Sweden avoiding lockdown

Breezin

charlie14 wrote: »

First thing comes to mind reading that is pot kettle black.
When it comes to Swedish health care you are not big on uncertainty either and I do not see much of any complexity in their strategy.

The reference to knee jerk reaction, where the whole world practically is using the same strategy as Britain and Ireland reminded me of the mother watching her soldier son in an army parade saying they were all out of step except her Johnnie.

There are better-led armies. This is a devastating lesson for the Brits, and for us.

https://youtu.be/kQrtd-WCjos

biko

To people linking to www.medrxiv.org, please note what they say on their front page

Caution: Preprints are preliminary reports of work that have not been certified by peer review.
They should not be relied on to guide clinical practice or health-related behavior
and should not be reported in news media as established information.

charlie14

Breezin wrote: »

There are better-led armies. This is a devastating lesson for the Brits, and for us.

https://youtu.be/kQrtd-WCjos

Armies are led by Generals, Navies by Admirals.
An eminent scientist in his own field but he is not a epidemiologist.
It is his view, but not one that is shared by that many epidemiologists.
Even in Sweden.

Hmmzis

marno21 wrote: »

That's what they're saying. They're saying that closing schools/colleges, banning mass gatherings and closing some non essential businesses (whatever they are) is sufficient to suppress the virus. The lockdowns are unnecessary.

In saying that, I do believe a certain length of lockdown was necessary to stop the march of the virus, get people into a habit of realising what the virus is and how to live with it, and prepare the health service while the virus was suppressed. That period is now over, and the lockdown is no longer necessary and to be realistic, more damaging than it is beneficial.

What I find the most curious is the inverse correlation of the 'stay-at-home' order. How is that even possible? If people are 99% home, how do they pick up the infection? Would be very interesting to see how that mechanism is explained.

The mask wearing one might be explained by complacency setting in after the first week or two. Not observing distance, not being that careful about donning and doffing the mask, etc.

The mass gatherings, schools, pubs, clubs, concerts, parades effects are quite expected as this virus has been spreading very well from all sorts of mass gatherings. Could well explain the initial slowness of the spread, given first cases in Europe were back in December and January. Then apres-ski and other winter parades and festivals kicked it into high gear.

Eagerly awaiting peer review for this one.

Kermit.de.frog

129 new deaths.

biko

25265 cases
3175 dead
12.6% of known cases have passed

Numbers from FHMs own tracking page
https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa

Breezin

charlie14 wrote: »

Armies are led by Generals, Navies by Admirals.
An eminent scientist in his own field but he is not a epidemiologist.
It is his view, but not one that is shared by that many epidemiologists.
Even in Sweden.

Did you watch the report? It's not one scientist, but three very senior figures, talking to a health journal editor who exposed the UK's botched overreaction to swine flu a decade ago.
It is a reputational disaster for Imperial and its hysterically shortsighted modelling design.

Ginger n Lemon

Published today

"Sweden’s unique strategy to deal with coronavirus will ensure it has only a small second wave of cases unlike other countries that could be forced to return to lockdown, according to the architect of the contentious policy.

Anders Tegnell, Sweden’s state epidemiologist who devised the no-lockdown approach, estimates that 40 per cent of people in the capital, Stockholm, would be immune to Covid-19 by the end of May, giving the country an advantage against a virus that “we’re going to have to live with for a very long time"

This thread could use a poll - did Sweden do the right thing or not.

What Username Guidelines

Ginger n Lemon wrote: »

Published today

"Sweden’s unique strategy to deal with coronavirus will ensure it has only a small second wave of cases unlike other countries that could be forced to return to lockdown, according to the architect of the contentious policy.

Anders Tegnell, Sweden’s state epidemiologist who devised the no-lockdown approach, estimates that 40 per cent of people in the capital, Stockholm, would be immune to Covid-19 by the end of May, giving the country an advantage against a virus that “we’re going to have to live with for a very long time"

This thread could use a poll - did Sweden do the right thing or not.

I know all pandemics dont act the same but interestingly during Spanish Flu, you can see places like Philadelphia and New York had bigger first waves which had an effect on the size of the second, or didnt even have a second, with places like St Louis flattening the curve initially but relaxing measures too soon.

https://www.nationalgeographic.com/history/2020/03/how-cities-flattened-curve-1918-spanish-flu-pandemic-coronavirus/

The other part I dont get, and maybe it's for another thread, but is a vaccine ever going to work if not available very soon? All pandemics in the past seem to come in varying waves, some lasting a few months at most before dipping for some time. But it seems lots of commentary around coronavirus is that it's just here to stay and the new normal will be around forever or until a vaccine.

4068ac1elhodqr

Ginger n Lemon wrote: »

This thread could use a poll - did Sweden do the right thing or not.

but....In 6mths time

As the much bigger question is whether or not natural 'immunity' can exist for longer periods of time (e.g. 6mths+, for November onwards)?

The WHO said there is no evidence for it.
Then again... the WHO have left a breadcrumb of flase information and widescale incompetence to date.

charlie14

Ginger n Lemon wrote: »

Published today

"Sweden’s unique strategy to deal with coronavirus will ensure it has only a small second wave of cases unlike other countries that could be forced to return to lockdown, according to the architect of the contentious policy.

Anders Tegnell, Sweden’s state epidemiologist who devised the no-lockdown approach, estimates that 40 per cent of people in the capital, Stockholm, would be immune to Covid-19 by the end of May, giving the country an advantage against a virus that “we’re going to have to live with for a very long time"

This thread could use a poll - did Sweden do the right thing or not.

What this thread could use is clarification if Sweden`s primary strategy aim is herd immunity or not.
From what you posted it seems that is what Tegnell is banking on.

Utopia Parkway

What Username Guidelines wrote: »

I know all pandemics dont act the same but interestingly during Spanish Flu, you can see places like Philadelphia and New York had bigger first waves which had an effect on the size of the second, or didnt even have a second, with places like St Louis flattening the curve initially but relaxing measures too soon.

https://www.nationalgeographic.com/history/2020/03/how-cities-flattened-curve-1918-spanish-flu-pandemic-coronavirus/

The other part I dont get, and maybe it's for another thread, but is a vaccine ever going to work if not available very soon? All pandemics in the past seem to come in varying waves, some lasting a few months at most before dipping for some time. But it seems lots of commentary around coronavirus is that it's just here to stay and the new normal will be around forever or until a vaccine.

I'm a bit puzzled by this myself. Many many viruses mutate into less deadly versions of themselves over time as the less deadly strains spread more successfully as they don't kill their hosts like the deadlier strains. The Spanish flu mutated into a version of the common flu after about 12 months. SARS mutated into a less deadly version of itself over about 8 months.

But as you say all the commentary on COVID-19 is that "it's here and it's not going away until we have a vaccine". Unless I'm mistaken there is a reasonable chance it will mutate, become less deadly and burn out by itself over time. Now you still have to utilise social distancing and look for a vaccine but the possibility it will burn itself out so to speak is never raised. Maybe they just don't want the public to become complacent about it?

Anyway slightly off topic.

Kermit.de.frog

135 new deaths which moves Sweden above the Netherland for deaths per million.

What Username Guidelines

Utopia Parkway wrote: »

I'm a bit puzzled by this myself. Many many viruses mutate into less deadly versions of themselves over time as the less deadly strains spread more successfully as they don't kill their hosts like the deadlier strains. The Spanish flu mutated into a version of the common flu after about 12 months. SARS mutated into a less deadly version of itself over about 8 months.

But as you say all the commentary on COVID-19 is that "it's here and it's not going away until we have a vaccine". Unless I'm mistaken there is a reasonable chance it will mutate, become less deadly and burn out by itself over time. Now you still have to utilise social distancing and look for a vaccine but the possibility it will burn itself out so to speak is never raised. Maybe they just don't want the public to become complacent about it?

Anyway slightly off topic.

Absolutely, the social distancing is important and it seems as if lockdown-light as per sweden has about the same effect as our lockdown here. I know we cannot rely on a virus mutating, but it seems that's almost always happened in the past, or slowed due to immunity. Right now we have almost 1% of Dublin's population confirmed positive, and given the stringent testing criteria it's likely to be more like 10%, maybe 20% if the asymptomatic theories are correct or if it was here in Decemeber (debateable) This in itself, along with social distancing, cocooning, and less mass gatherings may be the type of thing to keep R0 below 1 and eventually 'burn out' even with imported cases. Maybe wishful thinking.

But maybe this is what is happening in Sweden.

tobefrank321

Ginger n Lemon wrote: »

Published today

"Sweden’s unique strategy to deal with coronavirus will ensure it has only a small second wave of cases unlike other countries that could be forced to return to lockdown, according to the architect of the contentious policy.

Anders Tegnell, Sweden’s state epidemiologist who devised the no-lockdown approach, estimates that 40 per cent of people in the capital, Stockholm, would be immune to Covid-19 by the end of May, giving the country an advantage against a virus that “we’re going to have to live with for a very long time"

This thread could use a poll - did Sweden do the right thing or not.

We probably won't know for a long time if they did or not. Not until January 1st next year at least.

Ironically if Sweden do achieve mythical herd immunity, it will make the rest of Scandinavia safer - less infected people moving across borders from Sweden.

All I can say is its an interesting approach from Sweden. They may see huge spikes in the coming months and then deaths tail off, if herd immunity is achieved. Then they either have to repeat in 2021 or hope for a vaccine then too.

wadacrack

People are taking personal responsibility for their safety.

https://www.youtube.com/watch?v=2HWfnZLKfQY

millb

sydthebeat wrote: »

as a continuation as to how sweden are historically adding to their daily numbers:

28th April, originally reported at 34, now 66

29th April, originally 26, now 66

Over 120 new deaths reported today.

Probably a good indicator is the numbers in IC. Critical Care which is >400 v's ~ 80 here.

"Sweden's coronavirus-related death toll rose to 3,175 people today, and the number of confirmed cases to 25,265.
For the first time since more than a month, the number of patients in intensive care has fallen below 500, according to Taha Alexandersson, deputy crisis manager at the National Board for Health "
https://www.thelocal.se/20200310/timeline-how-the-coronavirus-has-developed-in-sweden

biko

It will be interesting to see how Sweden fares by autumn/winter.
Since Tegnell and the government chose to expose people early it means Sweden should not get a second wave when lockdown ends.

The initial effort failed (to protect old and infirm) but if Sweden is spared a second wave it could tell us how to handle the next virus (there will be others).

charlie14

biko wrote: »

It will be interesting to see how Sweden fares by autumn.
Since Tegnell and the government chose to expose people early it means Sweden should not get a second wave when lockdown ends.

The initial effort failed (to protect old and infirm) but if Sweden is spared a second wave it could tell use how to handle the next virus (there will be others).

What I do not get with this immunity theory on Sweden, is say if at some stage they do reach 60% -70% infections, that still leaves those that are most vulnerable at high risk of dying in this, or subsequent waves, does it not ?

Far as I know herd immunity if high enough can be highly effective in conjunction with a vaccine, but without a vaccine are Sweden not in the same boat as everyone else when it comes to those that are vulnerable ?

Ginger n Lemon

charlie14 wrote: »

What I do not get with this immunity theory on Sweden, is say if at some stage they do reach 60% -70% infections, that still leaves those that are most vulnerable at high risk of dying in this, or subsequent waves, does it not ?

Far as I know herd immunity if high enough can be highly effective in conjunction with a vaccine, but without a vaccine are Sweden not in the same boat as everyone else when it comes to those that are vulnerable ?

Its not that 60-70% will get just immunity. Antibodies reduce seriousness of the future version of same or similar virus, so if you have 70% of population with antibodies against covid, and you have 500 infected people flying in and passing it onto these 60/70%, these 60/70% will pass on a weaker version of the virus to most vulnerable (if 60-70% all get infected at same time and interact with elderly, small chance). So while its not ideal, their most vulnerable will have a weaker version of virus to deal with. And that is mighty important.

Hmmzis

charlie14 wrote: »

What I do not get with this immunity theory on Sweden, is say if at some stage they do reach 60% -70% infections, that still leaves those that are most vulnerable at high risk of dying in this, or subsequent waves, does it not ?

Far as I know herd immunity if high enough can be highly effective in conjunction with a vaccine, but without a vaccine are Sweden not in the same boat as everyone else when it comes to those that are vulnerable ?

That's not quite how herd immunity works. If you have 60-70% with effective antibodies, then the infections have very few places to go as the virus would constantly bounce off the protected people. While it could infect the odd few of the 30-40% who don't have any protection themselves, they are very unlikely to spread it much further due to lack of susceptible hosts to spread it to. Vaccination is one way of how to get heard immunity. The other is to get through the actual infection in sufficient numbers (like that one town in Italy where they found 70% had gone through this already). In most real cases it's a combination of both.

The herd immunity percentage is directly dependent on the Re value. If people change their behaviour due to the danger of infections, the Re goes down, therefore a lesser percentage is needed to starve the virus of hosts. Once Re goes below 1, you've achieved "herd immunity" as the currently infected people spread it to a lesser amount of susceptible people.

In the current lock-down situation, the Re is below 1 and the infections would fizzle out over time as less and less people would get infected, spreading to even less people until it reaches 0 (NZ did exactly that). If we change our behaviour so that the Re value goes above 1, then we will lose our "herd immunity" and sooner or later we'll have a big problem again.

The first call is now for the smart people to figure out the least restrictive set of behaviour changes we need to implement/keep that keep the Re value below 1.

Bit cynical

charlie14 wrote: »

What I do not get with this immunity theory on Sweden, is say if at some stage they do reach 60% -70% infections, that still leaves those that are most vulnerable at high risk of dying in this, or subsequent waves, does it not ?

Yes initially, but herd immunity is the threshold after which the level of infection naturally decreases.

charlie14

Ginger n Lemon wrote: »

Its not that 60-70% will get just immunity. Antibodies reduce seriousness of the future version of same or similar virus, so if you have 70% of population with antibodies against covid, and you have 500 infected people flying in and passing it onto these 60/70%, these 60/70% will pass on a weaker version of the virus to most vulnerable (if 60-70% all get infected at same time and interact with elderly, small chance). So while its not ideal, their most vulnerable will have a weaker version of virus to deal with. And that is mighty important.

Thank for that, but there are a snags that kind of stand out.
If someone vulnerable is infected by this other 30-40% (or this 500 of a plane) without a vaccine their risk is the same as now.
If this 60 -70% can still pass it on to someone vulnerable how weakened it would be is questionable. (What I would find even more questionable is if you are immune how would you be passing it on) Either way to me it seems that without a vaccine it is no difference too the present for the vulnerable.

By the way, where did you get that 40% immunity in 3 weeks time?
Just listened to a video of Tegnell posted here and he said 25% for Stockholm with lower infections for the rest of the country. What that is about I do not know. Weeks ago it was 27% or according to your diplomat, 30%.
At 25% for Stockholm alone, then herd immunity of 60-70% looks a long long way off. Especially with their R0 below 1.

Ginger n Lemon

charlie14 wrote: »

Thank for that, but there are a snags that kind of stand out.
If someone vulnerable is infected by this other 30-40% (or this 500 of a plane) without a vaccine their risk is the same as now.
If this 60 -70% can still pass it on to someone vulnerable how weakened it would be is questionable. (What I would find even more questionable is if you are immune how would you be passing it on) Either way to me it seems that without a vaccine it is no difference too the present for the vulnerable.

By the way, where did you get that 40% immunity in 3 weeks time?
Just listened to a video of Tegnell posted here and he said 25% for Stockholm with lower infections for the rest of the country. What that is about I do not know. Weeks ago it was 27% or according to your diplomat, 30%.
At 25% for Stockholm alone, then herd immunity of 60-70% looks a long long way off. Especially with their R0 below 1.

Irish times had this article published

https://www.irishtimes.com/news/world/europe/sweden-insists-its-no-lockdown-approach-to-coronavirus-will-pay-off-1.4248417?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fworld%2Feurope%2Fsweden-insists-its-no-lockdown-approach-to-coronavirus-will-pay-off-1.4248417

charlie14

Bit cynical wrote: »

Yes initially, but herd immunity is the threshold after which the level of infection naturally decreases.

I can get that, it has less possible hosts, but it still leaves 30-40% of the population susceptible hosts which will include all of the present vulnerable.
They are not going to acquire immunity without a vaccine. Either that or the percentage for those with immunity will need to be much higher than 60-70%.
Questionable just how much higher it can go when we know not just the age profile, but all those with underlying conditions that are very vulnerable.

One of the main problems I have with this Sweden plan is I cannot see how they are even going to get to that 60-70% with an Ro of less than 1 at this stage for immunity to have any great influence without a vaccine.

Bit cynical

The theory, if I understand it correctly, is that once you have a certain number who have been infected and developed immunity, then although there will still be some getting infected, the R0 figure will be below zero due to the large amount of people with immunity. New infections will still be going on but will gradually diminish due to R0 < 0.


Things like the 2m rule and other social distancing measures don't reduce future infections to zero either straight away but will also reduce the R0 figure and eventually the number of infections will fall. The only problem with this is that immunity is reduced and the country is vulnerable to a second wave when restrictions are lifted.

Bit cynical

charlie14 wrote: »

I can get that, it has less possible hosts, but it still leaves 30-40% of the population susceptible hosts which will include all of the present vulnerable.
They are not going to acquire immunity without a vaccine. Either that or the percentage for those with immunity will need to be much higher than 60-70%.
Questionable just how much higher it can go when we know not just the age profile, but all those with underlying conditions that are very vulnerable.

One of the main problems I have with this Sweden plan is I cannot see how they are even going to get to that 60-70% with an Ro of less than 1 at this stage for immunity to have any great influence without a vaccine.

I don't think herd immunity is the primary goal of the Swedish strategy; it is certainly not the stated strategy. Their strategy as far as I can make out is that whatever measures they introduce, they must be sustainable. This may mean a higher infection rate in the early stages and more people developing immunity. But even if they don't get 60% or 70%, getting, say, 35% in a city like Stockholm would still have an impact and cause the future infection rate to fall without imposing further restrictions.

The all-herd immunity strategy would involve no restrictions apart from isolation of the elderly and vulnerable. Let the virus spread and burn out in the general population and then restrictions on the vulnerable can be eased. This group would still be open to infection but because at this stage a high percentage of the population would be immune, a new outbreak would not get very far.

I'm not sure any country is adopting this approach though poor countries may be forced into it for economic reasons. The problem is that too many would be infected at the height of the curve and hospitals overrun in most countries.

charlie14

Hmmzis wrote: »

That's not quite how herd immunity works. If you have 60-70% with effective antibodies, then the infections have very few places to go as the virus would constantly bounce off the protected people. While it could infect the odd few of the 30-40% who don't have any protection themselves, they are very unlikely to spread it much further due to lack of susceptible hosts to spread it to. Vaccination is one way of how to get heard immunity. The other is to get through the actual infection in sufficient numbers (like that one town in Italy where they found 70% had gone through this already). In most real cases it's a combination of both.

The herd immunity percentage is directly dependent on the Re value. If people change their behaviour due to the danger of infections, the Re goes down, therefore a lesser percentage is needed to starve the virus of hosts. Once Re goes below 1, you've achieved "herd immunity" as the currently infected people spread it to a lesser amount of susceptible people.

In the current lock-down situation, the Re is below 1 and the infections would fizzle out over time as less and less people would get infected, spreading to even less people until it reaches 0 (NZ did exactly that). If we change our behaviour so that the Re value goes above 1, then we will lose our "herd immunity" and sooner or later we'll have a big problem again.

The first call is now for the smart people to figure out the least restrictive set of behaviour changes we need to implement/keep that keep the Re value below 1.

I get that, but without a vaccine, and with 30-40% still available to hosting the virus, then the vulnerable are still very susceptible without a vaccine.
With what we now know of those that are vulnerable I would doubt it would even be possible to get that percentage above 70. How Sweden can even reach that based on their latest figures of 25% just for Stockholm and an Ro less than 1 looks very doubtful or very far into the future

Hmmzis

charlie14 wrote: »

I get that, but without a vaccine, and with 30-40% still available to hosting the virus, then the vulnerable are still very susceptible without a vaccine.
With what we now know of those that are vulnerable I would doubt it would even be possible to get that percentage above 70. How Sweden can even reach that based on their latest figures of 25% just for Stockholm and an Ro less than 1 looks very doubtful or very far into the future

That's the thing, with adjusted human behaviour you don't need the percentage to be 70%. The lower we can get the Re (the effective, not unrestricted), the lower the inflection ratio for "herd immunity". One thing to keep in mind here is that humans cannot be assumed a homogeneous mass of randomly moving entities. Not everyone is contacted by everyone, some people have less contacts, some more, that's why herd immunity as such is even possible without 100% vaccination and/or infection rates.

charlie14

Bit cynical wrote: »

I don't think herd immunity is the primary goal of the Swedish strategy; it is certainly not the stated strategy. Their strategy as far as I can make out is that whatever measures they introduce, they must be sustainable. This may mean a higher infection rate in the early stages and more people developing immunity. But even if they don't get 60% or 70%, getting, say, 35% in a city like Stockholm would still have an impact and cause the future infection rate to fall without imposing further restrictions.

The all-herd immunity strategy would involve no restrictions apart from isolation of the elderly and vulnerable. Let the virus spread and burn out in the general population and then restrictions on the vulnerable can be eased. This group would still be open to infection but because at this stage a high percentage of the population would be immune, a new outbreak would not get very far.

I'm not sure any country is adopting this approach though poor countries may be forced into it for economic reasons. The problem is that too many would be infected at the height of the curve and hospitals overrun in most countries.

I could see Stockholm possibly getting to 35%, even with an Ro below 1, but that would be considerable lower for the other 80% of the population.
But even if that percentage had full immunity to this or subsequent waves, without a vaccine I cannot see how much restrictions on the vulnerable could be eased.