booster shots thereafter. Ideally it could become part of the regular flu shot, which is required yearly but for a different reason.

      • In case anyone cares: Sweden's testing has gone way up, so its case rate has gone up. But its death rates continue to go down.

        The infection rate is about 12% since May. While more people are being tested, the same percentage is coming back positive. However unlike other parts of the world, increasing the testing rate is considered a good thing.

    • At risk of sounding stupid, I (until I read your comment) would have used the words infections and cases in this context interchangibly.

      Wouldn't a new case be a new infection?

      Asking honestly, fully willing to learn if somebody is willing to explain.

      • Re: No. (Score:5, Insightful)

        by Rei ( 128717 ) on Saturday June 27, 2020 @11:19AM (#60234500) Homepage

        Cases are infections. Infections are not cases. A case is a diagnosed infection. Undiagnosed infections are roughly an order of magnitude more common than diagnosed ones in the developed world (give or take large margins), and two or more orders of magnitude in most of the develping world.

        Case growth does not imply infection growth. Case counts are testing rates times positive rates. While infections vastly outnumber cases, an increase in the amount of testing nearly linearly increases the number of cases, without altering the actual underlying infection rate. Positive rates are more meaningful, although they can still be deceptive (depending on where and who you test, and under what conditions; shifts in this can shift your positive rates).

        Case rates are almost meaningless in terms of monitoring infection rates. Positive rates are meaningful, but with the above caveats. Hospitalizations are mostly testing-rate insensitive, but test rates do have some impact, as people who feel bad who have a diagnosis are more likely to go to the hospital than those who feel bad who don't. ICU rates have little to no test-rate influences, as do death rates (at least in the developed world, where pretty much everyone with confirmed COVID or COVID-like symptoms will be registered, and testing on hospital admission is pretty much universal in order to protect staff and other patients).

        In terms of sensitivity to testing rates and methodologies, from worst to best:
        1) Cases (almost worthless)
        2) Positive rates
        3) Hospitalizations
        4) ICU cases
        5) Deaths

        In terms of lag time, from worst to least:
        1) Deaths
        2) ICU cases
        3) Hospitalizations
        4,5) Positive rates
        4,5) Cases

        In terms of sensitivity to advances in treatment methodology, in order from most to least:
        1) Deaths
        2) ICU cases
        3) Hospitalizations
        4,5) Positive rates
        4,5) Cases

        • Thank you, I better understand what your saying. I guess I always had this in the back of my mind. In my province we haven't had any new "confirmed" cases in the last couple of weeks, and no current cases either. But they are now only testing 500-1000 people a day, so who really knows. I guess we can only say its better than it has been, because they are now testing people with less obvious symptoms, and some time ago we would see 60-100 new cases in a day.

          Must admit, I've learned quite a bit through di

      • by Ichijo ( 607641 )

        I think a "case" is a known infection, and there are many unknown infections. If you report 1,610 new infections, those are just the known ones. I think Rei's objection is that there are likely many more unknown infections than that and so reporting 1,610 new infections understates the true number of new infections.

    • by hey! ( 33014 )

      Also, for that matter, are they physically incapable of using running averages

      This.

      I have been downloading US state and county figures every day since early March, and virtually every jurisdiction shows some kind of highly regular sawtooth pattern in the new confirmed cases reported. My experience with inter-government data sharing suggest this is an artifact of work flow: batches of data get validated and entered, then people take a little time to do their regular jobs.

      This means is that everything a gove

    • by Alain Williams ( 2972 ) <addw@phcomp.co.uk> on Saturday June 27, 2020 @01:00PM (#60234926) Homepage

      Reporting 303 new cases will sell fewer newspapers (or web site visits) than reporting 1610 new cases.

      The press have not behaved well when reporting the Covid-19 story - they have stoked the rumour mills; attacked earlier decisions that proved wrong with the benefit of hindsight; presented emotionally charged personal stories as if they were happening to everyone; ... We need to return to a far more objective press as we had (not universally) 20+ years ago - quite how to achieve this I do not know. Unfortunately most are click-whores these days.

  • Sweden vs. LA (Score:5, Interesting)

    by truckwash ( 1327459 ) on Saturday June 27, 2020 @10:49AM (#60234398)

    So Sweden is doing about as good (or bad) as L.A. county (roughly the same population), but L.A. county went through
    a 2.5 month stay-at-home order. What is different about Sweden that they achieved the same curve without a lock-down?

    • Re:Sweden vs. LA (Score:4, Insightful)

      by Anonymous Coward on Saturday June 27, 2020 @10:59AM (#60234436)

      What is different about Sweden that they achieved the same curve without a lock-down?

      Population density might have something to do with it.

      Sweden: 59 per square mile
      LA County: 2100 per square mile

      • Re:Sweden vs. LA (Score:5, Insightful)

        by Rei ( 128717 ) on Saturday June 27, 2020 @11:24AM (#60234518) Homepage

        What exactly do remote tracks of Swedish forest have to do with infection spread in the places where people actually live (like Stockholm, Gothenburg, Malmö, etc)?

        It's amazing how many people don't understand the difference between population density and urbanization. Sweden has a relatively low population density. It's also very urbanized [google.com]. That is, to say, most people live in cities with significant populations, rather than small towns or in the countryside.

        • Sweden has exactly two cities with a significant population.

          • Overall population is important but I suspect density is the larger factor. It's why New York and New Jersey look particularly bad even though the put some of the most strict measures in place. They just have people packed in together to such a degree that it's practically impossible to keep the virus from spreading.

            If someone has a good breakdown on Swedish cases we could probably have a better discussion, but as it stands we have a lot of people comparing apples to orangutans.
        • "Urbanized" means lives in a city. It doesn't make any claim as to the size of the city. It's quite telling your mention Malmo, that barely qualifies as a large town in the USA.

          In other news Australia has an incredibly "urbanized" population, but know how they kept the spread low, by limiting movement of people to within 50km of where they live, a policy would would infect most of the country I live in. In doing so they effectively kept entire major cities virus free, because urbanisation does not tell you

          • by Rei ( 128717 )

            "Malmö, that barely qualifies as a large town in the USA

            Malmö (Sweden's third largest city, and the capitol city of of Skåne) is larger than the capitol city of all but 14 US states.

            Stockholm would be roughly tied for the US's 11th largest city.

            Sweden has only 3% of the population of the US.

            In doing so they effectively kept entire major cities virus free

      • About a third of Sweden's cases and a little less than half of Sweden's deaths are in Stockholm [folkhalsomyndigheten.se], which has a population density of 4800 people per km^2, or 13,000 people per square mile.
        • Note that the reported figures are for Stockholm County (population of 2,383,269, density of 366 people per km^2), but you seem to be giving the number for Stockholm municipality (population of 975,904, density of 5,191 people per km^2).

          It's a bit like mixing up Greater London and City of London.

    • by Ogive17 ( 691899 )
      What is the population density of Sweden vs the population density of LA county?

      Is it really that hard to spot the obvious differences? This is why Sweden was compared mostly to other Scandinavian countries in infection rates.
    • by q_e_t ( 5104099 )
      Swedes stayed at home to some extent in a self-imposed lock down.
    • by pz ( 113803 )

      What is different?

      1. Sweden has lower population density than Los Angeles County, as pointed out by other posters.
      2. Sweden has better air quality; this fact is important as conditions like asthma are contributory to poor COVID-19 outcomes.
      3. Swedish citizens have universal access to high-quality health care.
      4. Sweden has substantially lower levels of poverty, indigency, and illiteracy.

      Those are just good guesses. I don't have proof that any of those factors had any actual influence.

    • "What is different about Sweden that they achieved the same curve without a lock-down?"

      They are all blonde, fit, not type A-blood people.

  • that just days later, on Wednesday, Sweden reported 1,610 new infections — roughly one infection for every 6,354 people in Sweden and its highest number of daily infections since the outbreak began.

    I thought statements like these [only] applied to the 3rd world; where not much ever works as it should some say.

    The USA is not much different but there's an explanation for this: We have what some [on the [left] have called demagoguery from its leaders.

    For Sweden I cannot explain why.

  • Drama too much (Score:2, Insightful)

    by vyvepe ( 809573 )
    We are far from over with COVID-19. We will see how other countries will be able to shut down their economies again when future waves arrive. The Sweden approach may turn out as the best one at the end. It is way too soon to call Sweden a "pariah state".
    • Re:Drama too much (Score:5, Insightful)

      by Rhys ( 96510 ) on Saturday June 27, 2020 @11:33AM (#60234560)

      This.

      Reactions to the virus will only be something that can be evaluated in hindsight after we have effective herd immunity, be that vaccine or be that everyone got it and the susceptible are dead.

      As long as their hospitals aren't overloaded, having a higher death rate for a shorter period of time, vs a lower death rate for a longer period of time...if those are equal or close, I'd pick the former. This lockdown thing sucks. Its bad for my family's physical and mental health and we're suffering none of the (direct) economic consequences of it.

      • Good lord, could you people try to stop being such pussies? 3 months of living at home alone and you're acting like the world is ending.

      • Re:Drama too much (Score:4, Insightful)

        by AleRunner ( 4556245 ) on Saturday June 27, 2020 @12:23PM (#60234810)

        This.

        Reactions to the virus will only be something that can be evaluated in hindsight after we have effective herd immunity, be that vaccine or be that everyone got it and the susceptible are dead.

        As long as their hospitals aren't overloaded, having a higher death rate for a shorter period of time, vs a lower death rate for a longer period of time...if those are equal or close, I'd pick the former. This lockdown thing sucks. Its bad for my family's physical and mental health and we're suffering none of the (direct) economic consequences of it.

        Why do you choose between those two? There is a completely different alternative as in Vietnam, New Zealand and Slovenia. You lock down properly for a couple of months, eliminate the virus, then open up again and only close down small groups of people in particular areas where infection starts again, if it does.

        Alternatively, do what Japan does and have everybody wearing masks. It achieves almost the same effect without lockdown but with a bit more waste paper.

      • ..if those are equal or close, I'd pick the former

        But they aren't. In June the 16th, a study was published that showed reduced mortality in grave cases by using dexamethasone. If you are sick after June the 16rh, and ill enough to be hospitalized, you have one third less possibilities of dying that if you were before that date. In a week or two, another treatment might be discovered, then annother. That's how it works. Getting AIDS now is much less life threatening than in the 90's. The more you flatten the curve, the less total deaths you get.

    • Life here in Stockholm is pretty much business as usual. People are more careful in general and respect distance and so on.. there are of course always clusters of morons, that fit the worthless media picture perfectly. If you dig around the swedish data you'll find that approx 50% of all deaths due to covid here was old people living in nursing homes or having some kind of communal service taking care of them. The horrible story here is that it was a total fuck up during the first months. No protective g
    • Re:Drama too much (Score:4, Insightful)

      by thegarbz ( 1787294 ) on Saturday June 27, 2020 @02:20PM (#60235242)

      The Sweden approach may turn out as the best one at the end.

      Based on what? Killing people? Yeah I agree. Are you still under the delusion that the idea of getting herd immunity by affecting everyone is a good idea despite being universally panned by every qualified epidemiologist in the world?

      Please learn to separate religion from science. Your "beliefs" have no place here.

  • by Anubis IV ( 1279820 ) on Saturday June 27, 2020 @11:07AM (#60234464)

    Sweden reported 1,610 new infections — roughly one infection for every 6,354 people in Sweden and its highest number of daily infections since the outbreak began.

    The numbers of infections in my county, as of a few days ago, puts us at more than one infection per 200 people. My city, just yesterday, announced a two-week poll to see whether citizens here wanted to make masks mandatory when out in public, before backpedaling three hours later and announcing they would be mandatory starting next week.

    I mean, don’t get me wrong, Sweden needs to get its act together, but I’m not exactly in a position to throw stones here.

  • by JoeyRox ( 2711699 ) on Saturday June 27, 2020 @11:12AM (#60234480)
    They believe the virus is unavoidable and the entire world population will eventually contract it. The only difference is whether you catch it now or later, ie the shape of the infection curve. Their contention is you might as well catch it now, while still implementing measures to protect the at-risk population like the elderly (although by their own admission they didn't do enough to senior-living facilities). This is based on the notion that flattening the curve doesn't really help all that much, which is true when you look at mortality rates of the severely ill who do get hospitalization in the USA, and that a efficacious vaccine is not very likely.
    • by pelpet ( 981194 ) on Saturday June 27, 2020 @12:07PM (#60234736)

      Swede here.

      The problem is not really the Covid-strategy but the low-level care nursing homes have. The have very few medical personell and many worker are payed hourly and cannot afford to stay home when ill. The also did not have any protective equipment, no oxygen installed (that had been dismantled) and they did undertook to few protective measures. Many workers are also migrants that does not even read or speak Swedish. Migrants are also infected at a much higher rate than Swedes in general.

      This situation have been built up over three decades and are essentially everyone's fault. Both the politicians and the voters who have allowed it.

      • by Shinobi ( 19308 ) on Saturday June 27, 2020 @12:45PM (#60234888)

        To highlight this, a friend of mine who lives in one of the more immigrant saturated suburbs of Stockholm shared two recordings(before quickly having them removed by Youtube for "hate speech" due to complaints).

        One was from mid-march, of a turkish wedding, with 70+ people in close proximity. The other was from mid-may, and was of the same group holding a funeral for 3 people dead from Covid-19.

  • The whole virus thing becomes a bad memory in a few months when the vaccine becomes available. Until then, try not to take it personally.

    Also, don't use it as an excuse to be shitty to others.

    • There won't be a vaccine in months. A couple of years, possibly. But no other virus in this family has a vaccine, so odds are none will ever be available for this one.

  • I lived my whole life in different Scandinavian countries and I'm not aware of a popular radio program that everyone in Scandinavia listens to? Enlighten me please?

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