Updates regarding Sweden’s approach to COVID-19; Sweden’s rate of deaths per million is 6 times that of Norway

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Updates

An April 13, 2021 Guardian article is entitled: “Sweden has highest new Covid cases per person in Europe.”

An excerpt reads:

Infectious disease experts have said the results should not be seen as evidence that lockdowns were unnecessary, but acknowledged they may indicate Sweden’s overall stance on fighting the pandemic may have some aspects worth studying.

Preliminary data from the EU statistics agency, Eurostat, compiled by the Reuters news agency showed Sweden had 7.7% more deaths in 2020 than its average for the previous four years, a lower figure than in 21 of the 30 countries surveyed.

Spain and Belgium, which opted for repeated strict lockdowns, had so-called excess mortality of 18.1% and 16.2% respectively.

However, Sweden did much worse than its Nordic neighbours, with Denmark registering just 1.5% excess mortality and Finland 1.0%. Norway had no excess mortality at all in 2020.

A Feb. 28, 2021 ABC News article is entitled: Sweden has avoided a COVID-19 lockdown so far: Has its strategy worked? The country is the only in Europe to avoid some kind of lockdown.”

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Sweden, from what I can gather from following this story from the outset, has set a particular trajectory in place with regard to how it approaches COVID-19.

This post has many updates, beginning with a June 24, 2020 Bloomberg article, entitled: “Sweden’s Covid Expert Says ‘World Went Mad’ With Lockdowns.”

An excerpt reads:

But Sweden now has one of the world’s highest Covid-19 mortality rates, with more deaths per 100,000 than the U.S., according to Johns Hopkins University data. Polls suggest Swedes have started to lose faith in their country’s response to the pandemic.

A June 26, 2020 BBC article is entitled: “Coronavirus: Sweden says WHO made ‘total mistake’ by including it in warning.”

An excerpt reads:

According to WHO data, EU member state Sweden has seen 155 infections for every 100,000 inhabitants in the past 14 days, far higher than anywhere else in the organisation’s defined Europe region, other than Armenia.

A July 7, 2020 New York Times article is entitled: “Sweden Has Become the World’s Cautionary Tale: Its decision to carry on in the face of the pandemic has yielded a surge of deaths without sparing its economy from damage — a red flag as the United States and Britain move to lift lockdowns.”

An excerpt reads:

Implicit in these approaches is the assumption that governments must balance saving lives against the imperative to spare jobs, with the extra health risks of rolling back social distancing potentially justified by a resulting boost to prosperity. But Sweden’s grim result — more death, and nearly equal economic damage — suggests that the supposed choice between lives and paychecks is a false one: A failure to impose social distancing can cost lives and jobs at the same time.

October 2020 updates

An Oct. 7, 2020 Science article reads: “‘It’s been so, so surreal.’ Critics of Sweden’s lax pandemic policies face fierce backlash.”

An excerpt reads:

It says the price for Sweden’s laissez-faire approach has been too high. The country’s cumulative death rate since the beginning of the pandemic rivals that of the United States, with its shambolic response. And the virus took a shocking toll on the most vulnerable. It had free rein in nursing homes, where nearly 1000 people died in a matter of weeks. Stockholm’s nursing homes ended up losing 7% of their 14,000 residents to the virus. The vast majority were not taken to hospitals. Although infections waned over the summer, scientists worry a new wave will hit in the fall. Cases are rising rapidly in the greater Stockholm area, where almost one-quarter of the Swedish population lives.

The group’s criticism has not been welcomed—indeed, some of the critics say they have been pilloried or reprimanded. “It has been so, so surreal,” says Nele Brusselaers, a member of the Vetenskapsforum and a clinical epidemiologist at the prestigious Karolinska Institute (KI). It is strange, she says, to face backlash “even though we are saying just what researchers internationally are saying. It’s like it’s a different universe.”

A Time article accessed on Oct. 18, 2020 is entitled: “The Swedish COVID-19 Response Is a Disaster. It Shouldn’t Be a Model for the Rest of the World.”

An excerpt (I have omitted the embedded links) reads:

In order to be admitted for hospital care, patients needed to have breathing problems and even then, many were reportedly denied care. Regional healthcare managers in each of Sweden’s 21 regions, who are responsible for care at hospitals as well as implementing Public Health Agency guidelines, have claimed that no patients were denied care during the pandemic. But internal local government documents from April from some of Sweden’s regions—including those covering the biggest cities of Stockholm, Gothenburg and Malmö—also show directives for how some patients including those receiving home care, those living at nursing homes and assisted living facilities, and those with special needs could not receive oxygen or hospitalization in some situations. Dagens Nyheter published an investigation on Oct. 13 showing that patients in Stockholm were denied care as a result of these guidelines. Further, a September investigation by Sveriges Radio, Sweden’s national public broadcaster, found that more than 100 people reported to the Swedish Health and Care Inspectorate that their relatives with COVID-19 either did not receive oxygen or nutrient drops or that they were not allowed to come to hospital.

These issues do not only affect the elderly or those who had COVID-19. The National Board of Health and Welfare’s guidelines for intensive care in extraordinary circumstances throughout Sweden state that priority should be given to patients based on biological, not chronological, age. Sörmlands Media, in an investigation published May 13, cited a number of sources saying that, in many parts of the country, the health care system was already operating in a way such that people were being denied the type of inpatient care they would have received in normal times. Regional health agencies were using a Clinical Frailty Scale, an assessment tool designed to predict the need for care in a nursing home or hospital, and the life expectancy of older people by estimating their fragility, to determine whether someone should receive hospital care and was applied to decisions regarding all sorts of treatment, not only for COVID-19. These guidelines led to many people with health care needs unrelated to COVID-19 not getting the care they need, with some even dying as a result—collateral damage of Sweden’s COVID-19 strategy.

Dr. Michael Broomé, the chief physician at Stockholm’s Karolinska Hospital’s Intensive Care Unit, says his department’s patient load tripled during the spring. His staff, he says, “have often felt powerless and inadequate. We have lost several young, previously healthy, patients with particularly serious disease courses. We have also repeatedly been forced to say no to patients we would normally have accepted due to a lack of experienced staff, suitable facilities and equipment.”

An Oct. 19, 2020 CBC article is entitled:” Swedish virologist says her country’s COVID-19 strategy has failed, but nobody will admit it.”

An excerpt (I’ve omitted the embedded links) reads:

But as of Monday, Sweden’s per capita death rate from COVID-19 was the 15th highest in the world, or 13th if you exclude the tiny islands of Andorra and San Marino, according to data from Time magazine and Johns Hopkins University.

Now Sweden is shifting its policy. According to the Telegraph, starting Monday, the government has empowered regional health authorities — in consultation with the federal public health agency — to instruct citizens to stay away from crowded spaces like shopping malls, museum, gyms, and concerts, and avoid taking public transport or visiting the elderly. However, there will be no legal or financial consequences for non-compliance.

Einhorn, a virologist, author and filmmaker in Sweden, is one dozens of medical experts who have been critical of the country’s COVID-19 response from the start. Here is part of her conversation with As It Happens host Carol Off.

November 2020 updates

A Nov. 5, 2020 CTV article is entitled: “Swedish PM self-isolates as nation passes grim threshold.”

A Nov. 11, 2020 Reuters article reads: “Stockholm rushes to stem nursing home COVID surge with visit ban, quick tests.”

A Nov. 13, 2020 Guardian article is entitled: “Swedish surge in Covid cases dashes immunity hopes; Country has opted for light-touch, anti-lockdown approach since start of pandemic.”

An excerpt reads:

New infections and hospital admissions have surged in Sweden as the country battles a second wave of the coronavirus pandemic that officials had hoped its light-touch, anti-lockdown approach would mitigate.

A Nov. 28, 2020 Telegraph article is entitled: “Swedish government sidelines epidemiologist who steered country’s no lockdown experiment as deaths rise.”

An excerpt reads:

The high-profile epidemiologist who led Sweden’s no lock-down strategy in the spring appears to be being sidelined by the government after his prediction that greater immunity would mean a lighter second wave proved badly wrong.

Anders Tegnell’s biweekly press conference was on Thursday pushed into the shade by an overlapping press conference fronted by Sweden’s Prime Minister Stefan Lofven, where new scenarios prepared by the Public Health Agency were announced.

“There’s certainly a split, and I’m pretty sure that many in the government have rather lost faith in the Public Health Agency,” said Nicholas Aylott, an associate politics professor at Stockholm’s Södertorn University.

December 2020 updates

A Dec. 1, 2020 Financial Times article is entitled: “Sweden recommends children of Covid sufferers should stay at home: Public health agency makes U-turn after criticism that it underestimated potential for asymptomatic transmission.”

A Dec. 3, 2020 Guardian article is entitled: “Swedes’ support for anti-lockdown stance slips amid rising Covid deaths.”

a Dec. 15, 2020 CBC article is entitled: “Sweden failed to protect elderly during pandemic, commission finds. Report cites systemic shortcomings in care, inadequate measures from government and agencies.”

A Dec. 17, 2020 BBC article is entitled: “Coronavirus: Swedish King Carl XVI Gustaf says coronavirus approach ‘has failed'”.

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I’ve written previously about Sweden’s approach to COVID-19 and have outlined why news from Sweden interests me. You can find previous posts about Sweden by using this website’s internal search engine.

By way of an update, a May 1, 2020 Guardian article is entitled: “Has Sweden’s coronavirus strategy played into the hands of nationalists? Talk of Swedish exceptionalism and wounded national pride has echoes of the forces unleashed in Britain by Brexit.”

Another May 1, 2020 Guardian article is entitled: “‘We stick to the rules’: why cinemas in Sweden have stayed open during the pandemic: Many of the country’s movie theatres have continued to operate despite alarming death toll, with social distancing measures in place.”

Links to additional recent articles regarding Sweden are available at a post entitled:

Responses to coronavirus appear directly connected to cultural history

By way of previous updates, an April 20, 2020 Tyee article is entitled: “Debates Roil Sweden and New Zealand, Whose Pandemic Policies Are Opposite: Plus, check-ins with four more nations fighting COVID-19 in different ways.”

An April 21, 2020 Bloomberg article is entitled: “Sweden Says Controversial Virus Strategy Proving Effective.”

An April 21, 2020 Nature article is entitled: “‘Closing borders is ridiculous’: the epidemiologist behind Sweden’s controversial coronavirus strategy: Anders Tegnell talks to Nature about the nation’s ‘trust-based’ approach to tackling the pandemic.”

With regard to herd immunity, an April 22, 2020 Guardian article is entitled: “WHO warns that few have developed antibodies to Covid-19: Herd immunity hopes dealt blow by report suggesting only 2%-3% of people have been infected.”

On the same subject, an April 25, 2020 CBC article is entitled: “Canada’s top doctor warns against relying on herd immunity to reopen economy: Quebec’s premier has touted the method as a way to get his province back to work.”

An excerpt reads:

Canada’s top doctor says there isn’t enough evidence to back herd immunity as a way to reopen society, as Quebec’s premier is considering the approach to restart his province’s economy.

“The idea of … generating natural immunity is actually not something that should be undertaken,” Canada’s Chief Public Health Officer Theresa Tam said Saturday, urging people to be “extremely cautious” about the concept.

Herd immunity is conferred when enough people in a given population have been infected with a virus, marking them immune to reinfection and slowing down the rate at which the virus spreads on its own.

Sweden’s deaths per million is six times that of Norway

Peter Daszak @PeterDaszak writes in an April 21, 2020 tweet:

Sweden now has one of the highest death rates per capita globally due to COVID. 6X worse than neighboring Norway.

Our World in Data

The Our World in Data website data for April 21, 2020 notes that Sweden currently has 156.45 deaths per million according to available figures.

Norway, according to data posted at the site, has 28.41 deaths per million. Among other countries, Canada has 44.78 deaths per million while the U.S. has 128.52 deaths per million, and the U.K. has 243.19 deaths per million.

Britain’s rate of 243.19 deaths per million may be an understatement; an April 22, 2020 CBC article is entitled: “Britain’s coronavirus death toll may be vastly understated, study of data suggests: British government disputes analysis, but faces call for an inquiry into its coronavirus response.”

An excerpt reads:

Since the lockdown, the government has given conflicting explanations of why it failed to join a European Union ventilator scheme and admitted there have been problems getting health workers enough protective equipment.

Brazil, Belarus, and California’s 22nd congressional district

An April 21, 2020 Globe and Mail article is entitled: “The notorious nine: These world leaders responded to the coronavirus with denial, duplicity and ineptitude.”

The subhead reads: “While COVID-19 caught many countries off guard, some politicians’ responses have stood out as too slow or ineffective. Here are some of the highlights, from Belarus to Brazil and Cambodia to California.”

Of related interest is an April 21, 2020 CNN article entitled: “Dissident artist Ai Weiwei says virus has only strengthened China’s ‘police state'”.

An excerpt reads:

In recent weeks, much has been made of China’s alleged efforts to conceal the initial outbreak of the virus — an allegation Beijing strongly denies.

According to Ai, China’s selective handing of information early on provided a “chance for the virus to spread.” However, understanding China’s motivations is as important to Ai as the alleged cover-up, or the suggestion that the country’s infection numbers and fatalities have been under-reported.

“The West’s blame is very superficial,” said Ai. “They (in the West) only talk about China practically — (that it) doesn’t release information. But they never ask, ‘Why?'”

As Ai sees it, China would not function as a state without the “control and manipulation” of information.

“For China, everything is for political use. And they have a clear reason to give the numbers they want to, or to limit or to change or distort the so-called truth,” said Ai.

“A number means nothing to them,” he said, adding that there’s little recognition of the individuals and “deep souls” making up the death toll. “In many cases in China, you don’t even get the real names or how many people. They are completely lost because the state wants (to preserve) its own image.”

The broader topic here is state-level public relations, a topic I’ve addressed at previous posts including one entitled:

Public relations in the United States, United Kingdom, and China shares overlapping features

A related concept concerns what the anthropologist and political scientist James C. Scott terms ‘seeing like a state.’ A previous post outlines the concept:

The blurb for Seeing Like a State: How Certain Schemes to Improve the Human Condition Have Failed (1998) closely matches contents of the book

New Zealand

New Zealand is at the other end of the continuum.

An April 22, 2020 CBC article is entitled: “New Zealand’s COVID-19 ‘eradication’ strategy looks to be paying off: Strict, early lockdown by prime minister may end coronavirus on island nation.”

On April 22, 2020 New Zealand had 2.7 deaths per million, according to the Our World in Data website.

Context of storytelling about COVID-19 and other topics

All stories are part of a wider context of storytelling. This applies to stories related to COVID-19. This applies as well to all of the ways in which we as human beings seek to shape stories.

In this context, I was interested to come across an April 22, 2020 Nature article entitled: “Neurophysiological and behavioural markers of compassion.”

An excerpt reads:

We identified neural networks associated with threat are reduced when practicing compassion, and heightened when being self-critical.

From my perspective as an observer, it’s my sense that it’s useful to contextualize neuroscience research; in that context, a previous post is entitled:

Brain Culture (2011) addresses the metaphor of brain as frontier

Of related interest is the concept of mindfulness, a topic explored at a page at this website entitled:

Mindfulness meditation

A related concept concerns the relationship between storytelling and the universe. The topic is a source of useful speculation. By way of example, an April 17, 2020 Undark article is entitled: “Book Review: A Physicist’s Grand Tour of the Universe: In ‘Until the End of Time,’ Brian Greene explores a stunning array of human thought, from evolution to consciousness.”

An excerpt reads:

Greene’s biggest challenge – and ours – is to find meaning in a universe governed by unthinking and uncaring physical law. Steven Weinberg put it bluntly in his 1977 book “The First Three Minutes”: “The more the universe seems comprehensible, the more it also seems pointless.” Certainly the human experiment is temporary; one of Greene’s overarching themes is transience and the search for the timeless. We inhabit “a breathtaking if transient present,” Greene writes. By striving to understand the larger cosmos we gain perspective; it shows us “how singular and fleeting the here and now actually is.”

Not everyone will welcome the message, but Greene makes it crystal clear: It’s physics all the way down. “Particles and fields. Physical laws and initial conditions. To the depth of reality we have so far plumbed, there is no evidence for anything else.” And yet we yearn for more. Which means we have to construct our own meaning as best we can. “During our brief moment in the sun, we are tasked with the noble charge of finding our own meaning.”

Books that try to cover so much ground can easily falter. Harari, for example, can seem a little too eager to provoke; some writers seem to be overly keen on fitting the available facts to some preferred, over-arching theory. Greene, happily, does not fall into either of these traps. He is not selling you anything, he is merely relaying a story. But it is the grandest story one can imagine, told by a master storyteller. And look, you’re not going anywhere for a while. Buy this book, and buy Carroll’s “The Big Picture,” and hunker down.