Failed COVID Strategy Leaves Sweden Deeply Divided

Yves here. Lack of social cohesion and trust wasn’t high in most advanced economies even before Covid, thanks to rising income inequality. Covid deepened existing fissures between the “freedom” types and most business owners versus those who preferred a vigorous government response, including restrictions on activity. At least in the West, the often less than stellar management of this public health crisis gave critics of intervention talking points. But the flip side is Asian countries, which generally had had experience with SARS, have suffered less damage to their economies and normalcy by taking aggressive action early on, which allowed them to be more selective about ongoing restrictions.

And it’s not as if high levels of social trust was key to greater success in Asian nations. For instance, readers have said South Koreans don’t have all that much faith in their government….but public health is an exception.

The story above is familiar. But it’s still worth cycling back to Sweden, which was touted early on as correctly staring down health risks to save their economy. It turned out, as this site and many others anticipated, the Swedish response was a lose-lose: markedly higher death rates than their low population density neighbors, yet similar damage to the economy as the rest of Europe. That confirms our oft-repeated point that the damage to commerce comes from consumers curtailing and modifying their activities, which they do even if there are no lockdowns. For instance, Google tracking of personal movements found it contracted in the various US states a week to ten days before officials imposed “shelter in place” type rules.

And since the odds of drive-by Sweden-failure-denialists trying to thought police in comments are high, we feel compelled to provide a few details. From The Lancet at the end of December:

In the second wave of the COVID-19 pandemic, the Swedish national response continues to be an outlier with cases and deaths increasing more rapidly than in its Nordic neighbours. On Dec 20, 2020, COVID-19 deaths in Sweden had reached more than 80003 or 787 deaths per 1 million population, which is 4·5 to ten times higher than its neighbours. This difference between Nordic countries cannot be explained merely by variations in national cultures, histories, population sizes and densities, immigration patterns, the routes by which the virus was first introduced, or how cases and deaths are reported. Instead, the answers to this enigma are to be found in the Swedish national COVID-19 strategy, the assumptions on which it is based, and in the governance of the health system that has enabled the strategy to continue without major course corrections.

From the BBC in late December:

Sweden’s king has said his country “failed” to save lives with its relatively relaxed approach to the coronavirus pandemic….

Prime Minister Stefan Lofven said he agreed with the king’s remarks.

“Of course the fact that so many have died can’t be considered as anything other than a failure,” Mr Lofven told reporters.

Now to the collateral damage.

By Irene Peroni, an Italian freelance journalist based in Oslo, Norway. She has worked for BBC Monitoring and BBC News Online in the past, and is currently collaborating with a few Italian and Swiss media outlets, including Swiss-Italian radio RSI. Originally published at openDemocracy

Sweden continues to battle the new, more contagious COVID-19 strain, February 2021 |Wei Xuechao/PA. All rights reserved.

Sweden, a bastion of welfare and one of the countries that scores highest on pretty much anything to do with the wellbeing of its inhabitants, seems to have woken up to a serious identity crisis.The choice to adopt and follow a COVID-19 strategy unlike any other in Europe has recently led to an extreme polarization in an otherwise rather homogenous public debate.

Statistics prove beyond a shadow of doubt that the other Scandinavian countries, which enforced much stricter policies, have suffered considerably fewer losses.

Sweden’s state epidemiologist Anders Tegnell, who firmly opposed face masks and believed that measures should rely only on the Swedish people’s sense of personal responsibility, enjoyed overwhelming support in the early phases of the crisis.

Fan pages, mostly on Facebook, counted tens of thousands of members. His face featured on T-shirts, gadgets and even a tattoo, worn on the arm by one of his proudest admirers.

The alluring message that Sweden’s approach was right and everybody else’s self-isolation regime was hopelessly wrong reached well beyond the nation’s borders.

In other European countries, staunch critics of lockdowns pointed at footage of happy, bare-faced Swedes hanging out in crowded bars as evidence that the draconian measures imposed elsewhere were an unnecessary violation of civil rights.

The Swedish model became a symbol for anti-lockdown and no-mask movements across the world.

Beyond the ‘Opinion Corridor’

But now, one year after the first cases of COVID-19 were detected in Scandinavia, the situation has changed dramatically.

Sweden’s Public Health Agency recently announced that several among its key figures have been granted police protection.

Tegnell himself is currently enduring massive criticism and even death threats.

In one instance, a citizen went so far as to argue that he should be “executed by a firing squad on live state television”.

And yet, despite the fact that both King Carl XVI Gustaf and prime minister Stefan Löfven in December publicly acknowledged that the Swedish approach had failed, Tegnell has never retracted anything, let alone made an official apology.

Until very recently, an astounding, near total lack of criticism, not only from public opinion but even from major opposition parties, characterised Sweden’s COVID. This might be due to the so-called åsiktskorridor (‘opinion corridor’).

This is a Swedish concept meaning that the public debate tends to take place within certain limits, along an established path. Those who disagree, often choose not to speak out. They feel out of tune with the rest of society.

Hate Speech

Andreia Rodrigues, a 26-year-old law graduate from Portugal, started organizing protests in central Stockholm in the early days of the pandemic, when she realized that the lack of preventive measures could lead to a large number of casualties. She was met with suspicion and hostility.

“Especially during the first few weeks, many would tell us to go home if we didn’t like Sweden’s strategy,” she recalls.

“Others would shout ‘long live Sweden’, as if we were enemies of the country just because we expressed an opinion which differed from the mainstream one.”

There were some people who would send messages to express solidarity to her group, called “Save Sweden – COVID-19”, but would not want to join for fear of the stigma.

“They would write things like ‘what would my family and my colleagues say if they understood that I am critical of the strategy?’”

Keith Begg, a 46-year-old Irish/Swedish national, was another key figure who lobbied for a stricter pandemic strategy.

The moderator of a private Facebook page called “Media watchdogs of Sweden”, which is critical of Sweden’s COVID-19 strategy, Begg recently decided to move back to Ireland after his group was accused on public radio of deliberately trying to damage Swedish interests abroad.

“I received a letter in my postbox referring to me as a traitor, I got hate speech… calling me a dirty foreigner,” Begg told The Irish Times.

Haters deemed one group of people even more despicable than foreigners who had a critical view of Sweden: they were the so-called landsförrädare, ‘traitors’.

Early in spring last year, a group of 22 researchers, later referred to as ‘the 22’, published an open letter criticizing Sweden’s Public Health Agency in the daily newspaper Dagens Nyheter. They did so at a time when the vast majority of the population supported “the strategy”.

Lena Einhorn, a virologist and a member of the 22, knows how it feels to receive abusive mail and even threats.

Now that public opinion has shifted, it is someone else’s turn to be affected by “the shit we received this spring”, she told Swedish news agency TT.

She underlined that at the time, “prime minister Stefan Löfven did not express any anger for what we were being exposed to.”

Scarred and Divided

But with the Swedish public more divided than ever, politicians appear to increasingly deny the obvious.

Tegnell himself went as far as to claim that “the Swedish strategy is actually similar to those adopted by all countries”, raising a few eyebrows among his Scandinavian neighbours.

Norway, for one, had repeatedly warned Sweden against its strategy early in the crisis – not least because it was pretty clear that pursuing such different paths would have damaged the close cooperation and exchange of workforces between the two countries.

The first time the authorities advised people to use face masks on public transport at peak time, was in December

While the then-US president, Donald Trump, and UK prime minister, Boris Johnson, gave up on their idea of herd immunity as a viable solution very early on, Sweden de facto stuck to it for much longer – and imposed the first measures far too late.

The first time the authorities advised people to use face masks on public transport at peak time was in December.

Some blame Sweden’s failures and shortcomings on the enormous power entrusted to the Public Health Agency, which is part of Sweden’s “administration model”.

Agencies are in charge of making day-to-day decisions in the areas they are responsible for.

It is very likely that once the threat is over, this model will have to be dismantled and rebuilt.

The handing of the pandemic will inevitably leave Swedish society deeply scarred and divided, while its repercussions might be felt way beyond the next general elections in September 2022.

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  1. skippy

    For anyone watching Sweden went neoliberal some time ago, remember old NC commenter Lex even giving it a pass, considering other options and head winds at that time …

    That said the Asian experience seems to have some correlation to diet and BDI factors, contra some anglophone nations or regional subsets – ethnic food sans any genetic factors may play in.

    1. lyman alpha blob

      Someone posted a link here not long ago showing that a majority of hospitalizations were obesity-related. Could be “ethnic foods” causing the problems in the US – who else loves high fructose corn syrup as much as USians?

      1. R

        Obesity has no material bearing on ICU admission or outcome, at least in the UK.

        There is endless data here in the reports of UK ICNARC (Intensive Care National Audit and Research Centre – standardised reporting from a healthcare system covering 60m), e.g: the report for 5th March 2021:

        The short answer is that more ICU admissions are deaths are in obese people than thin people but that this distribution merely matches the distribution of thin and obese people in the population at large.

        The real risk factors of admission and death in these data are age and ethnicity, which is a mix of ethno-specific disease prevalence (doubtless part genetic, part cultural / diet, part living conditions) and poverty (housing conditions and financial precariousness affect ability to shelter, to distance and isolate at home, to stay off work when sick etc.) and marginalisation (access to medical and public health advice restricted by language and cultural barriers, discriminatory levels of provision).

        1. PlutoniumKun

          Anecdotally, I know physicians who have worked in Covid wards who say that they only need to ‘visually assess’ someone (i.e. look and see if they are overweight) to see if they are likely to go critical or not.

          Of course, the question therefore is whether it is being overweight which leads to problems, or if it is a marker of something else, such as bad diet, diabetes or vitamin D deficiency which may make them more vulnerable.

        2. R

          I am still reading the CDC piece, so I reserve the right to alter my view!

          But it’s too convenient to say obesity and not be transparent about the confounders of poverty and comorbidity and ethnicity. The US healthcare and welfare system is so profoundly unequal that it is hard to see how you would adjust for these robustly.

          1. marku52

            HFCS consumption reduces your vit D levels, and so does obesity, IIRC a lot of othe D gets tied up in the fat cells.

            For poor people living in a food desert, it’s a double whammy.

            1. R

              I’ve read the latest ICNARC paper – taking my own medicine – and it seems the second wave has changed the relationship of obesity and outcome in the UK.

              In the first wave, the BMI distribution of ICU patients tracked the BMI distribution of the national population. No longer! In the second wave, patients with healthy and slightly overweight BMI are roughly 25% less likely be admitted to ICU relative to age-and-sex-matched general population. Patients severely overweight are 25% more likely to be admitted to ICU. And patients who are obese (BMI 40+) are 300% more likely, i.e. 4x as likely to be admitted to ICU!

              However, these are only age and sex matched. There is no analysis controlling for co-morbidities so these might all be patients with unmanaged metabolic and renal disease which is killing them, not the BMI.

              ICNARC provides a nice trend analysis too. Over the course of the pandemic, the % of ICU admissions with BMI >30 has risen from 40% to 50%. There is no hypothesis offered for this trend.

              However, there are some data showing the relative affectedness off different regions of the UK. It could well be that areas which escaped the first wave and were hammered in the second wave have higher BMI, given London was worst affected in the first wave and has the lowest BMI in the UK on account of age structure (lots of young people, few elderly – get rich, get fat and get out!). Of course, this factor cuts both way: if we are honest, it is asking too much of the data to determine that obesity is a risk factor for ICU admission etc. given that it changed between pandemic waves and the national population BMI structure may not be the appropriate reference.

              Finally, there are two other nuggets in the ICNARC data.

              One, the trend showing that the poorest quintile of the population contributed 20% of cases at the height of each wave, as you would expect, but during the summer, when community transmission was all but wiped out in the UK, it contributed 50% of cases! COVID-19 is an occupational disease….

              Two, the analyses of outcomes of different treatment pathways (ventilation within 24h, any respiratory support, any renal support etc.) show that IN EVERY CASE, SURVIVAL ODDS IMPROVED WITH INCREASING BMI. :-) And we are not talking small effects, for example comparing BMI30, there was 76% survival to 86% survival for basic respiratory care and 39% to 46% for advanced respiratory care, that last one is a 1.2x odds ratio and I would take that with a box of doughnuts.

              Indeed, even patients requiring renal care had improved survival of 28% to 31% (renal patients have it tough with COVID) and the worst outcome was for all those paragons of moderation with BMI of 25-30, with just 22% survival….

              In short, there is far more to COVID outcomes than raw BMI but papers like the CDC paper are (mis-)used to blame the victims of public inaction and inequality. The NC mantra that economics is not a morality play needs a counterpart for public health…..

          2. R

            OK, I have read the CDC paper.

            First, who wrote it? Nine authors with between them four affiliations to CDC COVID-19 Response Team and seven to … Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC. The lead authors (first and last named) had a dual affiliation to COVID-19 and Nutrition groups and a sole affiliation to the Division of Nutrition respectively.

            So I read the rest of the paper with my ears up, given the authors have a vested interest in the “obesity is a disease” circus…..

            So what does it say?

            1) it is a retrospective analysis of 148k patients’ records (good power) but with minimal data about the patients. The study looks at BMI as the primary variable and then performs various regressions on the likelihood of ICU admission, invasive mechanical ventilation etc. It’s fairly simplistic stuff.

            2) The paper is looking at the relative likelihood of these outcomes for patients compared to patients with a defined “healthy” BMI of 18.5-24.9kg/sq.m.

            3) The paper makes a badge of honour out of its shame: “Models did not adjust for other underlying medical conditions known to be risk factors for COVID-19,*** because most of these conditions represent intermediate variables on a causal pathway from exposure (i.e., BMI) to outcome.” Or in layman’s terms, we did not bother to look at co-morbidities because we had decided they were all BMI anyway.

            4) It redeems itself by doing a an analysis of the findings’ sensitivity to co-morbidities. Lo and behold “A sensitivity analysis adjusting for other underlying medical conditions found weaker associations between BMI and severe COVID-19–associated illness, which might be partially attributable to indirect effects of obesity on COVID-19 or overadjustment by including intermediate variables on the causal pathway from exposure (i.e., BMI) to outcome.”. Is this important finding the headline? No. Is it even in the main paper? No – it is in the supplementary material!

            5) What does the supplementary Table 1 say? Well, it is very interesting because the data are presented for all patients and then for patients <65 years and patients 65+ years.
            – The age grouped data are the most interesting.
            – For each of hospitalisation and ICU care as outcomes, the odds ratios for higher BMI categories vs "healthy" are not much higher in the 65+ patient analysis. We're talking 1.05x or 1.1x even at the highest BMI category of 45kg/sq.m! And the confidence intervals on these odds ratios straddle 1, i.e. the null hypothesis, except for the BMI 45 category.
            – For invasive mechanical ventilation and for death, the odds ratios do increase with higher BMI but below a BMI of 40 (second highest bracket), the odds ratio of death is again sub 1.1x and the confidence interval straddles 1, i.e. the null hypothesis cannot be discounted.
            – Only the odds ratio of invasive mechanical ventilation has a pronounced monotonically increasing odds ratio with increasing BMI for patients aged 65+
            – The data for patients <65 years are markedly different. There is a pronounced increase in odds ratio of hospitalisation, invasive mechanical ventilation and death. The increase is large in relative terms, of 1.4x for hospitalisation to 1.9x for IMV and death (but probably not a huge increase in absolute terms, give the survival rates in the young – my hunch is that a subset of young obese people are super-sensitive to COVID for metabolic and renal disease related reasons and their outcomes skew the ratio because so few other young people progress so badly)
            – amusingly, being overweight at anything up to BMI 40 is protective against ICU admission in the <65 year olds! I would treat this as a no change but it being overweight is statistically a marker of longevity and survival in medicine in the elderly so there may be something in this signal re COVID in the young.

            So what did we learn? That "old" people should not worry about BMI hurting ther chances, it's being old that will kill them from COVID. And that being morbidly obese as a "young" person will markedly increase your chances of being one of those tabloid sob stories of COVID death but still by a tiny absolute amount and the rest should quit worrrying.

            So, I go back to my view this paper is people barking up the wrong tree – the obesitree.

            However, I did read the latest ICNARC paper and that had some interesting trends – to follow in a second comment because this one is long enough as it is.

            1. skippy

              The statement I made was about national ethnicity w/ diet being a strong indicator from the Asian outcome.

              The CDC paper is U.S. centric, so you have a mixed bag baseline before one even gathers data.

              Albeit here in Australia progress has been made over the last decade in lowering BDI from an early age through school and national campaigns promoting an outdoor lifestyle and better diet. This in conjunction with early lock downs [preserving rights in the long term] seems to suggest better social-economic outcomes in the near term. I would add that contrary to popular ideas abroad that Australians as a whole seem to come together in tough circumstances – see 2011 floods and then go back to their own business afterwards.

              Sadly as an expat I think the system in place pre corvid, the framework that established it, and the institutional administration that decides policy, due to the aforementioned – is – the big issue here when looking at Sweden, U.K., and the U.S. – 500K U.S. deaths with worrisome long term morbidity issues has all kinds of nasty consequences.

              Then I get flash backs about old debates about suicides and social organization being a T or F goal post ….

    2. Keith Newman

      There’s an error in the Lancet quote. It can’t be 80003 deaths. It must have been 8003. According to Johns Hopkins today there have been 13146 deaths so far in Sweden.

    3. Tom Bradford

      the Asian experience seems to have some correlation to diet and BDI factors, contra some anglophone nations or regional subsets – ethnic food sans any genetic factors may play in.

      New Zealand’s experience – thoroughly European in its eating practices with the resulting weight problems – would seem to contradict this claim.

      IMHO it comes down to having: 1) living memory of the reality of these things, expunging any “it can’t happen to us because we’re better” complexes, and 2) having the sheer good fortune to have the right person in charge at the right time.

    4. c_heale

      Doubt very much diet has any particular effect. There is a lot of Western style junk food here in Korea and a lot of Raman style noodles.

      One factor is people are used to wearing masks here. First, as in Japan, not wearing a mask when you have a cold is really frowned on, and was long before covid arrived. A second factor is there a lot of dust pollution here, especially in Spring from factories in China and Korea, and this is hazardous in itself, so people wear masks when the dust level is high. Thirdly, white skin is traditionally seen as beautiful, since when Korea had a royal family, they and the elite were pale, whereas the peasants were tanned. In the summer it is not uncommon to see women completely covered up, with only their eyes visible, and many women wear sunscreen as part of their make up. Masks are part of this summer sun protection. Finally, the winters are really cold (we had -20 this year) so people wear masks or face protection then too.

      Test, trace, and isolation has been extremely well done here from the beginning too.

      1. c_heale

        Forgot to add. Winters can get down to -20°C so people where masks or face protection then too.

        1. Anthony G Stegman

          The Korean women must have low levels of vitamin D since they absorb no UV rays on their skin. It is difficult to get sufficient vitamin D from diet alone.

  2. Cuibono

    Still,overall fewer cases per million than the UK. and fewer deaths too.
    not defending them but not sure there is too much to learn here.
    Failure was the norm. US, UK, Europe.

    1. Yves Smith Post author

      Yes but the UK has the lowest residential real estate square footage per capita of any major economy (as in the worst crowding), and is also much more dense. That’s why the proper comparison is to Sweden’s neighbors, who have similar population densities and housing and also similar cultural habits (no hugging and air kissing!).

      1. Michaelmas

        Also, London in the U.K. has an extraordinary flow of traffic — at least pre-Brexit and pre-COV19 — through Heathrow and Gatwick, and the big train stations there like Victoria station, which effectively make it a gateway and travel hub for Europe and much of the rest of the world. Just Heathrow handled more than 80 million people in 2019.

      2. berit

        March 13th:
        Norway 639 deaths. Sweden’s population is approximately the double of Norway’s. The PM and the Minister of Health have been calling the shots here, dutifully informed by leading medical officers, unprepared, but catching up to speed after initial hesitation. Anders Tegnell, the swedish state epidemiologist, has fallen from grace, death threats instead of adulation. Much arrogance, much deference to authority, I think, also in politics, so many dead, >13.000. Deplorable. Sad.

        1. berit

          I went back this morning and read more carefully Yves’ take on the situation in Sweden, …
          … “the answers to this enigma are to be found in the Swedish national COVID-19 strategy, the assumptions on which it is based, and in the governance of the health system that has enabled the strategy to continue without major course corrections.”
          Spot on, I think, from information available and my vantage point in Norway.

          1. Yves Smith Post author

            Thanks a lot but that’s actually from the authors of the VoxEU piece, although it did seem sound to me. They are right to focus on why Sweden (like Brazil!) stuck with a failed strategy when other no/light restriction countries relented.

            1. berit

              Got it. Reading NC in the middle of the night is enlightening anyway, as I got your excellent quote from the Lancet, though I overlooked the attribution. Most interesting thread. Thank you!

    2. The Historian

      You do realize that the UK’s and the US’s policies towards Covid were not all that different than Sweden’s, don’t you? It would make sense that Sweden’s, US’s, and UK’s death rates were similar. Unlike Sweden, US and the UK made the pretense of ‘doing something’, but neither country had any real lockdowns – and at least in the US, they were only ‘local’ – until after the fact, and neither country enforced mask wearing country wide. In essence, like Sweden, it was left up to the individual in most cases to try and protect themselves.

      No, Sweden’s experience can only be contrasted with those countries who enforced social isolation and mask policies early before Covid got out of control, NOT the US or the UK.

      1. Phillip Cross

        Not so.

        The UK has had some painfully long and strict national lock downs over the last 12 months.

        Sweden also had quite a few restrictions, it was not totally laissez-faire.

        1. c_heale

          The UK lockdowns were accompanied by vast amouts of contradictory and confusing messages (and a lot of outright lies) from the UK Government, especially in the beginning so many people didn’t take them seriously.

  3. Kasia

    Sweden going their own way is beneficial from a scientific point of view as this will someday allow a comparison of the different approaches. We must remember we are probably only in the third quarter of the pandemic and so the jury is still out.

    Foreign residents of Sweden immediately sense the stifling conformity of that society. What’s interesting is that now the rest of the world is demanding Sweden conform to the international approach to Covid. Within Sweden there is mass acceptance of the Swedish Way towards the pandemic.

    I am well informed on Sweden and in the beginning I was convinced officials saw the pandemic as a way of culling their elderly in order to free up money for other uses. People were openly encouraged to visit old folk homes in the early days of the pandemic. In addition, feminists hold much sway in Sweden, and there was discussion of how much the burden would disproportionately fall on women to take care of children if the schools were closed. But in general Sweden’s Covid policy is made by the public health department and is not a political issue. The current governing coalition is a left/right hybrid and consists of the Social Democrats, the Greens from the left, joined by the Liberal (Folk) Party from the “right”, whose main program is pro-business and pro-transsexual rights. But there is no political opposition to the current policies outside of a few foreigners insisting on international conformity over national conformity.

    One element I find strange is the Swedish hostility to mask wearing. While masks may be far from 100 percent effective, surely they allow a society to have more economic activity for a given infection rate. In other words wearing masks allows a society to keep more things open in ratio to a given death rate. And so anti-lockdown people who warn of the economic disaster linked to lockdowns, really should be pro-mask, since there doesn’t seem to be much of a downside to mask wearing besides people constantly getting their glasses fogged like I do.

    There has also been studies comparing societies that are “socially tight” to those which are “socially loose”. Sweden definitely is socially tight (at least “old-stock” Swedes are) but so is Norway and Finland and to a lesser extent Denmark. China, South Korea, and Japan are also culturally tight. Culturally loose societies include the US, Spain, and Brazil. Generally culturally tight societies have a better outcome. Perhaps Sweden overestimated their cultural tightness? The real question will be, as sick as this sounds, is whether Sweden will eventually benefit from culling a good portion of their elderly male population, since generally 70% of those dying from Covid are men.

    1. vlade

      I don’t think the problem is that Swedes overestimated the tightness. Where the tight/loose plays role is in how much pressure is there to conform. Which means that if society goes masked etc. (China/SK/etc.), the tightness helps it, as the rules are kept more than in a society where breaking the rules is seen as a norm. But if the societ decides that it is against the rules, the tightnees puts more pressure on those who want to follow them, so it becomes harder to wear a mask etc.

      1. Kasia

        I agree. What I am trying to do is separate the concepts of anti-lockdown and anti-mask. I wish Sweden would have adopted a pro-mask, anti-lockdown approach. Certainly their social tightness would have encouraged a very high percentage of mask wearing although in most of Europe, even in the looser states, there is near 100 percent mask compliance. But your point is very important: that Sweden’s conformity has pressured Swedes towards not wear masks.

          1. c_heale

            Is there evidence for that? If I take South Korea, Spain, and the UK (I know all three countries very well), both Spain and the UK had strict lockdowns and limited mask wearing and high infection rates. Korea has never had a complete lockdown (apart from maybe Gwangju city in the initial outbreak.) and had relatively low infection rates.

            However correlation is not causation.

            1. skippy

              Timing is everything due to transmission rates and number of infected going manifold w/a side of unfettered mutation throwing a curve ball in it all.

              My argument is how mainstream economic frameworks approached the problem, considering the known of risk, the preceding architecture developed, and lastly the metrics used to establish a response to a known historical occurrence E.g. MBAs running risk analysis of medical and social preferences on $$$$$$ terms alone.

            2. Timmy B

              Lockdowns without a comprehensive testing and tracing component were not very effective. Trying to compare a single variable across multiple countries, such as mask wearing, to determine if it was effective, when there were other variables such as lockdowns, (which widely varied in scope) testing (also widely varying in scope) and tracing, doesn’t yield a meaningful result.

    2. skippy

      Sweden used neoliberal economic metrics to shape its policy response, completely contrary to any scientific or other means of information to shape policy.

      I would point out here in Australia that the states being administrated by labor party’s [neo-lite] are both enjoying a better quality of life and economic outcomes vs the Liberal/Conservative states [hard neoliberalism]. Basically everyone in these states is doing pretty much what they did before covid with only some workers being affected by the transitions businesses are experiencing E.g. expectations of the previous norm.

      I would also point out that Sweden is not a vary good baseline due to a number of factors and would focus on the E.U., U.S., U.K. and Brazil for a better contrary example.

      I think the key issue here is the past ideas of Sweden being some socialist paradise, how covid highlighted that inaccuracy, and how some are having difficultly with brand image.

      1. Mark

        Australia/NZ are pretty special cases. Few other countries have eliminated COVID to the same degree while largely maintaining freedoms. (Except for unlucky/incompetent (take your pick), Melbourne.

        But either way most of Australia has enjoyed a largely COVID free world for 12months. The biggest impacts outside of VIC have been not being able to travel overseas and not having foreign tourists/students/

      2. Kasia

        That may all be true but I get super suspicious when people try to push their political beliefs by claiming pandemic success. First the antithesis of “neoliberalism” to “socialism” is so unclear as to be meaningless. I totally agree that people have for a long time projected (both positively and negatively) their fantasy concepts of “socialism” on Sweden or more recently towards Denmark. And I would say the same thing is happening with “neoliberalism” which has become a left leaning code word for “things I don’t like”, in a similar way that “socialism” functions for the right. But don’t get me wrong, I personally think Denmark is the ideal society, but the reasons for that are complex and if people of say left-leaning persuasion actually looked under the hood of Danish society, they would see many things that deeply shock them.

        Australia (and New Zealand) are isolated islands and have had a very different Covid experience than say Europe of the Americas. Being so isolated makes an aggressive lockdown policy more viable. But I also get super suspicious when people use “science” to justify political choices. There will always be a tradeoff to be made between public health and the economy. For example I hear of many antidotal reports of suicides. Also the lockdowns tend to destroy the petit-bourgeois by annihilating precarious small businesses to the benefit of huge multi-nations. And the interesting thing about Covid is that the “science” is at a pretty early stage. So policy makers will definitely be going by more by intuition than by scientific certainty. Or more correctly, in many countries, they will be following the interests of their powerful donors.

        1. PlutoniumKun

          I’d agree very much with most of your points, especially the distinction between ‘neoliberalism’ and ‘socialism’ when it comes to analysing success or otherwise. It probably only makes sense to distinguish between particular actions driven by ideology or the strength of specific institutions. A notable example being in the UK where track and trace was given to private contractors (a colossally expensive failure), while the vaccine is being delivered within the still strong existing public structures. Of course, those public structures can’t be created overnight.

          I think that if there is a less to be learned is that successful countries used the strongest most appropriate structure to hand – witness how, for example, China used the existing network of neighbourhood committees (essentially, old folks hired to be nosy parkers) to enforce a very hard lockdown with great success.

            1. PlutoniumKun

              Thats an astonishing comparison.

              What makes it even worse, is that its not even that big of a scandal in the UK. I’m old enough to remember those far away days when an MP adding a few hundred pounds to his travel claim would be top news on the BBC.

              1. Synoia

                Might just take a look at what a Pound can buy today.

                I went through Uni, at £10 – £15 a month in food an lodging.

                Bitter was 1/10 a pint, Larger 2/- a pint.

        2. Larry Y

          Australia (and Taiwan) were not isolated from China. They were even more connected than Northern Italy or NYC, yet managed to suppress community transmission.

          Taiwan was especially vulnerable. It helped that they could easily ignore the WHO’s bad advice on closing borders and airborne spread.

          1. PlutoniumKun

            I’ve often joked that the best policy approach to development economics was to do what countries like Taiwan and South Korea did in the late 1990’s, which was to listen carefully to IMF advice and then do the exact opposite.

            Its a particularly sad situation when the same applies to WHO. Yet in truth, thats exactly what Taiwan, ROK and Vietnam did, and they benefited from it.

            1. MarkT

              I’m not sure why you have such an issue with the WHO. It is beholden to member governments. It is simply a scientific body to coordinate member governments’ science policy in the field of health. If the member governments are screwed up, so will their delegates be to any organisation that is supposed to encourage cooperation.

              1. The Rev Kev

                Speaking for myself, too many times they screwed up with their advice. Example; last year for week after week they were refusing to call Coronavirus a pandemic, even though it met ALL their own qualifications of a pandemic itself. So then the WHO removed the word ‘Pandemic’ from their official lexicon so that it could not be used. This went for weeks before they restored the word and then labelled Coronavirus a pandemic but far too much valuable time was lost.

                1. drumlin woodchuckles

                  Is it wrong to wonder whether certain key command figures within WHO were working with the ChinaGov to do this on purpose in order to give the virus time to spread all over the world in order to give China a ” new rising Hegemon” advantage?

                  1. The Rev Kev

                    Unlikely. Before the pandemic hit, the countries that were rated as having the greatest capabilities in dealing with such a threat were also its main competitors. They had no way of knowing that those very same countries would deal with it the worse.

                    Besides, spreading a pandemic would have serious blowback as it would be hitting their customers and so much of the Chinese economy is about exports to them. It would be like living in a forest and starting a forest fire on the chance that it would hit your neighbours worse and hoping that the wind does not shift.

                2. MarkT

                  The WHO is there to coordinate cooperation between UN member states. If the WHO says “masks aren’t needed” it’s because they have read no literature which says that they are. Very simple really.

        3. Irrational

          On Denmark or anywhere as the ideal society:
          In my view, every country has its advantages and disadvantages, nowhere is perfect. What’s more, everyone has a different view of how the pros and cons stack up.
          Speaking as a Danish expat with no plans of going “back” I mind government knowing everything about you, the smugness/sense of superiority often communicated by the average Dane coupled with a flip-side of xenophobia.
          OK, so other governments are heading towards transparent citizenry and xenophobia, but Denmark has pedigree!

        4. Tom Bradford

          “Australia (and New Zealand) are isolated islands and have had a very different Covid experience than say Europe of the Americas. Being so isolated makes an aggressive lockdown policy more viable.”

          I’d argue “being an island” is too convenient an explanation. Covid was established in NZ before the borders were closed and without an early and “aggressive” lockdown would have spread as vigorously within the islands as it has elsewhere. Too, the UK is an island and the US has only two land borders one of which it has been ‘aggressively’ closed for some time while the other was closed by the other side so ‘isolation’ was completely possible for it. Merely harder, and more expensive, to police

          The difference is purely political. The UK, US and elsewhere tried to limit the economic effects of the pandemic – in essence took the decision on the bridge to try to save the ship for its owners at the expense of the passengers. NZ’s approach (the only one I can really speak to) was to realise that if you put trying to save the passengers first you’d have the best chance of saving the ship as well. Sweden’s approach seems to have been that if the captain makes the passengers aware of the problem you could look to them to act in their own best interests to save themselves and the ship. This is highly laudable and civilised, but unhappily appears to have placed too much confidence in the passengers to see the wisdom in doing the right things.

          Had those in charge had the wit and basic competence to see that we were all in this together, or just realised that the ship going under was as likely to take the captain with it (as I think it accurate to say it did with Trump), with countries isolating themselves by closing their borders and instituting aggressive lockdowns to knock community spread on the head a year ago it would all be over now, bar the shouting.

          1. MarkT

            I agree completely. There are too many people (and journalists) out there saying “NZ and Australia are special cases”. Complete rubbish. As you say, the virus was already established in NZ when the borders were closed. (There was already a “super-spreader” event taking place in rural Southland, as a result of family coming into the country from the USA to attend a wedding.)

            The simple reality is that Western Europe and the USA had a window of (arguably) 6 to 8 weeks during which appropriate action could have been taken to stamp the thing out. Had this been done, all would now be well. History will judge why this road was not taken. My clear impression at the time was that leaders of these states at first denied the reality of what was happening, and then went on to prioritise “the economy” (whatever that is).

            1. skippy

              Two times in Bush Jr presidency he was informed by his mainstream economic advisors that doing something that had beneficial long term results was off the table due to the short term ramifications …

              His initial environmental campaign platform and when informed of the systemic risk building in the mortgage origination market. Both times he was informed that it would kill the economy or in the later case detract from the ME wars.

          2. TimmyB

            The “well, Australia and New Zealand are islands” excuse falls apart when one is reminded that both the UK and Ireland are also islands. Obviously, there were other factors besides geography in play related to New Zealand and Australia’s success.

        5. skippy

          I gave a brief summation and as above thread notes its complex as you drill down, but there are broad indicators regardless.

          My use of neoliberalism is specific to methodological individualism that underlies much of mainstream economics and notions about stability and not some ideological left or right trip wire. It is the framework that shapes the policies, around the system, that was put into place before covid.

          Nowhere do I deploy the “Science” buffing term to some narrow political scope.

          Anthropology is pretty clear on the psychological effect to humans, with plans, after large natural [or not] events. It completely upends the social expectations based on some steady normative and when that goes out the window some don’t know how to adjust on their own – dreams lay shattered at their feet.

          Neoliberalism was always about creating a two tier society, that is why ownership of creating laws is priority and social democracy a threat too it. Hence the powerful donors will advance their interests first and foremost. That is why I pointed out the 3 states in Australia that are better off under Labour [Pluralist] than the LNP, same for NZ.

          On top of all that here in Queensland we’re ramped up for above average economic activity because ***rights were preserved*** in the long run rather than in the short term.

        6. Basil Pesto

          To call Australia, which, inter alia, leans/leaned heavily, not to say unscrupulously, on an imported student population, an ‘isolated island’ as if to say “behold, my powers of discernment!” is frankly trivial (I don’t mean to single you out Kasia, it’s a cliché I’ve heard a lot). We’re not the Galapagos. If we wanted to cock up our handling of Covid-19 at scale, we easily could have. There is nothing about having no international land borders which makes an aggressive lockdown policy more viable than anywhere else (keeping in mind that closing borders is but one part of a lockdown policy).

          What perhaps did make us more amenable to such policies with respect to stringent border restrictions is our longstanding strict ‘biosecurity’, which places strict and strictly enforced restrictions on the importation of plant/animal/biological matter into the country (a policy which I admit is so strict because we are, indeed, relatively isolated with no land borders). If people can understand that bringing back harmful plant/animal species/diseases with them back from one of their numerous overseas holidays is harmful to the motherland, then it’s hardly a big leap to understanding fairly intuitively that precluding a malevolent human-targeting virus from crossing those same borders as much as possible is sound, reasonable, straightforward, uncontroversial public policy.

    3. Thomas P

      Thje issue with women staying home to take care of children was less the “burden” for them, but what would happen to health care, if large number of women stayed home from work.

      There was no intentional policy to infect the elderly. This is a good application for Henlon’s razor: “never attribute to malice that which is adequately explained by stupidity”. Nor are the number of deaths enough to significantly affect society in the years to come, Sweden is not an outlier when it comes to excess mortality.

      1. juno mas

        It is compared to its Nordic neighbors.

        Anders Tegnell may not have had malice in his heart, but the overconfident policy he prescribed was shown the lie just months before in Italy; elderly death and dread everywhere. Sweden was actually lucky, not smart. If Stockholm didn’t have a relatively young demographic, the pandemic could have been much worse. Sweden, to date, does not know the extent of Covid infection in its population. The non-symptomatic expression of the virus may become a long-term health issue for the nation.

        Anders Tegnell spun the roulette wheel with other peoples lives. That doesn’t comport well with good medical outcomes.

    4. lyman alpha blob

      Thanks for touching on the situation with the elderly. I don’t know all the details on the ground in Sweden, but my impression is that overall they dealt with things very similar to how the US did, except they were explicit about wanting to allow people to mostly go about their business, where the US was not. For example my governor just lifted a travel ban and quarantine restrictions with several other Northeastern states – restrictions that had zero enforcement to begin with. With no enforcement, I don’t see how its much different than Sweden making suggestions for people’s pandemic behavior.

      From Yves’ BBC link above –

      According to an official report released earlier this week, the strategy failed in its effort to protect the elderly in care homes – for which the government has admitted responsibility.

      Over 90% of Covid-related deaths have been among those aged 70 and over, and nearly half of all Covid deaths have been in care homes, the government says.

      There was a very good article from Andrew Cockburn in Harper’s from last fall making the case that in the US, we have not so much a pandemic problem as a nursing home problem, and the latter won’t go away when coronavirus does. He makes a pretty good comparison between homes where profit was the primary driver and some other homes where they really took the pandemic seriously and had much better results. Long read but well worth the time –

      Sweden admits that their policy was to try to take care of the elderly while allowing most others to go about their business normally, and that their policy was a failure. Judging by the situation in NY, I’m not sure we even tried with our elderly here in the US.

    5. fajensen

      One element I find strange is the Swedish hostility to mask wearing.

      There is a consensus-tyranni in Sweden. Except, it’s not like it says in The Branding, being based on Equality, Democracy and Equality. Instead, the way it works is that, “Management” creates the consensus and then everyone are expected to use their Freedom of Expression to buy into it and agree with visible enthusiasm.

      If one wears a mask, one is advertising that one thinks that “Management Spokespeson”, Anders Tegnell, is perhaps wrong about masks, and maybe even pulling more random stuff right out of his ass on live TV!

      Consensus has thus not been achieved and “Management” will have work harder on coercing it, making it tougher on everyone, so everyone gets angry about the dissidents.

      They are starting to panic slightly in Sweden. Employers are introducing quarantaine rules, mask wearing at work, regular testing at work, not exactly travel bans but no business travel and they give one the beady eye when one travels in ones vacation. Because it is a work instruction, it is enforceable. Unlike the government’s recommandations, which are only words with no legal power behind them.

      I understand why they are panicking. My wifes workplace, a school, had a case of some idiot going to work despite having a sick child (one of the many “Wisdoms of Tegnell” is that children are not infectious, and it is only advice anyway).

      Four days later everyone are taken out by Corona, my wife got it, I got it. She got off easy with 3 weeks off work, two of her colleagues are still sick after two months, another is back but severely impaired, she has an oxygen machine with her. They did not close down. Meaning, the kids probably got it too, took it back home, infected some of the adults, adults come back to drop off kids, wades around the place unmasked, infects the temp-staff, the temp staff is now out, different temp-staff comes in. The circus continues, everyone is out sick once a week or so with “something”, whatever could it be???.

      All-In-All they are gunning for The Brazillian Variant. Because they haven’t got their shit together. Now more than one year into the pandemic while everyone thinks it is a joke because nothing happens, the government says nothing, Anders Tegnell waffles on, and the news & media doesn’t even go there!

    6. Ian Ollmann

      > We must remember we are probably only in the third quarter of the pandemic and so the jury is still out.

      It seems unlikely the deaths will reverse themselves, so unless you are proposing a final pandemic wave to end all waves in April which drowns out previous data, I think we are nearing the end of this thing. Immunizations, at least in the US, should be taking a big bite out of the pandemic by Summer.

      1. jed1571

        Perhaps a bit pedantic, but I don’t think those that are getting the Pfizer and Moderna vaccines are “immunized.”

        The CDC link mentions that the terms are often used interchangeably, but here’s their definition of immunity:

        Immunity: Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected.

        These vaccines have not demonstrated that vaccinated persons can be exposed without becoming infected, only that the vaccines will limit the damage to those exposed that do become infected.

    1. Bill Smith

      By these measures Sweden didn’t do badly compared to most countries -> except their neighbors?

      1. Heraclitus

        Two factors would have given Sweden worse results than their neighbors, even if they’d locked down:

        Dr. Tegnell’s predecessor, Johan Giesecke, said in an early 2020 Unherd interview that Swedish nursing homes were much larger than their Norwegian counterparts. Thus, once Covid was established within them, there was an easier path for spread. Perhaps their nursing homes are larger because of Neoliberalism: someone is making money off their ‘efficient’ size.

        He was definitely wrong about a few things, but perhaps right that, ‘You can’t keep it out.’

        Second, Sweden took in far more refugees during the past ten years as a percentage of their population than did Norway, Denmark, or Finland. There was already a housing crisis, and these refugees are likely living in cramped quarters. They make up a significant percentage, I’m not sure of the exact number, of workers in nursing homes.

        These numbers are not broken out in public, probably for reasons of political correctness. They don’t want to stigmatize immigrants from Africa, Iraq, or Syria. This is understandable. But it doesn’t help us understand to what extent Swedish policy failed, or what policy it was that failed. Was it making the nursing homes larger, employing lots of immigrants to do the grunt work, or failing to lock down in the same way as the US and UK did?

        Is it possible to compare the illness and death rates of native born Swedes outside nursing homes with their Norwegian, Danish, and Finnish counterparts, also outside of nursing homes?

  4. The Rev Kev

    There’s something rotten in the State of Sweden. Their neoliberal regime tried to control the virus and to keep the economy open. They tried to have the best of both worlds and ended up with the worse of both worlds instead. Not only is that country divided now but it is also isolated as the other Nordic countries have closed their borders to the Swedes themselves. At the heart of this disaster is the Swedish custom of åsiktskorridor (‘opinion corridor’) as it ended leading them into a kill zone instead but I doubt that this will happen. Why? Because questioning this idea would be outside of the åsiktskorridor (‘opinion corridor’) itself, that’s why. So what this means is that the Swedes will have to wait for the present pandemic to pass before they can go back to something resembling their old lives. Time will tell if they changed anything from this experience. Hopefully they will.

  5. Old Sarum

    I worked for a large Swedish multinational in the UK for few years back in late the nineties. It comes as no surprise to me that the Swedish power elite responded in the manner described, as the major institution I worked for had caught the American disease hook, line, and Master of Business Administration.

    Inconvenient truths were brushed away in a plethora of pointless meetings. In short it was the usual MBA bleepshow, which preferred discussion of mission statements and “total quality management” box ticking to actuality.

    Pip Pip!

  6. PlutoniumKun

    An important element of the Swedish approach is not just cultural – I think that the Swedes without necessarily realising it bought into the ‘flu’ model that many western public health authorities had at the beginning of the pandemic. I think it was implicit in the difference between western and asian public health response was that the former was predicated on the virus ripping through the population and then burning itself out as flu’s have in the past, rather than the latter assuming that the virus could become endemic. The ‘flattening the curve’ strategy implicitly assumed that there would be just one or two curves to flatten – an assumption that was rarely questioned even by health experts at the time. Many public health authorities behaved like WWI generals trying to fight the last war rather than the one they were engaged in.

    So far, the successful countries have been those which have seen the virus as an existential threat and went hard and went early to crush it. While social political systems can help with this, I think at the root was a failure by many public health authorities to question their own assumptions about what they were dealing with. I don’t think its a coincidence that the countries that reacted best were those with more direct experience of SARS1. While many countries paid lip service to the ‘official’ WHO line on things like travel and aerosol transmission (i.e. its not aerosol spread and international travel its fine), its clear that those who behaved otherwise (most notably the Chinese, Vietnamese and Taiwanese) have been far more successful. So at root we have here a problem not of societal behaviour or politics, but the failure of the public health/scientific community to correctly identify the nature of the enemy and to put in place the correct policies to deal with it.

    Its always easy to categorise countries according to the supposed conformity of their populace and systems – but when you did deeper its rarely this simple. For outsiders, for example, South Korea and Japan seem very similar, but as the blogger AKK (often linked here) has pointed out, South Korea consistently ranks on standard metrics as a very low trust society. But for whatever reason, they reacted extremely efficiently and promptly. I’m reluctant to put too much credit on individuals rather than systems, but it does seem that much can be credited to politicians who grasped the need to listen carefully to a range of experts (and not just entrust it to a Tegnost/Fauci figurehead), to communicate clearly (which is something politicians are supposed to be good at), and be decisive. Leadership really does matter.

    1. Zamfir

      I often think about a remark I read somewhere last year. A public health expert was looking back on their work in february 2020. Probably in the UK, but you could imagine the same remark from other countries. He talked about the hospital images from Italy in early march the lockdown there, and he said “this suddenly opened up the policy space”

      Up to that point, they had not even considered such society-wide measures. Completely not on the map, on the assumption that there would be no political or public support – at least, not unless the disease was another order of magnitude worse yet. The assumption was simply that the disease would be out of control, time to bite the bullet.

      1. PlutoniumKun

        What annoys me is that even things which were within the ‘policy space’, such as shutting down international travel, mandatory mask wearing, strict controls on public transport, cancelling school trips*, etc., were not done, at least not in time.

        I hate to repeat myself, but at the time there were people who were calling for these things, but the usual response was ‘WHO are not recommending this….’, and this was the end of discussion. Even very good scientists who get to senior public policy roles don’t get their jobs through being willing to question assumptions.

        *the first wave in Ireland was almost entirely caused by teenagers in upmarket schools returning from February/March ski trips to Austria/Italy. These could have been stopped by a single government memo to schools. But it never seems to have occurred to anyone to do this.

        1. Zamfir

          I have looked through some pandemic “handbooks” that were prepared here in the before time, most of them dealing with influenza. From what I have seen, suppression or long-term slowing of the virus were just not considered as important items. There is an assumption, almost implicit, that suppression is likely futile. There are detailed guidelines on the suppression of small outbreaks. Beyond a rather modest scale, the scenarios simply take as input that some large percentage of the population gets infected.

          A lot of focus goes to medication, with all kinds of variations which medication may or may not be effective in reducing bad outcomes. Vaccines and their expected timescale, vaccines for another strainthat might still work, tamiflu, antibiotics. How to distribute them, and to whom. How to organize hospital care etc.

          Quite some attention is given to people being simply sick at home. There’ s a understandable worry about the social impact if a large chunk of the population is bound to their bed at the same time

          At some points, there is mention of ‘corona’ style measures. Banning gatherings, close shops and public transport, encouraging people to stay at home. It’s not stated explicitly, but the assumption seems to be that these will be short-lived measures at the very peak of the wave, with no impact on the total number of infected people, only on the their distribution in time.

          In policy terms: there are policies for small numbers of trained people who will try to suppress a virus early on, and there are policies for society-wide measures to deal with the impact if that stage has failed. Not much on society-wide measures aimed at suppression, which was in hindsight that category that we needed. And by extension, not much thought on when such measures would be justified, or who would initiate them.

  7. John A

    Sweden also has a very high proportion of elderly people in care homes. Higher than most other countries. This is where the majority of Covid related deaths have occured.
    This is an interesting paper from SSRN

    It lists 16 possible factors for Sweden’s relatively high death rate compared to its Nordic neighbours

    (1) the “dry-tinder” situation in Sweden (we suggest that this factor alone accounts for 25 to 50% of Sweden’s COVID death toll);

    (2) Stockholm’s larger population;

    (3) Sweden’s higher immigrant population;

    (4) in Sweden immigrants probably more often work in the elderly care system;

    (5) Sweden has a greater proportion of people in elderly care;

    (6) Stockholm’s “sport-break” was a week later than the other three capital cities;

    (7) Stockholm’s system of elderly care collects especially vulnerable people in nursing homes. Other possible factors are:

    (8) the Swedish elderly and health care system may have done less to try to cure elderly COVID patients;

    (9) Sweden may have been relatively understocked in protective equipment and sanitizers;

    (10) Sweden may have been slower to separate COVID patients in nursing homes;

    (11) Sweden may have been slower to implement staff testing and changes in protocols and equipage;

    (12) Sweden elderly care workers may have done more cross-facility work;

    (13) Sweden might have larger nursing homes;

    (14) Stockholmers might travel more to the Alpine regions;

    (15) Sweden might be quicker to count a death “a COVID death.” We give evidence for these other 15 possible factors. It is plausible that Sweden’s lighter lockdown accounts for but a small part of Sweden’s higher COVID death rate.

    1. PlutoniumKun

      The words ‘probably’ and ‘may’ do a lot of heavy lifting in that paper.

      Hmmm… George Mason University. I’m sure the authors didn’t have any priors whatever before writing that paper.

        1. jhallc

          Lot’s of “may” and “Might” in there as well.

          “Sweden has a greater proportion of people in elderly care;” – Cuomo would have been in heaven had he been “governor ”

          “in Sweden immigrants probably more often work in the elderly care system;” – Yeah…so it’s all the immigrants fault /s.

          1. a different chris

            That whole list is a masterwork in how to lead people (especially people who view themselves as smart) by the nose. Nice tie in to the discussion about Ms. Markle and the Royals, as in the best way to push crap is to wrap it in the inarguable.

            Starts out with 3 facts, at least allowing that the concept of “dry tinder” (say what?) is a fact.

            Slip in a “probably”.

            Hit us with two more facts, then slip in something that looks like a fact but… who decided that the nursing home people were “more vulnerable” than.. other nursing home people? You know, there’s a reason they are called nursing homes.

            Now we start adding mays, and finish up with a nice round of mights. But since we started with facts, the rest of it registers emotionally the same way as incontrovertible facts do even with the disclaimers.

      1. Patrick

        Yes. George Mason is central headquarters and viral center of the Koch-Buchanan libertarian (and I reckon neoliberal) project.

    2. Thomas P

      One may add that the regular flu hit Sweden a lot less than our neighbors during the winter of 2020, and that is most years one of the major killers of the elderly. This winter there has been no flu season in Sweden, the measures taken may not have been enough to stop Covid, but several other common diseases that aren’t quite as contagious have gone missing for the time being.

      1. PlutoniumKun

        Yes, the ‘missing’ flu season has been a major confounding factor in death rates. The same has been seen in Japan, where there was a marked drop in overall deaths among old folk over the past year (despite a surge in early summer, probably due to unattributed Covid deaths), and I’d guess the same applies in most countries. Flu (and other respiratory infections) are often a major contributor to sending people with a variety of health problems over the edge, but as there is no consistency with how multi factor deaths are recorded its a very difficult thing to assess.

      2. Dave Note

        This could be due to ‘the authorities’ falsely reporting flu deaths as Covid deaths.

        There are decades of data chronicling any countries death, by category and cause, and can be graphed over time to show any rise above the background yearly running average.

        Anything above the line of yearly average deaths in any country can be viewed as ‘excess deaths’.

        Swapping flu deaths for Covid deaths will not show up as ‘excess deaths’

        Go to this interactive graph and add Britain and Sweden, all four ages groups

        You will notice as on Feb 22, Sweden has three age groups below Zero, the running average of excess deaths.

        Below normal excess deaths, go figure

        1. Yves Smith Post author

          I sincerely doubt that. You are assuming the same level of flu as in prior years, which is not the case.

          In the US, just about no one is testing as even having the flu. From an MD at the end of January, which is about 2/3 of the way through flu season:

          I will tell you all again – By now in every other year of my life – I would be teeming with flu patients – and Upper Resp Infection patients. I continue to have seen absolutely ZERO flu patients – (we are running now at 3% of the normal in our region) – and just a few stragglers with URI. I do not think this can be solely attributed to hesitation to visit the clinic in a pandemic – my Zoom office visits for everything else are through the roof. They are not even showing up in our urgent care live or Zoom visits, either.

          Confirmed mid February in WebMD:

          Do you know anyone who’s had the flu this year? Probably not.

          The U.S. is seeing historically low levels of influenza this season, which started in September 2020.

          This time last year, the national map of flu activity published by the CDC showed so many active cases that some states had burned right through red to a dark purple for “very high” activity. This year, the map is a calm green with hardly a blip on the public health radar. Public health labs across the U.S. reported a grand total of 3 cases of flu in the U.S. last week, out of nearly 16,000 samples tested. Clinical laboratories, which tested nearly 25,000 samples, found just 14 flu cases.

          So far this season, labs reporting to the CDC had just 1,585 samples test positive for flu of any kind. Compare that to last year over the same period, when there were more than 183,000 positive samples. Those numbers are making infectious disease specialists do double takes.

          “Nobody has seen a flu season this low, ever. And some of us have some gray hair,” says William Schaffner, MD, an infectious disease expert at Vanderbilt University in Nashville. Vanderbilt is part of a network of hospitals that are actively looking for flu cases among their patients. They can’t find any.

          So far this year, only one child has died of the flu. Last year, that number was 195.

          1. Synoia

            Could one consider Covid as this year’s flu? Form my reading both Flu and Couid viruses are somewhat similar.

            It would also be interesting to have a comparison of the Covid virus with the 1917 era flu pandemic.

  8. John A

    A young A&E doctor in Sweden has written a book about his experiences dealing with Covid. It was reviewed here.

    The title is ‘Varför det mesta du vet om Covid-19 är fel – En evidensbaserad utvärdering’ [Why most things you know about Covid-19 are wrong – An evidence based evaluation].
    I have read the book and find much of what he says very interesting. If NC is interested I would be happy to translate this review. Let me know

    Apparently an English translation has been produced but Amazon refuses to stock it!

    1. Arizona Slim

      This NC-er would be very interested in the translation. Perhaps our mods could hoist it from comments?

      1. John A

        Ask them to dm me and I will do the translation. I am by no means a conspiracy theorist about covid etc., just think a doctor on the front line has a box seat in terms of experiences.

        1. flora

          Thanks for the link. His observations are interesting and seem reasonable, even though they run counter to many ‘official’ narratives.

        2. Tinky

          He’s certainly correct about this:

          During the autumn, many have probably got the impression that the pandemic is very serious. Then ten times more people were tested than in the spring and ten times more were found. But not ten times as many were infected, he writes, which would have been clearer if one had chosen to present the proportion of tests that are positive instead of the absolute number of tests.

          That issue has given me pause from the beginning, as while most numbers are normalized for population, they are not presented as a percentage of tests that are positive.

    2. skippy

      This guy ….

      “So, to conclude: covid is over in Sweden. We have herd immunity. Most likely, many other parts of the world do too, including England, Italy, and parts of the USA, like New York. And the countries that have successfully contained the spread of the disease, like Germany, Denmark, New Zealand, and Australia, are going to have to stay in lockdown for at least another year, and possibly several years, if they don’t want to develop herd immunity the natural way.”

      ***Natural way*** … there is that word again … like smart[tm] … the dialectal is a huge tell …

      This is a critical thinking blog and yet it seems some are pushing Agnotology … why – ????

      1. Basil Pesto

        lol ‘stay in lockdown’? we haven’t been in lockdown for months – the occasional 5 day (absolutely effective) snap lockdown excepted – parts of the country even longer. Unless he thinks restricting flights in/out is a lockdown. Agnotology indeed.

        1. skippy

          Fkmedeadsideways ….

          Through this entire event we in Queensland have only had a few weeks of lock down for non essential workers and some mandatory mask wearing and for the most part everyone is now living without all the dramas ….

          And from an economic stand point are set to reap the rewards from it ….

          All this in complete contradiction to what is playing out in the countries or states that took the opposite route due to ideology …

    3. drumlin woodchuckles

      Perhaps this would be an opportunity for some NOmazon booksellers to risk stocking it, or at least telling their customers if they can order it, and see if that generates a little business for those NOmazon booksellers.

  9. Bob Hertz

    Fascinating. In Sweden, the liberal left population is extremely opposed to masks and lockdowns….more or less the opposite of America.

    Nursing homes have relatively high death rates at all times. Depending on the levels of care required, some residents have a life expectancy of 12 to 24 months even without Covid.

    I realize that hastening death is not a good thing, but it is not a monstrous crime either. It is sad, but many aspects of geriatrics are sad. (I speak as someone with two relatives in nursing homes.)

  10. Barry

    There is a serious error in the Lancet report (presumably a transcription error). I am surprised no one noticed. Eight thousand deaths -not EIGHTY thousand

    1. lyman alpha blob

      I thought that seemed high – last I knew they were in the single digit thousands and I hadn’t heard of any disastrous new outbreak there. Definitely a transcription error – if you click the link it clearly says 8000, with the 3 at the end being a footnote notation in the original.

  11. Patrick

    There is an inaccuracy in Irene Peroni’s article. Her statement about Boris Johnson and Donald Trump abandoning the herd immunity approach as a viable solution early on in the pandemic is not entirely correct. I do admire her use of the term “defacto” to describe Sweden’s herd immunity approach. To this day top officials in Sweden are still denying that they ever pursued herd immunity. To this day you can still find articles that support Sweden’s herd immunity approach. One of the few outspoken advocates of herd immunity in this country, Dr. Scott Atlas, was a special covid 19 advisor to Trump from August-December of 2020. He also spent time by the side of Florida’s Governor DeSantis and had his ear, accompanying him on several of his self congratulatory “covid 19 victory tours” while the virus raged unchecked throughout Florida communities. There is evidence indicating that the leaders of the U.K. and the U.S. pursued a defacto herd immunity approach. To read some of the comments here one might think that the course of events that took place in the last year, the response to the pandemic from those in charge of making crucial decisions and the resulting impact their policies had on the general population are unclear, uncertain or open to interpretation. I don’t think that is the case. Anders Stegnell has admitted that they probably should have done a better job of curbing fatalities among the elderly back at the start of the pandemic. However, it’s a fact that those elderly victims in care homes were never offered treatment, only palliative care as they succumbed to pulmonary edema. Dr.Scott Atlas has returned to his position as a Senior Fellow at Stanford’s Hoover Institution. There is a recent interview in the Financial Times where the interviewer joins him for lunch. He yammers on about how it’s all mainly a question of civil liberties and how his primary concern during the pandemic has always been for the health and well being of the most vulnerable and economically disadvantaged members of society. I recommend the interview to anyone with a taste for the macabre. The interviewer orders and consumes raw meat for one of his entrees.

    1. Synoia

      There is evidence indicating that the leaders of the U.K. and the U.S. pursued a defacto herd immunity approach.

      It is difficult to distinguish between the defacto herd immunity approach and incompetence. I would place my bet on incompetence, because the “implementation” of Brexit also appears somewhat less than “planned.”

  12. Barking Cat

    Ms. Peroni says: “This is a Swedish concept meaning that the public debate tends to take place within certain limits, along an established path. Those who disagree, often choose not to speak out.”

    In the US, cautious skeptics of the official narrative are routinely censored, slandered and scorned.

    I’ve read the comments and don’t see a strong consensus regarding the interpretation of Sweden’s strategy. Demographics? Economics? Libertarianism? Purposeful euthanasia? Everyone has a different explanation. That’s meaningful isn’t it?

    It appears that the Swedish government chose to treat its citizens as sensible intelligent adults. Perhaps Establishment Swedes did not believe all the propaganda and political posturing surrounding this event. Who could blame them? Examples: Pandemic modeler Neil Ferguson made extraordinary sci-fi claims about potential death rates and then ignored his own advise ’cause he was horny. In the US, creepy Bill Gates, of all people, was given the megaphone. And the Surgeon General breathlessly warned of a “Pearl Harbor” moment! I can easily name dozens of examples of government-media manipulation of Covid statistics that were intended to panic the public into conformity. I’d rather be treated like an adult.

    Complete honesty from the beginning would have been very helpful. But here we are, criticizing the egregious mistakes of open societies like Sweden, US and UK while avoiding any discussion of China, the authoritarian nation that remains obstinately uncooperative regarding the origin of the virus.

    1. c_heale

      I would say from the comments earlier, Sweden did not treat its citizens as adults. A narrow ‘opinion corridor’ was imposed from above and anyone with views outside this was denigrated and ostracised.

      I come from the UK and in many ways it is not a particularly open society. Apart from some of the arts it is quite socially conformist, especially in recent years. It also has an extremely conformist mass media.

    2. Basil Pesto

      And the Surgeon General breathlessly warned of a “Pearl Harbor” moment!

      Yes, that was plainly ridiculous. ~2.5 thousand people died at Pearl Harbour. Covid has taken orders of magnitude more in the United States alone.

      Who’s treating whom like sensible adults here? Playing the ‘sensible intelligent adult’ card can be fraught when one falls back on the laziest, tossed off ‘but, like, the establishment man’ rhetoric.

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