Sweden avoiding lockdown

Flinty997

My comment was in response to your post about ..

"...postponed or cancelled health screenings & elective procedures, are very likely to be leading causes of our unusually high excess death rates..."

Traditionally done by the health service. Though can be out sourced.

Lockdown measures were constantly being changed. Introduced and withdrawn. Trying to rewrite a narrative of being locked down in your house unable to exercise for 2+ years or to this day doesn't stand up to any scrutiny.

"...Prof Smyth recalled the early stages of the pandemic...." Clearly alludes that it was in stages, as in not constant.

odyssey06

https://www.boards.ie/discussion/comment/121010181#Comment_121010181

That is a statement of fact without foundation. Nobody has shown real excess deaths for Ireland i.e. age adjusted figures.

When the UK age adjusted their supposed excess death increase for 2022, there was no 'real' increase in excess deaths.

So not only have you not shown actual increase in excess deaths, you haven't shown any direct link from lockdown policies to excess deaths increase.

CalamariFritti

Funny how the guys who were falling over themselves to argue excess deaths are now doing the same trying to argue there wasn't any. 😁

odyssey06

https://www.boards.ie/discussion/comment/121010731#Comment_121010731

Nothing funny about it.

The longer the run of years you are comparing the excess deaths with, the more important it becomes to take into account demographic changes over that period.

If you are comparing against a baseline of 2015-2019, then 2020 would be more comparable - the more years you extend it, the less comparable it becomes.

Of course, why bother trying to understand how excess deaths are calculated when you can just make cheap shots.

Sconsey

https://www.boards.ie/discussion/comment/121010181#Comment_121010181

So the facts have moved from 'clearly the strictest lockdown in Europe' to 'fairly high' and 'near the top'.

Flinty997

Seems like many still locked down. Perhaps always were.

Blut2

https://www.boards.ie/discussion/comment/121008649#Comment_121008649

So just to be clear, your reply when presented with statistics given by Oxford University and the Financial Times is "no, they're wrong, I know better"?

Right...

https://www.boards.ie/discussion/comment/121008841#Comment_121008841

The chart, and statistics run from January 1st 2020 to the present day.

The excess deaths are against expected average for that stated country. Its not possible to have fewer excess deaths every year for decades, you're not understanding the concept.

Blut2

https://www.boards.ie/discussion/comment/121008988#Comment_121008988

You can add any 7 countries you want to the tool.

Ireland regularly had the strictest lockdowns in Europe from May 1st 2020 to June 25th 2020, Aug 9th to Sep 25th 2020, Oct 21 2020 to May 9th 2021, Sep 10 2021 to Dec 7th 2021. And for the rest of the period was never far from the top.

By any definition thats one of the strictest lockdowns in Europe.

odyssey06

https://www.boards.ie/discussion/comment/121011319#Comment_121011319

Your selective graphing has been queried on the thread by other posters.

Several posters have queried how the 'strictness' was established, as it does not reflect the reality of the lockdowns in 2020 across Europe. That is not a 'statistic', that is an assumption made by the authors which feeds into the statistics and reflects how granular a view of the data they took to build their statistics. Entirely valid points have been raised by multiple posters on how strict in reality Ireland's lockdown was versus France and Belgium.

What is the 'expected average' of excess deaths? It is just based on a previous baseline e.g. 2015-2019, or was the 'expected average' adjusted to take into account demographic changes since the baseline?

So it is possible to have fewer excess deaths every year using non age adjusted figures, it may simply reflect a shrinking population. It is possible to have higher excess deaths every year, it may simply reflect a growing and or aging population.

Age adjusting is an important step for valid comparisons especially the more years that have elapsed since the baseline. Because otherwise, there may be no real increase in excess deaths, or such demographic changes may be a significant factor in more people dying. It may just reflect an increase in the size of the population of highest mortality risk in the country - compared with the previous baseline for that country. The graph you have cited does not appear to be age adjusted - it just reflects a previous years baseline.

This has been pointed out to you multiple times on the thread already. This age adjusting is a basic concept in actuarial analysis of excess deaths.

Flinty997

https://www.boards.ie/discussion/comment/121011319#Comment_121011319

Why is not possible to have lower average than other countries. Why is it not possible for that to be true for decades.

Sconsey

https://www.boards.ie/discussion/comment/121011365#Comment_121011365

Eh no, you said Ireland clearly had the strictest lockdown in Europe, even looking at your skewed view of Europe (no Greece, no Italy, no Spain, no UK, etc. all countries that stricter lockdowns than us at times) in that diagram it is a real struggle to say Ireland was anywhere near the strictest. Try creating the graph with Ireland, Greece, France, Belgium, UK, Italy, Austria and your numbers fall apart.

Or better yet, look at the global tool on that site with the time slider, it shoes that the first week or two in January 2021, is the only time in the three year period when Ireland had a stricter lockdown than the rest of Europe. So I suppose you can say Ireland clearly had the strictest lockdown in Europe*.

*for about two weeks in Jan 2021

charlie14

There seems to be some confusion on Sweden`s excess deaths. Especially for 2020.

They had a very mild flu season end of 2019 and the beginning of 2020, with deaths even lower in the first 3 months of 2020 when compared to 2019. So in reality their excess deaths were all from the beginning of April until the 31st. December 2020.

Emblematic

https://www.boards.ie/discussion/comment/121012009#Comment_121012009

I think we need to be careful when we say this or that country had a stricter lockdown than Ireland. Are we looking at peak periods or are we averaging over the entire Covid period. When we do this average, we see that Ireland comes fairly high in the rankings.

odyssey06

https://www.boards.ie/discussion/comment/121014497#Comment_121014497

Is that strictness or duration \ length though. The same words seems to have been conflated to represent both. We could have had a longer period of restrictions but that does not mean stricter lockdown.

To me a lockdown is a stay at home order or curfew type situation, however some times it is also used to imply significant restrictions such as pubs being closed. But there's no way a "lockdown" without stay at home orders but e.g. pubs are closed is a 'strict' lockdown.

Sconsey

https://www.boards.ie/discussion/comment/121014497#Comment_121014497

I was pointing out the nonsense statement of another poster who said 'Ireland clearly had the strictest lockdown'. That is not the case, we neither had the 'highest strictness' nor the' longest strictness'.

When people make absolute statements like that, to backup some other point they are making, it undermines their whole argument.

charlie14

https://www.boards.ie/discussion/comment/121014497#Comment_121014497

I don`t see how it could be quantified under either heading when countries had various regional differences for the same periods of time.

Regional areas of Germany would be one example of such, as would Madrid in relation to the rest of Spain. Even Sweden as far as I recall had dufferences after their regional authorities regained the right to make their own decisions on health related issues.

daithi7

https://www.boards.ie/discussion/comment/121015503#Comment_121015503

Maybe, but did we have one of the highest levels of lockdown on aggregate?

(Very simple :Just measure & combine both factors (strictness & duration) for each month of covid & then average them for the whole period)

That's where afaik Ireland consistently comes out near the very top of measures. I.e. we had one of the longest & strictest lockdown regimes in aggregate.

And it's this measure & the net excess deaths (as a proxy for all the direct negative health effects of the disease) since covid & to this very day that really matter imho. (I.e. that gives a great indication of your bang for buck on lockdown measures or otherwise for preventing avoidable deaths & unnecessary adverse health effects )

Sweden seems to indicate that most authorities & governments got this balance vway wrong I.e. the cure was worse than the disease.

Sconsey

https://www.boards.ie/discussion/comment/121017101#Comment_121017101

Right, so you are coming up with a measure that the experts don't seem to think is relevant. The stat you are looking for does not seem to exist so I would question how relevant it is. If you need to come up with your own measure to justify your point I don't think you really have a point.

Emblematic

https://www.boards.ie/discussion/comment/121015987#Comment_121015987

That is indeed true, but you have to go with whatever data and measures are available. By the metric under discussion, Ireland is was one of the more stringent countries in the EU when the area under the curve is measured.

In addition, I think the practice is that if a measure was introduced in one region, it was counted as affecting the whole country for the purposes of the index.

While this intruduces inaccuracies, these inaccuracies will tend to push up the score for countries with regional polices such as the example you gave, Germany.

Ireland did not have much in the way of regional policies (there were some) so should be lower in the ranking for that reason but we are not. This furthers the case that Ireland had strict policies by EU standards.

Emblematic

https://www.boards.ie/discussion/comment/121014999#Comment_121014999

It is the combination of the two we need I think. The area under the curve as it were that probably gives the best indication.

There are, of course, issues with using any kind of index. How, for example, are the different components of it weighted.

But this difficulty is present also where someone is using a snapshot of the index at a particular time in order to argue that Ireland did not have a strict lockdown.

daithi7

https://www.boards.ie/discussion/comment/121017153#Comment_121017153

It's simply the area under the curve, just taking out vaccinations as they are another item entirely imho.

Lockdown measures and vaccination programmes are interdependent but are ultimately separate things. This is obvious surely!?

odyssey06

https://www.boards.ie/discussion/comment/121019338#Comment_121019338

Not obvious at all. Should this be excluded from 'stringency' index?

Sweden will require visitors from other Nordic nations to have a vaccine pass to cross the border.

Is that a strict lockdown measure?

Sconsey

https://www.boards.ie/discussion/comment/121019338#Comment_121019338

Yeah you still don't understand so I will spell it out as best I can and link you to the source.....at some points in time over the last three years, lockdown measures varied depending on if you were vaccinated or not. The red line in the chart I shared measures the weighted average of 'strictness' for both vaccinated and non vaccinated people in each country. The same chart has a total of three plots for each country: strictness for non-vaccinated, strictness for vaccinated and a weighted average of the two. I have no clue why you are talking about removing vaccination programmes?

https://ourworldindata.org/explorers/coronavirus-data-explorer?facet=none&uniformYAxis=0&country=~SWE&hideControls=true&Metric=Stringency+index&Interval=7-day+rolling+average&Relative+to+Population=true&Color+by+test+positivity=false

Since government policies may differ by vaccination status, a stringency index is calculated for three categories: those who are vaccinated; those who are non-vaccinated; and a national average which is weighted based on the share of people that are vaccinated.

daithi7

OK, so it looks like the area under the curve is the relevant metric to measure versus adjusted excess deaths.

E.g. a bit like this study, where Sweden's overall covid response is rated very, very highly!!!

https://www.bloomberg.com/graphics/2023-opinion-lessons-learned-from-covid-pandemic-global-comparison/

"...Unusual among comparable countries, Sweden never shuttered its kindergartens, elementaries or middle schools — and only briefly kept older students out of classrooms. It also refrained from most other restrictions, generally opting for recommendations over prohibitions...."

" ...The Swedish experience offers lessons for the next pandemic. Public health is a value, but so is education and the right to self-determination. Treating people as mature and responsible citizens paid off for Sweden. And other nations saw it. As the pandemic entered its second and third year, ever more countries gradually — and without calling it that — “became Swedish.”.... "

Former Former Former

https://www.boards.ie/discussion/comment/121020343#Comment_121020343

a bit like this study

That's not a study, it's an opinion piece by an economics journalist.

odyssey06

https://www.boards.ie/discussion/comment/121020343#Comment_121020343

What else happened in the second and third year... vaccines were rolled out. And Sweden became more like those other countries. With vaccine passes.

There's nothing to say that following Sweden's model which was dependent on those responsible citizens, it's hospitals capacity AND also the fact that its neighbours locked down... would have Swedish results.

The UK or England at least tried something like it, and had to abandon it.

Emblematic

https://www.boards.ie/discussion/comment/121020889#Comment_121020889

There was a convergence however I think it's probably more true to say that as time went on and restrictions were gradually relaxed other countries changed and became more like Sweden rather than Sweden changing to be more like other countries. Sweden, after all, never had much in the way of restrictions.

odyssey06

https://www.boards.ie/discussion/comment/121022712#Comment_121022712

Again the words missing from your posts are: vaccination, vaccine rollout, vaccine passes. I could also add Omicron.

Sweden became more like other countries too.

Needing a vaccine pass to enter a country is a restriction.

Emblematic

https://www.boards.ie/discussion/comment/121022724#Comment_121022724

I think, however, the movement was greater on the part of other countries in terms of lockdowns, restrictions and the like.

odyssey06

https://www.boards.ie/discussion/comment/121022730#Comment_121022730

A movement based on vaccines and the changing nature of the virus. Nothing to do with becoming more like Sweden, and discussing the changes without mentioning them is utterly disingenuous.

Flinty997

https://www.boards.ie/discussion/comment/121022712#Comment_121022712

You have it backwards. It's Sweden that changed. Even changed their legislation to facilitate restrictions. There's no probably about it.

Emblematic

https://www.boards.ie/discussion/comment/121022757#Comment_121022757

I'm not saying they did not change at all but rather that the bigger change was with the countries that had heavy restrictions and lockdowns as they eventually became more like Sweden. Sweden also relaxed their restrictions but, because those restrictions were fairly minimal even at peak, they had less distance to travel.

Thanks to the lower levels of restrictions and closures in Sweden during the pandemic, they seem to be suffering less excess deaths overall.

Flinty997

https://www.boards.ie/discussion/comment/121022791#Comment_121022791

You mean eventually the pandemic was over. All countries lifted their restrictions.

Sweden no different in that regard. They didn't invent the ending of a pandemic, or a return to normality.

Irish normality is a health service in crisis.

https://www.thejournal.ie/new-childrens-hospital-completion-date-6150517-Aug2023/

https://healthmanager.ie/2023/06/ireland-may-have-1000-bed-capacity-deficit-in-public-hospitals/#:~:text=Winter%202022%2F2023%20also%20saw,in%20public%20acute%20adult%20hospitals.

astrofool

https://www.boards.ie/discussion/comment/121020509#Comment_121020509

A libertarian most likely as Sweden's economic performance during the pandemic was worse than most comparable countries (and much worse than Ireland).

Goldengirl

https://www.boards.ie/discussion/comment/121022982#Comment_121022982

And that " study " makes no mention of deaths or elderly left to die...but why would you mention that when discussing the effects of Covid ?!

charlie14

https://www.boards.ie/discussion/comment/121017433#Comment_121017433

I have no idea if a measure was introduced in one region it was counted as affecting the whole country either, but if it the index was compiled on that basis then I would look on it as being somewhat scattergun. It`s not the high ground I would choose to compare one country to others on the severity of lockdow. Especially when there were so many different elements involved with lockdown and how their severity were rated in in index. TBH I would look on it somewhat like a SWOT analysis whereby you can bascally present whatever result you favor at the outset.

Emblematic

https://www.boards.ie/discussion/comment/121022922#Comment_121022922

No, the discussion was about how much each country moved. The assertion (I think you supported this too) was that Sweden moved to become like other countries when in fact, due to a much less restrictive policy, the movement from no restrictions to light restrictions and back to no restrictions was much less than than, say, Ireland where we went from no restrictions to quite heavy restrictions and eventually back again.

People seem to be attempting to establish a narrative that Sweden essentially gave up on having no restrictions and imposed the same level as everyone else, thus proving (according to the narrative) that that Sweden was wrong. The big shifts and impositions on the public, however, were mainly in countries other than Sweden.

Goldengirl

https://www.boards.ie/discussion/comment/121024217#Comment_121024217

But the point is , surely , as per the thread title , that while they may have avoided heavier restrictions because of the timing of their change of strategy , in following the " no lockdown " policy initially for 2020 , they showed how bad things can get , with death rates so much higher than neighbouring countries and economy suffering , even in a country like Sweden where people are more inclined to distance and live alone .

astrofool

https://www.boards.ie/discussion/comment/121027947#Comment_121027947

Sweden were also one of the countries at the forefront of the vaccine rollout similar to Denmark (https://www.nature.com/articles/s41598-022-21055-0), which doesn't tally with their herd immunity strategy working (lest people forget, that was the reason for the reduced restrictions they had in 2020, rather than any libertarian play).

Also interesting to watch the anti vax and anti restriction groups clash here, as anti vax can't blame excess deaths on vaccine and anti restrictions can't explain away the 2020 numbers and later numbers aren't accounted for by a small % of missed diagnoses due to lack of screening (which doesn't happen yearly for most programs). It's almost as if there are a lot of complex factors at play.

Emblematic

https://www.boards.ie/discussion/comment/121028381#Comment_121028381

In fairness, I don't think they were ever against the use of vaccines complementing naturally acquired immunity. It is probably the combination of the two that allowed them to remain comparatively open throughout the pandemic. This may be one of the reasons that they have lower excess deaths overall from the pandemic than, say, Ireland that had quite strict measures and sadly had higher excess deaths.

odyssey06

https://www.boards.ie/discussion/comment/121029396#Comment_121029396

Again, as has been pointed out to you multiple times on the thread, you are making statements of fact about excess deaths and drawing conclusions that you have not established.

You are quoting excess death figures that are not age adjusted. Then drawing inferences from that.

You have made an assumption about excess deaths that you have not established.

Your continue to repeat time trying to establish it as a narrative - it is without foundation.

Emblematic

https://www.boards.ie/discussion/comment/121029428#Comment_121029428

I'm just suggesting it as possibility not an established fact. It does make a certain amount of sense though that lockdowns, although they may have an effect of slowing down a virus, are likely in themselves unhealthy and this needs to be taken into consideration.

Part of the evidence might be that Sweden, as we have noted and contrary to predictions made early on, actually had lower excess deaths when you take into consideration the longer timeframe. Why exactly this is the case will need to be investigated further but it is certainly too early to rule out, as I think some are doing, that allowing normal life to continue to a large extent in Sweden was good for the country's health. For me it seems fairly obvious but that is just my opinion.

As for age adjustment, I have not seen evidence put forward that the differing age profile of Sweden worked in Sweden's favour to produce the more favourable outcome that they had. If anything, Sweden's generally older age profile should have worked against them. It is, after all, older people who succumb more to infections and viruses and generally need more medical care. But if you have something to substantiate your claim please put it forward.

Of course it could also be some other unknown factor that worked in Swedens favour. Again, the onus is on Sweden's critics to find this other factor if that is what they want to base their argument on. I think you will agree that merely suggesting it could be something else is not sufficient.

odyssey06

https://www.boards.ie/discussion/comment/121029494#Comment_121029494

No. You misunderstand how excess deaths are calculated. A countrys age profile is built into the baseline.

The age adjustment is of the excess death figures themselves to take into account demographic changes since last baseline. The further from the baseline of 2019 or 2015-2019 the less reliable any comparisons are.

When the UK did this their supposed excess death increase in 2022 was negligible.

If you are using non age adjusted figures excess deaths for 2022 for Sweden, Ireland, UK etc that is 'built on sand' when it comes to drawing any lessons.

BlueSkyDreams

https://www.boards.ie/discussion/comment/121028381#Comment_121028381

If comparing multiple data sets & finding no consistent logic, despite analysis & inclusion of all identifiable simple & complex factors, then:

A) any singular factor in isolation is usually not overly influential vs the remainder of the factors (otherwise we spot the correlation of definitive factors with a certain outcome)

B) and/or, we haven't accounted for the most pertinent factors.

There are known unknowns. But there are often unknown unknowns.

The scenario outlined makes for conflicting data sequence analysis & with no clear root cause identifiers vs outcome.

I dont know much about covid, but general rules of problem solving would still apply.

Emblematic

https://www.boards.ie/discussion/comment/121029566#Comment_121029566

Then apply the appropriate adjustment to Sweden and show how the the published figures are misleading in their case. In your view, should the adjusted figures be much higher for Sweden and what basis do you have for holding this view?

odyssey06

https://www.boards.ie/discussion/comment/121029600#Comment_121029600

Applying the appropriate adjustment is a non trivial process involving experts and access to official data sets.

The onus is on your to show how the figures you are citing are fit for purpose \ valid for comparison, to support the claims that you are making.

I have demonstrated with reference to the UK how comparisons based on unadjusted excess death figures would be totally misleading.

Emblematic

https://www.boards.ie/discussion/comment/121029739#Comment_121029739

Yes and now you need to show that you can provide the adjusted figures for Sweden in order to show they were wrong.

I know you might think this is unfair but you've got to understand that the excess deaths figures, at least on the face of it, prove you glaringly wrong if you're one of the people who thought Sweden would have huge amounts of deaths over the extended period. There's all sorts of adjustments that could be made but if you feel that adjusting for age will make Sweden's death toll from combined Covid plus lockdowns and restrictions seem greater, then provide that analysis. Merely stating that it might be this or that won't cut it, I'm afraid.

Had the figures been different and indicated that Sweden, over the extended period, had overall high excess deaths, then the onus would be on me to prove that the figures were (in this counterfactual situation) misleading. But that is not the case.

odyssey06

https://www.boards.ie/discussion/comment/121029810#Comment_121029810

I need to do no such thing. You are the one making claims on the basis of facts that may not bear the weight of argument placed on them. The onus is on you to support and validate them, or at least acknowledge the caveats. To pretend otherwise is utterly disingenuous.

With reference to the UK example, I have proved the hazards of using unadjusted excess death figures, where a supposed 7% increase when age adjusted was determined to be 1% reduction.

If you continue to falsely misrepresent the figures as fact and valid for comparison, I will continue to point this out. If it is phrased as 'the excess deaths figures suggest', that is a different matter.

Goldengirl

https://www.boards.ie/discussion/comment/121029494#Comment_121029494

Their health service and their preparedness . Its been said and shown repeatedly here but for some reason you don't appear to register it.

Emblematic

https://www.boards.ie/discussion/comment/121029841#Comment_121029841

The reason you might want to do such an analysis is to show that in the case of Sweden is to show, if it is indeed the case, that Sweden's apparent low excess deaths are misleading.

I take your point that excess deaths can be misleading in certain circumstances. All figures need to be treated with caution in that respect. An example of this would be that during the first year of the pandemic, Sweden appeared at various points to have a higher official covid death rate than Ireland. However when the older age profile of Sweden was taken into consideration, the result was pretty much the same as here.

You might therefore wish to show how changes in Sweden's age profile over the last few years might give a lower than expected result other things being equal.

In the absence of any such analysis, however, we're forced to go with the figures even though they are not perfect. They are the best we've got.