Wednesday, May 13, 2020

Sweden

Sweden's method may turn out to be correct. Herd immunity may occur at 40% instead of 80% and when C19 reoccurs in the fall they may have much less problem.  The theory is at least plausible. It will be great if they are right, because then everyone will know what to do this October.

Yet Sweden's death rate per million is sixth worst in the world and catching up to France in 5th. That data is being systematically buried at the conservative sites I frequent at present. If you want to tell me that China and some other countries actually have higher rates that are being censored, I won't quibble.  But you take my point, even in that situation.  Twice today I have seen the argument advanced that the models predicted that Sweden would be far, far worse than that, so this is more proof that the models were wrong and so...well, I think it means that they can choose whatever experts they like, who tell them what they want to hear.  I thought from the start that models would vary wildly at first and take a while to settle out. 

If Sweden's approach is only generally bad, instead of catastrophically bad, so you get to feel good about yourself for being able to say nyah, nyah, nya-nya-nyah and put Experts in quotes, I'll choose having fewer dead people myself, thanks. (Numbers of indirect deaths by suicide and despair are just made up, BTW.)

Any yes, that sentiment is out there, and out there a lot.  They may be overrepresented in comment sections and I should just ignore them, but today I'm not.

11 comments:

Grim said...

I think the case to be made for Sweden is “After a year, they’ll have had a lower death rate, coupled with less social disruptions and a better economic outcome.” Initial death might be higher because they’re running higher risks.

I suspect that everyone will adopt it in November. Until the election is over, there’s too much weight on the scale for Democratic governors.

Randomizer said...

I had the same thought about the conservative sites using Sweden as the example. Sweden is doing much worse than Finland and Norway. Then I considered that Sweden isn't flattening the curve, and as Grim says, in the long-term, Sweden could do better. The conservative sites should talk about that strategy, because without that, referencing Sweden is not persuasive.

Douglas2 said...

My expectation of Sweden (and of the UK before they abruptly changed course) was that the deaths would be "front loaded". The time to compare deaths between Sweden and other places will be when the lockdown countries have experienced their "second wave" High deaths in Sweden this early is exactly what we expect to happen.

Remember, when we were being instructed on what "flatten the curve" means, it was sold as:

"keep the need for hospitalization below hospital capacity"

They showed us nice graphs with a steep tall hump exceeding a capacity threshold, and contrasted a gentle hump stretching way out in time but not exceeding that threshold. Note that the area under the curve is the same in each case.

In the (A) version of "flatten the curve", lives are saved because when the hospital can't cope with the number and severity of the cases arriving at its door, people die that would not have died otherwise.

In the (B) version of "flatten the curve"we know (from the updated models) that additional cases are now unlikely to overwhelm the healthcare capacity, so no one will die as a result of inadequate capacity to treat them in Hospital. But we are still to maintain (most elements of) lockdown because to suggest otherwise is to be willing to kill grandma.

In the (B) version, lives are saved because even though the area under the curve is the same, there may be a breakthrough in time such as a treatment or vaccine that will mean that deaths after a certain point of time fall to effectively zero. But we are also encouraged to not expect that for at least 18 months and it might never happen.

So somehow, even though the area under the curve is the same for flattened and not flattened, just the time when the deaths happen being different, we are to maintain lockdown indefinitely because it saves lives, even though the mechanism for it saving lives is not likely.

It may be that I'm completely missing something in the above, but from what I can see, we are in the "underpants Gnomes" stage of public-policy decisions. I can see that there is "acceptable opinion is for the proper course forward" from where we find ourselves now, but I don't see the how the "stay home/don't reopen" policy results in deaths-above-bormal being prevented rather then deaths-above-bormal being merely delayed.

I hope that I'm just not reading the right authors on this, and that it does make sense.

Boxty said...

Most people have no idea what you mean by area under the curve. Maybe "total number of deaths over time is the same" would be a better explanation. Either way, I haven't heard that Sweden's hospitals are overwhelmed.

bs king said...

Grim - it's worth noting that so far Sweden's projections are that their economic impact will be equal to or slightly worse than their neighbors: https://www.cnbc.com/2020/04/30/coronavirus-sweden-economy-to-contract-as-severely-as-the-rest-of-europe.html

Obviously projections aren't reality so we'll see, but these are their own numbers so not likely to be inflated specifically to make them look bad.

In the long term, it's really what everyone's saying. If this picks up again in the fall, or if it turns out you can get reinfected or a million other plot twists, this could all be a better or worse strategy.

As for states...I think the experience is going to vary wildly depending on what happens where. By and large it keeps looking like the further south you go, the better off you are, which could be great news for all of us over the summer. I also think that New York and California are forming almost all of the national impression about what "Democrat governors" are doing, and it's worth noting that many blue states have not ever followed their lead. I live in MA and I keep getting surprised how many people assume we have a California style lockdown because we're blue and have a bad outbreak, and we don't seem to have half the rules they do. We've never even had a "stay at home" order. We're still at the peak of our outbreak and the list of business allowed to open is still growing as different activities are assessed and found safe. On a definitely related note, our governor has sky high approval ratings and we've had very few protests.

Of possible interest...I found this site the other day and it has projections for what % of each state has possibly been infected so far. They are putting MA at 10%:
https://covid19-projections.com/

Christopher B said...

bs king - I'd also put Whitmer in the list of people giving the impression of what Democrat governors are doing due to publicity.

We have a similar experience in Kentucky. People think we have a stay at home order but according to IHME we don't. We never had a true lock down. Many business have remained open using curbside or delivery services though some major employers have shut down.

Since I'm familiar with Iowa I often compare the two. According to IHME both states are going to wind up in about the same place, peaking around 700 fatalities by August. Iowa will peak slightly higher but sooner than Kentucky. It's been interesting that the perception has been that Iowa is doing very poorly since they've had a lot of reported outbreaks at meat processing plants. There certainly have been differences in emphasis by the two governors but overall Iowa's Republican governor seems to get much more critical coverage by the in-state press than Kentucky's Democrat governor does.

bs king said...

Whitmer, that's a good point.

I think keeping straight what's actually open in your state or town is going to be critical for the economy going forward. We found out this week that we had mistakenly thought that our lawn guys weren't allowed to come out, so we hadn't called them at all. We typically only call them twice/year so they didn't lose business from us overall, but we wondered how many other people had skipped doing something they could have done due to misinformation/mistaken impressions.

We've been thrilled with our local paper through all of this for this reason. Apparently there's an out of work business exec in our town organizing a list of people available to help run errands for the vulnerable now, and vulnerable local businesses to help as they reopen. For those of us lucky enough to have kept our jobs, it'd be nice to get some suggestions about where to point your money.

Grim said...

@bs king: Yeah, Sweden can’t escape the effects of being part of a wider community that has taken lockdown actions. However, the small business situation should be better, even if their larger industries like Husqvarna post terrible numbers.

David Foster said...

"Numbers of indirect deaths by suicide and despair are just made up, BTW"

Really? Isn't it true that areas where mass unemployment has developed...where, for example, a lot of the factories have moved to China or elsewhere...generally have higher suicide and addiction rates? Why would unemployment induced by Covid-19 operate differently.

If you mean that any kind of precise quantification of such deaths before-the-fact is virtually impossible, then I'd agree with that. But there also isn't much precision in estimating Covid-19 deaths before the fact.

Assistant Village Idiot said...

@ Grim - your word choice gives away that you are quite convinced Sweden's approach is going to work. That may be so, but I want to know who or what has persuaded you of that. I am hopeful, and I think not unrealistically so. But so far all they have is the theory, which we all know but have not seen. Similarly, your thought is that Sweden will also have economic effects, but those come from being interconnected with all the other places that are doing it wrong. Regardless of who does what, the Chinese communists have dealt us a terrible hand and we are driven to various bad choices.

@ David Foster - I do think that bad news always increases despair and suicide. But in the extremely good economy we just left, the suicide rate had not diminished much. We also don't know what the effect of temporary unemployment or diminished employment is, especially when it is shared rather than feeling singled u=out for extreme misfortune (which is what often drives suicide. That and meth these days.) There has been a sudden outpouring of people with a clear agenda of wanting to open the economy insisting that there will be many more suicides. I have yet to see anything very solid. In favor of that theory is that the loss of a business does seem to be a greater force for suicide than the loss of a job, fairly steadily for decades. But even that is not a measurement of temporary economic situations. We simply don't know temporary very well.

Grim said...

What has convinced me is a nexus of four things:

1) ROK scientists determined that COVID immunity among the recovered is durable.

2) Rand Paul’s physician advised him the same and he has been working with COVID patients without relapse.

3) We are far enough in to Georgia’s similar reopening strategy to see that it doesn’t seem to be producing expected bad outcomes.

4) Sweden has seen a sharp decline in deaths in recent days. Deaths are a lagging indicator.

#1 was the crucial question. If it hadn’t proven true, Sweden would be on a path to ruin. If it is true, and the other three tend to support it, then the Swedish approach will work. The fact that the death rate proves to be orders of magnitude lower than 3% in otherwise healthy adults is also reason to think the approach will work in a way that satisfies the proportionality requirement of ethics, compared with economic devastation deaths (which may mostly be baked in, as per our previous conversation).

I also don’t think that even we will be able to afford the alternative in the fall. We are running through trillions right now, while the tax base is being devastated. States and localities won’t be able to keep this up — many aren’t paying property taxes, and will file reduced reduced income taxes and sales taxes — and there may prove to be limits to the money supply even for the Feds.

But I definitely agree that the Chinese have given us a set of undesirable choices. I just think that by fall, we won’t really have a choice anymore.