GUWonder

How are they calculating how much face mask use there is in Sweden? I just walked by a bunch of retailers and relatively well-traveled streets and saw 0 -- zero -- people with masks inside the retailers and on the sidewalks out of the several hundred people I passed. On the buses? Maybe 1%. In Sweden for those coming on the train from Denmark? Then it's a substantial percentage, but that's courtesy of Denmark's doing and it's a lower percentage than on the train in Denmark coming from Sweden once you get beyond CPH airport.

Lots of the Swedes in my circle who are annoyed by my critical take on Tegnell & Co yet willing to still engage with me are indeed pointing out that Sweden is now comparatively better than the US in this regard. I always expected the US to turn out worse than Sweden in this regard.

In the meantime, there are Swedes and others who are trying to proclaim the pandemic no longer a threat in Sweden because of "herd immunity". This despite the fact that even the worst hit Stockholm neighborhood has fewer than one-fifth of the population with antibodies related to this virus and most likely less than one-eleventh of the Swedish population with antibodies for this and there still being a very large population of the elderly who are still alive and at risk of getting hit badly by this virus with increased spread.

With major events closed down during the summer, and given Swedish summer vacation habits -- especially this year -- it's not a surprise to me that Sweden's hit from this virus has dropped to this level. But I'm told to expect the next big hit from this virus in Sweden was most likely to start showing up 8-15 weeks after schools restarted in the country.

And in some ways it seems like Tegnell & Co are getting worried because they have more recently been tweaking around the edges with recommendations that seem a bit stricter in ways than what they were 8-10 days ago. And yet they are saying that the elderly will be able to be at family Christmas parties this year. Let's see how that goes and what that means for the death tolls in Q1 and early Q2 2021.

That's the kind of line that a doctor in Chicago was making in March. I will try to see if I can find a video of that doctor in Illinois where she was making the above kind of point.

RedChili

Newsflash 1: There's no quarantine in Sweden. So, obviously, nobody's tested after quarantine in Sweden. It's the same in those countries that do have quarantine. People that arrive in Norway from red countries, don't do any tests at all. They only go into a 10 day quarantine, and they're completely free to mingle with the population once those 10 days are over.

Newsflash 2: The number of people being treated for the virus is negligent compared to the number of tests. I believe that the total number of people being treated for covid-19 in Sweden today is between 300-400 people. Even if you're right that these people are tested after treatment (something that I doubt), it would be a tiny number.

It seems that you don't understand that false negatives don't exist, only false positives. So, when a person's first test is negative, there's no need to do a second test. A second test is inly required if the first test is positive. Which means that if anything, the number of 1.6% positive tests is inflated, and the real number of infected people is lower than that number.

If the health authorities would do as you suggest, "Of course people are tested several times, to ensure they are negative after treatment/quarantine/isolation," it would actually drive the positive percentage up, not down.

It's not only people that expect a positive outcome, but people that have some reason for being tested, such as having returned from a vacation, or working in a hospital. Anyway, random testing of huge segments of the population wouldn't be desirable as the laboratories and hospitals in Sweden are overwhelmed by really sick people from all kinds of other diseases. Too much random testing would take dearly needed manpower away from where the big needs are.

You're correct that it's not proven, but this theory would explain why Sweden is almost the only country in Europe seeing a reduction in infection rates while other countries are seeing a rise in numbers.

If you got this graph from euromomo, it's wrong. Here's a graph that I made from the raw data available from SCB (the most reliable source) for weeks 1-34. The data shows the number of deaths per day per one million residents between 2015-2020:




As you can see, 2020 saw a spike in mortality numbers between weeks 14-20, but in week 21 it dropped to the same level as 2015-2019. The last few weeks have seen exceptionally low numbers. Week 27-33 saw numbers fluctuate between 20.6-21.6 per day per million, while the same weeks in 2015-2019 saw numbers between 20.3-25.1. The number for week 34 is right now at 16.8, which is obviously not correct, but correct data about week 34 isn't available yet.

Week 27-33 combined saw the following numbers:
2015: 23.0
2016: 23.0
2017: 21.9
2018: 22.6
2019: 21.1
2020: 21.2

RedChili

It was apparently a Yougov poll. They are not very exact. In my personal experience, I would say that they are in the ballpark. I went shopping today, and I would say that between 5-10% of the people I saw had face masks.

Personally, I think the U.S. figures are exaggerated.

Where did you get this information? Curious.

vanillabean

I am reminded of "what happens if the pooled test result is negative?
If a pooled test result is negative, then all the samples can be presumed negative with the single test. In other words, all of the people who provided samples can be assumed to test negative for SARS-CoV-2 infection.”

CPH-Flyer

I am sorry to burst your bubble, but false negatives are also a part of the testing flow.

Here is a New England Journal of Medicine article on the challenges and implications of false negatives. They do seem to be much more rare than false positives, but the implications are probably more critical.

​​​​​​​https://www.nejm.org/doi/full/10.1056/NEJMp2015897

FlitBen

Only a few countries are both able and willing to mass sample national sub-populations featuring low case rates. Which is why US CDC remains an epidemic intelligence powerhouse via the routine surveillance they can afford to conduct in key states and countries.

That said, they rarely intervene much during recent seasonal flus except via vaccination. Nearly all are low-mortality contagions like Covid-19, hardly any of which entail stringent responses in the long run. From such experience, Swedish and other public-health authorities likely have little reason to prioritize resources for school-age children over other groups with greater circulation and hospitalization risks.

GUWonder

Segregation is a failed policy, and Sweden’s counting upon segregation and herd immunity failed to protect the lives and health of its people.

School-age children are part of society, and they are part and parcel of spreading communicable pathogens in society; All that involves schools being open in Sweden has consequences with regard to the spread of this coronavirus virus in Sweden, as these children too don’t live in segregation from the other groups.

Tegnell & Co seem to be of the opinion that Christmas family get togethers should be able to continue on this year pretty much as usual. Hopefully, Swedish families are more risk averse at Christmas than Tegnell, at least when it comes to COVID19.

fransknorge

I am certain there is a quarantine in Sweden: if you get sick and got tested positive, you are put in quarantine/self isolation, you are not let free to roam (or if it is the case then I am lost for words). The recommendation to declare someone recovered in two negative tests 48 hours apart. So after quarantine or symptom cleared, then more tests are done to be declared recover. At least that is the recommendation, if Sweden could do it freestyle.
No. Just no. Countries which test a lot as I describe typically have low percentages of positive tests, which makes sense. If the percentage goes up then it means the virus circulation increases.

For false negative, here is some reading: https://www.nejm.org/doi/full/10.1056/NEJMp2015897

So again for making my point, Sweden due to lack of laboratory capacity does not know the true scale of the pandemic on its territory and numbers are not reliable.


No it does not, there are other explanations which fits data better. And Sweden is not the only country with a reduction in infection rates. Luxembourg, Germany in the last week are also.

With all due respect, for the time being I will trust a respected organization without political agenda and year of experience reporting this statistic.

GUWonder

168 of the 2004 Communicable Diseases Act in Sweden allows for regional government medical officer to quarantine people. Quarantine and isolation can be imposed in Sweden.

FlitBen

The main approach to handling low-mortality contagions before H1N1 was to survey spread and have communities adapt with the least disruption while developing treatments. Back then, few stringent measures were used due to worries about counter-productive social behaviors arising over time. Baseline mortality rates for Covid-19 are comparable to that for the 1957 and 1968 flu pandemics.

I believe the downward case incidence in Sweden can be explained by a combination of better at-risk group segregation and progressing herd immunity, along with collective behavioral change to some extent. Population age profile should factor, but Sweden's is not too different from the rest of 'old' Europe.

Their response has been delivering good news recently, with virulence diminishing despite all the unavoidable global shutdowns and the earlier care homes debacle. Here is a good piece on the situation.
Experts agree that it is too early to draw serious conclusions about overall outcomes, especially with the fall still looming.

GUWonder

It's not too early to draw serious conclusions about what happened in the first two quarters of the pandemic hitting the country. Sweden's death counts per capita were horrendous during Q2. The economy didn't outperform its locked down neighbors.

Sweden does have a legal regime allowing for some government authorities to order lock downs of sort with its 2004 Communicable Diseases Act in mind .... but quarantines/isolating/locking down an area for a disease like Covid-19 can't be imposed on an area greater than a few blocks around an individual and those who may have been exposed to an individual. In other words, the government can't order a lockdown of a city or the country. It has to fish for individuals to use as a basis to impose such restrictions and then can institute them on an area no greater than a few blocks in a neighborhood.

Segregation remains a failed approach. The idea that there is now "better" segregation in Sweden is a joke. Who knows what to make with the idea of herd immunity in Sweden, especially as the vast majority of Sweden has not been hit by this virus yet.

The Swedish response delivered way more deaths per capita in the peak quarter for this disease here. And the economy got hit nearly as hard or even harder than its neighbors with lockdowns.

RedChili

They do exist, but they are extremely rare. They are so rare that they don't repeat tests if the first test is negative. So, the implications for that person's surroundings can be critical, but there are practically no implications for the statistics.

No, that's now how it's done in Sweden (or in any other Nordic country that I know of). The recommendation in Sweden is to remain in isolation for minimum 48 hours until all symptoms are gone if you haven't been tested, or for minimum 48 hours after all symptoms are gone and minimum 7 days after the first symptoms appeared if there is a positive test result. People are not tested a second time. One reason that I know this is that I was sick myself in May, and I followed the recommendations given on the web sites and in a phone call with a nurse. I read quite extensively about it when I was sick, as it had direct implications for me.

Probably correct, but if they would do what you suggest, i.e. repeat tests of positive patients, that would produce inflated positive statistics.

The main problem isn't laboratory capacity but availability of personnell to conduct tests. Between March and mid-June, they were only able to test people that were really sick, so the true numbers were far higher than the statistics show. From mid-June, anybody could get tested for any reason. So, if you're feeling bad, or if you've been abroad, or if you've been in contact with a positive person, you can get tested. You would probably get a slightly higher figure if you could test all 10 million people, but the important thing here is not the exact number but the trend. The trend is a huge reduction. As long as they don't change the criteria of who's being tested, there's no reason to believe that the trend is wrong.

I wrote "almost the only country."

The thing is that you're doing the opposite. You're trusting an organization that can't be trusted. And I can prove it. In reply 944 in this thread, you posted a screenshot from Euromomo which showed a low excess in Swedish mortality for week 32. But at the current map from the same provider, there's no excess for the same week:



The SCB (Swedish Bureau of Statistics) is the number one source for statistics from Sweden. But even their information about week 34 is still incoomplete. (For week 34, they have 1460 deaths, while the five previous years were 1563, 1528, 1586, 1478, and 1513.) If Euromomo claims to have access to statistics about Sweden that even SCB doesn't have, it basically means that they are not reliable. SCB is far more reliable.

Fully agree. Even worse is the fact that many quick cunclusions are not based upon looking at the whole picture but only at a few chosen numbers.

bluesaturn

Yesterday Svd wrote that a leading Swedish virus expert (Tegnell I think) claims all European countries would follow now the Swedish way. I somehow can understand that Tegnell lives in his Swedish COVID19 bubble, but the journalists as well? Where are the critical questions?
How embarrassing is this to make such a claim where it is clear that most European countries are on a different route than Sweden concerning COVID19?
I am not even shocked anymore. I could even see a similar behaviour in another organisation, where people are simple in denial about facts and are just happy they get their permanent salary and continue with their bad project management etc. No change, no motivation to do better.

RedChili

Peter fell out of a second floor window of the Burj Khalifa. Simultaneously, George fell out of a 154th floor window of the same building. Three seconds afterwards, George said, "So far so good," and onlookers drew the conclusion that Peter was seriously injured while George had no injuries at all.

GUWonder

The above analogy has nothing to do with comparing Sweden with its immediate neighbors when it comes to the official response to the coronavirus spread and what that meant during the peak harm of the coronavirus in the region this year.

Arguing by analogy is a cute rhetorical play, but it is a logical flop since it doesn't make for logical syllogisms with generally sound and valid conclusions.

Sweden's already racked up multiple times more deaths per capita with this coronavirus than the neighboring countries.

Sweden has a much worse unemployment rate than Denmark, maybe they should use it? It doesn't take all that much training to have someone administer the tests reliably. How much more complicated do you believe it is it to properly operate already calibrated machines to run the samples and run with the read outs?

With regard to "As long as they don't change the criteria of who's being tested, there's no reason to believe that the trend is wrong", I suggest not assuming it to be all that simple. Criteria that are expanded to include more testing doesn't miss trends as easily as criteria of sort that stay constant when the spread is becoming more pervasive in scope as well as maybe scale.