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What are the obvious patterns that actually tell us much useful about Sweden though?

(By the way, I suspect the reason that Sweden didn't do loads better or worse than say UK or Germany, despite apparently taking a very different approach, is that actually, the bits of its approach that were significant weren't really as different from other countries' as seems to be the general assumption)
On paper there were a bunch of reasons that Sweden should have had built in advantages compared to plenty of other nations. For example they have a low proportion of intergenerational households, and a higher proportion of people that live alone. Combine those sorts of things with good fortune in terms of how much initial seeding of the virus there was, and the burden of disease should be much smaller than the likes of the UK, Italy etc. Managing to end up comparable to some countries that did extremely badly, that did not have those structural advantages, in the first wave is a sign of failure. A failure to make the most of those advantages in order to significantly reduce death.

There are a bunch of reasons why things go in waves, with waves that have a peak and an endpoint even if the brakes are never applied to a degree sufficient to stop things in their tracks. And it is certainly true that applying the brakes more gently in ways that stop short of full lockdowns still has some impact. Including the natural braking that stems from people responding to mood music and the obvious threat, and changing their behaviour in response to circumstances. So I dont think Sweden had no brakes at all, but they made cold calculations and miscalculations that squandered their advantages, or rather used up that advantage serving a certain sort of policy and economic agenda rather than using it solely to minimise death. Thats a big part of why its considered a scandal there, and why many apologies for this have already been issued later in the pandemic. There is a period of soul-searching there which may not be put in quite the same terms as I am doing now, but is still quite a bit different to how the UK seeks to dress up its own dismal failures.

Those somewhat curtailed waves still dont go as far in terms of trajectory reduction as we saw in countries that applied the brakes firmly at an early stage before exponential growth reached giddy heights at all. There are examples of countries that slammed the brakes on early and left them in place for sufficient time, and thus ended up with a much, much smaller first wave. Some of the countries that managed that feat the first time did not manage to do it with such good timing and strength the second time. And some achieved this feat the first time more through luck than judgement, or due to a mix of advantageous factors that are possible to guess, and factors that are still poorly understood, eg Germany. As far as I know the jury is out on exactly why Germany did so well the first time, but whatever the factors that gave them the chance to do that, they were able to then make use of it to bring in appropriate policies on top before it was too late to avoid joining the list of appauling pandemic nations in the first wave. Germany managed that in the first wave, but not the second time around. And that detail certainly needs to be acknowledged if daring to compare the likes of Sweden to Germany - look at the first wave, Sweden cannot be compared to Germany in that wave, the suspicion is that Sweden should have been rather well placed to avoid the horrific numbers and should have done so much better. Instead their first wave trend resembled a cross between those shit show countries like the UK who had few built in advantages and were late to brake but then eventually did so quite strongly, and what we saw in the second waves in countries with less assumed advantages than Sweden, that then applied brakes more hesitantly and with insufficient strength the second time around. Swedens trajectory also underwent a change part way through their second wave, and this might be linked with some changes to their policies and level of government intervention that took place there during that wave. As for the UK, timing of our Delta wave and the weak braking throughout that wave and the following Omicron wave rather shows up as a gradual increases in death seen over a longer period of time, in contrast to a bunch of other countries whose deaths only started rising notably again later.

I think the countries that managed to apply the brakes with the correct timing on more than one occasion did so because of a combination of factors that made them consider it more feasible for them to do so, but also because of a certain sense of what their priorities should be. That list of successful, decent countries in the pre-vaccine waves isnt huge, but its existence brings shame to those whose priorities consistently pointed in another direction, as does the small list of those who went even further via 'zero covid' policies. Germany might be an example of a country that used their first wave success in order to reach a different sense of 'balance' and 'priorities' in the second wave, not caring to keep the burden so low the second time around.

Here is the same graph I posted earlier but with less countries, in order to make the first and second wave burdens and trajectories easier to see.

Screenshot 2022-04-04 at 19.57.jpg
 
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And yeah I shouldnt really try to have it both ways, even though I sometimes do when I'm trying to make some specific points about policy. So I should acknowledge the following for a start:

Sweden didnt have anything approaching the complete set of possible pandemic advantages. They didnt have the advantage of a really good health care capacity, especially when it came to intensive care. They had the care home weakness seen in many countries. They did not have a large capacity to test people right from the start, they had plenty of weaknesses when it came to hospital infection control procedures and PPE. Including a lack of early appreciation for healthcare worker to healthcare worker modes of transmission, a slowness to recognise that close contact between staff away from the patient setting, eg in meetings was an issue, especially given the lack of staff testing and failures to attribute mild staff illness to covid.

And you know I like to ponder the extent to which care home and health care transmission really magnified pandemic waves and their consequences for the vulnerable to a much greater extent than general community transmission alone would cause. This includes me looking in that sort of direction when questions arise as to why a bunch of low income countries on certain continents didnt do so badly, even when taking into account any expected lesser quantity of deaths due to their population age pyramids. It seems plausible that some of the perceived health care advantages that high income countries had on paper were actually disadvantages which ended up acting as case multipliers in specific settings, that then had to be compensated for via very heavy policies applied to the population as a whole. And that high income countries which fared relatively well either had more proper layers of protection in place in those specific settings, or simply dodged explosive problems on those fronts because they suppressed the virus with policy strength and timing that prevented a critical amount of seeding in those and other settings from occurring in the first place. And of course that last point leads me back to my strong opinions on why countries needed to go hard and fast at the start of a wave. Nipping things in the bud can compensate for all manner of weaknesses and problem areas.
 
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It's not only Shanghai - some other large cities too.

Surely they are going to have to give up on their zero Covid thing at some point soon.
 
 
Most of Australia ( WA excluded as they were late to the party ) has actually returned to business as usual now. There's still a few lingering state mandates around needing to be vaxxed and masked to go into medical settings, and to do some jobs but that's it. Any other mandates are decided by individual businesses themselves now.

We're heading into winter so this might change again.
Screenshot_20220410-083007.png
 
Philadelphia just reinstated its mask mandate - first major city in the US to do so.

 
Philadelphia just reinstated its mask mandate - first major city in the US to do so.

When even parts of the Libetarian USA take the need for some restrictions more seriously than us, you really have to wonder just how much of a bunch of selfish uncaring arseholes our own government is.

...and how fucking ignorant and selfish most of the population is to enthusiastically follow that narrative
 
It looks like they have quite a low vaccination rate (75% of over 18s) so it's not exactly comparable with the UK.

Vaccines are important but they arent the only factor. Philadelphia decided to have publicly available benchmarks/rules for when different sorts of measures come back in, setting clear trigger points for action that the UK never wanted to have because they dont leave room for political rather than data-driven decisions. Although in terms of overriding political decisions, they could always change those rules and thresholds in future. For example authorities there claim that the vaccination rate is not a factor which influences their thresholds, but behind the scenes it probably is some part of the picture. But since they've set other clear data thresholds, it will be the actual effects of the vaccine on population health during a particular wave that is key, rather than arbitrary uptake percentages.

The UK did benefit from a well timed booster campaign and the population immunity effects of failures in prior waves. But there is still a large component of 'success' in a wave that is actually dependent far more on establishment and population attitudes affecting the perceptions of what counts as success. Take for example the key area of pressure on health services - the current UK approach can be deemed a success in terms of the pressure on health services not reaching a level where authorities had no wiggle room left, no choice but to impose harsh measures. But in terms of actual pressure on the health service that affects capacity and standard of care, its still quite possible to view it as a horror show that not all establishments around the world are happy to replicate. Its still questionable as to quite how far some of those will go to avoid that scenario, ie how far they would actually go in regards tough measures. But when it comes to the milder measures such as mask mandates, its absolutely no surprise that some find it easy to follow the 'act early' lesson of the pandemic, by not abandoning every single element the precautionary approach....


City Health Commissioner Cheryl Bettigole said we don’t yet know whether the BA.2 subvariant will have the same impact on hospitals as the original omicron variant this past winter. But the masks, she said, are a precautionary measure.

“I suspect that this wave will be smaller than the one we saw in January. But if we wait to find out and to put our masks back on, we’ll have lost our chance to stop the wave,” she said during Monday’s press conference, announcing the new mandate.

“If we mask up now and find out that hospitalizations don’t increase in the US in response to this variant the way they have in the UK, then great. We can then take off our masks with a sense of relief. But if we fail to act now, knowing that every previous wave of infections has been followed by a wave of hospitalizations, and then a wave of deaths, it will be too late for many of our residents. This is our chance to get ahead of the pandemic.”

Just because the UK messaging and response to the BA.2 Omicron wave was, due to policy decided before it arrived, totally different to previous responses, doesnt mean the current wave is going to be viewed quite so differently absolutely everywhere else. And lets not exaggerate the differences in approach, even between the UK and Philly - their BA.2 Omicron mask response is just a version of what even the UK still felt the need to do when facing BA.1 Omicron.
 
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By the way there had been some chatter in the USA recently that maybe they've reached a magic level of population immunity. This thinking was sponsored in the usual way, via seeing tentative signs that the timing of a sizeable BA.2 wave in the USA was diverging somewhat from the previous lag seen between waves in UK/Europe and waves in the USA, creating a window of opportunity to indulge in such hopes. Since many factors beyond population immunity go into the timing, size and implications of a wave in a particular location, I was unwilling to utterly rule out such possibilities, but still had to place that chatter into the premature, wishful thinking pile when I heard it a week or two ago. Given how many previous occasions the temptation to hope for really strong herd immunity effects had not come to fruition when it came to number of infections and avoidance of a wave, and that the UK still managed to have a huge BA.2 wave despite vaccine successes, good booster timing and huge number of previous infections, I had little choice but to groan when I heard that chatter. And the UK authorities long since gave up relying on such things, which is why their reopening agenda sought to downplay all emphasis on number of infections, and spent upwards of a year setting that scene.
 
BA.4 and BA.5

Scientists are still understanding the information about the new omicron variant (BA.4, BA.5). BA.5 detected in South Africa currently has a 84% growth advantage against BA.2. BA.4 detected in South Africa currently has a 63% growth advantage over BA.2. Both BA.4 and BA.5 have the L452R pathogenic mutation, which is also found in the Delta variant. Since these variants are now already dominant in South Africa, it is unclear what this means for the rest of the world, as we are already experiencing much bigger BA.2 waves than they did – but scientists will be keeping an eye on this especially as cases begin to develop in the UK.
 
The US FDA approves a new COVID-19 diagnostic test, the InspectIR COVID-19 Breathalyzer, which identifies via gas chromatography mass spectrometry five volatile organic compound markers associated with SARS-CoV-2 infection in exhaled breath (91.2% test sensitivity, 99.3% test specificity).
 
The US FDA approves a new COVID-19 diagnostic test, the InspectIR COVID-19 Breathalyzer, which identifies via gas chromatography mass spectrometry five volatile organic compound markers associated with SARS-CoV-2 infection in exhaled breath (91.2% test sensitivity, 99.3% test specificity).

Could be extremely useful in the UK airline and other travel sectors if they could ramp up production x10
.....Oh I forgot Covid 19 is over in the UK no need to test people cooped up for hours with hundreds of others any more
 
Could be extremely useful in the UK airline and other travel sectors if they could ramp up production x10
.....Oh I forgot Covid 19 is over in the UK no need to test people cooped up for hours with hundreds of others any more

1 machine per flight, 250 passengers, 10 minutes per test. Not very practicable.

Also, given the number of flights per day, even ramping up production 10x it wouldn't be viable anyway, especially given the competing demands from hospitals etc.
 
I dunno it takes that long to get through the other aspects of security before you board, they could process it whilst you go through that other shit, but as you say other uses should come first, but hey they are allready talking about not testing hospital inpatients (allready only testing 2/3rds anyway if im understanding the Welsh stats correctly)
 
I dunno it takes that long to get through the other aspects of security before you board, they could process it whilst you go through that other shit, but as you say other uses should come first, but hey they are allready talking about not testing hospital inpatients (allready only testing 2/3rds anyway if im understanding the Welsh stats correctly)

The rate of people checking on to a flight and going through security is far higher than one every ten minutes. It would take 41 hours for a machine to process the samples from the 250 people on a flight.
 
Enabling vulnerable people to travel with some degree of safety, nothing to concern you of course, jack

Vulnerable people can travel in safety by wearing respirators. I don't see how turning people away at the gate and therefore requiring them to remain in a country until they test negative is more equitable.
 
Vaccines are important but they arent the only factor.
They're by far and away the most important factor, no? The likes of Denmark and South Korea have just seen omicron sweep through probably half their entire populations, but despite relatively low previous infection rates, good vaccination rates have kept deaths no greater than during a (relatively bad) flu season. Compare and contrast with Hong Kong.

How many people in vulnerable groups have been left unvaccinated is the best predictor of death numbers across the world over the last year. Across Europe, you can look at death numbers and make a pretty accurate prediction of the vaccination rate.
 
They're by far and away the most important factor, no?
Yeah, and I was talking specifically about factors that Philadelphia were influding in their decision making. I wont repeat all that again now. But I will add that I believe they actually had a bit of a public data scandal in terms of misleading vaccination rates data not so long ago.

Vaccinations have also make a notable difference to calculations that involve precautionary principals. But for some administrations the vaccines alone dont utterly eradicate their desire to take some precautionary measures when a new wave is arriving and they arent quite sure of its magnitude or ramifications. The UK for example is in a much better place due to vaccines, but then there are political decisions about what those advantages are used to enable exactly. Decisions were made here about things like mask requirements and costs of free testing and how that stuff is balanced against pressure on the NHS. It doesnt surprise me that not everywhere wants to follow our example in quite the same way, since the ongoing pressure on the NHS is rather bad and has other knock on health consequences. We absolutely need our levels of infection to come down from the giddy heights in order to avoid the slow, grinding pressure on the NHS from continuing for an even more absurd length of time.

But sure, when it comes to overall calculations the vaccines are a hugely significant factor. Not just the uptake rates though, but also details of the types of vaccines used, and the current strain. Please do factor this in when you criticise the likes of Japan and their timing of easing of measures like you did on the Shanghai thread. Because certain data makes a lot more sense out of their calculations and timing.

And Im not making that last point to have a go at you, but rather because I found specific data about Japan which I think is a good example of this. It appears that the timing of UK booster vaccine doses relative to the Omicron wave was a major difference maker here. And so it makes sense to consider that when looking at what other countries have been doing. So here is data on Japans uptake by date, including boosters. Their timing was well behind ours, so we shouldnt be surprised that their timing of relaxing of measures is different too.


Whats probably harder to do when considering how good or bad a position countries are in, is figuring out exactly what sort of vaccine uptake percentages are 'good enough'. Boosters look to have made a notable difference without hitting the sort of extremely high percentages of uptake we were used to seeing with the fist 2 doses. And factors such as what sort of proportion of the population also gained some immunity via previous infection also come into play. And that gets quite complicated, for example it is possible to find posts by 2hats which consider the possibility that we have to be careful when looking at data from South Africa in regards the impact of various Omicron strains, because they had a different wave-variant history than many countries. Other stuff too when considering the effects of vaccines, eg the UK 'lucked into' having that big gap between first and second doses, which some later evidence implies had a benefit to the immunity picture.
 
Vulnerable people can travel in safety by wearing respirators. I don't see how turning people away at the gate and therefore requiring them to remain in a country until they test negative is more equitable.
They could travel with a hell of a lot more safety if during this period of very high case numbers other people also wore masks (remember how that works ?) and some form of testing was retained
(I do realise the mask bit is so awfully fucking hard to endure for the sake of others if you dont actually give a fuck)
 
No-one was talking about masks - the discussion was about testing. If you want to test people for travel, when case numbers are high, then that means a large number of people having to cancel travel plans altogether. That's a slightly different level of inconvenience compared to asking people to wear a mask.

Requiring a negative test to travel does indeed protect those who are vulnerable and need to travel from one protected environment to another. On the other hand, someone else can't travel to care for their ill relative. Or whatever.
 
Early signs of what could be a new 'wave' in Gauteng, South Africa, quite possibly driven by BA.4 (or a sub-lineage). Fortunately deaths, and to a lesser degree hospitalisations, are now decoupled from infections (likely hybrid immunity plays a significant role here, along with recent prior infection in unvaccinated persons).
Waves of COVID-19 cases in Gauteng.
COVID-19 metrics in Gauteng, as percentage of highest wave peak.

A thread.
 
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